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Sample records for 24-hour rectal manometry

  1. Effects of ranitidine and cisapride on acid reflux and oesophageal motility in patients with reflux oesophagitis: a 24 hour ambulatory combined pH and manometry study.

    Inauen, W; Emde, C; Weber, B; Armstrong, D; Bettschen, H U; Huber, T; Scheurer, U; Blum, A L; Halter, F; Merki, H S

    1993-08-01

    The effect of ranitidine and cisapride on acid reflux and oesophageal motility was investigated in 18 patients with endoscopically verified erosive reflux oesophagitis. Each patient was treated with placebo, ranitidine (150 mg twice daily), and ranitidine (150 mg twice daily) plus cisapride (20 mg twice daily) in a double blind, double dummy, within subject, three way cross over design. Oesophageal acidity and motility were monitored under ambulatory conditions for 24 hours on the fourth day of treatment, after a wash out period of 10 days during which patients received only antacids for relief of symptoms. Acid reflux was monitored by a pH electrode located 5 cm above the lower oesophageal sphincter. Intraoesophageal pressure was simultaneously recorded from four transducers placed 20, 15, 10, and 5 cm above the lower oesophageal sphincter. Upright reflux was three times higher than supine reflux (median (range) 13.3 (3.7-35.0)% v 3.7 (0-37.6)% of the time with pH upright reflux (p conventional dose of ranitidine (150 mg twice daily) can be improved to more than 60% by combination with cisapride (20 mg twice daily). The cisapride induced increase in oesophageal contractile force and propagation velocity seems to enhance the clearance of gastro-oesophageal reflux. Combination of a histamine H2 receptor antagonist with a prokinetic agent may therefore provide an alternative treatment for reflux oesophagitis. PMID:8174947

  2. Iatrogenic colorectal perforation induced by anorectal manometry: Report of two cases after restorative proctectomy for distal rectal cancer

    2007-01-01

    There are no reports regarding perforation of the colorectum induced by anorectal manometry. We report two cases of colorectal perforation that occurred during manometry in the patients undergoing restorative proctectomy for distal rectal cancer. In the first patient,computed tomography showed an extraperitoneal perforation in the pelvic cavity and a rupture of the rectal wall. A localized perforation into the retroperitoneum was managed conservatively. In the second patient, a 3 cm linear colon rupture was detected above the anastomotic site. A primary closure of the perforated colon and proximal ileostomy were conducted, but the patient died 2 wk later. We hypothesize that the perforation induced by anorectal anometry may be associated with the relative weakening of the proximal bowel wall due to anastomosis, decreased compliance, and abnormal rectal sensation. We suggest that measurement of the maximum tolerable volume should not be routinely performed after restorative proctectomy for distal rectal cancer.

  3. Geneva 24 Hours Swim

    2003-01-01

    The 18th edition of the Geneva 24 hours swim competition will take place at the Vernets Swimming Pool on the 4th and 5th of October. More information and the results of previous years are given at: http://www.carouge-natation.com/24_heures/home_24_heures.htm Last year, CERN obtained first position in the inter-company category with a total of 152.3 kms swam by 45 participants. We are counting on your support to repeat this excellent performance this year. For those who would like to train, the Livron swimming pool in Meyrin is open as from Monday the 8th September. For further information please do not hesitate to contact us. Gino de Bilio and Catherine Delamare

  4. Geneva 24 hours swim

    2003-01-01

    The 18th edition of the Geneva 24 hours swim competition will take place at the Vernets Swimming Pool on the 4th and 5th of October. More information and the results of previous years are given at: http://www.carouge-natation.com/24_heures/home_24_heures.htm Last year, CERN obtained first position in the inter-company category with a total of 152.3 kms swam by 45 participants. We are counting on your support to repeat this excellent performance this year. For those who would like to train, the Livron swimming pool in Meyrin is open as from Monday the 8th September. For further information please do not hesitate to contact us. Gino de Bilio and Catherine Delamare

  5. How to Interpret Conventional Anorectal Manometry

    Kim, Jie-Hyun

    2010-01-01

    Anorectal manometry is the most well established and widely available tool for investigating anorectal function. Anal sphincter tone can be quantified by anorectal manometry. The anorectal sensory response, anorectal reflexes, rectal compliance, and defecatory function are also assessed by anorectal manometry. This report will focus on defining parameters for measurement and interpretation of anorectal manometry tests.

  6. Fecoflowmetric Analysis of Anorectal Motor Function in Postoperative Anal-Preserving Surgery Patients With Low Rectal Cancer Comparison With the Wexner Score and Anorectal Manometry

    Ryu, Yasuhiko; Akagi, Yoshito; Yagi, Minoru; Sasatomi, Teruo; Kinugasa, Tetsushi; Yamaguchi, Keizo; Oka, Yousuke; Fukahori, Suguru; Shiratsuchi, Ichitaro; Yoshida, Takefumi; Gotanda, Yukito; Tanaka, Natsuki; Ohchi, Takafumi; Romeo, Kansakar; Shirouzu, Kazuo

    2015-01-01

    The aim of this study was to elucidate whether fecoflowmetry (FFM) could evaluate more detailed evacuative function than anorectal manometry by comparing between FFM or anorectal manometric findings and the clinical questionnaires and the types of surgical procedure in the patients who received anal-preserving surgery. Fifty-three patients who underwent anal-preserving surgery for low rectal cancer were enrolled. The relationships between FFM or the manometric findings and the clinical questi...

  7. Sensory and motor dysfunction assessed by anorectal manometry in uterine cervical carcinoma patients with radiation-induced late rectal complication

    Purpose: To investigate the effects of radiation on anorectal function in patients with carcinoma of the uterine cervix. Methods and Materials: Anorectal manometry was carried out on 24 patients (complication group) with late radiation proctitis. All of the manometric data from these patients were compared with those from 24 age-matched female volunteers (control group), in whom radiation treatment had not yet been performed. Results: Regardless of the severity of proctitis symptoms, 25% of patients demonstrated all their manometric data within the normal range, but 75% of patients exhibited one or more abnormal manometric parameters for sensory or motor functions. Six patients (25%) had an isolated sensory dysfunction, eight patients (33.3%) had an isolated motor dysfunction, and four patients (16.7%) had combined disturbances of both sensory and motor functions. The maximum tolerable volume, the minimal threshold volume, and the urgent volume in the complication group were significantly reduced compared with those in the control group. The mean squeeze pressure in the complication group was significantly reduced, whereas the mean resting pressure and anal sphincter length were unchanged. Conclusions: Physiologic changes of the anorectum in patients with late radiation proctitis seem to be caused by a variety of sensory and/or motor dysfunctions in which many different mechanisms are working together. The reduced rectal reservoir capacity and impaired sensory functions were crucial factors for functional disorder in such patients. In addition, radiation damage to the external anal sphincter muscle was considered to be an important cause of motor dysfunction

  8. Excel VBA 24-hour trainer

    Urtis, Tom

    2015-01-01

    Master VBA automation quickly and easily to get more out of Excel Excel VBA 24-Hour Trainer, 2nd Edition is the quick-start guide to getting more out of Excel, using Visual Basic for Applications. This unique book/video package has been updated with fifteen new advanced video lessons, providing a total of eleven hours of video training and 45 total lessons to teach you the basics and beyond. This self-paced tutorial explains Excel VBA from the ground up, demonstrating with each advancing lesson how you can increase your productivity. Clear, concise, step-by-step instructions are combined wit

  9. Java programming 24-hour trainer

    Fain, Yakov

    2015-01-01

    Quick and painless Java programming with expert multimedia instruction Java Programming 24-Hour Trainer, 2nd Edition is your complete beginner's guide to the Java programming language, with easy-to-follow lessons and supplemental exercises that help you get up and running quickly. Step-by-step instruction walks you through the basics of object-oriented programming, syntax, interfaces, and more, before building upon your skills to develop games, web apps, networks, and automations. This second edition has been updated to align with Java SE 8 and Java EE 7, and includes new information on GUI b

  10. HTML5 24-Hour Trainer

    Lowery, Joseph W

    2011-01-01

    Comprehensive written and interactive instruction for learning HTML5 HTML is the core technology for building websites. Today, with HTML5 opening the Internet to new levels of rich content and dynamic interactivity, developers are looking for information to learn and utilize HTML5. HTML5 24-Hour Trainer provides that information, giving new and aspiring web developers the knowledge they need to achieve early success when building websites. Covers the most basic aspects of a web page, including a brief introduction to Cascading Style Sheets (CSS) Provides lessons that are backed up by prof

  11. 24-Hour Academic Libraries: Adjusting to Change

    Bowman, Adam C.

    2013-01-01

    The purpose of this study was to explore the adaptive measures that academic libraries perform when implementing and operating a 24-hour schedule. Five in-depth interviews were conducted with current managerial-level librarians at 24-hour academic libraries. The exploratory interviews revealed similar measures for security, budgeting, employee…

  12. 24-Hour Measurement of Gastric pH in Rural South Africa

    2015-01-01

    Background. Previous studies have established norms of 24-hour gastric pH profiles for western countries. This study was designed to establish the pattern for a rural African population with a high incidence of oesophageal cancer. Methods. After lower oesophageal manometry a probe was placed 10 cm distal to the lower oesophageal sphincter. We carried out 24-hour ambulatory monitoring of gastric pH on 59 healthy subjects. This was satisfactorily completed on 26 female and 18 male (age 21–64, m...

  13. Estudo prospectivo comparativo de duas modalidades de posicionamento do sensor de phmetria esofágica prolongada: por manometria esofágica e pela viragem do Ph Comparative prospective study of two positioning modes of 24-hour esophageal pH monitoring: by esophageal manometry and by the pH step-up technique

    Ary Nasi

    2008-12-01

    incluídos todos pacientes que aceitaram participar da pesquisa e excluídos os casos nos quais não se identificou acidificação intragástrica. RESULTADOS: Se fosse adotada a técnica da viragem, haveria erro no posicionamento do sensor em 945 pacientes (91,6%, portanto, o sensor seria posicionado na posição padronizada em apenas 86 (8,4% casos. Em relação à caracterização do grau de erro, haveria erro considerado grosseiro em 597 (63,2% pacientes. Em relação ao tipo de erro, o sensor seria posicionado abaixo do local padronizado em 857 (90,7% casos. Não houve diferença significante entre os dois grupos de estudo em relação a nenhum dos parâmetros analisados, indicando que a posição adotada pelo paciente durante a manobra da viragem não interfere no erro inerente à técnica. CONCLUSÕES: 1. O posicionamento do sensor distal de pHmetria pela técnica da viragem do pH não é confiável. 2. A técnica da viragem proporciona margem de erro expressiva. 3. O tipo de erro mais comum que tal modalidade técnica proporciona é o posicionamento mais distal do sensor, que pode superestimar a ocorrência de refluxo. 4. Não há influência da posição adotada pelo paciente durante a realização da técnica da viragem do pH na eficiência do método.BACKGROUND: By internationally accepted standardization, the esophageal pH-meter distal sensor is positioned 5 cm above the superior border of the lower esophageal sphincter, identified by esophageal manometry. However, several authors suggest alternative positioning techniques that leave out the manometry; among such techniques, the pH step-up is the one to be pointed out. This subject is controversial; some publications state that the step-up technique is not reliable while some others consider it reliable. AIMS: Considering the existent controversy and the small number of prospective works with suitable sample and methodology, we have idealized the present study, that aims the evaluation of the suitability of

  14. WordPress 24-hour trainer

    Plumley, George

    2015-01-01

    Create and expand feature-rich sites with no programming experience Ready to build, maintain, and expand your web site with WordPress but have no prior programming experience? WordPress 24-Hour Trainer, 3rd Edition is your book-and-video learning solution that walks you step-by-step through all the important features you will need to know. Lessons range from focused, practical everyday tasks to more advanced, creative features. Learn from an industry professional how to enter content, create pages, manage menus, utilize plug-ins, connect to social media, create membership and e-commerce site

  15. Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

    Mei Sun; Wei-Lin Wang; Wei Wang; De-Liang Wen; Hui Zhang; Yu-Kun Han

    2001-01-01

    @@ INTRODUCTION Birth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

  16. Human prolactin - 24-hour pattern with increased release during sleep.

    Sassin, J. F.; Weitzman, E. D.; Kapen, S.; Frantz, A. G.

    1972-01-01

    Human prolactin was measured in plasma by radioimmunoassay at 20-minute intervals for a 24-hour period in each of six normal adults, whose sleep-wake cycles were monitored polygraphically. A marked diurnal variation in plasma concentrations was demonstrated, with highest values during sleep. Periods of episodic release occurred throughout the 24 hours.

  17. HEART RATE VARIABILITY AND 24-HOUR MINIMUM HEART RATE

    Heart rate variability (HRV) indices based on 24-hour electrocardiograph recordings have been used in clinical research studies to assess the aggregate activity of the autonomic nervous system. While 24-hour HRV is generally considered non-invasive, use in research protocols typically involves cons...

  18. US EPA Region 9 24-Hour PM-25 Designated Areas

    U.S. Environmental Protection Agency — Designated Areas for particulate matter less than 2.5 microns, according to the 24-Hour National Ambient Air Quality Standards (NAAQS). Nonattainment areas are...

  19. Effect of overtime work on 24-hour ambulatory blood pressure.

    Hayashi, T; Kobayashi, Y; Yamaoka, K; Yano, E

    1996-10-01

    Recently, the adverse effects of long working hours on the cardiovascular systems of workers in Japan, including "Karoshi" (death from overwork), have been the focus of social concern. However, conventional methods of health checkups are often unable to detect the early signs of such adverse effects. To evaluate the influence of overtime work on the cardiovascular system, we compared 24-hour blood pressure measurements among several groups of male white-collar workers. As a result, for those with normal blood pressure and those with mild hypertension, the 24-hour average blood pressure of the overtime groups was higher than that of the control groups; for those who periodically did overtime work, the 24-hour average blood pressure and heart rate during the busy period increased. These results indicate that the burden on the cardiovascular system of white-collar workers increases with overtime work. PMID:8899576

  20. The 24 Hours before Hospitalization: Factors Related to Suicide Attempting.

    Chiles, John A.; And Others

    1986-01-01

    Psychiatric inpatients (N=59) were interviewd concerning psychological and environmental events that occurred in the 24 hours prior to their hospitalization. Suicide attempters were more likely to have used alcohol or marijuana and less likely to have contacted a health care professional than suicide ideators, even when past history of suicide…

  1. Exploring the experiences patients who undergo 24hour Video- electroencephalography

    Antigoni Fountouki; Dimitrios Theofanidis; Paraskeuas Perifanos; Eleni Marineli

    2012-01-01

    Epilepsy is a frequent neurological disorder well-known by ancient times. The most accurate and valid diagnostic tool for epilepsy, is electroencephalography which provides details on the brain's function by recording brain cells' waves. Aim of the study was the exploration of the patients' total experience at a psychological and emotional level during a 24hour EEG. Materials and Methods: The sample included 40 subjects aged 18-40 years with a history or suspicion of epileptic symptoms. Due t...

  2. Does a 24-hour ultra-swim lead to dehydration?

    2011-01-01

    We investigated the change in body composition and hydration status in one male ultra-endurance swimmer during a 24-hour swim. Body mass, percent body fat and skeletal muscle mass using the anthropometric method as well as total body water using bioelectrical impedance analysis were determined pre race, every 6 hours and after the race. Parameters of hydration status (urinary specific gravity, haematocrit, plasma sodium) and skeletal muscle damage (plasma urea) were measured at the same time....

  3. Aggressive behavior during the first 24 hours of psychiatric admission

    Vitor Crestani Calegaro

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS. The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002 and individual component scores, and their results showed more activation (p < 0.001 and thinking disorders (p = 0.009, but less anxious-depression (p = 0.008. Violent patients had more severe psychomotor agitation (p = 0.027, hallucinations (p = 0.017 and unusual thought content (p = 0.020. Additionally, self-aggressive patients had more disorientation (p = 0.011 and conceptual disorganization (p = 0.007.CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.

  4. Breast milk intake: 12 hour versus 24 hour assessment.

    De Carvalho, M; Pittard, W

    1982-11-01

    Letter to the editor commenting on "Clinical and field studies of human lactation: methodological considerations," by Brown et al. The point is made that in test-weighing infants to estimate breast milk intake, culture related breastfeeding practices must be studied before a 12 hour test period is used to estimate intake for a complete 24 hour period. In western cultures milk intake between 7 am and 7 pm was found to differ significantly from intake between 7 pm and 7 am, whereas in a Bangladesh study milk intake during the 2 12 hour periods was comparable. PMID:7137079

  5. The 24-hour society between myth and reality.

    Costa, G

    2001-12-01

    The 24-hour society appears to be an ineluctable process towards a social organisation where time constraints are no more "restricting" the human life. But, what kind of 24-hour society do we need? At what costs? Are they acceptable/sustainable? Shift work, night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage, of which shift workers are builders and victims at the same time. The borders between working and social times are no more fixed and rigidly determined: not only the link between work place and working hours is broken, but also the value of working time changes according to the different economic/productive/social effects it can make. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of physical health; psychological well-being, family and social life? The research on irregular working hours and health shows us what can be the negative consequences of non-human-centered working times organisations. Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building a more sustainable society, at acceptable costs and with the highest possible benefits. PMID:14564852

  6. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

    Hartley, Geoffrey L.; Zaharieva, Dessi; Basset, Fabien A.; Hynes, Zach

    2016-01-01

    Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (Tc) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease Tc after exposure and to eliminate the typical 0.5–1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance. PMID:27478839

  7. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

    Michael J. Taber

    2016-01-01

    Full Text Available Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (Tc and cognitive test battery (CTB performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature. Participants (recruited from those who have regular occupational exposure to cold were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease Tc after exposure and to eliminate the typical 0.5–1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance.

  8. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation.

    Taber, Michael J; Hartley, Geoffrey L; McGarr, Gregory W; Zaharieva, Dessi; Basset, Fabien A; Hynes, Zach; Haman, Francois; Pinet, Bernard M; DuCharme, Michel B; Cheung, Stephen S

    2016-01-01

    Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (T c) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease T c after exposure and to eliminate the typical 0.5-1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance. PMID:27478839

  9. Flexibility of working hours in the 24-hour society.

    Costa, G

    2006-01-01

    The 24-hour Society undergoes an ineluctable process towards a social organisation where time constraints are no more restricting human life. The borders between working and social times are no more fixed and rigidly determined, and the value of working time changes according to the different economic and social effects you may consider. Shift and night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of health and social well-being? Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building up a more sustainable society. Flexible working times now appear to be one of the best ways to cope with the demands of the modern life, but there are different points of view about labour and temporal 'flexibility" between employers and employees. For the former it means a prompt adaptation to market demands and technological innovations; for the latter it is a way to improve working and social life, by decreasing work constraints and increasing control and autonomy. Although it can be easily speculated that individual-based 'flexibility" should improve health and well-being, and especially satisfaction, whereas company-based flexibility" might interfere negatively, the effective consequences on health and well-being have still to be analysed properly. PMID:17017360

  10. Preparation and results of a 24-hour orbital flight.

    Titov, G S

    1963-01-01

    The space age presents man with unprecedented opportunities for discovery and for cooperative endeavors to benefit all mankind. My flight of August 6-7, 1961 was conducted for the purpose of determining whether man can stay and work effectively and whether all systems of the spaceship can operate successfully during a period of 24 hours in space. The flight of Vostok II represents an experimental step in a logical sequence which included the first earth orbiting flight of USSR citizen Yuri A. Gagarin. Preparation for the flight included the study of theoretical and applied subjects, testing in various kinds of apparatus which provide acceleration, heat and isolation experience, brief airborne weightless flights and parachute landings, in addition to extensive training in a real spacecraft having simulators for normal and emergency contingencies of space flight. The actual flight was therefore carried out with a sense of confidence and familiarity and with continuous close radio contact with ground centers from whom my fellow cosmonauts served as spokesmen. Sequential boosters totaling 600 000 kg thrust placed the 4731 kg spaceship into a perfect orbit varying in altitude from 178-246 km in a plane 64 degrees 58' inclined to the equator. The spaceship made 17 orbits around the earth landing 25 hours, 18 minutes after take-off. The cabin had full atmospheric pressure and a comfortable habitability which could be extended for 10 days. I was able to maneuver the spaceship and perform many other control functions, make observations and take pictures of the earth and its cloud cover, eat meals and sleep all with good efficiency. I experienced mild symptoms suggestive of seasickness which were aggravated by head turning, ameliorated by sleep and entirely relieved by resumption of g-loading during descent. Altogether analyses of the physical and structural performance of the spaceship and the continuously monitored physiological responses of the pilot indicate that all

  11. Exploring the experiences patients who undergo 24hour Video- electroencephalography

    Antigoni Fountouki

    2012-07-01

    Full Text Available Epilepsy is a frequent neurological disorder well-known by ancient times. The most accurate and valid diagnostic tool for epilepsy, is electroencephalography which provides details on the brain's function by recording brain cells' waves. Aim of the study was the exploration of the patients' total experience at a psychological and emotional level during a 24hour EEG. Materials and Methods: The sample included 40 subjects aged 18-40 years with a history or suspicion of epileptic symptoms. Due to the study's explorative/explicative nature, a qualitative research design was used. Data collection was performed through semi-structured interviews, direct observations and field notes. Following patients' permission, the interviews were recorded and the verbatim data was analyzed via thematic content analysis. Results: The verbatim text was the raw material where key words or phrases with autonomous meaning, relevant to the study's aims where subsequently organized in 4 major themes and 20 sub-categories, namely: Emotional-Psychological state (Positive: Joy, Optimism, Positive Thinking, Self-Confidence. Negative: Sadness, Anxiety, Fear, Panic, Pessimism. Behavior of patients (Calmness, Comfort, Nervousness, Aggravation. Options for patient involvement (TV, Reading, Music, Sleep, Lack of internet. Interpersonal relationships (family, friendly. Conclusions: During achieving the study's aims, many methodological and practical obstacles have been encountered as it proved to be particularly challenging to encompass patients' emotions and accurately cite their experiences during the EEG. However, results that have been revealed are adequate in formulating a holistic picture about the psychological state and the emotions that patients experience during the procedure.

  12. 24-hour central blood pressure and intermediate cardiovascular phenotypes in untreated subjects

    Bednarek, Agnieszka; Jankowski, Piotr; Olszanecka, Agnieszka; Windak, Adam; Kawecka-Jaszcz, Kalina; Czarnecka, Danuta

    2014-01-01

    Background: Recently, 24-hour monitoring of central systolic blood pressure (SBP) has become available. However, the relation between end-organ damage and the 24-hour central SBP profile and variability has not so far been analyzed. Therefore, the aim of this cross-sectional study was to evaluate the relation between 24-hour central SBP, 24-hour central SBP profile as well as central SBP short-term variability and parameters of cardiac and vascular intermediate phenotypes. Methods: The study ...

  13. The regulation of subcutaneous adipose tissue blood flow in the ischaemic forefoot during 24 hours. Studies using the 133-xenon wash-out technique continuously over 24 hours

    Jelnes, R

    1988-01-01

    A method for continuous measurement of subcutaneous adipose tissue blood flow in the forefoot during 24 hours (SBF) is described. The method is based on the radioisotope wash-out principle using 133-Xenon. A portable semiconductor detector is placed just above a local depot of 1-2 microCi 133-Xenon...

  14. A New Method to Make 24-Hour Urine Collection More Convenient: A Validity Study

    Pooneh Nabavizadeh; Shadi Ghadermarzi; Mohammad Fakhri

    2014-01-01

    Background and Objectives. This study proposes a novel urine collection device that can divide each urine collection into 20 parts and store and cool just one part. The aim of the current study is to compare measured biomarkers from the proposed urine collection device to those of conventional 24-hour sampling method. We also hypothesized that the new method would significantly increase patients' adherence to the timed urine collection. Methods. Two 24-hour urine samples with the conventional...

  15. Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias

    Hendrikx, Tijn; Rosenqvist, Mårten; Wester, Per; Sandström, Herbert; Hörnsten, Rolf

    2014-01-01

    Background: Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias...

  16. Low level of adherence to instructions for 24-hour urine collection among hospital outpatients

    Miler, Marijana; Šimundić, Ana-Maria

    2013-01-01

    Introduction: We hypothesized that patients are poorly informed about proper procedure for 24-hour urine specimen collection and its relevance in determination of biochemical analytes, despite availability of leaflets and webpage with instruction for collection. The aim of this survey was to question outpatients how well are they informed about procedure of 24-hour urine specimen collection. Materials and methods: The survey with 10 questions was done in outpatient laboratory of University...

  17. Effect of Variable Energy Served on 24-Hour Energy Intake in 16 Preschools, Chicago, Illinois, 2007

    Debbie A. Lown, PhD, RD; Marian L. Fitzgibbon, PhD; Alan Dyer, PhD; Linda Schiffer, MS, MPH; Sandra Gomez, MS, RD; Carol L. Braunschweig, PhD, RD

    2011-01-01

    Introduction The effect of varying portion size in a natural environment on the self-regulation of 24-hour energy intake has not been evaluated. We studied students at 16 preschools in Chicago to determine the effect of meals with variable energy and macronutrients on the amount consumed over a 24-hour period (ie, at preschool and outside of preschool). Methods The food items and portion sizes served at 16 preschools in the Chicago Public Schools early childhood education programs were observ...

  18. The Three-Continent, 24-Hour Help Desk: An Academic First?

    Sykes, Jean

    2002-01-01

    Describes Follow the Sun, a computer help-desk service that takes advantage of time differences around the world to permit four universities (University of Colorado Boulder, Australia's Macquarie and Newcastle universities, and the London School of Economics) to share services and provide 24-hour support to users. (EV)

  19. Assessment of 201Tl myocardial SPECT reinjected at 24 hours after stress imaging

    To improve the quality of 24 hours delayed images (24 DL) of stress thallium-201 myocardial SPECT, reinjection was performed at 24 hours later (24 RI), and the results were compared with those of 24 DL. A total of 45 patients were studied, including 18 patients in 24 DL, 27 patients in 24 RI. All of them showed persistent defect or incomplete redistribution on the routine stress and 3 hours delayed SPECT scans. In 24 RI, 37 MBq of thallium-201 was reinjected at 24 hours later. Myocardial count of 24 DL was about 1/4 of stress image, while 24 RI was about 1/2. Quality of 24 RI image was nearly equal to 3 hours delayed image. Of regions without redistribution on 3 hours delayed image, 5 (36%) regions showed new redistribution at 24 RI. Of regions incomplete redistribution, 6 (25%) regions showed further redistribution. Compared with 24 DL, the frequency of redistribution tended to be higher in this protocol than that of the 24 DL (11%, 17% respectively). In conclusion, the reinjection on 24 hours delayed imaging was considered to be useful to evaluate viability of myocardium in patients with CAD. (author)

  20. Behavioral and mood effects of snoezelen integrated into 24-hour dementia care.

    Weert, J.C.M. van; Dulmen, A.M. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2005-01-01

    OBJECTIVES: To investigate the effectiveness of snoezelen, integrated in 24-hour daily care, on the behavior and mood of demented nursing home residents. DESIGN: Quasiexperimental pre- and posttest design. SETTING: Twelve psychogeriatric wards of six nursing homes, spread over different parts of the

  1. Mood-Dependent Cognitive Change in a Man with Bipolar Disorder Who Cycles Every 24 Hours

    Lam, Dominic; Mansell, Warren

    2008-01-01

    A case study of a bipolar patient whose mood changes every 24 hours is described to illustrate the changes in cognitive processing and content during different phases of bipolar disorder. The participant completed a battery of questionnaires and tasks on 4 separate occasions: twice when depressed and twice when manic. Depression tended to be…

  2. [Identification of paroxysmal, transient arrhythmias: Intermittent registration more efficient than the 24-hour Holter monitoring].

    Hendrikx, Tijn; Rosenqvist, Mårten; Sandström, Herbert; Persson, Mats; Hörnsten, Rolf

    2015-01-01

    Many patients suffer from palpitations or dizziness/presyncope. These patients are often referred for Holter ECG (24 hour), although the sensitivity for detecting arrhythmias is low. A new method, short intermittent regular and symptomatic ECG registrations at home, might be a convenient and more sensitive alternative also suitable for primary health care. In this case report we present a patient who had contacted health care several times during a seven year period for paroxysmal palpitations. Routine examination with 24 hour Holter ECG and event recorder did not result in a diagnosis. Using intermittent handheld ECG registration at home, a paroxysmal supraventricular arrhythmia was diagnosed. Further investigation revealed that the patient had a concealed Wolff-Parkinson-White (WPW) syndrome. PMID:25584602

  3. Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations

    Brown, Ian J; Dyer, Alan R; Chan, Queenie;

    2013-01-01

    High intakes of dietary sodium are associated with elevated blood pressure levels and an increased risk of cardiovascular disease. National and international guidelines recommend reduced sodium intake in the general population, which necessitates population-wide surveillance. We assessed the...... utility of casual (spot) urine specimens in estimating 24-hour urinary sodium excretion as a marker of sodium intake in the International Cooperative Study on Salt, Other Factors, and Blood Pressure. There were 5,693 participants recruited in 1984-1987 at the ages of 20-59 years from 29 North American and...... European samples. Participants were randomly assigned to test or validation data sets. Equations derived from casual urinary sodium concentration and other variables in the test data were applied to the validation data set. Correlations between observed and estimated 24-hour sodium excretion were 0.50 for...

  4. [24-hour blood pressure measurement in normal pregnancy in hypertensive pregnant patients].

    Rath, W; Schrader, J; Guhlke, U; Buhr-Schinner, H; Haupt, A; Kramer, A; Kuhn, W

    1990-08-01

    Noninvasive 24-hour ambulatory blood pressure monitoring was performed in 17 normotensive and 19 preeclamptic pregnant women. The normotensive women showed a significant nightly decline in their systolic and diastolic blood pressure. In contrast, the preeclamptic women demonstrated either an attenuated circadian rhythm or no circadian rhythm at all. This result was even more pronounced in patients with severe hypertension, some of whom had a nocturnal increase in blood pressure in spite of being treated with antihypertensive drugs in an evening dose. The lack of nocturnal blood pressure decrease was also found 24 hours post partum. In summary, these results suggest that preeclamptic women are endangered by hypertensive emergencies mostly during the night. Therefore blood pressure controls should be extended into the night, and antihypertensive drugs should also be given in a sufficient evening dose. PMID:2214601

  5. 24 Hour ST Segment Analysis in Transient Left Ventricular Apical Ballooning

    Frank Bode; Christof Burgdorf; Heribert Schunkert; Volkhard Kurowski

    2013-01-01

    OBJECTIVE: The etiologic basis of transient left ventricular apical ballooning, a novel cardiac syndrome, is not clear. Among the proposed pathomechanisms is coronary vasospasm. Long-term ST segment analysis may detect vasospastic episodes but has not been reported. METHODS: 30 consecutive patients with transient left ventricular apical ballooning, left ventricular dysfunction and normal or near-normal coronary arteries were investigated. A 24-hour Holter ECG was obtained after emergency admi...

  6. Bilateral transversus abdominis plane (TAP) block with 24 hours ropivacaine infusion via TAP catheters

    Petersen, Pernille L; Hilsted, Karen L; Dahl, Jørgen B;

    2013-01-01

    The analgesic effect of a TAP block has been investigated in various surgical settings. There are however limited information about block level and block duration. Furthermore, there is a lack of information about continuous TAP block after ultrasound-guided posterior TAP blocks.The aim of this d...... of this double-blind randomized study was therefore to investigate the effect of an ultrasound-guided posterior TAP block with 24 hours local anesthetic infusion via a TAP catheter....

  7. Patients in 24-hour home care striving for control and safety

    Swedberg Lena; Chiriac Eva; Törnkvist Lena; Hylander Ingrid

    2012-01-01

    Abstract Background This article concerns Swedish patients receiving 24-hour home care from health care assistants (HC assistants) employed by the municipality. Home care is a complex interactive process involving the patient, family, HC assistants as well as professional care providers. Previous studies exploring patient perspectives on home care have been based mainly on patient interviews. In contrast, the present study took a broad perspective on patients’ experiences and thoughts by comb...

  8. An assessment of 24-hour ambulatory EEG/ECG monitoring in a neurology clinic.

    Cull, R. E.

    1985-01-01

    The relative merits of 24-hour ambulatory EEG/ECG monitoring and routine EEG recording have been compared in a group of 62 patients attending a neurological clinic because of episodes of loss of consciousness. Overall, ambulatory EEG abnormalities were detected in 21 cases (34%) compared with 16 cases (26%) for routine EEG. Ambulatory EEG mainly improved the detection of generalised paroxysmal activity, but in some cases lateralised abnormalities were detected which were not present on the ro...

  9. Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study

    Elliott, Rosalind; McKinley, Sharon; Cistulli, Peter; Fien, Mary

    2013-01-01

    Introduction Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environmental factors. Methods This observational study was conducted in the adult ICU of a tertiary referral hospital in Australia, enrolling 57 patients. Polysomnography (PSG) was performed over a 24-hour pe...

  10. A 24-Hour Study of the Hypothalamo-Pituitary Axes in Huntington's Disease.

    Kalliolia, Eirini; Silajdzic, Edina; Nambron, Rajasree; Costelloe, Seán J.; Martin, Nicholas G.; Hill, Nathan R.; Frost, Chris; Watt, Hilary C.; Hindmarsh, Peter; Björkqvist, Maria; Warner, Thomas T.

    2015-01-01

    BACKGROUND: Huntington's disease is an inherited neurodegenerative disorder characterised by motor, cognitive and psychiatric disturbances. Patients exhibit other symptoms including sleep and mood disturbances, muscle atrophy and weight loss which may be linked to hypothalamic pathology and dysfunction of hypothalamo-pituitary axes. METHODS: We studied neuroendocrine profiles of corticotropic, somatotropic and gonadotropic hypothalamo-pituitary axes hormones over a 24-hour period in controlle...

  11. Patients in 24-hour home care striving for control and safety

    Swedberg Lena

    2012-06-01

    Full Text Available Abstract Background This article concerns Swedish patients receiving 24-hour home care from health care assistants (HC assistants employed by the municipality. Home care is a complex interactive process involving the patient, family, HC assistants as well as professional care providers. Previous studies exploring patient perspectives on home care have been based mainly on patient interviews. In contrast, the present study took a broad perspective on patients’ experiences and thoughts by combining field observations on care situations with patient and HC assistant interviews. The aim of the study presented in this article was to promote a new and broadened understanding of patients receiving 24-hour home care by constructing a theoretical model to illuminate their main concern. Methods Field observations and semi-structured interviews were conducted with four patients receiving 24-hour home care and their HC assistants. Grounded theory methodology was used. Results The core process identified was Grasping the lifeline, which describes compensatory processes through which patients strived for control and safe care when experiencing a number of exposed states due to inadequate home care. Patients tried to take control by selecting their own HC assistants and sought safe hands by instructing untrained HC assistants in care procedures. When navigating the care system, the patients maintained contacts with professional care providers and coordinated their own care. When necessary, a devoted HC assistant could take over the navigating role. The results are illuminated in a theoretical model. Conclusions The results accentuate the importance to patients of participating in their own care, especially in the selection of HC assistants. The model illustrates some challenging areas for improvement within the organisation of 24-hour home care, such as personnel continuity and competence, collaboration, and routines for acute care. Furthermore, it may be

  12. Circadian polymorphisms in night owls, in bipolars, and in non-24-hour sleep cycles

    Kripke, DF; Klimecki, WT; Nievergelt, CM; Rex, KM; Murray, SS; Shekhtman, T; Tranah, GJ; Loving, RT; Lee, HJ; Rhee, MK; Shadan, FF; Steven Poceta, J; Jamil, SM; Kline, LE; Kelsoe, JR

    2014-01-01

    © 2014 Korean Neuropsychiatric Association. People called night owls habitually have late bedtimes and late times of arising, sometimes suffering a heritable circadian disturbance called delayed sleep phase syndrome (DSPS). Those with DSPS, those with more severe progressively-late non-24-hour sleep-wake cycles, and those with bipolar disorder may share genetic tendencies for slowed or delayed circadian cycles. We searched for polymorphisms associated with DSPS in a case-control study of DSPS...

  13. Pattern of 24 hour intragastric acidity in active duodenal ulcer disease and in healthy controls.

    Merki, H S; Fimmel, C J; Walt, R P; Harre, K; Röhmel, J; Witzel, L

    1988-01-01

    Twenty four hour intragastric acidity was measured by continuous recording using intragastric combined glass electrodes in 46 duodenal ulcer patients within 48 hours of endoscopic confirmation of active ulceration. Acidity during predefined time periods was compared with that measured in 40 healthy controls without gastrointestinal disease: it was significantly higher in duodenal ulcer patients at all times, but 25% of ulcer patients had median 24 hour acidity within the interquartile range o...

  14. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion

    Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-01-01

    Abstract Although reducing dietary salt consumption is the most cost-effective strategy for preventing progression of cardiovascular and renal disease, policy-based approaches to monitor sodium intake accurately and the understanding factors associated with excessive sodium intake for the improvement of public health are lacking. We investigated factors associated with high sodium intake based on the estimated 24-hour urinary sodium excretion, using data from the 2009 to 2011 Korea National H...

  15. Impedance and electrically evoked compound action potential (ECAP drop within 24 hours after cochlear implantation.

    Joshua Kuang-Chao Chen

    Full Text Available Previous animal study revealed that post-implantation electrical detection levels significantly declined within days. The impact of cochlear implant (CI insertion on human auditory pathway in terms of impedance and electrically evoked compound action potential (ECAP variation within hours after surgery remains unclear, since at this time frequency mapping can only commence weeks after implantation due to factors associated with wound conditions. The study presented our experiences with regards to initial switch-on within 24 hours, and thus the findings about the milieus inside cochlea within the first few hours after cochlear implantation in terms of impedance/ECAP fluctuations. The charts of fifty-four subjects with profound hearing impairment were studied. A minimal invasive approach was used for cochlear implantation, characterized by a small skin incision (≈ 2.5 cm and soft techniques for cochleostomy. Impedance/ECAP was measured intro-operatively and within 24 hours post-operatively. Initial mapping within 24 hours post-operatively was performed in all patients without major complications. Impedance/ECAP became significantly lower measured within 24 hours post-operatively as compared with intra-operatively (p<0.001. There were no differences between pre-operative and post-operative threshold for air-conduction hearing. A significant drop of impedance/ECAP in one day after cochlear implantation was revealed for the first time in human beings. Mechanisms could be related to the restoration of neuronal sensitivity to the electrical stimulation, and/or the interaction between the matrix enveloping the electrodes and the electrical stimulation of the initial switch-on. Less wound pain/swelling and soft techniques both contributed to the success of immediate initial mapping, which implied a stable micro-environment inside the cochlea despite electrodes insertion. Our research invites further studies to correlate initial impedance/ECAP changes

  16. A New Method to Make 24-Hour Urine Collection More Convenient: A Validity Study

    Pooneh Nabavizadeh

    2014-01-01

    Full Text Available Background and Objectives. This study proposes a novel urine collection device that can divide each urine collection into 20 parts and store and cool just one part. The aim of the current study is to compare measured biomarkers from the proposed urine collection device to those of conventional 24-hour sampling method. We also hypothesized that the new method would significantly increase patients’ adherence to the timed urine collection. Methods. Two 24-hour urine samples with the conventional method and with the new automated urine collection device that uses just one-twentieth of each void were obtained from 40 healthy volunteers. Urine parameters including volume, creatinine, and protein levels were compared between the two methods and the agreement of two measurements for each subject was reported through Bland-Altman plots. Results. Our results confirmed that for all three variables, there is a positive correlation P<0.001 between the two measurements and high degree of agreement could be seen in Bland-Altman plots. Moreover, more subjects reported the new method as “more convenient” for 24-hour urine collection. Conclusions. Our results clearly indicate that a fixed proportion of each void may significantly reduce the urine volume in timed collections and this, in turn, may increase subjects’ adherence to this difficult sampling.

  17. Mechanical properties of the aortic arterial wall during 24 hours: a preliminary study in conscious sheep

    Previous experiences in animals showed a different behavior between the variability of pressure, arterial diameter and elasticity when they were registered for a couple of hours. To better understand arterial mechanics variability, we propose to measure simultaneously aortic pressure and diameter during 24 hours in a sheep. For that purpose, we developed a portable prototype device. It allows continuously recording physiological signals throughout the day and storing them in a solid state memory for later analysis. Pulse wave velocity and Peterson modulus were assessed beat-to-beat as arterial stiffness indexes. We identified 53,762 heart beats during 24 hours that were separated into 2 groups: below or above median mean pressure (71 mmHg). Mean diameter, pulse wave velocity and Peterson modulus increased for higher pressure values (p<0.05) whereas heart rate slowed down (p<0.05). Pressure-diameter loops were successfully recreated all along the experience. This new methodology sets the basis for further experiences involving the estimation of 24 hours arterial mechanics variability.

  18. Can high resolution manometry parameters for achalasia be obtained by conventional manometry?

    Fernando; AM; Herbella; Marco; G; Patti

    2015-01-01

    High resolution manometry(HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advan-tages over conventional manometry and it allowed the creation of different manometric parameters. On the other side, conventional manometry is still wild available. It must be better studied if the new technology made possible the creation and study of these parameters or if they were always there but the colorful intuitive panoramic view of the peristalsis from the pharynx to the stomach HRM allowed the human eyes to distinguish subtle parameters unknown or uncomprehend so far and if HRM parameters can be reliably obtained by conventional manometry and data from conventional manometry still can be accepted in achalasia studies. Conventional manometry relied solely on the residual pressure to evaluate lower esophageal sphincter(LES) relaxation while HRM can obtain the Integrated Relaxation Pressure. Esophageal body HRM parameters defines achalasia subtypes, the Chicago classification, based on esophageal pressurization after swallows. The characterization of each subtype is very intuitive by HRM but also easy by conventional manometry since only wave amplitudes need to be measured. In conclusion, conventional manometry is still valuable to classify achalasia according to the Chicago classification. HRM permits a better study of the LES.

  19. Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry

    Nagpal Anish

    2010-01-01

    Full Text Available Aims: To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD. Materials and Methods: Forty-six patients with typical symptoms of GERD, from March 2001 to November 2009, were studied. The study was limited to patients with positive findings on upper GI endoscopy done by ourselves and "typical" symptoms (heartburn, regurgitation, and dysphagia of GERD. Laparoscopic Nissen′s fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only 1 patient, who had negative endoscopic findings, underwent a 24-hour pH-monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient′s evaluation of outcome and quality of life after surgery. Results: Relief of the primary symptom responsible for surgery was achieved in 85% of patients at a mean follow-up of 28 months. Thirty-nine patients were asymptomatic, 2 had minor gastrointestinal symptoms not requiring medical therapy, 3 patients had gastrointestinal symptoms requiring medical therapy/ Proton Pump Inhibitors and in 2 patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in 6 patients. Median hospital stay was 3 days, decreasing from 6 in the first 10 patients to 3 in the last 10 patients. Conclusions: Preoperative oesophageal manometry is not mandatory for laparoscopic fundoplication done in selected patients with typical symptoms of GERD and upper GI endoscopy suggestive of large hiatus hernia.

  20. 77 FR 65310 - Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air...

    2012-10-26

    ... the 2006 24-hour Fine Particle (PM 2.5 ) National Ambient Air Quality Standards,'' 74 FR 58688... Federal Regulations DC District of Columbia EO Executive Order EPA Environmental Protection Agency FR... EPA finalized designations for the 2006 24-hour PM 2.5 NAAQS (74 FR 58688, November 13, 2009), the...

  1. Tasimelteon for the treatment of non-24-hour sleep-wake disorder.

    Neubauer, D N

    2015-01-01

    Tasimelteon (Hetlioz®), a melatonin receptor agonist, is the first, and, at the time of the publication, the only drug to be approved by the U.S. Food and Drug Administration (FDA) for the treatment of non-24-hour sleep-wake disorder (non-24). This circadian rhythm disorder occurs most commonly in blind individuals without light perception, and it results from their inability to entrain to the 24-hour photoperiod, although the indication does not specify a particular patient population. Non-24 is characterized by a persistent cycle of nighttime insomnia and daytime sleepiness, alternating with asymptomatic periods depending on an individual's degree of circadian rhythm synchronization with the photoperiod at any particular time. Phase II clinical trials in healthy individuals confirmed the circadian phase-shifting potential of tasimelteon. Phase III trials in totally blind subjects diagnosed with non-24 demonstrated the efficacy of tasimelteon in reducing both nighttime wakefulness and daytime napping. Physiologic monitoring revealed that tasimelteon resulted in a higher proportion of individuals becoming entrained to the 24-hour cycle compared with placebo. Safety assessments indicated that tasimelteon is well tolerated, with the most common adverse events being headache, alanine aminotransferase elevation, nightmares or unusual dreams, and upper respiratory or urinary tract infections. Tasimelteon is available as a capsule in a single 20-mg dose and it must be obtained through Vanda Pharmaceutical's HetliozSolutions program with dispensing through a specialty pharmacy. Safety studies in blind individuals diagnosed with non-24 are ongoing and a future clinical trial with Smith-Magenis syndrome patients is planned. PMID:25685859

  2. RF measurement made over 24 hours around mobile telephone base station (MTBS) in Malaysia

    The fact that so many people use of mobile phone has been accompanied by public debate about possible adverse effects on human health. The concern relate to the emissions of radiofrequency (RF) radiation from the mobile phone and from the MTBS that receive and transmit the signal. A study had been carried out by Nuclear Malaysia with aims to assess the levels of radiofrequency radiation and to analyze the radiation pattern against time for period of 24 hours. The finding of this study confirms that the MTBS transmit radiofrequency radiation with low level and vary against time. (Author)

  3. Comparing Serum and 24-hour Urine Calcium between Preeclamptic and Non-preeclamptic Patients

    N Shahbazian

    2014-02-01

    Results: No statistically significant difference was found between serum calcium means in the two groups (p=0.07, though mean of 24-hour urine calcium in preeclamptic patients was significantly lower than that of control group (p=0.0003. In preeclamptic group, the degree of hypocalciuria was related to disordered liver enzymes, serum creatinine greater than 1.2 mg/dl, thrombocytopenia and proteinuria more than 2g/24h. Conclusion: Preeclampsia is associated with hypocalciuria; the more hypocalciuria there exists , the more preeclampsia is observed.

  4. Fasting for 24 Hours Heightens Reward from Food and Food-Related Cues

    Cameron, Jameason D; Gary S. Goldfield; Finlayson, Graham; John E. Blundell; Doucet, Éric

    2014-01-01

    Introduction We examined the impact of a 24 hour complete fast (vs. fed state) on two measures of food reward: 1) ‘wanting’, as measured by response to food images and by the relative-reinforcing value of food (RRV), and 2) ‘liking’, as measured by response to food images and the hedonic evaluation of foods consumed. Methods Utilizing a randomized crossover design, 15 subjects (9 male; 6 female) aged 28.6±4.5 yrs with body mass index 25.3±1.4 kg/m2 were randomized and counterbalanced to norma...

  5. The regulation of subcutaneous adipose tissue blood flow in the ischaemic forefoot during 24 hours

    A method for continuous measurement of subcutaneous adipose tissue blood flow in the forefoot during 24 hours (SBF) is described. The method is based on the radioisotope wash-out principle using 133-Xenon. A portable semiconductor detector is placed just above a local depot of 1-2 μCi 133-Xenon in 0.1 ml isotonic saline injected into the subcutaneous adipose tissue in the forefoot. The detector is connected to a memory unit allowing for storage of data. Due to the short distance, the recorded elimination rate constant must be corrected for combined convection and diffusion of the radioactive indicator. After reconstructive vascular surgery, the 24-hour blood flow pattern normalized although the ankle/arm systolic blood pressure index did not come within normal range. SBF during day-time activities decreased by up to 50% postoperatively. This is caused by the reappearance of the local, sympathetic, veno-arteriolar vasoconstrictor response. During sleep SBF increased by 71%. The term postreconstructuve hyperamia seems improper, at least in a long-term context, normalization of preoperative ischaemia is a more correct notation. The coefficient of variation of nocturnal SBF was calculated to 10%. The method thus seems apt as a monitor in medical therapy for occlusive arterial disease. Changes of λ has, however, to be considered in each study. 94 refs. (EG)

  6. Comparison of 3 different anesthetic techniques on 24-hour recovery after otologic surgical procedures.

    Jellish, W S; Leonetti, J P; Fahey, K; Fury, P

    1999-03-01

    Intravenous propofol anesthesia is better than inhalational anesthesia for otologic surgery, but cost and intraoperative movement make this technique prohibitive. This study compares a propofol sandwich anesthetic with a total propofol or inhalational anesthetic for otologic surgery to determine which produces the best perioperative conditions and least expense. One hundred twenty patients undergoing ear surgery were randomly chosen to receive an anesthetic with either isoflurane (INHAL), total propofol (TPROP), or propofol used in conjunction with isoflurane (PSAND). Postoperative wakeup and the incidence and severity of nausea, vomiting, and pain were compared among groups. Antiemetic administration and discharge times from recovery and the hospital were also compared. The groups were similar, but anesthesia times were longer in the INHAL group. Emergence from anesthesia after PSAND or TPROP was more rapid than after INHAL. Recovery during the next 24 hours was associated with less nausea and vomiting with PSAND than with INHAL. The cost of the PSAND anesthetic was similar to that of INHAL, and both were less than TPROP. PSAND anesthesia may be similar to TPROP and better than INHAL for otologic procedures. PSAND was less expensive than TPROP and produced a similar recovery profile and antiemetic effect in the 24-hour period after surgery. PMID:10064647

  7. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  8. Sex differences in 24-hour ultra-marathon performance - A retrospective data analysis from 1977 to 2012

    Laura Peter; Christoph Alexander Rust; Beat Knechtle; Thomas Rosemann; Romuald Lepers

    2014-01-01

    OBJECTIVES: This study examined the changes in running performance and the sex differences between women and men in 24-hour ultra-marathons held worldwide from 1977 to 2012. METHOD: Changes in running speed and ages of the fastest 24-hour ultra-marathoners were determined using single- and multi-level regression analyses. RESULTS: From 1977 to 2012, the sex differences in 24-hour ultra-marathon performance were 4.6±0.5% for all women and men, 13.3% for the annual fastest finishers, 12.9±0...

  9. Sex differences in 24-hour ultra-marathon performance - A retrospective data analysis from 1977 to 2012

    Peter, Laura; Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas; Lepers, Romuald

    2014-01-01

    OBJECTIVES: This study examined the changes in running performance and the sex differences between women and men in 24-hour ultra-marathons held worldwide from 1977 to 2012. METHOD: Changes in running speed and ages of the fastest 24-hour ultra-marathoners were determined using single- and multi-level regression analyses. RESULTS: From 1977 to 2012, the sex differences in 24-hour ultra-marathon performance were 4.6±0.5% for all women and men, 13.3% for the annual fastest finishers, 12.9±0.8% ...

  10. Sex differences in 24-hour ultra-marathon performance - a retrospective data analysis from 1977 to 2012

    Peter, Laura; Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas; Lepers, Romuald

    2014-01-01

    OBJECTIVES: This study examined the changes in running performance and the sex differences between women and men in 24-hour ultra-marathons held worldwide from 1977 to 2012. METHOD: Changes in running speed and ages of the fastest 24-hour ultra-marathoners were determined using single- and multi-level regression analyses. RESULTS: From 1977 to 2012, the sex differences in 24-hour ultra-marathon performance were 4.6±0.5% for all women and men, 13.3% for the annual fastest finishers, 12...

  11. The 24-hour profiles of thyrotropin, throxine and triiodothyronine in goitrous and goitre-free Ugandans

    Plasma thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) concentrations were measured by radioimmunoassay with commercial assay kits in serial blood samples collected over a 24-hour period from 6 normal and 6 clinically euthyroid but goitrous male Ugandan subjects. Measurements on normal subjects revealed two peaks in plasma TSH concentration, one at about 08.00 hrs, the other at about 20.00 hrs. Plasma T4 concentrations showed two corresponding peaks, while plasma T3 concentrations showed no discernable pattern. Measurement on goitrous subjects revealed only the earlier peak in plasma TSH concentration, while the pooled mean TSH concentration was lower than in normal subjects. Plasma T4 concentrations showed two peaks, as for normal subjects, but the pooled mean T4 concentration was also lower than in normal subjects. Measurements on plasma T3 concentration again showed no discernable pattern. The significance of these findings is discussed

  12. The effect of Operation 24 Hours on reducing collision in the City of Edmonton.

    Halim, Siana; Jiang, Heming

    2013-09-01

    In the City of Edmonton, in order to reduce the prevalence of collisions, the Operation 24 Hours program (OPS24) was developed by using existing police and transportation services resources. The program uses traditional manned police speed enforcement method, which are supplemented by traffic safety messages displayed on permanent and mobile dynamic messaging signs (DMS). In this paper, collision data analysis was performed by looking at the daily number of collisions from 2008 to 2011 that covers 28 Operation 24 Hours (OPS24) events. The objective of the collision data analysis is to analyze if there is a reduction in collision frequencies after OPS24 was held and examined how long the collision reduction effect last. Weather factors such as temperature, thickness of snow, and wind gust have been considered by many as a great influence on collision occurrences, especially in a city with long and cold winter such as Edmonton. Therefore, collision modeling was performed by considering these external weather factors. To analyze the linear and periodic trend of different collision types (injury, fatal, and property damage only (PDO)) and examine the influence of weather factors on collisions, negative binomial time series model that accounts for seasonality and weather factors was used to model daily collision data. The modeling also considered collision proportion to account for missing traffic volume data; the Gaussian time series model that accounts for seasonality and weather factors was used to model collision proportion. To estimate the collision trend and test for changes in collision levels before/after OPS24, interrupted time series model with segmented regression was used. While for estimating how long the effect of the OPS24 last, change point method was applied. PMID:23727551

  13. A 24-Hour Study of the Hypothalamo-Pituitary Axes in Huntington's Disease.

    Eirini Kalliolia

    Full Text Available Huntington's disease is an inherited neurodegenerative disorder characterised by motor, cognitive and psychiatric disturbances. Patients exhibit other symptoms including sleep and mood disturbances, muscle atrophy and weight loss which may be linked to hypothalamic pathology and dysfunction of hypothalamo-pituitary axes.We studied neuroendocrine profiles of corticotropic, somatotropic and gonadotropic hypothalamo-pituitary axes hormones over a 24-hour period in controlled environment in 15 healthy controls, 14 premanifest and 13 stage II/III Huntington's disease subjects. We also quantified fasting levels of vasopressin, oestradiol, testosterone, dehydroepiandrosterone sulphate, thyroid stimulating hormone, free triiodothyronine, free total thyroxine, prolactin, adrenaline and noradrenaline. Somatotropic axis hormones, growth hormone releasing hormone, insulin-like growth factor-1 and insulin-like factor binding protein-3 were quantified at 06:00 (fasting, 15:00 and 23:00. A battery of clinical tests, including neurological rating and function scales were performed.24-hour concentrations of adrenocorticotropic hormone, cortisol, luteinizing hormone and follicle-stimulating hormone did not differ significantly between the Huntington's disease group and controls. Daytime growth hormone secretion was similar in control and Huntington's disease subjects. Stage II/III Huntington's disease subjects had lower concentration of post-sleep growth hormone pulse and higher insulin-like growth factor-1:growth hormone ratio which did not reach significance. In Huntington's disease subjects, baseline levels of hypothalamo-pituitary axis hormones measured did not significantly differ from those of healthy controls.The relatively small subject group means that the study may not detect subtle perturbations in hormone concentrations. A targeted study of the somatotropic axis in larger cohorts may be warranted. However, the lack of significant results despite many

  14. Fasting for 24 hours heightens reward from food and food-related cues.

    Jameason D Cameron

    Full Text Available INTRODUCTION: We examined the impact of a 24 hour complete fast (vs. fed state on two measures of food reward: 1 'wanting', as measured by response to food images and by the relative-reinforcing value of food (RRV, and 2 'liking', as measured by response to food images and the hedonic evaluation of foods consumed. METHODS: Utilizing a randomized crossover design, 15 subjects (9 male; 6 female aged 28.6±4.5 yrs with body mass index 25.3±1.4 kg/m(2 were randomized and counterbalanced to normal feeding (FED and 24-hour fast (FASTED conditions. Trait characteristics were measured with the Three Factor Eating Questionnaire. Two computer tasks measured food reward: 1 RRV progressive ratio task, 2 explicit 'liking' and 'wanting' (Leeds Food Preference Questionnaire, LFPQ. Also measured were ad libitum energy intake (EI; buffet and food 'liking' (visual analogue scale of personalized stimuli. RESULTS: There were no significant anthropometric changes between conditions. Appetite scores, hedonic ratings of 'liking', and ad libitum EI all significantly increased under the FASTED condition (p<0.05. Under the FASTED condition there were significant increases in the RRV of snack foods; similarly, explicit 'wanting' and 'liking' significantly increased for all food categories. 'Liking' of sweet foods remained high across-meals under FASTED, but savory foods decreased in hedonic saliency. CONCLUSION: Relative to a fed state, we observed an increase in hedonic ratings of food, the rewarding value of food, and food intake after a 24 hr fast. Alliesthesia to food and food cues is suggested by heightened hedonic ratings under the FASTED condition relative to FED.

  15. Is morning urinary protein-to-creatinine ratio a reliable estimator of 24-hour proteinuria in patients with kidney diseases?

    Ležaić Višnja; Ristić Stojanka; Dopsaj Violeta; Marinković Jelena

    2010-01-01

    Introduction. Proteinuria is the most frequent marker of kidney damage. Although 24-hour urinary proteinuria is the gold standard, the measurement of proteinuria from albumin urinary creatinine ratio is proposed as much useful metod. Objective. To evaluate the accuracy of urine protein-to-creatinine (P/Cr) ratio in morning urine specimens as compared with 24-hour total protein excretion for the measurement of proteinuria in patients with different kidney diseases and different renal fun...

  16. Relationship of 24-hour ambulatory blood pressure and heart rate with markers of hepatic function in cirrhotic patients

    Stergiou George S; Dourakis Spyros P; Alexopoulou Alexandra; Tzamouranis Dimitris G

    2010-01-01

    Abstract Background There is evidence that in cirrhotic patients, certain hemodynamic parameters, such as blood pressure and heart rate, are related to the severity of liver disease. This study investigated whether non-invasive 24-hour ambulatory blood pressure and heart rate are more closely associated with markers of liver disease severity than conventional office measurements. Methods Ambulatory patients with cirrhosis underwent office blood pressure and heart rate measurements, 24-hour am...

  17. The HELENA online food frequency questionnaire: reproducibility and comparison with four 24-hour recalls in Belgian-Flemish adolescents

    Vereecken, Carine; De Bourdeaudhuij, Ilse; Maes, Lea

    2010-01-01

    Abstract Objectives To investigate the reproducibility of the HELENA food frequency questionnaire (FFQ), developed as a basis for an online tailored intervention and to compare the FFQ with four computerized 24-hour recalls. Subjects/methods A convenience sample of 48 Belgian-Flemish adolescents completed four computerized 24-hour recalls, the FFQ and a retest one to two weeks later. Correlations, the Wilcoxons Signed Rank test and Bland and Altmans plots were used to...

  18. Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan

    Asayama, Kei; Metoki, Hirohito; Imai, Yutaka; Satoh, Hiroshi; Ohkubo, Takayoshi; Li, Yan; Kikuya, Masahiro; Thijs, Lutgarde; Staessen, Jan A.; Hoshi, Haruhisa; Wang, Ji-Guang; Dolan, Eamon; Hashimoto, Junichiro; O'Brien, Eoin; Obara, Taku

    2007-01-01

    BACKGROUND AND PURPOSE: Ambulatory arterial stiffness index (AASI) and pulse pressure (PP) are indexes of arterial stiffness and can be computed from 24-hour blood pressure recordings. We investigated the prognostic value of AASI and PP in relation to fatal outcomes. METHODS: In 1542 Ohasama residents (baseline age, 40 to 93 years; 63.4% women), we applied Cox regression to relate mortality to AASI and PP while adjusting for sex, age, BMI, 24-hour MAP, smoking and drinking habits, diabetes me...

  19. An approach to estimate the daily ration of cod during intensive feeding based on 24 hour fishery

    Ajiad, Adnan Mosa; Korsbrekke, Knut

    1992-01-01

    A model descnbing gashic evacuation developed by dos Santos (1990) using a modified version of the power exponential model for stomach evacuation is applied to the Northeast Arctic cod stomachs collected during 24 hour fishery. An approach to estimate the individual daily ration that takes into account the effects of initial meal size and fish weight on gastric evacuation rate in the course of 24 hour veriod is presented. The results indicate that the Northeast Arctic cod (l...

  20. 24-hour intraocular pressure in glaucoma patients randomized to receive dorzolamide or brinzolamide in combination with latanoprost

    Nakamura, Yoshimi; Ishikawa, Shusaku; Nakamura, Yuko; Sakai, Hiroshi; Henzan, Ichiko; Sawaguchi, Shoichi

    2009-01-01

    Purpose: To investigate the efficacy of dorzolamide 1% (bid or tid) or brinzolamide 1% bid on 24-hour intraocular pressure (IOP) control as well as patients’ preference for either drug when added in combination with latanoprost against glaucoma (IOP, ≥18 mmHg). Methods: In this randomized crossover study patients were assigned to receive latanoprost plus either dorzolamide or brinzolamide for four weeks. Thereafter, patients underwent 24-hour IOP monitoring while continuing to receive dorzola...

  1. Time-Based Measurement of Personal Mite Allergen Bioaerosol Exposure over 24 Hour Periods.

    Tovey, Euan R; Liu-Brennan, Damien; Garden, Frances L; Oliver, Brian G; Perzanowski, Matthew S; Marks, Guy B

    2016-01-01

    Allergic diseases such as asthma and rhinitis are common in many countries. Globally the most common allergen associated with symptoms is produced by house dust mites. Although the bed has often been cited as the main site of exposure to mite allergens, surprisingly this has not yet been directly established by measurement due to a lack of suitable methods. Here we report on the development of novel methods to determine the pattern of personal exposure to mite allergen bioaerosols over 24-hour periods and applied this in a small field study using 10 normal adults. Air was sampled using a miniature time-based air-sampler of in-house design located close to the breathing zone of the participants, co-located with a miniature time-lapse camera. Airborne particles, drawn into the sampler at 2L/min via a narrow slot, were impacted onto the peripheral surface of a disk mounted on the hour-hand of either a 12 or 24 hour clock motor. The impaction surface was either an electret cloth, or an adhesive film; both novel for these purposes. Following a review of the time-lapse images, disks were post-hoc cut into subsamples corresponding to eight predetermined categories of indoor or outdoor location, extracted and analysed for mite allergen Der p 1 by an amplified ELISA. Allergen was detected in 57.2% of the total of 353 subsamples collected during 20 days of sampling. Exposure patterns varied over time. Higher concentrations of airborne mite allergen were typically measured in samples collected from domestic locations in the day and evening. Indoor domestic Der p 1 exposures accounted for 59.5% of total exposure, whereas total in-bed-asleep exposure, which varied 80 fold between individuals, accounted overall for 9.85% of total exposure, suggesting beds are not often the main site of exposure. This study establishes the feasibility of novel methods for determining the time-geography of personal exposure to many bioaerosols and identifies new areas for future technical

  2. Non-24-Hour Sleep-Wake Disorder Revisited – A Case Study

    Garbazza, Corrado; Bromundt, Vivien; Eckert, Anne; Brunner, Daniel P.; Meier, Fides; Hackethal, Sandra; Cajochen, Christian

    2016-01-01

    The human sleep-wake cycle is governed by two major factors: a homeostatic hourglass process (process S), which rises linearly during the day, and a circadian process C, which determines the timing of sleep in a ~24-h rhythm in accordance to the external light–dark (LD) cycle. While both individual processes are fairly well characterized, the exact nature of their interaction remains unclear. The circadian rhythm is generated by the suprachiasmatic nucleus (“master clock”) of the anterior hypothalamus, through cell-autonomous feedback loops of DNA transcription and translation. While the phase length (tau) of the cycle is relatively stable and genetically determined, the phase of the clock is reset by external stimuli (“zeitgebers”), the most important being the LD cycle. Misalignments of the internal rhythm with the LD cycle can lead to various somatic complaints and to the development of circadian rhythm sleep disorders (CRSD). Non-24-hour sleep-wake disorders (N24HSWD) is a CRSD affecting up to 50% of totally blind patients and characterized by the inability to maintain a stable entrainment of the typically long circadian rhythm (tau > 24.5 h) to the LD cycle. The disease is rare in sighted individuals and the pathophysiology less well understood. Here, we present the case of a 40-year-old sighted male, who developed a misalignment of the internal clock with the external LD cycle following the treatment for Hodgkin’s lymphoma (ABVD regimen, four cycles and AVD regimen, four cycles). A thorough clinical assessment, including actigraphy, melatonin profiles and polysomnography led to the diagnosis of non-24-hour sleep-wake disorders (N24HSWD) with a free-running rhythm of tau = 25.27 h. A therapeutic intervention with bright light therapy (30 min, 10,000 lux) in the morning and melatonin administration (0.5–0.75 mg) in the evening failed to entrain the free-running rhythm, although a longer treatment duration and more intense therapy

  3. Low mean impedance in 24-hour tracings and esophagitis in children: a strong connection.

    Salvatore, S; Salvatoni, A; Ummarino, D; Ghanma, A; Van der Pol, R; Rongen, A; Fuoti, M; Meneghin, F; Benninga, M Alexander; Vandenplas, Y

    2016-01-01

    Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the Los Angeles classification. Mean impedance value was automatically calculated over 24-hour tracings. Data were adjusted for age through z-score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric Mann-Whitney and Kruskal-Wallis tests, multiple, and stepwise regression were used. P-value reflux episodes were the variables that were significantly associated with the baseline z-score. Impedance z-score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance. PMID:25345864

  4. Evaluation study of the California Expanded Food and Nutrition Education Program: 24-hour food recall data.

    Del Tredici, A M; Joy, A B; Omelich, C L; Laughlin, S G

    1988-02-01

    The California Expanded Food and Nutrition Education program (EFNEP) Evaluation Study evaluated the effectiveness of the California program. The eating habits of 683 persons were studied in a group receiving EFNEP instruction (355 participants) and a control group (328 participants) that received no instruction. The 24-hour food recall was used to assess eating habits using the Synectics method. At the beginning of the study, there were no differences in food recall scores between the EFNEP and the control groups. After 6 months of instruction in the EFNEP group, there was a significant increase in food recall score for that group and no change in the control group. The improvements observed in the EFNEP group resulted from increased intakes from the milk, protein, and fruit and vegetable food groups. The program characteristics that led to those changes were determined to be in the length of the EFNEP visit, the number of EFNEP visits, and the EFNEP instruction topics. These results show that the California EFNEP is effective in producing significant changes in the eating habits of the low-income individuals it serves. PMID:3339205

  5. Electrodes for 24 hours pH monitoring--a comparative study.

    McLauchlan, G; Rawlings, J M; Lucas, M L; McCloy, R F; Crean, G P; McColl, K E

    1987-08-01

    Three pH electrodes in clinical use were examined--(1) antimony electrode with remote reference electrode (Synectics 0011), (2) glass electrode with remote reference electrode (Microelectrodes Inc. MI 506) and (3) combined glass electrode with integral reference electrode (Radiometer GK2801C). In vitro studies showed that both glass electrodes were similar and superior to the antimony electrode with respect to response time, drift, and sensitivity. The effect of the siting of the reference electrode on the recorded pH was examined in five human volunteers. The pH reading using a remote skin reference electrode was higher by a mean of 0.3 pH units (range 0.0-0.6) in the stomach, lower by 0.65 pH units (0.5-0.8) in the duodenum and lower by 0.3 pH units (0.0-0.6) in the oesophagus than that simultaneously obtained with an intraluminal reference electrode. Buccal reference electrodes gave similar readings to skin. Combined reference and glass pH electrodes are recommended for 24-hour ambulatory pH monitoring. PMID:3666560

  6. 24 hours in the life of HIV-1 in a T cell line.

    Pejman Mohammadi

    2013-01-01

    Full Text Available HIV-1 infects CD4+ T cells and completes its replication cycle in approximately 24 hours. We employed repeated measurements in a standardized cell system and rigorous mathematical modeling to characterize the emergence of the viral replication intermediates and their impact on the cellular transcriptional response with high temporal resolution. We observed 7,991 (73% of the 10,958 expressed genes to be modulated in concordance with key steps of viral replication. Fifty-two percent of the overall variability in the host transcriptome was explained by linear regression on the viral life cycle. This profound perturbation of cellular physiology was investigated in the light of several regulatory mechanisms, including transcription factors, miRNAs, host-pathogen interaction, and proviral integration. Key features were validated in primary CD4+ T cells, and with viral constructs using alternative entry strategies. We propose a model of early massive cellular shutdown and progressive upregulation of the cellular machinery to complete the viral life cycle.

  7. Obtaining liver tridimensional scaffold through the decellularization of rabbit whole liver in 24 hours

    Federico, Schliamser; Ayelen, Rinaldi; Romina, Comin; Alba Nelly, Borchert; Adrian, Nari Gustavo; Alicia, Salvatierra Nancy; Mariana Paula, Cid

    2016-04-01

    In the present work, we development a new protocol for liver decellularization in which the hole decellularization was reached over 24 h. Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrixin which the time period involved didn't pass 24 h. Methods: The decellularization is obtained through the use of water and SDS (0,1-0,3 %), after freezing at -80 degrees, is the best alternative of different physical and/or chemical mechanisms to break down organ cells and leave only the extracellular matriz. After 24 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using microscopic observation corroborated the macroscopic results, with the hematoxylin-eosin and Masson staining showing no cells or nuclear material. In addition, the DNA quantification was less than 10% in the decellularized liver compared to control. Finally,the time taken to develop the decellularization protocol was less than 24 hours.

  8. Continuous 24 hour ambulatory monitoring of intragastric pH in man.

    Kapur, B K; Howlett, P J; Kenyon, N G; Lunt, M J; Mills, J G; Smallwood, R H; Wilson, A J; Bardhan, K D

    1987-05-01

    A system has been developed which permits continuous 24 hour ambulatory recording of intragastric pH under near-physiological conditions. The system utilises a Cecar combination pH electrode connected through a pre-amplifier to an Oxford Medical Systems Medilog 4-24 cassette recorder, and the pH recorded continuously on to tape. The data is replayed at high speed, digitised and then analysed. Sources of error included system drift, system noise and the effect of changes in electrode environment due to saliva, food, loss of fluid contact, temperature variations and electrode time constant. These were found to be small. In contrast, the major changes in pH detected reflect real changes at the electrode tip. These changes can be recorded by the system. Developments in electronics and improvements in both the size and quality of pH electrodes, over the past few decades, has enabled intragastric pH recordings to be made with greater ease. However, a large number of investigators still assess gastric acidity by infrequent, intermittent sampling of gastric secretion through a naso-gastric tube. This new ambulatory system is a significant improvement and its versatility allows studies in acid secretion physiology, pharmacology and pathophysiology. PMID:3595080

  9. Pathophysiological changes detected by MRI within 24 hours after head injury

    This report concerns the evaluation of the usefulness of high-field magnetic resonance imaging (MRI) for the diagnosis and prognosis of patients with head injuries. For this purpose we compared the CT and MRI results obtained on 48 such patients. MRI of all cases was taken within 24 hours after head injury using a 1.5-Tesla unit. The sensitivity of the two modalities in the detection of small traumatic lesions was compared. Traumatic lesions of 23 patients (47.9%) were not detected by CT, but they were demonstrated on MRI. Overall, MRI was significantly more sensitive than CT in detecting early and/or subtle traumatic changes of the brain parenchyma (P1-WI and T2-WI. (B) Corpus callosum lesions with hyperintensity on T2-WI were in fact hemorrhagic contusions by signal changes on sequential MRI. The follow-up of chronological changes of a given corpus callosum lesion was essential for confirmation of its pathology. (C) In one case, scratch-like lesions with strong hypointensity on T1-WI and hyperintensity on T2-WI were clearly demonstrated in the white matter. These observations appeared to indicate axonal damages. (D) Even if initial GCS score is low (2-WI and subsequently disappeared completely. We conclude that performing MRI in the early stage of a head injury is of utility for the understanding of pertinent pathophysiological changes and for predicting outcome. (author)

  10. Depressive Symptoms and 24-Hour Ambulatory Blood Pressure in Africans: The SABPA Study

    Mark Hamer

    2012-01-01

    Full Text Available Disturbances in circadian rhythm might play a central role in the neurobiology of depression. We examined the association between depressive symptoms and 24-hour ambulatory BP in a sample of 405 (197 black and 208 Caucasian urbanized African teachers aged 25 to 60 yrs (mean 44.6 ± 9.6 yrs. Depressive symptoms were assessed using the self-administered 9-item Patient Health Questionnaire (PHQ-9. After adjusting for age, sex, and ethnicity, participants with severe depressive symptoms (PHQ-9 ≥ 15 had higher odds of hypertension defined from ambulatory BP and/or use of antihypertensive medication (odds ratio = 2.19, 95% CI, 1.00–4.90 in comparison to participants with no symptoms. Compared to Caucasians with no depressive symptoms, those with severe symptoms had blunted nocturnal systolic BP drop of 4.7 mmHg (95% CI, −0.5 to 10.0, P=0.07. In summary, depressive symptoms were associated with the circadian BP profile in black and Caucasian Africans.

  11. Importance of all movement behaviors in a 24 hour period for overall health.

    Chaput, Jean-Philippe; Carson, Valerie; Gray, Casey E; Tremblay, Mark S

    2014-12-01

    Physical inactivity and childhood obesity are well-recognized public health concerns that are associated with a range of adverse health outcomes. Historically, the benefits of physical activity (e.g., moderate-to-vigorous physical activity-MVPA) to overall health have dominated discussions and emerging evidence indicates that a broader, more integrated approach is needed to better understand and address current public health crises. Existing guidelines for children and youth around the world only focus on MVPA, and recently sedentary behavior, despite an accumulating body of evidence showing that light-intensity physical activity (LPA) such as walking can provide important health benefits. Furthermore, there is accumulating support for the importance of adequate sleep and that these behaviors moderate the health impact of each other. Ignoring the other components of the movement continuum (i.e., sleep, sedentary time, LPA) while focusing efforts exclusively on MVPA (accounting for <5% of the time in a 24 h period) limits the potential to optimize the health benefits of movement behaviors. In order to address this limitation, experts in Canada are currently developing the world's first Integrated 24 Hour Movement Behaviour Guidelines for Children and Youth to help advance an integrated healthy active living agenda that has the potential to significantly improve the overall health and well-being of children and youth. PMID:25485978

  12. Morphine Rectal

    Rectal morphine is used to relieve moderate to severe pain. Morphine is in a class of medications called opiate ( ... Rectal morphine comes as a suppository to insert in the rectum. It is usually inserted every 4 hours. Use ...

  13. Prediction of late (24-hour) radioactive iodine uptake using early (3-hour) uptake values in Japanese patients with Graves' disease

    Measurement of 24-hour radioactive iodine uptake (RAIU), which is commonly used to calculate the dose of radioiodine (RI) therapy, cannot be accomplished in a single day. The purpose of this study was to predict 24-hour RAIU from 3-hour RAIU in Japanese patients with Graves' disease, and to investigate other factors that could be used to predict 24-hour RAIU. A total of 66 Japanese patients (14 men and 52 women; age, 17-83 years) with Graves' disease who had undergone both 3-hour and 24-hour 123I RAIU measurements between January 2006 and September 2011 were included in this study. Stepwise multiple regression analyses were performed in order to identify factors that could be used to predict 24-hour RAIU. The investigated factors were gender, age, thyroid volume, thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), serum creatinine, second generation assay TSH receptor antibody (TRAb2), antithyroid drugs discontinuation period (ADP), iodine restriction period and 3-hour RAIU. The ADP was converted to an ordinal scale ADP score (ADPS) for multiple regression analyses. Multiple regression analyses showed that 3-hour RAIU (P10 EU +23.0 x log10 FT3 -2.7 x ADPS (r=0.82, P<0.001). The present results indicate that prediction of LU from EU, FT3 and ADPS is feasible in Japanese patients with Graves' disease. (author)

  14. 24 hour ST segment analysis in transient left ventricular apical ballooning.

    Frank Bode

    Full Text Available OBJECTIVE: The etiologic basis of transient left ventricular apical ballooning, a novel cardiac syndrome, is not clear. Among the proposed pathomechanisms is coronary vasospasm. Long-term ST segment analysis may detect vasospastic episodes but has not been reported. METHODS: 30 consecutive patients with transient left ventricular apical ballooning, left ventricular dysfunction and normal or near-normal coronary arteries were investigated. A 24-hour Holter ECG was obtained after emergency admission. ST segment analysis was performed automatically in 2 leads and confirmed by visual inspection. Criteria for an ischemic event were: 1. ST elevation or 2. horizontal or down-sloping ST segments ≥1 min duration and ≥100 µV J+80 point deviation corrected for baseline ST-deviation. RESULTS: Patients presented with ST segment elevation (n = 19 and/or T wave inversion (n = 20 on admission ECG. Ejection fraction was 50±12%. No transient ST elevations were observed during Holter ECG analysis. In 3 patients, 8 transient episodes of ST depression were recorded. Durations of episodes varied between 75 s and 790 s (mean 229 s. Maximal ST deviation averaged -191±71 µV. Ischemic burden was -1 to -22 mVs (mean -8 mVs. 27 patients showed no ischemic events. CONCLUSIONS: ST segment analysis of 24 h Holter recordings revealed minor ischemic events in only 10% of patients with transient left ventricular apical ballooning. Overall, ST segment changes were not indicative of recurrent coronary spasm playing a major role in the genesis of transient left ventricular apical ballooning.

  15. PATTERNS OF THE MAXIMUM RAINFALL AMOUNTS REGISTERED IN 24 HOURS WITHIN THE OLTENIA PLAIN

    ALINA VLĂDUŢ

    2012-03-01

    Full Text Available Patterns of the maximum rainfall amounts registered in 24 hours within the Oltenia Plain. The present study aims at rendering the main features of the maximum rainfall amounts registered in 24 h within the Oltenia Plain. We used 30-year time series (1980-2009 for seven meteorological stations. Generally, the maximum amounts in 24 h display the same pattern as the monthly mean amounts, namely higher values in the interval May-October. In terms of mean values, the highest amounts are registered in the western and northern extremity of the plain. The maximum values generally exceed 70 mm at all meteorological stations: D.T. Severin, 224 mm, July 1999; Slatina, 104.8 mm, August 2002; Caracal, 92.2 m, July 1991; Bechet, 80.8 mm, July 2006; Craiova, 77.6 mm, April 2003. During the cold season, there was noticed a greater uniformity all over the plain, due to the cyclonic origin of rainfalls compared to the warm season, when thermal convection is quite active and it triggers local showers. In order to better emphasize the peculiarities of this parameter, we have calculated the frequency on different value classes (eight classes, as well as the probability of appearance of different amounts. Thus, it resulted that the highest frequency (25-35% is held by the first two classes of values (0-10 mm; 10.1-20 mm. The lowest frequency is registered in case of the amounts of more than 100 mm, which generally display a probability of occurrence of less than 1% and only in the western and eastern extremities of the plain.

  16. Weight/age-dependent glucose turnover (GTO) in fed and 24 hour fasted rats

    In small animals such as the rat, cardiac output and oxygen consumption are constant with age when normalized to the body surface area but not to body weight (BW). The authors explored this relationship for GTO in pentobarbital-anesthetized fed and 24 hours fasted Sprague-Dawley rats weighing between 200 and 55 g. A bolus of 10 μCi/kg BW of [6-3H]-glucose was injected into the carotid artery followed by a constant infusion equal to 1.5 μCi/minute *kg BW and samples taken from the right atrium every 15 minutes for glucose specific activity (SA) measurements over a 2 period. Steady state measurements of GTO (μmol/minute) plotted as a function of BW (g) revealed GTO to be inversely related in fed rats but independent of BW in fasted rats. Although plasma [glucose] was significantly lower in fasted rats, there were no weight related differences within each group. Fasting decreased GTO across the whole range of body weights; however, the magnitude of the fasting effect was much larger in the smaller animals (50% lower) compared to the larger animals (25% lower). Although the lean body mass is increasing in this range of BW, the decrease in GTO indicates an age/weight-related decrease in glucose utilization which diminishes the effect of fasting as the animal grows. This data explains the inconsistency in the literature regarding the fasting effect on GTO in the rat and emphasizes the importance of weight/age matching of experimental groups to minimize the variability in the data when GTO is of interest

  17. Office and 24-hour heart rate and target organ damage in hypertensive patients

    García-García Ángel

    2012-03-01

    Full Text Available Abstract Background We investigated the association between heart rate and its variability with the parameters that assess vascular, renal and cardiac target organ damage. Methods A cross-sectional study was performed including a consecutive sample of 360 hypertensive patients without heart rate lowering drugs (aged 56 ± 11 years, 64.2% male. Heart rate (HR and its standard deviation (HRV in clinical and 24-hour ambulatory monitoring were evaluated. Renal damage was assessed by glomerular filtration rate and albumin/creatinine ratio; vascular damage by carotid intima-media thickness and ankle/brachial index; and cardiac damage by the Cornell voltage-duration product and left ventricular mass index. Results There was a positive correlation between ambulatory, but not clinical, heart rate and its standard deviation with glomerular filtration rate, and a negative correlation with carotid intima-media thickness, and night/day ratio of systolic and diastolic blood pressure. There was no correlation with albumin/creatinine ratio, ankle/brachial index, Cornell voltage-duration product or left ventricular mass index. In the multiple linear regression analysis, after adjusting for age, the association of glomerular filtration rate and intima-media thickness with ambulatory heart rate and its standard deviation was lost. According to the logistic regression analysis, the predictors of any target organ damage were age (OR = 1.034 and 1.033 and night/day systolic blood pressure ratio (OR = 1.425 and 1.512. Neither 24 HR nor 24 HRV reached statistical significance. Conclusions High ambulatory heart rate and its variability, but not clinical HR, are associated with decreased carotid intima-media thickness and a higher glomerular filtration rate, although this is lost after adjusting for age. Trial Registration ClinicalTrials.gov: NCT01325064

  18. Role of 24 hour telephonic helpline in delivery of mental health services

    Bir Singh Chavan

    2012-01-01

    Full Text Available Background: A large number of persons with psychiatric disorders are not seeking treatment due to various reasons, thus contributing to the huge treatment gap. One of the ways to bring these people into treatment is through telephonic helplines. Materials and Methods: Following a large number of suicides in the city of Chandigarh in 2003, The department of Psychiatry, GMCH, Chandigarh was designated as nodal center for the prevention of suicide. A 24-hour suicide prevention helpline was set up as an immediate measure to help persons in crisis. Apart from providing telephonic counseling to persons in crisis, the helpline coordinated with police, media, schools, radio stations etc., to reduce the number of suicides in the city. Results: Majority of the callers were males (65.93%, between 20 to 39 years old (56.34%, married (79.50%, had less than 12 years of formal education (60.68%, and were earning less than Rs. 5000/month (56.80%. 72.96% callers had contacted the mental health services for the first time. A significant number of persons (434, 13.26% called the helpline for marital, academic, stress-related problems. Majority of the calls were received between 8 A.M. and 2 P.M. The number of suicides in the city of Chandigarh showed a decline in the following years since the helpline was set up. Conclusions: The telephonic helpline seems to be a very effective way of getting persons into contact with health services. They are cost-effective, the person can maintain his confidentiality and devoid of stigma.

  19. Effect of Reinforcing Qi and Moistening Intestine Oral Liquid on Anorectal Manometry of Asthenia Type Constipation Patients

    2000-01-01

    Objective: To study the change of anorectal manometry in asthenia type constipation patients and effect of reinforcing Qi and moistening intestine oral liquid (RQMI) on it. Methods: The total of 135 cases were divided into healthy group, RQMI treated group, Maren pill (MRP) treated group and prepulsid (PPS) treated group, their anal maximal voluntary squeez pressure, rectoanal contraction reflex, rectoanal inhibitory reflex, defecation reflex, rectal volume sensory threshold and rectal maximal tolerable volume were observed. Results: The rectal sensory function of patients weakened obviously and anal sphincter reactivity reduced as compared with those of healthy person (P<0.01), and both were improved by RQMI treatment (P<0.05). Conclusion: RQMI is superior to MRP and prepulside in improving anorectal dynamic abnormality in constipation patient of asthenia type.

  20. The Relationship Between Daytime, Nighttime and 24-Hour Heart Rate with Urinary Albumin and Protein Excretion in Patients with Newly Diagnosed Type 2 Diabetes

    Barış AFŞAR

    2012-05-01

    Full Text Available OBJECTIVE: Autonomic nervous system dysfunction (ASD has been widely observed in patients with type 2 diabetes. 24-hour ambulatory blood pressure (ABP and heart rate measurements have been found to associate with ASD in patient with Type 2 diabetes. Since albumin excretion is also related with ASD in type 2 diabetes; in the current study, the relationships between daytime, nighttime and 24- hour heart rates with 24 hour urinary albumin excretion (UAE and 24-hour urinary protein excretion (UPE were analyzed in patients with newly diagnosed type 2 diabetes. MATERIAL and METHODS: All patients underwent following procedures: history taking, physical examination, BP measurement, 12 lead electrocardiographic evaluations, routine urine analysis, biochemical analysis, 24-hour urine collection to measure UAE, UPE and creatinine clearance. 24-hour ABP and heart rate monitoring were performed for all patients. RESULTS: In total 80 patients with newly diagnosed type 2 diabetes were included. Stepwise linear regression revealed that logarithmically converted 24-hour UAE were independently related with 24- hour ambulatory SBP, (P:0.001 and heart rate (night (P<0.0001. Stepwise linear regression revealed that logarithmically converted 24-hour UPE were independently related with age (P:0.032, with averaged fasting blood glucose (P:0.023, with 24-hour ambulatory SBP, (P:0.002 and with heart rate (night (P:0.001. CONCLUSION: Nighttime heart rate, but not daytime and 24-hour heart rate was related with both 24-hour UAE and UPE in patients with Type 2 diabetes.

  1. Executive functions are not affected by 24 hours of sleep deprivation: A color-word stroop task study

    Abhinav Dixit

    2015-01-01

    Full Text Available Background: Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. Materials and Methods : The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am, after 12 hours (7-9 pm and after 24 hours (7-9 am, next day. The subjects were allowed to perform normal daily activities. Results: The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. Conclusion: The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in

  2. 24-hour intraocular pressure in glaucoma patients randomized to receive dorzolamide or brinzolamide in combination with latanoprost

    Yoshimi Nakamura

    2009-07-01

    Full Text Available Yoshimi Nakamura, Shusaku Ishikawa, Yuko Nakamura, Hiroshi Sakai, Ichiko Henzan, Shoichi SawaguchiDepartment of Ophthalmology, University of the Ryukyus Faculty of Medicine, Okinawa, JapanPurpose: To investigate the efficacy of dorzolamide 1% (bid or tid or brinzolamide 1% bid on 24-hour intraocular pressure (IOP control as well as patients’ preference for either drug when added in combination with latanoprost against glaucoma (IOP, ≥18 mmHg.Methods: In this randomized crossover study patients were assigned to receive latanoprost plus either dorzolamide or brinzolamide for four weeks. Thereafter, patients underwent 24-hour IOP monitoring while continuing to receive dorzolamide (for two successive days/nights: at first bid then tid or brinzolamide bid (once overnight. They were then switched over to receive the other test medication for a further four weeks and subsequently reexamined for 24-hour IOP. A questionnaire survey on treatment satisfaction was performed.Results: In 20 patients dorzolamide bid or tid or brinzolamide bid exerted significant (p < 0.001 reductions of IOP from baseline at all time-points over 24 hours; no difference was detected among the treatment regimens. Significantly (p < 0.05 more patients preferred dorzolamide (n = 9 over brinzolamide (n = 2, whereas nine patients gave a neutral answer. Conclusion: Dorzolamide bid or tid and brinzolamide bid when combined with latanoprost therapy elicited significant IOP reduction for 24 hours. It is rational to consider patients’ preference of therapeutic regimen especially long-term users such as those with glaucoma.Keywords: glaucoma, brinzolamide, dorzolamide, latanoprost combination therapy, 24-hour intraocular pressure (IOP, questionnaire survey

  3. Personal best marathon performance is associated with performance in a 24-hour run and not anthropometry or training volume

    Knechtle, B; Wirth, A.; P. Knechtle; Zimmermann, K.; Kohler, G.

    2009-01-01

    OBJECTIVE: To investigate the influence of anthropometric and training parameters on race performance in ultra-endurance runners in a 24-hour-run. DESIGN: Descriptive field study. SETTING: The 24-hour-run in Basel 2007. SUBJECTS: Fifteen male Caucasian ultra runners (mean +/- SD; 46.7 +/- 5.8 y, 71.1 +/- 6.8 kg, 1.76 +/- 0.07 m, BMI 23.1 +/- 1.84 kg/m2). INTERVENTIONS: None. MAIN OUTCOME MEASUREMENTS:Determination of age, body mass, body height, length of lower limbs, skin-fold thicknesses, c...

  4. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome

    Eric Moulton; Mélika Amor-Sahli; Vincent Perlbarg; Christine Pires; Sophie Crozier; Damien Galanaud; Romain Valabregue; Marion Yger; Flore Baronnet-Chauvet; Yves Samson; Didier Dormont; Charlotte Rosso

    2015-01-01

    International audience Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after throm-bolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombo-lyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean...

  5. Effect of an L- and T-Type Calcium Channel Blocker on 24-Hour Systolic Blood Pressure and Heart Rate in Hypertensive Patients

    Komukai, Masae; Tsutsumi, Takeshi; Ebado, Mio; Takeyama, Youichi

    2012-01-01

    Background and Objectives The aim of this study was to evaluate the effects of an L- and T-type calcium channel blocker (CCB) on 24-hour systolic blood pressure (24-hour SBP) and heart rate (24-hour HR) profiles in essential hypertensive patients. Subjects and Methods Thirty-seven consecutive patients were enrolled in this study. The 24-hour SBP and HR were recorded before and after treatment with efonidipine (L- and T-type CCB, 40 mg), after waking. Changes in 24-hour SBP and HR and the diur...

  6. Correlation of 2 hour, 4 hour, 8 hour and 12 hour urine protein with 24 hour urinary protein in preeclampsia.

    Savita Rani Singhal

    2014-09-01

    Full Text Available To find shortest and reliable time period of urine collection for determination of proteinuria.It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin >1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient.There was significant correlation (p value < 0.01 in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivity of 92.45%, 95.28%, 91.51%, and 96.23% and a specificity of 68.42%, 94.74%, 84.21% and 84.21% were obtained, respectively.Two-hour urine proteins can be used for assessment of proteinuria in preeclampsia instead of gold standard 24-hour urine collection for early diagnosis and better patient compliance.

  7. Risk Stratification by 24-Hour Ambulatory Blood Pressure and Estimated Glomerular Filtration Rate in 5322 Subjects From 11 Populations

    Boggia, José; Thijs, Lutgarde; Li, Yan;

    2013-01-01

    subjects (median age, 51.8 years; 43.1% women) randomly recruited from 11 populations, who had baseline measurements of 24-hour ambulatory blood pressure (ABP(24)) and eGFR. We computed hazard ratios using multivariable-adjusted Cox regression. Median follow-up was 9.3 years. In fully adjusted models...

  8. GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

    Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R2=0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

  9. Value of 24-hour Delayed Film of Barium Enema for Evaluation of Colon Transit Function in Young Children with Constipation

    Yoo, Ha Yeong; Son, Jae Sung; Park, Hye Won; Kwak, Byung Ok; Kim, Hyeong Su; Bae, Sun Hwan

    2016-01-01

    Background/Aims A colon transit time test using radio-opaque markers (CTTRM) is considered the gold standard for evaluating colon transit function. A 24-hour delayed film of barium enema (BE) has been used as a supplementary method in structural evaluations. The aim of this study was to evaluate the utility of a 24-hour delayed BE film for assessing colon transit function in young children with constipation. Methods In total, 93 children with constipation who performed both single-contrast BE and CTTRM were enrolled in this study. Of these, the data from 70 children were analyzed (males 33, females 37; mean age [range], 5.63 ± 2.94 [2–14] years). The basic principle of the study is “velocity = distance/time”. Time values were identified in both studies, and the colon length and distance of barium movement were measured on the 24-hour delayed BE film. Thus, colon transit velocity values could be calculated using both methods. The correlation between colon transit velocity using a 24-hour delayed BE film versus CTTRM was analyzed statistically. Results Median value (interquartile range) of colon transit velocity using CTTRM was 1.57 (1.07–2.89) cm/hr, and that using BE of that was 1.58 (0.94–2.07) cm/hr. The Spearman correlation coefficient was 0.438 (P children younger than 4 years (r = 0.537, P = 0.032). Conclusions Although the correlation between BE and CTTRM was not very strong, the 24-hour delayed BE film could provide broad information about colon transit function in young children, especially those under 4 years who usually cannot undergo CTTRM. PMID:26979249

  10. Physical and Mental Health of Patients Immediately After Discharge From Intensive Care Unit and 24 Hours Later

    Momennasab, Marzieh; Ghahramani, Tahereh; Yektatalab, Shahrzad; Zand, Farid

    2016-01-01

    Background: Monitoring the health status of patients discharged from intensive care units is a crucial method of service evaluation. Objectives: This study aimed to assess the physical and mental health status of patients immediately after discharge from the ICU and 24 hours later. Patients and Methods: This descriptive comparative study was conducted on 104 patients discharged from the ICUs of a referral trauma center in Shiraz, Southwest Iran. Physical parameters, including respiratory rate, need for supplemental oxygen, heart rate, blood pressure, and need for cardiac monitoring, were assessed. Hospital anxiety and depression scale (HADS) was used for mental health evaluation. The mental and physical status of patients were assessed before ICU discharge and 24 hours later; data were recorded in information forms and were analyzed using SPSS statistical software version 17. Results: At the time of discharge, the respiratory rate of 28% of the participants was more than 24 minutes, and 95.2% received supplemental oxygen. However, after 24 hours these values decreased to 10% and 21.6%, respectively. The mean heart rate and systolic blood pressure were within the normal range at both time points. Additionally, 63% of the patients had anxiety scores above 11 at both time points, reflecting high anxiety. The number of patients who reported depression increased from 58.7% at ICU discharge to 69.6% after 24 hours. Conclusions: Despite the considerable improvement in most of the patients’ physical condition in the first 24 hours after discharge from ICU, a significant number of them remain at risk for the development of adverse effects from this transition. The high prevalence of mental health disorders in these patients reveals the necessity to conduct follow-up consultations.

  11. Microleakage of two self-adhesive cements in the enamel and dentin after 24 hours and two months.

    Zahra Jaberi Ansari

    2014-08-01

    Full Text Available Microleakage is a main cause of restorative treatment failure. In this study, we compared occlusal and cervical microleakage of two self-adhesive cements after 24 hours and two months.In this in-vitro experimental study, class II inlay cavities were prepared on 60 sound human third molars. Composite inlays were fabricated with Z100 composite resin. The teeth were randomly assigned to six groups. RelyX-Arc (control, RelyX-Unicem and Maxcem were used for the first three groups and specimens were stored in distilled water at 37°C for 24 hours. The same cements were used for the remaining three groups, but the specimens were stored for 2 months. The teeth were subjected to 500 thermal cycles (5°C and 55°C and immersed in 0.5% basic fuchsin for 24 hours and then sectioned mesiodistally and dye penetration was evaluated in a class II cavity with occlusal and cervical margins using X20 magnification stereomicroscope. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests.After 24 hours, cements had significant differences only in cervical margin microleakage (P=0.0001 and microleakage of RelyX-Unicem and Maxcem was significantly more than that of RelyX-Arc (both P=0.0001. Cervical microleakage in RelyX-Unicem and Maxcem was greater than occlusal (P=0.0001 and P=0.001, respectively. Microleakage was not significantly different between the occlusal and cervical margins after 2 months.Cervical microleakage was greater than occlusal in RelyX-Unicem and Maxcem after 24h. The greatest microleakage was reported for the cervical margin of RelyX-Unicem after 24 hours.

  12. Effect of Helicobacter pylori infection on 24 hour intragastric acidity in patients with gastritis and duodenal ulcer.

    Wagner, S.; Gladziwa, U; Haruma, K; Varrentrapp, M; Gebel, M

    1992-01-01

    Helicobacter pylori status, gastric histology, and 24 hour acidity were studied in 35 gastritis patients, 21 duodenal ulcer patients, and 14 subjects with normal gastric mucosa. H pylori was identified in 21 of 35 patients with chronic active gastritis and in 19 of 21 duodenal ulcer patients, but in none of those with normal gastric mucosa. Mean scores of activity of gastritis were similar in H pylori positive gastritis and duodenal ulcer patients, but were significantly lower in H pylori neg...

  13. Evaluation of high dose atorvastatin therapy 24 hours before elective percutaneous coronary intervention on peri-PCI myocardial infarction

    Rahmani R; Nafasi L; Salary A; Meisami A; Abdollahi A

    2013-01-01

    Background: Percutaneous coronary intervention (PCI) may been associated with high-er risk of cardiac events during this procedure. The goal of this study was to compare high dose atorvastatin therapy with low dose atorvastatin therapy 24 hours before PCI to a reduction in Peri- percutaneous coronary intervention myocardial infarction.Methods: One hundred ninety patients with stable angina were enrolled in a randomiz-ed controlled clinical trial study. All patients received low dose atorvasta...

  14. Risk Stratification and Effects of the First 24-Hour Pharmacotherapy in Predominantly Hypertensive Patients with Acute Myocardial Infarction

    Peleška, Jan; Grünfeldová, H.; Monhart, Z.; Faltus, Václav; Tomečková, Marie; Ryšavá, D.; Velimský, T.; Ballek, L.; Hubač, J.; Charalampidi, K.

    2009-01-01

    Roč. 27, Suppl. 4 (2009), S421-S422. ISSN 0263-6352. [European Meeting on Hypertension /19./. 12.06.2009-16.06.2009, Milan] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : pilot registry of acute myocardial infarction * hypertension and other cardiovascular risk factors * first 24-hour pharmacotherapy of myocardial infarction Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  15. 24-hour evaluation of dental plaque bacteria and halitosis after consumption of a single placebo or dental treat by dogs.

    Jeusette, Isabelle C; Román, Aurora Mateo; Torre, Celina; Crusafont, Josep; Sánchez, Nuria; Sánchez, Maria C; Pérez-Salcedo, Leire; Herrera, David

    2016-06-01

    OBJECTIVE To determine whether consumption of a single dental treat with specific mechanical properties and active ingredients would provide a 24-hour effect on dental plaque bacteria and halitosis in dogs. ANIMALS 10 dogs of various breeds from a privately owned colony that had received routine dental scaling and polishing 4 weeks before the study began. PROCEDURES Dogs were randomly assigned to receive 1 placebo or dental treat first. A 4-week washout period was provided, and then dogs received the opposite treatment. Oral plaque and breath samples were collected before and 0.5, 3, 12, and 24 hours after treat consumption. Volatile sulfur compounds (VSCs) concentration was measured in breath samples. Total aerobic, total anaerobic, Porphyromonas gulae, Prevotella intermedia-like, Tannerella forsythia, and Fusobacterium nucleatum bacterial counts (measured via bacterial culture) and total live bacterial counts, total live and dead bacterial counts, and bacterial vitality (measured via quantitative real-time PCR assay) were assessed in plaque samples. RESULTS Compared with placebo treat consumption, dental treat consumption resulted in a significant decrease in breath VSCs concentration and all plaque bacterial counts, without an effect on bacterial vitality. Effects of the dental treat versus the placebo treat persisted for 12 hours for several bacterial counts and for 24 hours for breath VSCs concentration. CONCLUSIONS AND CLINICAL RELEVANCE Although clinical benefits should be investigated in larger scale, longer-term studies, results of this study suggested that feeding the evaluated dental treat may help to decrease oral bacterial growth in dogs for 12 hours and oral malodor for 24 hours. A feeding interval of 12 hours is therefore recommended. PMID:27227499

  16. HOW RELIABLE IS 24 HOUR SERUM LITHIUM LEVEL AFTER A TEST DOSE OF LITHIUM IN PREDICTING OPTIMAL LITHIUM DOSE?

    Kuruvilla, K.; Shaji, K. S.

    1989-01-01

    SUMMARY 57% of a group of 35 patients treated with Lithium Carbonate at dosages predicted by the nomogram suggested by Cooper et al (1973) failed to reach therapeutic levels of serum lithium. This finding casts serious doubts on the usefulness of the claim by Cooper et al (1973 & 1976) that 24 hour serum lithium level after a test dose of 600 mg. lithium can predict the daily lithium dose.

  17. Bilateral transversus abdominis plane (TAP) block with 24 hours ropivacaine infusion via TAP catheters: A randomized trial in healthy volunteers

    Petersen, Pernille L; Hilsted, Karen L; Jørgen B Dahl; Mathiesen, Ole

    2013-01-01

    Background The analgesic effect of a TAP block has been investigated in various surgical settings. There are however limited information about block level and block duration. Furthermore, there is a lack of information about continuous TAP block after ultrasound-guided posterior TAP blocks. The aim of this double-blind randomized study was therefore to investigate the effect of an ultrasound-guided posterior TAP block with 24 hours local anesthetic infusion via a TAP catheter. Methods In this...

  18. Improved simulation of water vapour and clear-sky radiation using 24-hour forecasts from ERA40

    Allan, Richard P

    2007-01-01

    Monthly mean water vapour and clear-sky radiation extracted from the European Centre for Medium Range Weather Forecasts 40-year reanalysis (ERA40) forecasts are assessed using satellite observations and additional reanalysis data. There is a marked improvement in the interannual variability of column-integrated water vapour (CWV) over the oceans when using the 24-hour forecasts compared with the standard 6-hour forecasts products. The spatial distribution ofCWV are well simulated by the 6-hou...

  19. 24-hour intraocular pressure in glaucoma patients randomized to receive dorzolamide or brinzolamide in combination with latanoprost

    Oishi, Yoshimi

    2009-01-01

    Yoshimi Nakamura, Shusaku Ishikawa, Yuko Nakamura, Hiroshi Sakai, Ichiko Henzan, Shoichi SawaguchiDepartment of Ophthalmology, University of the Ryukyus Faculty of Medicine, Okinawa, JapanPurpose: To investigate the efficacy of dorzolamide 1% (bid or tid) or brinzolamide 1% bid on 24-hour intraocular pressure (IOP) control as well as patients’ preference for either drug when added in combination with latanoprost against glaucoma (IOP, ≥18 mmHg).Methods: In this randomized cro...

  20. Flow cytometric comparison of platelets from a whole blood and finger-prick sample: impact of 24 hours storage.

    Swanepoel, Albe C; Stander, Andre; Pretorius, Etheresia

    2013-03-01

    In this study, we investigate the validity and laboratory utility of flow cytometry when analyzing platelet activation by studying CD41, CD42b, CD62P and CD63. We compare flow cytometry results from citrated whole-blood and finger-prick samples directly after collection and also after storing both a finger-prick and whole-blood sample for 24 hours. Citrated whole-blood and finger-prick samples were taken from three healthy individuals on two occasions, and a total of 60,000 cells were analyzed for each of the four phycoerythrin-labeled monoclonal antibodies. Half of each sample was analyzed immediately after sampling while the other half was kept in the fridge at 6 °C for 24 hours before analysis. No significant difference was found between the sampling methods or the period of time before analysis. Results therefore suggest that an appropriately prepared finger-prick sample can be used for platelet function analysis, and samples can be stored for 24 hours in the fridge at 6 °C before analysis. PMID:23320994

  1. [Exercise tolerance in angina patients 3 and 24 hours after administration of a new delayed-action preparation of metoprolol].

    Giusti, C; Verdecchia, P; Pentimone, F; Regoli, F; Cordoni, M; Bongini, A M

    1981-01-01

    To assess the duration of improved exercise tolerance by metoprolol given in a new sustained-release formulation, 40 in-patients affected by stable exercise-induced angina pectoris received single-blind placebo in day 1 and thereafter, in double-blind cross-over once daily administration, metoprolol RETARD 100 mg and 200 mg in days 3 and 5. Symptom-limited cycloergometric exercise tests were performed at 3 and 24 hours after placebo and after each of the two doses of metoprolol RETARD. Duration of exercise, maximal workload and total work performed did significantly increase at 3 and 24 hours after metoprolol RETARD 100 mg (P less than 0.01) and 200 mg (P less than 0.01), without any significant difference between the two doses. Peak systolic arterial pressure and heart rate were lowered by metoprolol RETARD 200 mg at 3 (P less than 0.01) and 24 (P less than 0.01) hours, whereas only the peak heart rate at 3 hours was lowered (P less than 0.05) by the 100 mg dose. It is concluded that in patients with stable exercise-induced angina pectoris, metoprolol RETARD 200 mg appears to be able to increase exercise tolerance and to reduce exercise-induced myocardial oxygen consumption throughout 24 hours period. This may justify a once daily dosing schedule of the 200 mg dose, aimed at improving patient compliance. PMID:7343379

  2. Relationship of 24-hour ambulatory blood pressure and heart rate with markers of hepatic function in cirrhotic patients

    Stergiou George S

    2010-12-01

    Full Text Available Abstract Background There is evidence that in cirrhotic patients, certain hemodynamic parameters, such as blood pressure and heart rate, are related to the severity of liver disease. This study investigated whether non-invasive 24-hour ambulatory blood pressure and heart rate are more closely associated with markers of liver disease severity than conventional office measurements. Methods Ambulatory patients with cirrhosis underwent office blood pressure and heart rate measurements, 24-hour ambulatory blood pressure monitoring and blood laboratory tests. Results Fifty-one patients (32 men, mean age 57.4 ± 11.3 years completed the study. Twenty six patients had compensated liver cirrhosis (group A and 25 patients had more advanced liver disease (group B. Group A and B patients differed significantly both in ambulatory asleep diastolic blood pressure (p Conclusions Heart rate seems to be a more reliable marker of ongoing liver dysfunction than blood pressure. Evaluation of blood pressure and heart rate with 24-hour ambulatory measurement does not seem to offer more information than conventional office measurements.

  3. Geometric modeling, functional parameter calculation, and visualization of the in-vivo distended rectal wall

    Haider, Clifton R.; Manduca, Armando; Camp, Jon J.; Fletcher, Joel G.; Robb, Richard A.; Bharucha, Adil E.

    2006-03-01

    The rectum can distend to accommodate stool, and contracts in response to distention during defecation. Rectal motor dysfunctions are implicated in the pathophysiology of functional defecation disorders and fecal incontinence. These rectal motor functions can be studied by intra-luminal measurements of pressure by manometry, or combined with volume during rectal balloon distention. Pressure-volume (p-v) relationships provide a global index of rectal mechanical properties. However, balloon distention alone does not measure luminal radius or wall thickness, which are necessary to compute wall tension and stress respectively. It has been suggested that the elastic modulus, which is the linear slope of the stress-strain relationship, is a more accurate measure of wall stiffness. Also, measurements of compliance may not reflect differences in rectal diameter between subjects prior to inflation, and imaging is necessary to determine if, as has been suggested, rectal pressure-volume relationships are affected by extra-rectal structures. We have developed a technique to measure rectal stress:strain relationships in humans, by simultaneous magnetic resonance imaging (MRI) during rectal balloon distention. After a conditioning distention, a rectal balloon was distended with water from 0 to 400 ml in 50 ml steps, and imaged at each step with MRI. The fluid filled balloon was segmented from each volume, the phase-ordered binary volumes were transformed into a geometric characterization of the inflated rectal surface. Taken together with measurements of balloon pressure and of rectal wall thickness, this model of the rectal surface was used to calculate regional values of curvature, tension, strain, and stress for the rectum. In summary, this technique has the unique ability to non-invasively measure the rectal stress:strain relationship and also determine if rectal expansion is limited by extra-rectal structures. This functional information allows the direct clinical analysis

  4. Diazepam Rectal

    ... the syringe tip into the rectum until the rim is snug against the rectal opening. Slowly count ... Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

  5. Albuminuria Assessed From First-Morning-Void Urine Samples Versus 24-Hour Urine Collections as a Predictor of Cardiovascular Morbidity and Mortality

    Lambers Heerspink, Hiddo J.; Brantsma, Auke H.; de Zeeuw, Dick; Bakker, Stephan J. L.; de Jong, Paul E.; Gansevoort, Ron T.

    2008-01-01

    Screening for albuminuria has been advocated because it is associated with cardiovascular morbidity and all-cause mortality. The "gold standard" to assess albuminuria is 24-hour urinary albumin excretion (UAE). Because 24-hour urine collection is cumbersome, guidelines suggest measuring albuminuria

  6. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome

    Moulton, Eric; Amor-Sahli, Mélika; Perlbarg, Vincent; Pires, Christine; Crozier, Sophie; Galanaud, Damien; Valabregue, Romain; Yger, Marion; Baronnet-Chauvet, Flore; Samson, Yves; Dormont, Didier; Rosso, Charlotte

    2015-01-01

    Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD), axial (AD), and radial (RD) diffusivities values were calculated in different Regions-of-Interest (ROIs): (1) the white matter underlying the precentral gyrus (M1), (2) the corona radiata (CoRad), (3) the posterior limb of the internal capsule (PLIC) and (4) the cerebral peduncles (CP). NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS) at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD) was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage. PMID:26562509

  7. Angiotensin-converting enzyme gene I/D genotype affected metoprolol-induced reduction in 24-hour average heart rate

    LIU Li-wei; LIU Hong; CHEN Guo-liang; HUANG Yi-ling; HAN Lu-lu; XU Zhi-min; JIANG Xiong-jing; LI Yi-shi

    2010-01-01

    Background Genetic factors can influence antihypertensive response to metoprolol, and many studies focused on the relationship between the genotype in β1-adrenergic receptor and blood pressure (BP), little was known about the association of angiotensin-converting enzyme (ACE) genotype with the therapeutic result of metoprolol. The present study aimed to investigate whether the ACE gene insertion (I) / deletion (D) polymorphism Is related to the response to metoprolol in Chinese Han hypertensive patients.Methods Ninety-six patients with essential hypertension received metoprolol (100 mg once daily) as monotherapy for 8 weeks. Twenty-four hours ambulatory blood pressure monitoring and dynamic electrocardiogram were performed before and after treatment. Genotyping analysis was performed using PCR. The association of the ACE gene I/D polymorphism with variations in BP and heart rate (HR) was observed after the 8-week treatment.Results The patients with ACE gene II polymorphism showed greater reduction in 24-hour average HR than those with ID or DD polymorphisms (P=0.045), no effect of this genotype on the reduction in seating HR or in BP was observed. After adjusting for age, gender, body mass index, BP and HR at baseline, the ACE gene I/D polymorphism was still an independent predictor for variations in 24-hour average HR.Conclusions The II polymorphism in ACE gene could be a candidate predictor for greater reduction in 24-hour average HR in Chinese Han hypertensive patients treated by metoprolol. Greater benefits would be obtained by patients with II polymorphism from the treatment with metoprolol. Larger studies are warranted to validate this finding.

  8. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome.

    Eric Moulton

    Full Text Available Fractional anisotropy (FA is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD, axial (AD, and radial (RD diffusivities values were calculated in different Regions-of-Interest (ROIs: (1 the white matter underlying the precentral gyrus (M1, (2 the corona radiata (CoRad, (3 the posterior limb of the internal capsule (PLIC and (4 the cerebral peduncles (CP. NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage.

  9. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome.

    Moulton, Eric; Amor-Sahli, Mélika; Perlbarg, Vincent; Pires, Christine; Crozier, Sophie; Galanaud, Damien; Valabregue, Romain; Yger, Marion; Baronnet-Chauvet, Flore; Samson, Yves; Dormont, Didier; Rosso, Charlotte

    2015-01-01

    Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD), axial (AD), and radial (RD) diffusivities values were calculated in different Regions-of-Interest (ROIs): (1) the white matter underlying the precentral gyrus (M1), (2) the corona radiata (CoRad), (3) the posterior limb of the internal capsule (PLIC) and (4) the cerebral peduncles (CP). NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS) at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD) was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage. PMID:26562509

  10. Self-Renewal and Differentiation Capacity of Urine-Derived Stem Cells after Urine Preservation for 24 Hours

    Lang, Ren; Liu, Guihua; Shi, Yingai; Bharadwaj, Shantaram; Leng, Xiaoyan; Zhou, Xiaobo; Liu, Hong; Atala, Anthony; Zhang, Yuanyuan

    2013-01-01

    Despite successful approaches to preserve organs, tissues, and isolated cells, the maintenance of stem cell viability and function in body fluids during storage for cell distribution and transportation remains unexplored. The aim of this study was to characterize urine-derived stem cells (USCs) after optimal preservation of urine specimens for up to 24 hours. A total of 415 urine specimens were collected from 12 healthy men (age range 20–54 years old). About 6×104 cells shed off from the urin...

  11. A randomized, controlled trial to assess short-term black pepper consumption on 24-hour energy expenditure and substrate utilization

    Annalouise O’Connor; Corbin, Karen D.; Nieman, David C.; Swick, Andrew G.

    2013-01-01

    ABSTRACTBackground: Thermogenic ingredients may play a role in weight management. In vitro and rodent work suggests that components of black pepper may impact energy expenditure, and in humans, other TPRV1 agonists e.g. capsaicin, augment EE. Objectives: To determine the impact of BP on 24-hour EE, respiratory quotient, and biochemical markers of metabolism and satiety, a randomized, controlled, cross-over study of black pepper (0.5mg/meal) versus no pepper control was conducted in post-menop...

  12. QTc interval prolongation in HIV-infected patients: a case–control study by 24-hour Holter ECG recording

    Fiorentini Alessandra

    2012-12-01

    Full Text Available Abstract Background Aim of the study was to assess QTc interval by a 24-hour ECG recording in a group of HIV-infected individuals with a basal prolonged QTc. The risk factors associated with QTc prolongation and the indices of cardiovascular autonomic control were also evaluated. Methods A case–control study was performed using as cases 32 HIV-infected patients with prolonged (>440 msec QTc interval as assessed by Holter ECG, and as controls 64 HIV-infected subjects with normal QTc interval. Autonomic function was evaluated by heart rate variability analysis during 24-hour recording. Results Duration of HIV disease was significantly longer among cases than among controls (p=0.04. Waist/hip ratio was also higher among cases than among controls (p=0.05. Frequency domain analysis showed the absence of physiologic decrease of low frequency (LF in the night period in both cases and controls. The LF night in cases showed a statistically significant reduction when compared with controls (p=0.007. Conclusions In our study group, QTc interval prolongation was associated with a longer duration of HIV infection and with a greater waist/hip ratio. HIV patients with QTc interval prolongation and with a longer duration of HIV infection were more likely to have an impairment of parasympathetic and sympathetic cardiac component.

  13. A randomized, controlled trial to assess short-term black pepper consumption on 24-hour energy expenditure and substrate utilization

    Annalouise O’Connor

    2013-10-01

    Full Text Available ABSTRACTBackground: Thermogenic ingredients may play a role in weight management. In vitro and rodent work suggests that components of black pepper may impact energy expenditure, and in humans, other TPRV1 agonists e.g. capsaicin, augment EE. Objectives: To determine the impact of BP on 24-hour EE, respiratory quotient, and biochemical markers of metabolism and satiety, a randomized, controlled, cross-over study of black pepper (0.5mg/meal versus no pepper control was conducted in post-menopausal women. Subjects spent two 24-hour periods in a whole room indirect calorimeter. Results: Post-meal glucose, insulin, gut peptides and catecholamines were measured. Energy expenditure, respiratory quotient, or biochemical markers assessed did not differ significantly between the black pepper and no pepper control study days. Conclusions: Our findings do not support a role for black pepper in modulating energy expenditure in overweight postmenopausal women. Future work targeting alternative populations, administering black pepper in the fasted state, or in combination with other spices, may reveal the thermogenic effect of this spice.Trial registration: This trial was registered at clinicaltrials.gov (NCT01729143.Key words: Black pepper, piperine, energy expenditure, metabolic chamber

  14. Urine 24-hour volume

    ... test results: Dehydration Any type of x-ray exam with dye (contrast material) within 3 days before the urine test Fluid from the vagina that gets into the urine Emotional stress Heavy exercise Urinary tract infection

  15. 24-hour urine protein

    ... of fluid (dehydration) Any type of x-ray exam with dye (contrast material) within 3 days before the urine test Fluid from the vagina that gets into the urine Severe emotional stress Strenuous exercise Urinary tract infection

  16. Oesophageal motility and gastro-oesophageal reflux before and after healing of reflux oesophagitis. A study using 24 hour ambulatory pH and pressure monitoring.

    Timmer, R.; Breumelhof, R; Nadorp, J H; Smout, A.J.

    1994-01-01

    In this study 24 hour oesophageal pH and pressure monitoring was used to assess oesophageal motility and acid clearance in 27 patients with reflux oesophagitis (Savary-Miller grades I-IV), before and after healing of oesophagitis. After the first 24 hour study patients were treated with omeprazole 40 mg for 8-24 weeks. After endoscopically verified healing and withdrawing omeprazole for four days 24 hour monitoring was repeated. A total of 106,630 pressure events was analysed. No significant ...

  17. Comparison between Preoperative Rectal Diclofenac Plus Paracetamol and Diclofenac Alone for PostoperativePain of Hysterectomy.

    Saghar Samimi Sede

    2014-09-01

    Full Text Available To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy.Ninety female patients (American Society of Anesthesiologists (ASA physical status I-II, scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8, 16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A 10 cm visual analog scale (VAS was used to assess pain intensity at rest.In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower (13.9 ± 2.7 mg compared to diclofenac group (16.8± 2.8 mg and placebo group (20.1 ± 3.6 mg (p<0.05. VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours (p<0.05. There had been a significant difference between combination group and the two other groups in terms of the first request of morphine (p<0.05.According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone.

  18. The problem of the enhanced specific locus mutation yield in the mouse after 24 hours' dose fractionation

    In irradiation of mouse spermatogonia, split doses with 24 hours between fractions give a higher yield of specific locus mutations than the whole dose given at once, or if the fractions are given many weeks apart. The enhancement of the challenging dose efficiency is 2.5 - 3.1 for a 500 R conditioning exposure and 1.7 for a 100 R conditioning exposure, the calculation being made on the assumption of a linearly decreasing efficiency of the conditioning dose with dose. Roughly, 24 hrs fractionation of a given dose leads to twice as many mutations as would be expected on the basis of extrapolation from lower doses. The mechanism behind the enhancement is still poorly understood. However, the enhancement may mean that under given conditions, genetic damage from radiation may be 2 - 3 times greater than commonly reckoned

  19. A 24-hour Approach to the Study of Health Behaviors: Temporal Relationships between Waking Health Behaviors and Sleep

    Irish, Leah A.; Kline, Christopher E.; Rothenberger, Scott D.; Krafty, Robert T.; Buysse, Daniel J.; Kravitz, Howard M.; Bromberger, Joyce T.; Zheng, Huiyong; Hall, Martica H.

    2013-01-01

    Background Although sleep is often associated with waking health behaviors (WHB) such as alcohol consumption, caffeine use, smoking, and exercise, the causal direction of these relationships is unclear. Purpose The present study used time-series data to examine the temporal dynamics of WHB and sleep characteristics in participants of the SWAN Sleep Study. Methods 303 women completed daily assessments of WHB and wore wrist actigraphs to measure sleep characteristics for the duration of the study (Mean=29.42 days, SD=6.71). Results Vector autoregressive modeling revealed that weekly patterns of sleep and WHB best predicted subsequent sleep and WHB, suggesting that the associations between WHB and sleep persist beyond their immediate influence. Some WHB predicted some subsequent sleep characteristics, but sleep did not predict subsequent WHB. Conclusions These novel findings provide insight into the temporal dynamics of 24-hour behaviors and encourage consideration of both sleep and WHB in health promotion and behavior change efforts. PMID:24043549

  20. Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

    Siriphuwanun V

    2014-09-01

    Full Text Available Visith Siriphuwanun,1 Yodying Punjasawadwong,1 Worawut Lapisatepun,1 Somrat Charuluxananan,2 Ketchada Uerpairojkit2 1Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Mueang District, Chiang Mai, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Purpose: To determine the incidence of and factors associated with perioperative cardiac arrest within 24 hours of receiving anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the ethical committee of Maharaj Nakorn Chiang Mai Hospital, Thailand. We reviewed the data of 44,339 patients receiving anesthesia for emergency surgery during the period from January 1, 2003 to March 31, 2011. The data included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA physical status classification, anesthesia information, location of anesthesia performed, and outcomes. Data of patients who had received topical anesthesia or monitoring anesthesia care were excluded. Factors associated with cardiac arrest were identified by univariate analyses. Multiple regressions for the risk ratio (RR and 95% confidence intervals (CI were used to determine the strength of factors associated with cardiac arrest. A forward stepwise algorithm was chosen at a P-value <0.05. Results: The incidence (within 24 hours of perioperative cardiac arrest in patients receiving anesthesia for emergency surgery was 163 per 10,000. Factors associated with 24-hour perioperative cardiac arrest in emergency surgery were age of 2 years or younger (RR =1.46, CI =1.03–2.08, P=0.036, ASA physical status classification of 3–4 (RR =5.84, CI =4.20–8.12, P<0.001 and 5–6 (RR =33.98, CI =23.09–49.98, P<0.001, the anatomic site of surgery (upper intra-abdominal, RR =2.67, CI =2.14–3.33, P<0.001; intracranial, RR =1.74, CI =1.35–2.25, P<0.001; intrathoracic, RR =2.35, CI =1.70–3

  1. Design, Implementation and Simulation of 12/24 Hours Digital Clock With Stop Watch and Date Indicator

    G.S.M. Galadanci

    2014-08-01

    Full Text Available In this paper thedesign, implementation and simulation of a digital clock capable of displaying seconds, minutes and 12 or 24 hours timing, with a date indicator that display days ,months and years including a stop watch is presented. The architectural design was carried out using synchronous decade counters and logic gates. The basic clock frequency signal (in hertz that drives the clock was generated using a clock voltage source of the simulator for frequency division of the desired clock pulse. The digital clock circuit was implemented and simulated using national instrument electronic work bench (multism software version 13.0 on personal computer (PC. The result of the simulation showed that the designed clock and stop watch gives an approximate timing count, comparable to different existing digital clocks/stop watch with percentage error of 0.0033%.

  2. Intracranial Pressure Elevation 24 Hours after Ischemic Stroke in Aged Rats is Prevented by Early, Short Hypothermia Treatment

    Lucy Anne Murtha

    2016-05-01

    Full Text Available Stroke is predominantly a senescent disease, yet most preclinical studies investigate treatment in young animals. We recently demonstrated that short-duration hypothermia-treatment completely prevented the dramatic intracranial pressure (ICP rise seen post-stroke in young rats. Here, our aim was to investigate whether a similar ICP rise occurs in aged rats and to determine whether short-duration hypothermia is an effective treatment in aged animals. Experimental Middle Cerebral Artery occlusion (MCAo - 3 hour occlusion was performed on male Wistar rats aged 19-20 months. At one hour after stroke-onset, rats were randomized to 2.5 hours hypothermia-treatment (32.5 °C or normothermia (37 °C. ICP was monitored at baseline, for 3.5 hours post-occlusion, and at 24 hours post-stroke. Infarct and edema volumes were calculated from histology. Baseline pre-stroke ICP was 11.2 ± 3.3 mmHg across all animals. Twenty-four hours post-stroke, ICP was significantly higher in normothermic animals compared to hypothermia-treated animals (27.4 ± 18.2 mmHg vs. 8.0 ± 5.0 mmHg, p = 0.03. Infarct and edema volumes were not significantly different between groups. These data demonstrate ICP may also increase 24 hours post-stroke in aged rats, and that short-duration hypothermia treatment has a profound and sustained preventative effect. These findings may have important implications for the use of hypothermia in clinical trials of aged stroke patients.

  3. Biomechanical evaluation of three fixation modalities for preperitoneal inguinal hernia repair: a 24-hour postoperative study in pigs

    Guérin G

    2014-12-01

    Full Text Available Gaëtan Guérin, Xavier Bourges, Frédéric Turquier Covidien-Surgical Solutions, Research and Development, Trévoux, France Purpose: Tacks and sutures ensure a strong fixation of meshes, but they can be associated with pain and discomfort. Less invasive methods are now available. Three fixation modalities were compared: the ProGrip™ laparoscopic self-fixating mesh; the fibrin glue Tisseel™ with Bard™ Soft Mesh; and the SorbaFix™ absorbable fixation system with Bard™ Soft Mesh. Materials and methods: Meshes (6 cm ×6 cm were implanted in the preperitoneal space of swine. Samples were explanted 24 hours after surgery. Centered defects were created, and samples (either ten or eleven per fixation type were loaded in a pressure chamber. For each sample, the pressure, the mesh displacement through the defect, and the measurements of the contact area were recorded. Results: At all pressures tested, the ProGrip™ laparoscopic self-fixating mesh both exhibited a significantly lower displacement through the defect and retained a significantly higher percentage of its initial contact area than either the Bard™ Soft Mesh with Tisseel™ system or the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system. Dislocations occurred with the Bard™ Soft Mesh with Tisseel™ system and with the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system at physiological pressure (<225 mmHg. No dislocation was recorded for the ProGrip™ laparoscopic self-fixating mesh. Conclusion: At 24 hours after implantation, the mechanical fixation of the ProGrip™ laparoscopic self-fixating mesh was found to be significantly better than the fixation of the Tisseel™ system or the SorbaFix™ absorbable fixation system. Keywords: hernia, mesh, fixation, ProGrip™ laparoscopic self-fixating mesh

  4. 24-HOUR ARTERIAL STIFFNESS VALUES IN MEN WITH DIFFERENT PHENOTYPES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCURRENT WITH HYPERTENSION

    N. A. Karoli

    2015-01-01

    Full Text Available Objective: to study the specific features of the daily arterial stiffness (AS profile in men with different phenotypes of chronic obstructive pulmonary disease (COPD concurrent with hypertension. Subjects and methods. The investigation enrolled 78 male patients with COPD and hypertension. The patients were divided according to COPD phenotypes into 2 groups: 1 COPD patients with emphysema; 2 those with bronchitis. The exclusion criteria were less than 40 years and more than 80 years of age; diabetes mellitus; coronary heart disease; vascular diseases; an exacerbation of chronic diseases; bronchial and pulmonary diseases of another etiology. The patients underwent 24-hour blood pressure and AS monitoring, external respiratory function testing: spirography with a short-acting β2-agonist test, a six-minute walk test at baseline and after a hemoglobin oxygen saturation test, and a CAT test. Results. The patients of both groups were observed to have a statistically significant increase in (dP/dtmax as compared to those of the control group (p < 0.05; p < 0.01 in both the daytime and nighttime. In these periods, the COPD patients with emphysema had a higher AIx than those with bronchitis (p < 0.001. There was a statistically significantly (p < 0.001 higher AIx in the nighttime than in the daytime in Groups 1 and 2 patients. Conclusion. The patients with different COPD phenotypes were noted to have impaired arterial elastic properties, circadian AS changes with predominantly nocturnal impaired vascular stiffness. Relationships were found between 24-hour AS values and clinicoanamnestic findings. 

  5. Bisacodyl Rectal

    Rectal bisacodyl is used on a short-term basis to treat constipation. It also is used to empty the bowels before surgery and certain medical procedures. Bisacodyl is in a class of medications called stimulant laxatives. It works by increasing activity of the intestines ...

  6. Radiological demonstration of gastroesophageal reflux. Diagnostic value of barium and bread studies compared with 24-hour pH monitoring

    Purpose: To correlate gastroesophageal reflux (GER), demonstrated by a radiological method using food, with the reflux events, as determined by 24-h pH monitoring. Material and Methods: One hundred and seventeen patients with a median age of 47 years (86 male and 31 female) were examinated. In the supine left position, the patient consumed 360 ml of barium contrast. Fluoroscopy was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver pate and barium. The test was positive if barium was observed ≥5 cm proximal to the gastroesophageal junction. An antimony pH-probe was placed 5 cm above the lower esophageal sphincter, previously determined by manometry. The position was controlled by radiography after positioning and before removal. The total time of esophageal pH<4 exceeding 5.0% was considered pathological. Results: The radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring. Conclusion: The high specificity of this radiological method justify direct therapeutic consequence of a positive test. However, a negative test still renders the problem unsolved. (orig.)

  7. Radiological demonstration of gastroesophageal reflux. Diagnostic value of barium and bread studies compared with 24-hour pH monitoring

    To correlate gastroesophageal reflux (GER), demonstrated by a radiological method using food, with the reflux events, as determined by 24-h pH monitoring. One hundred and seventeen patients with a median age of 47 years (86 male and 31 female) were examined. In the supine left position, the patient consumed 360 ml of barium contrast. Fluoroscopy was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver pate and barium. The test was positive if barium was observed >= 5 cm proximal to the gastroesophageal junction. An antimony pH-probe was placed 5 cm above the lower esophageal sphincter, previously determined by manometry. The position was controlled by radiography after positioning and before removal. The total time of esophageal pH<4 exceeding 5.0% was considered pathological. The radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring. The high specificity of this radiological method justify direct therapeutic consequence of a positive test. However, a negative test still renders the problem unsolved

  8. Systematic comparison of conventional oesophageal manometry with oesophageal motility while eating bread.

    Howard, P J; Maher, L; Pryde, A; Heading, R C

    1991-01-01

    Conventional oesophageal manometry is seldom accompanied by symptoms and may indeed be normal in patients with a history of dysphagia. We have recently shown that oesophageal manometry during eating may be helpful in the evaluation of patients with dysphagia but there has been little systematic comparison of fed oesophageal motor patterns with conventional clinical manometry. Oesophageal manometry in response to water swallows and during eating was therefore examined in 58 consecutive patient...

  9. Accuracy of children's school-breakfast reports and school-lunch reports (in 24-hour dietary recalls) differs by retention interval

    Baxter, Suzanne Domel; Guinn, Caroline H; Royer, Julie A.; Hardin, James W.; Mackelprang, Alyssa J.; Smith, Albert F.

    2009-01-01

    Background/Objectives Validation-study data were analyzed to investigate the effect of retention interval (time between the to-be-reported meal and interview) on accuracy of children's school-breakfast reports and school-lunch reports in 24-hour recalls, and to compare accuracy of children's school-breakfast reports for two breakfast locations (classroom; cafeteria). Subjects/Methods Each of 374 fourth-grade children was interviewed to obtain a 24-hour recall using one of six conditions from ...

  10. Screening for proteinuria in a rheumatology clinic: comparison of dipstick testing, 24 hour urine quantitative protein, and protein/creatinine ratio in random urine samples.

    Ralston, S. H.; Caine, N; Richards, I; O'REILLY, D; Sturrock, R D; Capell, H A

    1988-01-01

    Measurements of protein/creatinine ratio in 'spot' urine samples were compared with measurements of 24 hour quantitative proteinuria and side room 'dipstick' testing in 104 samples from 90 patients presenting consecutively to a rheumatology unit. Linear regression analysis showed a highly significant correlation between the random urinary protein/creatinine ratio and total protein excretion in 24 hour urine samples (r = 0.92, p less than 0.001, y = 6.55x + 0.04). Although an approximation of ...

  11. Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study

    Stefano Omboni; Posokhov, Igor N.; Rogoza, Anatoly N

    2015-01-01

    Objective. Central blood pressure (BP) and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings. Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed. Re...

  12. Comparison of the effects of bimatoprost and a fixed combination of latanoprost and timolol on 24-hour blood and ocular perfusion pressures: the results of a randomized trial

    Rossetti, Luca; Sacchi, Matteo; Karabatsas, Costas H; Topouzis, Fotis; Vetrugno, Michele; Centofanti, Marco; Boehm, Andreas; Vorwerk, Christian; Goldblum, David; Fogagnolo, Paolo

    2015-01-01

    Background To compare the effect of bimatoprost and the fixed combination latanoprost-timolol (LTFC) on 24-hour systolic (SBP) and diastolic (DBP) blood pressure and on 24-hour ocular perfusion pressure (OPP). Methods 200 patients with glaucoma or ocular hypertension, controlled on the unfixed combination of latanoprost and timolol or eligible for dual therapy being not being fully controlled on monotherapy were enrolled in a randomized, double-masked, placebo-controlled, multicentre clinical...

  13. Characterization of lymphocyte subsets over a 24-hour period in Pineal-Associated Lymphoid Tissue (PALT in the chicken

    McNulty John A

    2006-01-01

    Full Text Available Abstract Background Homeostatic trafficking of lymphocytes in the brain has important relevance to the understanding of CNS disease processes. The pineal gland of the chicken contains large accumulations of lymphocytes that suggest an important role related to homeostatic circadian neuro-immune interactions. The purpose of this initial study was to characterize the lymphocyte subsets in the pineal gland and quantitate the distribution and frequency of lymphocyte phenotypes at two time points over the 24-hour light:dark cycle. Results PALT comprised approximately 10% of the total pineal area. Image analysis of immunocytochemically stained sections showed that the majority of lymphocytes were CD3+ (80% with the remaining 20% comprising B-cells and monocytes (Bu-1+, which tended to distribute along the periphery of the PALT. T-cell subsets in PALT included CD4+ (75–80%, CD8+ (20–25%, TCRαβ/Vβ1+ (60%, and TCRγδ+ (15%. All of the T-cell phenotypes were commonly found within the interfollicular septa and follicles of the pineal gland. However, the ratios of CD8+/CD4+ and TCRγδ+/TCRαβ/Vβ1+ within the pineal tissue were each 1:1, in contrast to the PALT where the ratios of CD8+/CD4+ and TCRγδ+/TCRαβ/Vβ1+ each approximated 1:4. Bu-1+ cells were only rarely seen in the pineal interstitial spaces, but ramified Bu-1+ microglia/macrophages were common in the pineal follicles. Effects of the 24-h light:dark cycle on these lymphocyte-pineal interactions were suggested by an increase in the area of PALT, a decline in the density of TCRαβ/Vβ1+ cells, and a decline in the area density of Bu-1+ microglia at the light:dark interphase (1900 h compared to the dark:light interphase (0700 h. Conclusion The degree of lymphocyte infiltration in the pineal suggests novel mechanisms of neuro-immune interactions in this part of the brain. Our results further suggest that these interactions have a temporal component related to the 24-hour light

  14. Mean 24-hours sympathetic nervous system activity decreases during head-down tilted bed rest but not during microgravity

    Christensen, Nj; Heer, M.; Ivanova, K.; Norsk, P.

    Sympathetic nervous system activity is closely related to gravitational stress in ground based experiments. Thus a high activity is present in the standing-up position and a very low activity is observed during acute head-out water immersion. Adjustments in sympathetic activity are necessary to maintain a constant blood pressure during variations in venous return. Head-down tilted bed rest is applied as a model to simulate changes observed during microgravity. The aim of the present study was to test the hypothesis that mean 24-hours sympathetic activity was low and similar during space flight and in ground based observation obtained during long-term head-down tilted bed rest. Forearm venous plasma noradrenaline was measured by a radioenzymatic technique as an index of muscle sympathetic activity and thrombocyte noradrenaline and adrenaline were measured as indices of mean 24-hours sympathoadrenal activity. Previous results have indicated that thrombocyte noradrenaline level has a half-time of 2 days. Thus to reflect sympathetic activity during a specific experiment the study period must last for at least 6 days and a sample must be obtained within 12 hours after the experiment has ended. Ten normal healthy subjects were studied before and during a 14 days head-down tilted bed rest as well as during an ambulatory study period of a similar length. The whole experiment was repeated while the subjects were on a low calorie diet. Thrombocyte noradrenaline levels were studied in 4 cosmonauts before and within 12 hours after landing after more than 7 days in flight. Thrombocyte noradrenaline decreased markedly during the head-down tilted bed rest (pnoradrenaline decreased in the adaptation period but not during the intervention. During microgravity thrombocyte noradrenaline increased in four cosmonauts and the percentage changes were significantly different in cosmonauts and in subjects participating in the head down tilted bed rest study (170± 29% (Mean± SEM) vs. 57

  15. Effect of mitochondrial KATP channel on voltage-gated K+ channel in 24 hour-hypoxic human pulmonary artery smooth muscle cells

    WANG Tao; ZHANG Zhen-xiang; XU Yong-jian

    2005-01-01

    Background Hypoxic pulmonary hypertension (HPH) is initiated by inhibition of O2-sensitive, voltage-gated (Kv) channels in pulmonary arterial smooth muscle cells (PASMCs). The mechanism of hypoxic pulmonary hypertension has not yet been fully elucidated. The mitochondrial ATP-sensitive K+ channel (MitoKATP) is extremely sensitive to hypoxia, and is a decisive factor in the control of mitochondrial membrane potential (ΔΨm). This study investigated the changes of cell membrane potential and Kv channel in cultured human pulmonary artery smooth muscle cell (hPASMC) exposed to 24 hour-hypoxia, and explored the role of MitoKATP and ΔΨm in this condition.Results After exposure to diazoxide for 24 hours, the intensity of R-123 fluorescence in normoxic hPASMCs was significantly increased compared with control group (P<0.05), but there were no significant changes in these tests after the hPASMCs had been exposed to 5-HD for 24 hours. Twenty-four hour-hypoxia or 24 hour-hypoxia + diazoxide could markedly increase the intensity of R-123 fluorescence in hPASMC and the changes were more significant in 24 hour-hypoxia +diazoxide group than in 24 hour-hypoxia group (P<0.05) although 5-HD could partly weaken the effect of 24 hour-hypoxia on the intensity of R-123 fluorescence. After exposure to diazoxide for 24 hours, the cell membrane K+ currents and the expression of cell membrane Kv1.5 mRNA and protein in normoxic hPASMCs were significantly decreased compared with control group (P<0.05), but there were no significant changes in these tests after the hPASMCs had been exposed to 5-HD for 24 hours. Also, 24 hour-hypoxia or 24 hour-hypoxia + diazoxide decreased the cell membrane K+ currents and the expression of Kv1.5 mRNA and protein (P<0.05) but the changes were more significant in 24 hour-hypoxia + diazoxide group than in 24 hour-hypoxia group (P<0.05). Again, 5-HD could partly weaken the inhibitory effect of 24 hour-hypoxia on the cell membrane K+ currents and the expression

  16. 48. Can early 24 hours Holter monitoring predict obstructive coronary artery lesions in patients with low risk acute coronary syndrome?

    T. Taha

    2016-07-01

    Full Text Available Identification of patients at increased risk of death due to acute coronary syndrome (ACS can add to risk stratification and guide the next step in the management of those patients. Altered HRV has been associated with adverse outcomes in heart disease, but this has not been established in patients with acute chest pain.This study aimed to create a non-invasive, economical and risk-free method in the clinical evaluation and diagnosis of significant CAD among patients with unstable angina.Twenty-four-hour Holter recordings of 100 patients with ACS were initiated within 24 hours of admission at the emergency department; stress ECG was done for all patients while coronary angiography was done only for patients with abnormal stress test. Time domain, frequency domain, and nonlinear HRV were examined.The mean SDNN was statistically significantly lower in patients with abnormal stress test, many time and frequency domain HRV parameters was statistically lower in patients with significant coronary arteries obstruction. HRV measured close to the ACS onset may assist in risk stratification. HRV parameters may provide additional, incremental prognostic information to established assessment guidelines and possible early intervention in those patients.

  17. Hourly thermal load prediction for the next 24 hours by ARIMA, EWMA, LR and an artificial neural network

    Kawashima, Minoru [Shimizu Corp., Tokyo (Japan); Dorgan, C.E. [Dorgan Associates Inc., Madison, WI (United States); Mitchell, J.W. [Univ. of Wisconsin, Madison, WI (United States)

    1995-08-01

    Predicting the thermal load for the next 24 hours is essential for optimal control of heating, ventilating, and air conditioning (HVAC) systems that use thermal cool storage. It can be useful in minimizing costs and energy in nonstorage systems. A cooperative research project between a US. university and a Japanese corporation investigated four generally used prediction methods to examine the basic models with variations and to compare the accuracy of each model. A cooling and heating seasonal data set with known next-day weather was used to evaluate the accuracy of each prediction method. The results indicate that an artificial neural network (ANN) model produces the most accurate thermal load predictions. After the initial comparisons with a computer-generated data set, the ANN model was applied to two measured building loads from another research project. These sets included typical measurement noise related to continuous field monitoring. The predictions of the next-day cooling load using the ANN prediction model were close to the actual data, even when the next-day weather was forecast. This confirms that the ANN model has sufficient accuracy and is the correct method for practical utilization in HVAC system control, thermal storage optimal control, and load/demand management.

  18. A 24-Hour Global Campaign To Assess Precision Timing of the Millisecond Pulsar J1713+0747

    Dolch, T; Cordes, J M; Chatterjee, S; Bassa, C; Bhattacharyya, B; Champion, D J; Cognard, I; Crowter, K; Demorest, P B; Hessels, J W T; Janssen, G H; Jenet, F A; Jones, G; Jordan, C; Karuppusamy, R; Keith, M; Kondratiev, V I; Kramer, M; Lazarus, P; Lazio, T J W; Lee, K J; McLaughlin, M A; Roy, J; Shannon, R M; Stairs, I H; Stovall, K; Verbiest, J P W; Madison, D R; Palliyaguru, N; Perrodin, D; Ransom, S M; Stappers, B W; Zhu, W W; Dai, S; Desvignes, G; Guillemot, L; Liu, K; Lyne, A G; Perera, B B P; Petroff, E; Rankin, J M; Smits, R

    2014-01-01

    The radio millisecond pulsar J1713+0747 is regarded as one of the highest-precision clocks in the sky, and is regularly timed for the purpose of detecting gravitational waves. The International Pulsar Timing Array collaboration undertook a 24-hour global observation of PSR J1713+0747 in an effort to better quantify sources of timing noise in this pulsar, particularly on intermediate (1 - 24 hr) timescales. We observed the pulsar continuously over 24 hr with the Arecibo, Effelsberg, GMRT, Green Bank, LOFAR, Lovell, Nancay, Parkes, and WSRT radio telescopes. The combined pulse times-of-arrival presented here provide an estimate of what sources of timing noise, excluding DM variations, would be present as compared to an idealized root-N improvement in timing precision, where N is the number of pulses analyzed. In the case of this particular pulsar, we find that intrinsic pulse phase jitter dominates arrival time precision when the S/N of single pulses exceeds unity, as measured using the eight telescopes that ob...

  19. Dietary quality varies according to data collection instrument: a comparison between a food frequency questionnaire and 24-hour recall

    Paulo Rogério Melo Rodrigues

    2016-01-01

    Full Text Available Abstract The objective of this study was to assess the agreement between the Brazilian Healthy Eating Index – Revised (BHEI-R, estimated by a food frequency questionnaire (FFQ and multiple 24-hour recalls (24h-R. The Wilcoxon paired test, partial correlations (PC, intraclass correlation coefficient (ICC, and Bland-Altman method were used. The total BHEI-R scores and its components (“total fruits”, “whole fruits”, “total vegetables”, “integral cereals”, “saturated fat”, “sodium”, and “energy intake derived from solid fat, added sugar, and alcoholic beverages” were statistically different, with the ICC and PC indicating poor concordance and correlation. The mean concordance estimated for the total BHEI-R and its components varied from 68% for “integral cereals” to 147% for “whole fruits”. The suitable concordance limits were violated for most of the components of the BHEI-R. Poor concordance was observed between the BHEI-R estimated by the FFQ and by multiple 24h-R, which indicated a strong reliability of the BHEI-R on the instrument used to collect information on food consumption.

  20. Report from 24 hours reproductive health hotline in Shanghai:a preliminary analysis on first 9 months hotline data

    胡晓宇; 童传良; 陈军玲; 肖志琴; 程利南

    2002-01-01

    Objectives: To study reproductive health needs of Shanghai people, and to develop appropriate measures to meet their needs.Methods: Statistical analysis of 24 hours reproductive health hotline data 4,000 random sampled sex questions, comparing answers from differen t gender and different questions (sex questions vs other non-sex questions).Results: During the first 9 months a total of 44,216 calls wer e received by medical staff. The callers included various age groups (aged 12-7 8), different marital status, from Shanghai and outside. In total, the numbers o f men and women on hotline calls were almost same. The contents of the hotline c ounseling covered all aspects of reproductive health care; among them, the issue concerning male and female sex problems and prenatal and infant health care con stituted 26.5% and 34% respectively. Men asked questions about sex more frequent ly than women, whereas women asked questions more about baby care. Questions a bout sex problems were asked more often in the late evening until next early mor ning. Conclusions: Shanghai people showed higher needs in sexual heal th care, prenatal care and baby care. When they came across some related problem s or confusions, they would like to receive the professional instant counseling. Relevant health care programmes should be established in order to meet the fer tile-aged public's reproductive health needs.

  1. 24 Hour thallium is superior to nitrate augmented rest MIBI in demonstrating the true extent of myocardial ischemia

    Full text: The aims of this study was to compare 24 hour delayed rest Tl-201 SPECT (24hr Tl) and nitrate-augmented rest Tc-99m MIBI SPECT (GTN-MIBI) in detecting viable ischemic myocardium, and to document the significance of 24hr Tl demonstrated viable myocardium where GTN-MIBI and a stress MIBI pair shows a concordant fixed perfusion defect (FD). Retrospective review of 95 consecutive patients with a FD on a rest GTN-MIBI/stress MIBI SPECT pair who then underwent 24hr Tl. The gold standard was the composite clinical endpoint (CCE) of unstable angina/myocardial infarction/cardiac death in the 6 months following the imaging study, and also the rate of coronary revascularisation. Patients who demonstrated large or moderate extent of 24hr Tl uptake in the FD were considered to have GTN-MIBI underestimated ischemia (n=65); patients who demonstrated small amount or no 24hr Tl uptake in the FD were considered to have no GTN-MIBI underestimated ischemia (n=30). GTN-MIBI underestimates the true amount of myocardial ischemia when compared to 24hr Tl. In patients with a FD on a GTN-MIBI - stress MIBI pair consideration should be given to performing a 24hr Tl in order to unmask underestimated ischemic myocardium. Where such ischemia is unmasked, it is highly clinically important and carries a statistically significant adverse cardiac prognosis. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  2. Application of Classification Models to Pharyngeal High-Resolution Manometry

    Mielens, Jason D.; Hoffman, Matthew R.; Ciucci, Michelle R.; McCulloch, Timothy M.; Jiang, Jack J.

    2012-01-01

    Purpose: The authors present 3 methods of performing pattern recognition on spatiotemporal plots produced by pharyngeal high-resolution manometry (HRM). Method: Classification models, including the artificial neural networks (ANNs) multilayer perceptron (MLP) and learning vector quantization (LVQ), as well as support vector machines (SVM), were…

  3. Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

    Luciana Almeida Moreira da Paz Oliveira

    2015-06-01

    Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

  4. Effect of "no added salt diet" on blood pressure control and 24 hour urinary sodium excretion in mild to moderate hypertension

    Rahimi Rahim

    2007-11-01

    Full Text Available Abstract Background The incidence of Hypertension as a major cardiovascular threat is increasing. The best known diet for hypertensives is 'no added salt diet'. In this study we evaluated the effect of 'no added salt diet' on a hypertensive population with high dietary sodium intake by measuring 24 hour urinary sodium excretion. Methods In this single center randomized study 80 patients (60 cases and 20 controls not on any drug therapy for hypertension with mild to moderate hypertension were enrolled. 24 hour holter monitoring of BP and 24 hour urinary sodium excretion were measured before and after 6 weeks of 'no added salt diet'. Results There was no statistically significant difference between age, weight, sex, Hyperlipidemia, family history of hypertension, mean systolic and diastolic BP during the day and at night and mean urinary sodium excretion in 24 hour urine of case and control groups. Seventy eight percent of all patients had moderate to high salt intake. After 6 week of 'no added salt diet' systolic and diastolic BP significantly decreased during the day (mean decrease: 12.1/6.8 mmhg and at night (mean decrease: 11.1/5.9 mmhg which is statistically significant in comparison to control group (P 0.001 and 0.01. Urinary sodium excretion of 24 hour urine decreased by 37.1 meq/d ± 39,67 mg/dl in case group which is statistically significant in comparison to control group (p: 0.001. Only 36% of the patients, after no added salt diet, reached the pretreatment goal of 24 hour urinary sodium excretion of below 100 meq/dl (P:0.001. Conclusion Despite modest effect on dietary sodium restriction, no added salt diet significantly decreased systolic and diastolic BP and so it should be advised to every hypertensive patient. Trial Registration Clinicaltrial.govnumber NCT00491881

  5. Determination of the 24-hours survival of stored red cells beyond the legal duration (42 and 49 days). Value of a double labelling

    Red cell double labelling using chromium 51 and Tc 99m proved to be the good method for the measurement of 24-hour post-transfusion survival values of red cells stored at 40C. Satisfactory results were obtained with the preservative solution PAGGSS (Phosphate Adenine Guanosine Glucose Sorbitol Saline) for 42 and 49 days, and with ADSOL (Adenine Dextrose Saline Mannital) for 42 days. But for 49 days ADSOL does not maintain 24-hour post-transfusion survival of the cells at an acceptable level, 70 per cent, for this length of time

  6. Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

    Pieńkowska, Joanna; Gwoździewicz, Katarzyna; Skrobisz-Balandowska, Katarzyna; Marek, Iwona; Kostro, Justyna; Szurowska, Edyta; Studniarek, Michał

    2016-01-01

    Purpose Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. Material and Methods 79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4–6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. Results Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. Conclusions CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of

  7. A 24-hour temporal profile of in vivo brain and heart pet imaging reveals a nocturnal peak in brain 18F-fluorodeoxyglucose uptake.

    Daan R van der Veen

    Full Text Available Using positron emission tomography, we measured in vivo uptake of (18F-fluorodeoxyglucose (FDG in the brain and heart of C57Bl/6 mice at intervals across a 24-hour light-dark cycle. Our data describe a significant, high amplitude rhythm in FDG uptake throughout the whole brain, peaking at the mid-dark phase of the light-dark cycle, which is the active phase for nocturnal mice. Under these conditions, heart FDG uptake did not vary with time of day, but did show biological variation throughout the 24-hour period for measurements within the same mice. FDG uptake was scanned at different times of day within an individual mouse, and also compared to different times of day between individuals, showing both biological and technical reproducibility of the 24-hour pattern in FDG uptake. Regional analysis of brain FDG uptake revealed especially high amplitude rhythms in the olfactory bulb and cortex, while low amplitude rhythms were observed in the amygdala, brain stem and hypothalamus. Low amplitude 24-hour rhythms in regional FDG uptake may be due to multiple rhythms with different phases in a single brain structure, quenching some of the amplitude. Our data show that the whole brain exhibits significant, high amplitude daily variation in glucose uptake in living mice. Reports applying the 2-deoxy-D[(14C]-glucose method for the quantitative determination of the rates of local cerebral glucose utilization indicate only a small number of brain regions exhibiting a day versus night variation in glucose utilization. In contrast, our data show 24-hour patterns in glucose uptake in most of the brain regions examined, including several regions that do not show a difference in glucose utilization. Our data also emphasizes a methodological requirement of controlling for the time of day of scanning FDG uptake in the brain in both clinical and pre-clinical settings, and suggests waveform normalization of FDG measurements at different times of the day.

  8. The effect of long-term dexfenfluramine treatment on 24-hour energy expenditure in man. A double-blind placebo controlled study

    Breum, L; Astrup, A; Andersen, T;

    1990-01-01

    In order to investigate the effect of long-term treatment with dexfenfluramine (dF) on 24-hour energy expenditure (EE), 10 obese females were studied in a double-blind design. Shortly before and 4 weeks after cessation of a 13 months treatment period with either dF (30 mg/day) or placebo (PL) the...... C and at a humidity between 3 and 11 g/m3. Discontinuation of dF treatment did not change energy expenditure significantly from placebo, neither when expressed in kJ/kg lean body mass nor in kJ/kg body weight. After cessation of treatment total 24-hour EE decreased likewise nonsignificantly by 2...... differences. The conclusion is therefore that dF possesses no significant thermogenic effect during long-term administration in human obese subjects....

  9. Demand and characteristics of a psychiatric 24-hour emergency service performed by mandatory rotation of licensed psychiatrists in Swiss primary care

    Chmiel C; Rosemann T; Senn O

    2014-01-01

    Corinne Chmiel, Thomas Rosemann, Oliver SennInstitute of General Practice and Health Services Research, University of Zurich, Raemistrasse, Zurich, SwitzerlandBackground: To investigate characteristics of and satisfaction with psychiatric 24-hour emergency primary care performed by mandatory rotation of licensed psychiatrists as a viable baseline for possible reorganizational measures.Methods: This was a questionnaire-based cross-sectional study (November 2010–April 2011). The numbe...

  10. Effect of current and lifetime posttraumatic stress disorder on 24-hour urinary catecholamines and cortisol: results from the Mind Your Heart Study

    Wingenfeld, Katja; Whooley, Mary A.; Neylan, Thomas C.; Otte, Christian; Cohen, Beth E.

    2014-01-01

    Posttraumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular disease and several other chronic illnesses. Alterations in the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis in PTSD might contribute to these associations but findings regarding SNS and HPA activity in PTSD are heterogeneous. We measured 24-hour urinary catecholamines and cortisol in a large cohort of adult outpatients recruited from 2 Veterans Affairs medical cen...

  11. Capabilities of Cluster Analysis in Interpretation of 24-Hour Blood Pressure Monitoring Data in Patients with Arterial Hypertension and Left Ventricular Remodeling

    S.V. Samoyavcheva

    2015-12-01

    Full Text Available The aim of the investigation was to assess the potential of cluster analysis as an additional method of data analysis for 24-hour blood pressure monitoring (BPM in patients with both normal geometry and with various types and extents of remodeling of the left ventricle (LV. Materials and Methods. The investigation included 71 patients, ranging in age from 23 to 71. The inclusion criterion was significant arterial hypertension (AH, while exclusion criteria were symptomatic AH and severe co-morbidity. Body mass, height, waist measurement, body mass index, lipid profile, and glycemic level were determined for each subject in addition to carrying out echocardiography and conventional and cluster analysis of 24-hour BPM data of each. Results. In patient groups with different types of left ventricular hypertrophy (LVH, the conventional analysis demonstrated differences in the standard 24-hour BPM parameters. Development of concentric LVH is associated with the highest average day-time and average night-time blood pressure, pressure-induced loads and blood pressure variability. Eccentric LVH has a pathogenetic link to other factors and is formed under conditions of relatively low blood pressure. The use of cluster analysis allowed to reveal the increased occurrence of systolic-diastolic AH in concentric LVH, and isolated systolic AH and isolated diastolic AH in eccentric LVH. Conclusion. Such an integrated approach to the interpretation of 24-hour BPM results, comprising both conventional and cluster analysis, allows for objectification of the study results and reveals the significant features of AH in patients with different types of LV remodeling.

  12. New anthropometry-based age- and sex-specific reference values for urinary 24-hour creatinine excretion based on the adult Swiss population (epublish)

    Forni Ogna V.; Ogna A.; Vuistiner P.; Pruijm M.; Ponte B.; Ackermann D.; Gabutti L.; Vakilzadeh N.; Mohaupt M; Martin P.Y.; Guessous I.; Péchère-Bertschi A.; Paccaud F.; Bochud M; Burnier M

    2015-01-01

    Background Urinary creatinine excretion is used as a marker of completeness of timed urine collections, which are a keystone of several metabolic evaluations in clinical investigations and epidemiological surveys. The current reference values for 24-hour urinary creatinine excretion rely on observations performed in the 1960s and 1970s in relatively small and mostly selected groups, and may thus poorly fit to the present-day general European population. The aim of this study was to establish ...

  13. New anthropometry-based age- and sex-specific reference values for urinary 24-hour creatinine excretion based on the adult Swiss population

    Forni Ogna, Valentina; Ogna, Adam; Vuistiner, Philippe; Pruijm, Menno; Ponte, Belen; Ackermann, Daniel; Gabutti, Luca; Vakilzadeh, Nima; Mohaupt, Markus; Martin, Pierre-Yves; Guessous, Idris; Péchère-Bertschi, Antoinette; Paccaud, Fred; Bochud, Murielle; Burnier, Michel

    2015-01-01

    BACKGROUND:Urinary creatinine excretion is used as a marker of completeness of timed urine collections, which are a keystone of several metabolic evaluations in clinical investigations and epidemiological surveys. METHODS: We used data from two independent Swiss cross-sectional population-based studies with standardised 24-hour urinary collection and measured anthropometric variables. Only data from adults of European descent, with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.7...

  14. New anthropometry-based age- and sex-specific reference values for urinary 24-hour creatinine excretion based on the adult Swiss population.

    Forni Ogna, Valentina; Ogna, Adam; Vuistiner, Philippe; Pruijm, Menno; Ponte, Belen; Ackermann, Daniel; Gabutti, Luca; Vakilzadeh, Nima; Mohaupt, Markus; Martin, Pierre-Yves; Guessous, Idris; Péchère-Bertschi, Antoinette; Paccaud, Fred; Bochud, Murielle; Burnier, Michel

    2015-01-01

    BACKGROUND Urinary creatinine excretion is used as a marker of completeness of timed urine collections, which are a keystone of several metabolic evaluations in clinical investigations and epidemiological surveys. The current reference values for 24-hour urinary creatinine excretion rely on observations performed in the 1960s and 1970s in relatively small and mostly selected groups, and may thus poorly fit to the present-day general European population. The aim of this study was to establ...

  15. Challenges in converting an interviewer-administered food probe database to self-administration in the National Cancer Institute Automated Self-administered 24-Hour Recall (ASA24)

    Zimmerman, Thea Palmer; Hull, Stephen G.; McNutt, Suzanne; Mittl, Beth; Islam, Noemi; Guenther, Patricia M.; Thompson, Frances E; Potischman, Nancy A.; Subar, Amy F.

    2009-01-01

    The National Cancer Institute (NCI) is developing an automated, self-administered 24-hour dietary recall (ASA24) application to collect and code dietary intake data. The goal of the ASA24 development is to create a web-based dietary interview based on the US Department of Agriculture (USDA) Automated Multiple Pass Method (AMPM) instrument currently used in the National Health and Nutrition Examination Survey (NHANES). The ASA24 food list, detail probes, and portion probes were drawn from the ...

  16. Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

    Song, Suk Yun; Kang, Byung Chul; Rho, Kyung Min [Dept. of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2011-05-15

    To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 {+-} 0.7, which was significantly lower than that of group A, 8.2 {+-} 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 {+-} 59.5 mg in group A and 90.5 {+-} 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

  17. Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

    To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ± 0.7, which was significantly lower than that of group A, 8.2 ± 0.7 (p0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

  18. Inhaled steroid/long-acting β2 agonist combination products provide 24 hours improvement in lung function in adult asthmatic patients

    Langley Stephen

    2006-08-01

    Full Text Available Abstract Background The combination of inhaled corticosteroids (ICS and long-acting β2-agonists (LABA is recommended by treatment guidelines for the treatment of persistent asthma. Two such combination products, salmeterol/fluticasone propionate (SFC, Seretide™ GSK, UK and formoterol/budesonide (FBC, Symbicort™, AstraZeneca, UK are commercially available. Objectives The purpose of these studies was to evaluate and compare the duration of bronchodilation of both combination products up to 24 hours after a single dose. Methods Two randomised, double blind, placebo-controlled, crossover studies were performed. Study A was conducted in 33 asthmatic adults receiving 400–1200 mcg of budesonide or equivalent. Serial forced expiratory volume in one second (FEV1 was measured over 24 hours to determine the duration of effect of both SFC (50/100 mcg and FBC (4.5/160 mcg. Study B was conducted in 75 asthmatic adults receiving 800–1200 mcg of budesonide or equivalent and comprised a 4 week run-in of 400 mcg bd Becotide™ followed by 4 weeks treatment with either SFC 50/100 mcg bd or FBC 4.5/160 mcg bd taken in a cross-over manner. Serial 24-hour FEV1 was measured after the first dose and the last dose after each 4-weeks treatment period to determine the offset of action of each treatment. Results In study A, a single inhalation of SFC and FBC produced a sustained bronchodilation at 16 hours with an adjusted mean increase in FEV1 from pre-dose of 0.22 L (95% CI 0.19, 0.35 L for SFC and 0.25 L (95% CI 0.21, 0.37 L for FBC, which was significantly greater than placebo for both treatments (-0.05 L; p 1 from 2–24 hours post dose was -16.0 ml/hr for SFC and -14.2 ml/hr for FBC. The weighted mean AUC over 24 hours was 0.21 Lxmin and 0.22 Lxmin and mean change from pre-dose FEV1 at 12 hours was 0.21 L for SFC and 0.20 L for FBC respectively Conclusion Both SFC and FBC produced a similar sustained bronchodilator effect which was prolonged beyond 12 hours

  19. Relationship between blood pressure measurements recorded on patients' charts in family physicians' offices and subsequent 24 hour ambulatory blood pressure monitoring

    Birtwhistle Richard

    2004-03-01

    Full Text Available Abstract Background In most western countries 20% of adults have hypertension. Reports in the literature suggest that from 31 to 86% of treated patients are not at recommended target levels. However it is important to consider how we are determining whether targets are unmet and the degree to which they are unmet. Our underlying hypothesis is that white coat effect is partially responsible for the reported low rates of control of hypertension by primary care practitioners. Methods The study population consists of 1142 patients who are being assessed for enrolment in two community-based randomized controlled trials. Patients must have essential hypertension, be on antihypertensive medication, and must not have met their blood pressure targets. We are reporting on the proportion of patients who have not achieved target, and the degree to which they have not achieved their target. We also report on the mean daytime blood pressures on 24 hour ABPM and compare these to mean blood pressures found on the patients' charts. Results We identified 3284 patient charts of patients with hypertension. Of these, 1142 were determined to be "out of control" (did not achieve target and 436 agreed to undergo 24 hour ABPM for final determination of eligibility. Overwhelmingly (95.8% of the time it was the systolic blood pressure that was not under control. However, most of the patients who had not achieved target according to our criteria were within 10 mmHg of the recommended targets. Isolated systolic blood pressure was the best predictor of elevated mean daytime blood pressure on 24 hour ABPM. Conclusions At least 35% of patients had not achieved target blood pressure levels and this is primarily due to lack of control of systolic blood pressure. The best predictor of continuing hypertension on 24 hour ABPM was the mean systolic blood pressure on the patients chart. However, only 69% of patients who were uncontrolled according blood pressures recorded in the

  20. No association of skin-fold thicknesses and training with race performance in male ultra-endurance runners in a 24-hour run

    2011-01-01

    In male high-level long-distance runners over 10,000 m, a positive association between both the front thigh and medial calf skin-fold thickness and running performance has been demonstrated. It is assumed that the thickness of skin-folds of the lower limb is related to training in highly trained runners. We investigated in 22 male ultra-endurance runners in a 24-hour run the relationship between skin-fold thicknesses and race performance. The 22 runners achieved a total of 154 (47) km during ...

  1. Association between 24-hour urine sodium and potassium excretion and diet quality in six-year-old children: a cross sectional study

    Kristbjornsdottir Oddny K; Halldorsson Thorhallur I; Thorsdottir Inga; Gunnarsdottir Ingibjorg

    2012-01-01

    Abstract Background Limited data is available on sodium (Na) and potassium (K) intake in young children estimated by 24 hour (24h) excretion in urine. The aim was to assess 24h urinary excretion of Na and K in six-year-old children and its relationship with diet quality. Methods The study population was a subsample of a national dietary survey, including six-year-old children living in the greater Reykjavik area (n=76). Three day weighed food records were used to estimate diet quality. Diet q...

  2. Transient prolonged stunning by dipyridamole stress proved by post-stress (1 hour) and 24 hour Tc-99m-MIBI gated SPECT

    We performed 1st day Tc-99m-sestamibi gated SPECT with dipyridamole/rest Tl-201 SPECT and 2nd day 24 hour delay Tl-201 SPECT/rest Tc-99m-sestamibi gated SPECT in 27 patients with coronary artery disease (24) or having chest pain(3). Stress and rest Tc-99m-sestamibi gated SPECT was acquired at 60min post-injection. A 4-point scoring system (0 to 3 for normal to absent tracer uptake) for 17 segments was used. Wall motion was scored on another 4 point scale (0 to 3 for normal to dyskinesia) in the 1st day post-stress gated and the 2nd day rest gated SPECT. Post-stress gated SPECT showed wall motion abnormality in 94 segments (20%). Fifty-five segments among these 94 showed the same wall motion between post-stress and rest gated SPECT : i.e. 1-1 : 23 segment, 2-2 : 29 segments, 3-3 : 3 segments. Remaining 39 segments (41.5%) showed different wall motion between post-stress and rest Tc-99m-sestamibi gated SPECT. Twenty one segments with wall motion abnormality had normal perfusion (rest : 15 segments, 24 hour delay : 6 segments) at either rest or 24 hour delay. Fifteen among these 21 segments showed persistent post-stress and the 2nd day rest wall motion abnormality (persistent stunning). However, in 6 segments with prolonged (1 hour after stress) stunning, abnormal wall motion did improve in the 2nd day rest Tc-99m-sestamibi gated SPECT (transient prolonged stunning). These 6 segments had normal perfusion at rest (n=4) or at 24 hour delay (n=2). Post stress wall motions showed significantly higher scores in persistent stunning than in prolonged transient stunning (P value<0.05). It was concluded that we could find stunned myocardium with gated Tc-99m-sestamibi SPECT at either post-stress or rest and that some myocardial walls of post-stress 1 hour gated SPECT did not show truly rest wall motion. So, we should be cautious if we use post-stress Tc-99m-sestamibi wall motion to asses rest wall motion

  3. Sex and age-related differences in performance in a 24-hour ultra-cycling draft-legal event - a cross-sectional data analysis

    Pozzi, Lara; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald; Rüst, Christoph,

    2014-01-01

    International audience BackgroundThe purpose of this study was to examine the sex and age-related differences in performance in a draft-legal ultra-cycling event.MethodsAge-related changes in performance across years were investigated in the 24-hour draft-legal cycling event held in Schötz, Switzerland, between 2000 and 2011 using multi-level regression analyses including age, repeated participation and environmental temperatures as co-variables.ResultsFor all finishers, the age of peak cy...

  4. QT intervals and QT dispersion determined from a 12-lead 24-hour Holter recording in patients with coronary artery disease and patients with heart failure

    Hansen, S.; Rasmussen, V.; Torp-Pedersen, C.; Hansen, Stig Henrik Strange; Rasmussen, Verner; Torp-Pedersen, Christian; Jensen, Gorm Boje

    2008-01-01

    modes of lead selection was used: all 12-leads (QTdisp 12), only precordial leads (QTdisp 6), and one pair of preselected leads (QTdisp 2) in a 24-hour Holter recording every fourth hour each comprising 10 consecutive measurements in 54 healthy subjects, 29 patients with coronary artery disease (CAD...... QTdisp 12 (Mean +/- SD 33.13 +/- 14.86 ms; P < 0.05), whereas no circadian variation was observed in patients with MI (Mean +/- SD 40.35 +/- 18.80 ms; P = NS). CONCLUSIONS: Circadian variation of QT dispersion was detected in healthy subjects and in patients with uncomplicated CAD, but not in those who...

  5. «The world unplugged» and «24 Hours without Media» : media literacy to develop self-awareness regarding media

    Susan Moeller; Elia Powers; Jessica Roberts

    2012-01-01

    Across the globe, many students have easy and constant access to media, yet they often receive little or no instruction about the impact of their media consumption. This article outlines a «24 hours without media» exercise in accordance with the guidelines set in Module 7, Unit 1 of the UNESCO curriculum. In the fall of 2010, nearly 1,000 students from a dozen universities across five continents took part in «The World Unplugged» study. Researchers at the University of Maryland gathered stude...

  6. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion: The 2009-2011 Korea National Health and Nutrition Examination Survey.

    Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-03-01

    Although reducing dietary salt consumption is the most cost-effective strategy for preventing progression of cardiovascular and renal disease, policy-based approaches to monitor sodium intake accurately and the understanding factors associated with excessive sodium intake for the improvement of public health are lacking. We investigated factors associated with high sodium intake based on the estimated 24-hour urinary sodium excretion, using data from the 2009 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Among 21,199 adults (≥19 years of age) who participated in the 2009 to 2011 KNHANES, 18,000 participants (weighted n = 33,969,783) who completed urinary sodium and creatinine evaluations were analyzed in this study. The 24-hour urinary sodium excretion was estimated using Tanaka equation. The mean estimated 24-hour urinary sodium excretion level was 4349 (4286-4413) mg per day. Only 18.5% (weighted n = 6,298,481/3,396,973, unweighted n = 2898/18,000) of the study participants consumed less the 2000 mg sodium per day. Female gender (P intake ≥50 percentile (P obesity (P sodium intake, even after adjusting for potential confounders. Senior high school/college graduation in education and managers/professionals in occupation were associated with lower sodium intake (P sodium than those who were normotensive. However, those who receiving treatment for hypertension consumed less sodium than those who were normotensive (P sodium excretion. The logistic regression analysis for the highest estimated 24-hour urinary sodium excretion quartile (>6033 mg/day) using the abovementioned variables as covariates yielded identical results. Our data suggest that age, sex, education level, occupation, total energy intake, obesity, and hypertension management status are associated with excessive sodium intake in Korean adults using nationally representative data. Factors associated with high sodium intake should be considered in

  7. Prognostic factors for death and survival with or without complications in cardiac arrest patients receiving CPR within 24 hours of anesthesia for emergency surgery

    Siriphuwanun V

    2014-10-01

    Full Text Available Visith Siriphuwanun,1 Yodying Punjasawadwong,1 Worawut Lapisatepun,1 Somrat Charuluxananan,2 Ketchada Uerpairojkit2 1Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Purpose: To determine prognostic factors for death and survival with or without complications in cardiac arrest patients who received cardiopulmonary resuscitation (CPR within 24 hours of receiving anesthesia for emergency surgery. Patients and methods: A retrospective cohort study approved by the Maharaj Nakorn Chiang Mai University Hospital Ethical Committee. Data used were taken from records of 751 cardiac arrest patients who received their first CPR within 24 hours of anesthesia for emergency surgery between January 1, 2003 and October 31, 2011. The reviewed data included patient characteristics, surgical procedures, American Society of Anesthesiologist (ASA physical status classification, anesthesia information, the timing of cardiac arrest, CPR details, and outcomes at 24 hours after CPR. Univariate and polytomous logistic regression analyses were used to determine prognostic factors associated with the outcome variable. P-values of less than 0.05 were considered statistically significant. Results: The outcomes at 24 hours were death (638/751, 85.0%, survival with complications (73/751, 9.7%, and survival without complications (40/751, 5.3%. The prognostic factors associated with death were: age between 13–34 years (OR =3.08, 95% CI =1.03–9.19; ASA physical status three and higher (OR =6.60, 95% CI =2.17–20.13; precardiopulmonary comorbidity (OR =3.28, 95% CI =1.09–9.90; the condition of patients who were on mechanical ventilation prior to receiving anesthesia (OR =4.11, 95% CI =1.17–14.38; surgery in the upper abdominal site (OR =14.64, 95% CI =2.83–75.82; shock prior to cardiac arrest (OR =6.24, 95% CI =2.53–15

  8. Managing a 24-hour lifestyle

    This presentation on sleep deprivation highlighted the important factors that can increase the chances for human error because of lack of alertness. Effects that irregular work schedules have on the performance and alertness of employees were also discussed. Sleep deprivation and driver fatigue were listed as the major causes of single vehicle accidents. Alertness enhancing techniques, driving alertness management and other methods by which driver safety can be improved were presented. 22 diapositives

  9. Managing a 24-hour lifestyle

    Campbell, N. [Schlumberger Canada Ltd., Edmonton, AB (Canada)

    1997-07-01

    This presentation on sleep deprivation highlighted the important factors that can increase the chances for human error because of lack of alertness. Effects that irregular work schedules have on the performance and alertness of employees were also discussed. Sleep deprivation and driver fatigue were listed as the major causes of single vehicle accidents. Alertness enhancing techniques, driving alertness management and other methods by which driver safety can be improved were presented. 22 diapositives.

  10. 24 Hours of Meaty Torture

    Palesa; Temaswati; Mthethwa

    2011-01-01

    VEGETARIAN for a week! That was the plan.But it’s funny how side effects start kicking in so early when trying to let go of an everyday habit.The first morning of my experiment,I felt like I hadn’t eaten poultry in months(I had devoured a bucket of KFC the night before).Lunch was a disaster.I didn’t know whether to cook or spend an hour searching for a restaurant. That afternoon I received the worst phone call a first-time vegetarian can get:

  11. Estimate of the time-zero lung burden of depleted uranium in Gulf War veterans by the 24 hour urinary excretion and exponential decay analysis

    Aim: Significant presence of depleted uranium (DU) in the urine of British, Canadian, and United States veterans nine years after inhalational exposure in the Desert Storm conflict has been reported in the studies of DU urine analysis by mass spectrometry. The aim of this study is to report an estimate of the amount of DU in the respiratory system at the time of exposure from the quantitative current rate of daily excretion. Materials and Methods: Mass spectrometry (TIMS) analysis of 24-hour urinary excretion of the isotopes of DU in five positive (238U/235U > 191.00) and six negative (238U/235U o*e-bt). Substituting the half-life equation into the decay equation relates the initial DU concentration to the rate of excretion, total time, and an unknown decay constant (No = (dN/dt)*ebt/b). A minimum value for the biological half-life of ceramic DU oxide in the lungs was derived from the Batelle report of minimum dissolution time in simulated interstitial lung fluid corresponding to 3.85 years. The concentration of DU at time zero can also be determined by finding the minimum value of the function (No (dN/dt)*ebt/b) with respect to the biological half-life constant, thus estimating DU concentration at the time of exposure. Results: The average depleted uranium concentration was 3.27 x 10-5 mg / 24 hours in DU positive veterans and 1.80 x 10-8 in DU negative veterans. By the use of the Batelle report of the dissolution rate of ceramic uranium oxide in simulated interstitial lung fluid, the estimated lung burden was 0.336 mg in the DU positive and 0.0002 mg in the DU negative veterans. The absolute minimum concentration was 0.294 mg in the positive and 0.0002 in the DU negative veterans. Conclusion: Our work provides a model of estimating the minimum pulmonary concentration of DU at time zero by utilizing gravimetric and mass spectrometric data of the DU isotopes in 24-hour urinary samples and theoretical model of DU dissolution time in simulated interstitial lung fluid

  12. Relation between electromyography and anal manometry of the external anal sphincter.

    Sørensen, M; Tetzschner, T; Rasmussen, O O; Christiansen, J

    1991-01-01

    Thirteen patients with faecal incontinence and 26 control subjects were studied to investigate whether a quantitative electromyographic (EMG) signal could be correlated to anal manometry. Three different electrodes were used--a concentric needle electrode, a disposable sponge electrode, and a hard anal plug electrode. The maximum amplitude of the EMG recording was used as a quantitative parameter. Linear regression showed significant correlation between EMG and anal manometry with the sponge ...

  13. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study

    Pan CH

    2015-07-01

    Full Text Available Chih-Hong Pan,1,2,* Kai-Jen Chuang,3,4,* Jen-Kun Chen,5 Ta-Chih Hsiao,6 Ching-Huang Lai,2 Tim P Jones,7 Kelly A BéruBé,8 Gui-Bing Hong,9 Kin-Fai Ho,10,11 Hsiao-Chi Chuang12,13 1Institute of Occupational Safety and Health, Council of Labor Affairs, Executive Yuan, 2School of Public Health, National Defense Medical Center, 3School of Public Health, College of Public Health and Nutrition, 4Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, 6Graduate Institute of Environmental Engineering, National Central University, Taoyuan, Taiwan; 7School of Earth and Ocean Sciences, 8School of Biosciences, Cardiff University, Cardiff, Wales, UK; 9Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan; 10Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 11Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China; 12School of Respiratory Therapy, College of Medicine, 13Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan *These authors contributed equally to this work Abstract: Although zinc oxide nanoparticles (ZnONPs are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential

  14. Gfr estimation using 99mTc DTPA gates method for assessment of early diabetic nephropathy - a comparison with 24-hour creatinine clearance

    To correlate Gates glomerular filtration rate (GGFR) using technetium-99m diethylene triaminepentacetic acid (99mTc DTPA) with 24-hour creatinine clearance (CRCL) and to establish relationship with duration of diabetes in patients with early diabetic nephropathy. Study Design: A cross-sectional comparative study carried out in Nuclear Medical Centre from Aug 2009 to Jan 2010 at Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan. Patients and Methods: A total of eighty three subjects were enrolled, who were divided into three groups; group 1 comprised 31 normotensive diabetics, group 2 had 37 hypertensive diabetics while group 3 had 15 normal subjects. The DTPA GFR and creatinine clearance in healthy subjects as well as diabetic patients were compared using the unpaired student's t-test. The linear association between GFR, creatinine clearance and disease duration was expressed by Pearson's correlation coefficient 'r' along with their significance levels. Results: Gates GFR showed hyperfiltration in normotensive diabetics (96.6 +- 3.3 ml/min/1.73 m/sub 2/), significantly (p<0.05) higher than controls (85.5 +- 5 ml/min/1.73 m/sub 2/), whereas hypertensive diabetics had a significantly lower (p<0.05) Gates GFR (76.8 +- 3.7) than that of controls. Significant degree of correlation existed between GGFR and CRCL in hypertensive diabetics (p<0.05, r=0.716) and controls (r=0.546). Gates GFR also showed good correlation with duration of diabetes in both diabetic groups as compared to that of CRCL. GGFR also correlated well with duration of hypertension 0.37 (0.31-0.43) as compared to CRCL 0.155 (0.15-0.16) in all groups. Conclusions: The 99mTc-DTPA clearance correlates significantly with 24-hour creatinine clearance as well as with disease duration and can provide a simple and convenient index of kidney function in patients of early diabetic nephropathy. (author)

  15. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors

    Feza Y Karakayali

    2015-01-01

    Full Text Available Background: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. Materials and Methods: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. Results: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. Conclusion: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions.

  16. The effect of hysterectomy on ano-rectal physiology.

    Kelly, J L

    2012-02-03

    Hysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.

  17. Metabolic Engineering of Light and Dark Biochemical Pathways in Wild-Type and Mutant Strains of Synechocystis PCC 6803 for Maximal, 24-Hour Production of Hydrogen Gas

    Ely, Roger L.; Chaplen, Frank W.R.

    2014-03-11

    This project used the cyanobacterial species Synechocystis PCC 6803 to pursue two lines of inquiry, with each line addressing one of the two main factors affecting hydrogen (H2) production in Synechocystis PCC 6803: NADPH availability and O2 sensitivity. H2 production in Synechocystis PCC 6803 requires a very high NADPH:NADP+ ratio, that is, the NADP pool must be highly reduced, which can be problematic because several metabolic pathways potentially can act to raise or lower NADPH levels. Also, though the [NiFe]-hydrogenase in PCC 6803 is constitutively expressed, it is reversibly inactivated at very low O2 concentrations. Largely because of this O2 sensitivity and the requirement for high NADPH levels, a major portion of overall H2 production occurs under anoxic conditions in the dark, supported by breakdown of glycogen or other organic substrates accumulated during photosynthesis. Also, other factors, such as N or S limitation, pH changes, presence of other substances, or deletion of particular respiratory components, can affect light or dark H2 production. Therefore, in the first line of inquiry, under a number of culture conditions with wild type (WT) Synechocystis PCC 6803 cells and a mutant with impaired type I NADPH-dehydrogenase (NDH-1) function, we used H2 production profiling and metabolic flux analysis, with and without specific inhibitors, to examine systematically the pathways involved in light and dark H2 production. Results from this work provided rational bases for metabolic engineering to maximize photobiological H2 production on a 24-hour basis. In the second line of inquiry, we used site-directed mutagenesis to create mutants with hydrogenase enzymes exhibiting greater O2 tolerance. The research addressed the following four tasks: 1. Evaluate the effects of various culture conditions (N, S, or P limitation; light/dark; pH; exogenous organic carbon) on H2 production profiles of WT cells and an NDH-1 mutant; 2. Conduct metabolic flux analyses for

  18. Rectal culture (image)

    A rectal culture test is performed by inserting a cotton swab in the rectum. The swab is rotated gently, and withdrawn. A smear of the swab is placed in culture media to encourage the growth of microorganisms. The ...

  19. Understanding Minor Rectal Bleeding

    ... are the possible causes of minor rectal bleeding? Hemorrhoids Anal fissures Proctitis (inflammation of the rectum) Polyps ... can be cured if detected early. What are hemorrhoids? Hemorrhoids (also called piles) are swollen blood vessels ...

  20. Stages of Rectal Cancer

    ... Treatment Genetics of Colorectal Cancer Age and family history can affect the risk of rectal cancer. Anything ... to flow from the body to a collection bag. After the cancer is removed, the surgeon will ...

  1. A 24-hour dietary recall for assessing the intake pattern of choline among Bangladeshi pregnant women at their third trimester of pregnancy

    Shatabdi Goon

    2014-04-01

    Full Text Available Maternal choline intake during the third trimester of human pregnancy can modify systemic and local epigenetic marks in fetal-derived tissues, promoting better pregnancy outcomes, increased immunity, as well as improved mental and physical work capacity with proper memory and cognitive development. 103 pregnant women presenting to the antenatal care of Azimpur Maternity Hospital of Dhaka, Bangladesh in their third trimester of pregnancy were randomly selected for this cross sectional study exploring dietary intake patterns of choline. A dietary recall form was administered to estimate frequency and amount of food consumption of foods for the previous 24 hours. Most women reported diets that delivered less than the recommended choline intake (mean ± SD; 189.5 ± 98.2 providing only 42.72% of total RDA value. The results of this study may indicate that dietary choline among pregnant, Bangladeshi women may not be adequate to meet the needs of both, the mother and fetus. Further studies are warranted to determine clinical implications. Normal 0 false false false MicrosoftInternetExplorer4

  2. [Initial experience with anorectal manometry with the PC Polygraf apparatus in surgery].

    Slauf, P; Antos, F; Serclová, Z

    1997-03-01

    The authors present their initial experience with anal manometry using a PC Polygraph of Synectics Medical Co. They discuss the manometric examination of 14 patients with ulcerative colitis, incl. 12 who were operated. In all 12 patients an ilea-pouch-anal anastomosis was made. By manometry a postoperative drop of pressures at rest was found and partly also of pressures during muscular contraction as well as shortening of the zone of high anal pressure. The resulting values, however, did not influence continence, except for temporary soiling, the frequency of bowel movements being 2-8. Anal manometry is an important objective examination of the sphincter function as it makes it possible to compare values before and after therapy. It must be however combined with other anorectal physiological tests such as endosonography, EMG, defaecography etc. PMID:9229794

  3. "2001: A Space Odyssey" Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    Borowski, Stanley K.; Dudzinski, Leonard A.

    2001-01-01

    The prospects for "24 hour" commuter flights to the Moon. similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale. are examined using two near term. "high leverage" technologies-liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Iron-rich volcanic glass. or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow. has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat-essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller. more affordable. easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  4. 2001: A Space Odyssey Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    Borowski, Stanley; Dudzinski, Leonard A.

    2003-01-01

    The prospects for 24 hour commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, high leverage technologies: liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and lunar-derived oxygen (LUNOX) production. Iron-rich volcanic glass, or orange soil, discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4 percent oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an afterburner into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat, essentially scramjet propulsion in reverse. By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that big engine performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or in-line Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an expendable mode initially, to maximize delivered surface payload on each mission. The increased payload is

  5. "2001: A Space Odyssey" Revisited--The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners

    Borowski, Stanley K.; Dudzinski, Leonard A.

    1998-01-01

    The prospects for "24 hour" commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, "high leverage" technologies--liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Ironrich volcanic glass, or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way, LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging front the engine's choked sonic throat--essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  6. Association between 24-hour urine sodium and potassium excretion and diet quality in six-year-old children: a cross sectional study

    Kristbjornsdottir Oddny K

    2012-11-01

    Full Text Available Abstract Background Limited data is available on sodium (Na and potassium (K intake in young children estimated by 24 hour (24h excretion in urine. The aim was to assess 24h urinary excretion of Na and K in six-year-old children and its relationship with diet quality. Methods The study population was a subsample of a national dietary survey, including six-year-old children living in the greater Reykjavik area (n=76. Three day weighed food records were used to estimate diet quality. Diet quality was defined as adherence to the Icelandic food based dietary guidelines. Na and K excretion was analyzed from 24h urine collections. PABA check was used to validate completeness of urine collections. The associations between Na and K excretion and diet quality were estimated by linear regression, adjusting for gender and energy intake. Results Valid urine collections and diet registrations were provided by 58 children. Na and K excretion was, mean (SD, 1.64 (0.54 g Na/24h (approx. 4.1 g salt/24h and 1.22 (0.43 g K/24h. In covariate adjusted models Na excretion decreased by 0.16 g Na/24h (95% CI: 0.31, 0.06 per 1-unit increase in diet quality score (score range: 1–4 while K excretion was increased by 0.18 g K/24h (95% CI: 0.06, 0.29. Conclusions Na intake, estimated by 24h urinary excretion was on average higher than recommended. Increased diet quality was associated with lower Na excretion and higher K excretion in six-year-old children.

  7. Rectal bleeding in a 4-month-old boy

    A case of bleeding Meckel's diverticulum is described in an infant. A 4-month-old boy was seen initially with a 24-hour history of painless hematochezia. His parents had noted two episodes of maroon-colored stool that did not appear to be associated with any abdominal distress. His medical history was unremarkable, with normal growth and development. Physical examination revealed a well-nourished, well-hydrated infant in no apparent distress. Vital signs were normal. Rectal examination revealed no masses, but bright-red blood was noted on the examining finger. Findings from the remainder of the examination were normal. An upright roentgenogram of the abdomen was obtained and demonstrated no abnormalities. The abdominal technetium scan was abnormal. An exploratory laparotomy was performed later on the day of admission

  8. Post hemorrhoidectomy pain control: rectal Diclofenac versus Acetaminophen

    Rahimi M

    2009-03-01

    Full Text Available "nBackground: Anal surgeries are prevalent, but they didn't perform as outpatient surgeries because of concerns about postoperative pain. The aim of the present study was to compare the effects of rectal acetaminophen and diclofenac on postoperative analgesia after anal surgeries in adult patients. "nMethods: In a randomized, double-blinded, placebo-controlled study 60 ASA class I or II scheduled for haemorrhoidectomy, anal fissure or fistula repair, were randomized (with block randomization method to receive either a single dose of 650 mg rectal acetaminophen (n=20, 100 mg rectal diclofenac (n=20 or placebo suppositories (n=20 after the operation. The severity of pain, time to first request of analgesic agent after administration of suppositories and complications were compared between three groups. Pain scores were evaluated in patients by Visual Analogue Scale (VAS in 0 (after complete consciousness in recovery, 2, 4, 12 and 24 hours after surgery. The period between administration of the suppositories and the patients' first request to receive analgesic was compared between groups. "nResults: Pain scores were lower significantly in rectal diclofenac than the other groups. The period between administration of the suppositories and the patients' first request to receive analgesic in diclofenac group was 219±73 minutes, was significantly longer compared with placebo (153±47 minutes and acetaminophen (178±64 minutes groups. No complications were reported. "nConclusions: Diclofenac suppository is more effective than acetaminophen suppository in post hemorrhoidectomy pain management.

  9. Argon Plasma Coagulation Therapy Versus Topical Formalin for Intractable Rectal Bleeding and Anorectal Dysfunction After Radiation Therapy for Prostate Carcinoma

    Purpose: To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. Methods and Materials: Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ≥1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues–Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ≤25 mm, and no longer needing blood transfusions). Results: The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. Conclusions: Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction

  10. Effect of road transport for up to 24 hours followed by twenty-four hour recovery on live weight and physiological responses of bulls

    Prendiville Daniel J

    2010-07-01

    Full Text Available Abstract Background The transport of livestock can have major implications for their welfare, and there is strong public interest and scientific endeavour aimed at ensuring that the welfare of transported animals is optimal. The objective of the study was to investigate the effect of transport on live weight, physiological and haematological responses of bulls after road transport of 0, 6, 9, 12, 18 and 24 hours (h. Seventy-two Charolais bulls (mean weight (s.d. 367 (35 kg, naïve to transport, were randomly assigned to one of six journey (J times of 0 h, 6 h, 9 h, 12 h, 18 h and 24 h transport (n = 12 animals/treatment at a stocking density of 1.02 m2/bull. Blood samples were collected by jugular venipuncture before transport (-0.25 h, immediately after (0 h and at 1 h, 2 h, 4 h, 6 h, 8 h, 12 h and 24 h relative to time 0 h. The bulls were weighed before transport (- 24 h and - 0.25 h, immediately after (0 h, and at 4 h, 12 h and 24 h relative to time 0 h. Control animals were blood sampled before assignment (-0.25 h to novel pens, after (24 h, and at 1 h, 2 h, 4 h, 6 h, 8 h, 12 h and 24 h relative to the 24 h sampling time point. Results Bulls travelling for 6 h (280 km, 9 h (435 km, 12 h (582 km, 18 h (902 km and 24 h (1192 km lost 4.7, 4.5, 5.7 (P Conclusions Under the conditions of the present study, transport of bulls on journeys by road, ranging from 6 h (280 km to 24 h (1192 km duration, affected live weight, haematological and physiological measurements of metabolism and inflammation. Our findings showed that live weight and some physiological and haematological responses of bulls returned to pre-transport levels within 24 h with animals having had access to feed and water.

  11. Evaluation of the indications and arrhythmic patterns of 24 hour Holter electrocardiography among hypertensive and diabetic patients seen at OAUTHC, Ile-Ife Nigeria

    Adebayo RA

    2014-11-01

    Full Text Available Rasaaq A Adebayo,1 Amanze N Ikwu,1 Michael O Balogun,1 Anthony O Akintomide,1 Tuoyo O Mene-Afejuku,1 Victor O Adeyeye,1 Olaniyi J Bamikole,1 Luqman A Bisiriyu,2 Olufemi E Ajayi,1 Suraj A Ogunyemi,1 Omolola A Oketona1 1Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, 2Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria Background: There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogram (Holter ECG in the arrhythmic evaluation of hypertensive and diabetic patients. Objective: To evaluate indications, arrhythmic pattern of Holter ECG, and heart rate variability (HRV among patients with hypertensive heart disease (HHD with or without heart failure and type 2 diabetes mellitus (T2DM seen in our cardiac care unit. Methods: Seventy-nine patients (32 males and 47 females were studied consecutively over a year using Schiller type (MT-101 Holter ECG machine. Results: Out of the 79 patients, 17 (21.5% had HHD without heart failure, 33 (41.8% had HHD with hypertensive heart failure (HHF, while 29 (36.7% were T2DM patients. The mean (standard deviation ages of HHD without heart failure, HHF and T2DM patients were 59.65 (±14.38, 65.15 (±14.30, and 54.66 (±8.88 respectively. The commonest indication for Holter ECG was palpitation (38%, followed by syncope (20.3%. Premature ventricular contraction was the commonest arrhythmic pattern among the 79 patients, especially among HHF patients. The HRV, using standard deviation of all normal-normal intervals was significantly reduced in T2DM patients (81.03±26.33, confidence interval [CI] =71.02–91.05 compared to the HHD without heart failure (119.65±29.86, CI =104.30–135.00 and HHF (107.03±62.50, CI =84.00–129.19. There was a negative correlation between the duration of T2DM and HRV (r=−0.613. Conclusion: Palpitation was the commonest Holter ECG indication and

  12. Comparison of estimated energy intake from 2×24-hour recalls and a seven-day food record with objective measurements of energy expenditure in children

    Berit W. Rothausen

    2012-02-01

    Full Text Available The objective of the present study was to evaluate energy intake (EI estimated from two non-consecutive 24-hour recalls (24-HDRs and a pre-coded seven-day food record (7-dFR against objective measurements of energy expenditure (EE in children.A total of 67 7–8 year-olds and 64 12–13 year-olds completed the 2×24-HDRs, the 7-dFR, and wore ActiReg® (PreMed AS, Oslo, Norway, a combined position and motion recording instrument, during the same seven days as the 7-dFR was filled in.In the 7–8 year-olds, EI from the 2×24-HDRs (EI2×24-HDR was overestimated with 3% compared to EE (not significantly different, while EI from the 7-dFR (EI7-dFR was underestimated with 7% compared to EE (P=0.001. In the 12–13 year-olds, the corresponding figures was underestimation by 10% with the 2×24-HDRs (P<0.001 and by 20% with the 7-dFR (P<0.001. For both age groups combined, the 95% limits of agreement were −4·38 and 3.52 MJ/d for the 2×24-HDRs, and −5.90 and 2.94 MJ/d for the 7-dFR. Pearson correlation coefficients between EI and EE were 0.51 for EI2×24-HDR and 0.29 for EI7-dFR, respectively. The proportion classified in the same or adjacent quartiles was 76% for EI2×24-HDR and 73% for EI7-dFR in the 7–8 year-olds, and 83% for EI2×24-HDR and 70% for EI7-dFR in the 12–13 year-olds.Misreporting of EI seemed modest with both the 2×24-HDRs and the 7-dFR in the 7–8 year-olds when compared to EE measured with ActiReg®. Under-reporting appeared to be more evident in the 12–13 year-olds, especially with the 7-dFR. Compared to measurements of EE, the 2×24-HDRs seemed to perform slightly better than the 7-dFR in terms of ranking of individuals according to EI.

  13. Impedance measurements and high-resolution manometry help to better define rumination episodes

    B.F. Kessing; F. Govaert; A.A.M. Masclee; J.M. Conchillo

    2011-01-01

    Background. Rumination syndrome is a disorder of unknown etiology characterized by regurgitation of recently ingested food. We aimed to improve the diagnosis of rumination syndrome by classification of separate rumination symptoms using (1) an ambulatory manometry/impedance (AMIM) measurement and (2

  14. Functional and Anatomic Esophagogastic Junction Outflow Obstruction: Manometry, Timed Barium Esophagram Findings, and Treatment Outcomes.

    Clayton, Steven B; Patel, Rupal; Richter, Joel E

    2016-06-01

    Little is known about the clinical features, radiology and manometry findings, and treatment outcomes of patients with functional and mechanical esophagogastic junction outflow obstruction (EGJOO). Between November 2011 and February 2015, a total of 1443 high-resolution manometries were reviewed and 49 patients (3.4%) met the manometric criteria for EGJOO. Then, we performed a retrospective chart review, collecting data from manometric studies, timed barium esophagram findings (TBEs), endoscopic reports, and clinical records. Twenty-seven patients had functional EGJOO and 22 patients had an anatomic esophageal obstruction. Common causes of anatomic EGJOO included strictures (36% of patients) and hiatal hernias (31% of patients). There were no differences between groups in manometric or radiographic metrics. Each group had increased basal lower esophageal sphincter and intrabolus pressures, compared with individuals without EGJOO, and most patients had abnormal findings on TBE analysis. Two patients with functional EGJOO progressed to type 3 achalasia. We conclude that patients diagnosed with EGJOO based on manometry findings can have anatomic obstruction or functional EGJOO; high-resolution manometry and TBE do not distinguish between disease causes. PMID:26792374

  15. Technological insights: Combined impedance manometry for esophageal motility testing-current results and further implications

    Huan Nam Nguyen; Gerson Ricardo Souza Domingues; Frank Lammert

    2006-01-01

    This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implications for further research. The combined technique assesses simultaneously bolus transport and associated peristalsis, thus allowing detailed analysis of the relationships between bolus transit and esophageal motility. Recent studies demonstrate that combined impedance manometry provides important additional information about esophageal motility as compared to conventional manometry: (1) monitoring of bolus transport patterns, (2) calculation of bolus transit parameters, (3) evaluation of bolus clearance,(4) monitoring of swallow associated events such as air movement and reflux, and (5) investigation of the relationships between bolus transit and LES relaxation.Studies with healthy subjects have identified several useful parameters for comprehensive assessment of eosphageal function. These parameters were found to be pathological in patients with classical achalasia,mild GERD, and ineffective esophageal motility. The technology of combined impedance manometry provides an important new tool for esophageal function testing,advancing both clinical and basic research. However,several important issues remain to be standardized to make the technique suitable for widely clinical use.

  16. High-resolution Manometry Findings in Patients After Sclerotherapy for Esophageal Varices

    Herbella, Fernando A M; Colleoni, Ramiro; Bot, Luiz; Vicentine, Fernando P P; Patti, Marco G

    2016-01-01

    Background/Aims Endoscopic therapy for esophageal varices may lead to esophageal dysmotility. High-resolution manometry is probably the more adequate tool to measure esophageal motility in these patients. This study aimed to evaluate esophageal motility using high resolution manometry following eradication of esophageal varices by endoscopic sclerotherapy. Methods We studied 21 patients (11 women, age 52 [45–59] years). All patients underwent eradication of esophageal varices with endoscopic sclerotherapy and subsequent high resolution manometry. Results A significant percentage of defective lower esophageal sphincter (basal pressure 14.3 [8.0–20.0] mmHg; 43% hypertonic) and hypocontractility (distal esophageal amplitude 50 [31–64] mmHg; proximal esophageal amplitude 40 [31–61] mmHg; distal contractile integral 617 [403–920] mmHg · sec · cm; 48% ineffective) was noticed. Lower sphincter basal pressure and esophageal amplitude correlated inversely with the number of sessions (P < 0.001). No manometric parameter correlated with symptoms or interval between last endoscopy and manometry. Conclusions Esophageal motility after endoscopic sclerotherapy is characterized by: (1) defective lower sphincter and (2) defective and hypotensive peristalsis. Esophageal dysmotility is associated to an increased number of endoscopic sessions, but manometric parameters do not predict symptoms. PMID:26554823

  17. How useful is esophageal high resolution manometry in diagnosing gastroesophageal junction disruption: causes affecting this disruption and its relationship with manometric alterations and gastroesophageal reflux

    Constanza Ciriza-de-los-Ríos

    2014-01-01

    Full Text Available Background: High-resolution manometry (HRM is a breakthrough in the morphological study of the gastroesophageal junction (GEJ and its degrees of disruption. Objectives: a Assessment of risk factors involved in the disruption of the GEJ in patients with gastroesophageal reflux (GER symptoms; b the relationship between the type of GEJ and GER demonstrated by 24 hours pH-monitoring; and c identification of the alterations in the manometric parameters related to the morphology of the GEJ. Methods: One hundred and fifteen patients with symptoms of GER studied with HRM and classified by the type of GEJ (type I: Normal; type II: Sliding; type III: Hiatal hernia. Twenty four hour pH-monitoring without proton pump inhibitors was performed in all of them. Epidemiological aspects, manometric parameters (Chicago 2012 classification and the pH-monitoring results were evaluated. Results: Age (OR 1.033 [1.006-1.060]; p = 0.16, BMI (OR 1.097 [1.022-1.176]; p = 0. 01 and abdominal perimeter (OR 1.034 [1.005-1.063]; p = 0.0215 were independent risk factors for the GEJ type III (area under the curve 0.70. Disruption of the GEJ was associated with a lower resting pressure (p = 0.006, greater length (p < 0.001 and greater esophageal shortening (p < 0.001. Abnormal acidic reflux was found in the total period (p = 0.015, standing (p = 0.022 and supine (p = 0.001 in patients with GEJ type II and III with respect to type I. Conclusions: Increased age, overweight and central obesity pose a higher risk of GEJ type III (hiatal hernia. The greater disruption of the GEJ is associated with lower resting pressure, esophageal shortening, and higher acid exposure in the pH-monitoring.

  18. Anorectal manometry in children with chronic functional constipation Manometria anorretal em crianças com constipação intestinal crônica funcional

    Rosa Helena Monteiro Bigélli

    2005-09-01

    Full Text Available BACKGROUND: The anorectal manometry is a very utilized and well recognized examination in children with chronic funcional constipation. The major manometric findings in these children are: anal hypotonia, anal hypertonia, paradoxal contraction of the external anal sphincter, decreased ability of internal anal sphincter to relax during rectal distension and alterations in rectal contractility, sensibility and compliance. AIMS: To evaluate the anal basal pressure and the relaxation reflex before and after standard treatment for a better understanding of the physiopathologic mechanisms involved in pediatric chronic functional constipation. METHODS: Anorectal manometry was performed before treatment on 20 children with chronic functional constipation aged 4 to 12 years and the results were compared to those obtained after standard treatment, with a good outcome. RESULTS: There was a reduction in anal basal pressure after treatment, but no differences were detected between the anorectal manometries performed before and after treatment in terms of amplitude and duration of relaxation, residual pressure, latency time, or descent and ascent angle. CONCLUSIONS: We conclude that the anal basal pressure decreased in children recovering from chronic functional constipation, but the standard treatment did not provide all the conditions necessary for the relaxation reflex of constipated children to return to the values described in normal children.RACIONAL: A manometria é um exame bastante utilizado e bem reconhecido no diagnóstico diferencial da constipação intestinal crônica na criança. Os achados manométricos mais comumente verificados nas crianças com constipação intestinal crônica funcional são: hipotonia e hipertonia anal, contração paradoxal do esfíncter anal externo, habilidade diminuída do esfíncter anal interno para relaxar durante a distensão retal, aumento da complacência e do limiar de sensibilidade retal, além de diminui

  19. [Laparoscopic rectal resection technique].

    Anthuber, M; Kriening, B; Schrempf, M; Geißler, B; Märkl, B; Rüth, S

    2016-07-01

    The quality of radical oncological operations for patients with rectal cancer determines the rate of local recurrence and long-term survival. Neoadjuvant chemoradiotherapy for locally advanced tumors, a standardized surgical procedure for rectal tumors less than 12 cm from the anus with total mesorectal excision (TME) and preservation of the autonomous nerve system for sexual and bladder function have significantly improved the oncological results and quality of life of patients. The TME procedure for rectal resection has been performed laparoscopically in Germany for almost 20 years; however, no reliable data are available on the frequency of laparoscopic procedures in rectal cancer patients in Germany. The rate of minimally invasive procedures is estimated to be less than 20 %. A prerequisite for using the laparoscopic approach is implicit adherence to the described standards of open surgery. Available data from prospective randomized trials, systematic reviews and meta-analyses indicate that in the early postoperative phase the generally well-known positive effects of the minimally invasive approach to the benefit of patients can be realized without any long-term negative impact on the oncological results; however, the results of many of these studies are difficult to interpret because it could not be confirmed whether the hospitals and surgeons involved had successfully completed the learning curve. In this article we would like to present our technique, which we have developed over the past 17 years in more than 1000 patients. Based on our experiences the laparoscopic approach can be highly recommended as a suitable alternative to the open procedure. PMID:27277556

  20. Simultaneous videoradiography and solid state intraluminal pharyngeal manometry during barium swallow; videomanometry

    The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs

  1. Simultaneous videoradiography and solid state intraluminal pharyngeal manometry during barium swallow; videomanometry

    Olsson, Rolf

    1995-08-01

    The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs.

  2. Clinical value of duodenojejunal manometry. Its usefulness in diagnosis and management of patients with gastrointestinal symptoms.

    Soffer, E; Thongsawat, S

    1996-05-01

    The records of all patients who had duodenojejunal manometry (DJM) from 1989 to 1995 were retrospectively reviewed. We evaluated the main symptoms of the patients, the indication for the study, its result, and the impact on therapy and management. One hundred sixteen patients out of 154 were included in the study, of whom 96 were women and 20 were men, with a mean age of 41.2 years. Twenty-five had perfused tube studies, and 91 had prolonged ambulatory recordings. Forty-one patients were referred for evaluation of abdominal pain, 34 for chronic constipation, 24 for nausea and vomiting, 8 for pseudoobstruction, and the remaining 9 for other reasons. All patients had appropriate endoscopic, radiographic, or scintigraphic studies prior to manometry. Forty-seven (40.5%) had abnormal manometry: 20 of 41 (48.8%) for abdominal pain, 7 of 34 (20.6%) for chronic constipation, 10 of 24 (41.7%) for nausea and vomiting, 5 of 8 (62.5%) for pseudoobstruction, and 5 of 9 (55.6%) for the miscellaneous group. The various subgroups did not have specific patterns of motor abnormalities. In 22 patients (18.9%) manometry helped in the choice of therapy: in 15 patients by affecting surgical approach, particularly in the constipation group, and in 7 patients by affecting feeding options and prokinetic agents. Detection of motor abnormalities was helpful in patients with severe symptoms thought to have functional disease even when no specific therapy was rendered. Thus, DJM was abnormal in 2/5 patients referred for evaluation of suspected motility disorders. It directly affected therapy in approximately 1/5 patients, particularly in those with constipation. It is helpful in the management of patients even when specific therapy is not rendered, particularly in those with abdominal pain. The modest impact on specific therapy is related to limited availability of effective prokinetic drugs and the limited specificity and predictive value of tests results. PMID:8625755

  3. Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.

    Umeki, Hiroshi; Takasaki, Kenji; Enatsu, Kaori; Tanaka, Fujinobu; Kumagami, Hidetaka; Takahashi, Haruo

    2009-01-01

    OBJECTIVE: This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Case series with planned data collection. MATERIALS AND METHODS: Thirty-three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1-cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum v...

  4. Effects of Head Rotation and Head Tilt on Pharyngeal Pressure Events Using High Resolution Manometry

    Kim, Cheol Ki; Ryu, Ju Seok; Song, Sun Hong; Koo, Jung Hoi; Lee, Kyung Duck; Park, Hee Sun; Oh, Yoongul; Min, Kyunghoon

    2015-01-01

    Objective To observe changes in pharyngeal pressure during the swallowing process according to postures in normal individuals using high-resolution manometry (HRM). Methods Ten healthy volunteers drank 5 mL of water twice while sitting in a neutral posture. Thereafter, they drank the same amount of water twice in the head rotation and head tilting postures. The pressure and time during the deglutition process for each posture were measured with HRM. The data obtained for these two postures we...

  5. Clinical value of the esophageal scintigraphy in multi-swallow technique comparing to esophageal manometry

    Diagnosis of esophageal motility disorders is difficult due to the large physiologic variability of bolus transport. With the help of a parametric multiple swallow technique (introduced by Tatsch), using 'condensed images' of each single sallow action before creating a 'mean image' of six swallows, this problem can be solved. For testing this relatively new method, 12 patients underwent 16 pairs of parametric esophagel scintigraphy and esophageal manometry. This collective of patients consisted of 4 with achalasia and secondary hypomobility of the tubular esophagus, 7 with unspecific esophageal dysfunction confirmed by manometry and 1 with clinical dysphagia and normal status in manometry. Fourteen of 15 pathological manometric findings could be confirmed with parametric scintigraphy. Esophageal monometry was false negative in one case and esophageal scintigraphy in another one case. The calculated emptying rates 10 and 12 s after beginning of swallowing are (mean±SD) 56±34% and 60±34% respectively for solid meal and 54±25% 57±22% respectively for liquid meal. Of 60 emptying rates, 48 are in the pathologic range of less than 80%. As expected, no significant difference was found between emptying rates after 10 and 12 s (two-tailed matched pairs t-test, 5% significance level). In conclusion, parametric esophageal multiple swallow scintigraphy has been proven to be a non-invasive and sensitive tool for pre-and posttherapeutic care of patients with esophageal motility disorders. It should be mentioned that esophageal scintigraphy can give additional information in some cases of normal esophageal manometry. (orig.)

  6. Importance of anorectal manometry after definitive surgery for Hirschsprung′s disease in children

    Suzi Demirbag; Tugrul Tiryaki; Tarik Purtuloglu

    2013-01-01

    Objectives: The purpose of this investigation is to evaluate anorectal function after definitive surgery for Hirschsprung′s disease (HD) by anorectal manometry. Materials and Methods: We evaluated the anorectal manometric assessment of 18 children who were operated for HD. Functional outcomes were determined by a questionnaire. Rectoanal inhibitory reflex (RAIR) and maximum anal resting pressure (MARP) were monitored. The results were compared between obstructive patients and asymptomatic pat...

  7. Implementation of High-resolution Manometry in the Clinical Practice of Speech Language Pathology

    Knigge, Molly A.; Thibeault, Susan; McCulloch, Timothy M.

    2014-01-01

    Visual imaging modalities, videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic evaluation of swallow, for assessment of oropharyngeal dysphagia have been part of the speech language pathologist’s (SLPs) armamentarium for the diagnosis and treatment of dysphagia for decades. Recently, the addition of high-resolution manometry (HRM) has enabled the SLP to evaluate pharyngeal pressures and upper esophageal sphincter relaxation. Taken together, the use of visual imaging modalities wi...

  8. Non-invasive measurement of local pulse pressure by pulse wave-based ultrasound manometry (PWUM)

    Vappou, J.; Luo, J; Okajima, K.; Di Tullio, M; Konofagou, E E

    2011-01-01

    The central Blood Pressure (CBP) has been established as a relevant indicator of cardiovascular disease. Despite its significance, CBP remains particularly challenging to measure in standard clinical practice. The objective of this study is to introduce Pulse Wave-based Ultrasound Manometry (PWUM) as a simple-touse, non-invasive ultrasound-based method for quantitative measurement of the central pulse pressure. Arterial wall displacements are estimated using radiofrequency (RF) ultrasound sig...

  9. Ambulatory esophageal manometry/pH-metry discriminates between patients with different esophageal symptoms.

    Paterson, W G; Beck, I T; Wang, H

    1996-02-01

    Ambulatory esophageal manometry/pH-metry has been used primarily in patients with chest pain of presumed esophageal origin, and it is unclear whether the discriminating power of this test applies to other esophageal symptoms. In the present study, prolonged ambulatory manometry/pH recordings were compared in 17 healthy controls, 12 patients with atypical chest pain, and 11 patients with chest pain and nonstructural dysphagia using the Synectics microdigitrapper system. Chest pain patients tended to have higher values for all the pH variables, but their esophageal motility parameters were no different than controls. On the other hand, the chest pain plus dysphagia group was characterized by a significantly lower proportion of propagated contractions between 10 and 5 cm above the lower esophageal sphincter. This group also tended to have a higher frequency of high-amplitude or prolonged-duration contractions. In comparison to the results of standard stationary esophageal manometry, the prolonged ambulatory recordings were more sensitive in detecting esophageal motor dysfunction in the two patient groups. This study suggests that quantitative analysis of ambulatory pH/motility recordings is a sensitive method of evaluating patients with suspected esophageal dysfunction. PMID:8601383

  10. Importance of anorectal manometry after definitive surgery for Hirschsprung′s disease in children

    Suzi Demirbag

    2013-01-01

    Full Text Available Objectives: The purpose of this investigation is to evaluate anorectal function after definitive surgery for Hirschsprung′s disease (HD by anorectal manometry. Materials and Methods: We evaluated the anorectal manometric assessment of 18 children who were operated for HD. Functional outcomes were determined by a questionnaire. Rectoanal inhibitory reflex (RAIR and maximum anal resting pressure (MARP were monitored. The results were compared between obstructive patients and asymptomatic patients. Results: The median age at definitive operation was 19 months (range 12-72 months. Anorectal manometry was performed in 14 male and 4 female patients. All the cases underwent three staged procedure for HD and modified Duhamel procedure was performed as definitive procedure for all the patients. Mean age was 4.3 months (range 25 days to 5 years at time of diagnosis. Post-operative enterocolitis or severe constipation was observed in seven patients (38.8%. There were no patients with incontinence. Eighteen patients underwent anorectal manometry meanly 2 years after definitive operation. RAIR was absent in 14 (77.7% patients and abnormal in 4 (22.2%. There were no significant differences in the MARP values between symptomatic and asymptomatic patients. Conclusion: The results of our study showed that the majority of the patients have impaired anorectal motility. There were no significant differences in the results of the functional studies for the seven patients with symptoms of obstruction or constipation when compared with asymptomatic patients after surgery for HD.

  11. Sphincter of Oddi Manometry: Reproducibility of Measurements and Effect of Sphincterotomy in the EPISOD Study

    Suarez, Alejandro L; Pauls, Qi; Durkalski-Mauldin, Valerie; Cotton, Peter B

    2016-01-01

    Background/Aims The reproducibility of sphincter of Oddi manometry (SOM) measurements and results of SOM after sphincterotomy has not been studied sufficiently. The aim of our study is to evaluate the reproducibility of SOM and completeness of sphincter ablation. Methods The recently published Evaluating Predictors and Interventions in sphincter of Oddi dysfunction (EPISOD) study included 214 subjects with post-cholecystectomy pain, and fit the criteria of sphincter of Oddi dysfunction type III. They were randomized into 3 arms, irrespective of manometric findings: sham (no sphincterotomy), biliary sphincterotomy, and dual (biliary and pancreatic). Thirty-eight subjects had both biliary and pancreatic manometries performed twice, at baseline and at repeat endoscopic retrograde cholangiopancreatography after 1–11 months. Sham arm was examined to assess the reproducibility of manometry, and the treatment arms to assess whether the sphincterotomies were complete (elevated pressures were normalized). Results Biliary and pancreatic measurements were reproduced in 7/14 (50%) untreated subjects. All 12 patients with initially elevated biliary pressures in biliary and dual sphincterotomy groups normalized after biliary sphincterotomy. However, 2 of 8 subjects with elevated pancreatic pressures in the dual sphincterotomy group remained abnormal after pancreatic sphincterotomy. Paradoxically, normal biliary pressures became abnormal in 1 of 15 subjects after biliary sphincterotomy, and normal pancreatic pressures became abnormal in 5 of 15 patients after biliary sphincterotomy, and in 1 of 9 after pancreatic sphincterotomy. Conclusions Our data suggest that SOM measurements are poorly reproducible, and question whether we could adequately perform pancreatic sphincterotomy. PMID:26951046

  12. Breast metastases from rectal carcinoma

    LI Jia; FANG Yu; LI Ang; LI Fei

    2011-01-01

    Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

  13. MRI of rectal stromal tumour

    Dam, Claus; Lindebjerg, Jan; Rafaelsen, Søren Rafael

    2012-01-01

    aware of for the rectal multidisciplinary team. On suspicion of GIST, patients should be referred to a sarcoma centre. The diagnosis of rectal GIST can be suggested on MRI by the presence of a well-defined heterogeneously large mass with a necrotic center associated with a prominent extra...

  14. Rectal carcinoids: a systematic review.

    McDermott, Frank D

    2014-07-01

    Rectal carcinoids are increasing in incidence worldwide. Frequently thought of as a relatively benign condition, there are limited data regarding optimal treatment strategies for both localized and more advanced disease. The aim of this study was to summarize published experiences with rectal carcinoids and to present the most current data.

  15. Short–term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study

    Neoadjuvant chemoradiation therapy followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. However, deterioration of anorectal function after long-course neoadjuvant chemoradiation therapy combined with surgery for rectal cancer is poorly defined. The aim of this study was to evaluate the physiological and clinical change of anorectal function after neoadjuvant chemoradiation therapy for rectal cancer. We analyzed 30 patients on whom preoperative anorectal manometry data were available both before and after chemoradiation from October 2010 to September 2011. All patients underwent long-course neoadjuvant chemoradiation therapy. We compared manometric parameters between before and after neoadjuvant chemoradiation therapy. Of 30 patients, 20 were males and 10 females. The mean age was 64.9 ± 9.9 years (range, 48-82). Before nCRT, the rectal compliance was higher in patients with ulceroinfiltrative type (P = 0.035) and greater involvement of luminal circumference (P = 0.017). However, there was the tendency of increased rectal sensory threshold for desire to defecate when the patient had decreased circumferential ratio of the tumor (P = 0.099), down-graded T stage (P = 0.016), or reduced tumor volume (P = 0.063) after neoadjuvant chemoradiation. Neoadjuvant chemoradiation therapy did not significantly impair overall sphincter function before radical operation. The relationship between tumor response of chemoradiation and sensory threshold for desire to defecate may suggest that neoadjuvant chemoradiation may be helpful for defecatory function as well as local disease control, at least in the short-term period after the radiation in locally advanced rectal cancer patients

  16. Rectal injuries following radiation therapy

    Rectal injuries following radiation therapy were reviewed. Primary diseases in which radiation injuries appeared were described, and local injuries in the neibouring organs such as the small intestine, the bladder, the uterus, and the vagina were also referred to. Classification, frequency, fistulation, radiation necrosis, x-ray findings and occurrence time of rectal and sigmoid colonic injuries were reported. As occurrence factors of radiation injuries, total dose, measurement of dose, stage of primary disease, and history of laparatomy were mentioned. Countermeasures for reducing rectal injuries and treatment methods of local injuries were also described. (Serizawa, K.)

  17. Effect of empagliflozin monotherapy on postprandial glucose and 24-hour glucose variability in Japanese patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled, 4-week study

    Nishimura, Rimei; Tanaka, Yuko; Koiwai, Kazuki; Inoue, Kohei; Hach, Thomas; Salsali, Afshin; Lund, Søren S; Broedl, Uli C.

    2015-01-01

    Background This study evaluated the effect of empagliflozin on postprandial glucose (PPG) and 24-hour glucose variability in Japanese patients with type 2 diabetes mellitus (T2DM). Methods Patients (N = 60; baseline mean [SD] HbA1c 7.91 [0.80]%; body mass index 24.3 [3.2] kg/m2) were randomized to receive empagliflozin 10 mg (n = 20), empagliflozin 25 mg (n = 19) or placebo (n = 21) once daily as monotherapy for 28 days. A meal tolerance test and continuous glucose monitoring (CGM) for 24 hou...

  18. 咸味喜好值、钠摄入量与24h尿钠相关性初探%Pilot Study on the Correlation among Salty Taste Preference, Sodium Intake and 24-hour Urinary Sodium

    李扬; 曾瑜; 周小乔; 黄承钰; 李鸣

    2014-01-01

    Objective The aim of this study was to explore the correlation among salty taste preference,daily sodium intake,and 24-hour urinary sodium.Methods 12 subjects with heavy-,medium-and light-salty taste preference were provided with three-day diets.The daily sodium intakes and 24-hour urinary sodium were measured.Analysis was conducted to explore the correlation among salty taste preference,daily sodium intake and 24-hour total urine sodium.Results A positive correlation was observed between the salty taste preference and sodium intake (r=0.598,P<0.05),while no correlation was observed between daily sodium intake and 24-hour urinary sodium (r=-0.543,P>0.05).Conclusion The determination of salty taste preference on-site provides a certain reference to evaluate salt intake.%目的 初步探讨人群日常饮食的咸味喜好值、钠摄入量与24 h尿钠之间的相关性.方法 筛选咸味喜好值低、中、高的对象共12名;为其提供3d膳食,称重计算其每日钠摄入量,测定24 h尿钠总量;进一步对咸味喜好值、钠摄入量和24 h尿钠总量做相关性分析.结果 咸味喜好值和钠摄入量之间呈正相关(r=0.598,P<0.05),每日钠摄入量和24 h尿钠相关性未见统计学差异(r=0.543,P>0.05).结论 通过咸味喜好值的现场测定评估食盐摄入量具有一定的参考价值.

  19. Effects of Latanoprost 0.005%/Timolol Maleate 0.5% and Dorzolamide 2%/Timolol Maleate 0.5% Fixed Combinations on 24-hour Intraocular Pressure in Patients with Primary Open-Angle Glaucoma

    Berna Yüce

    2012-01-01

    Full Text Available Pur po se: To evaluate the effects of latanoprost/timolol maleate and dorzolamid/timolol maleate fixed combinations on-24 hours intraocular pressure in patients with open-angle glaucoma. Ma te ri als and Met hod: Forty-eight eyes of 24 patients with open-angle glaucoma were enrolled in the study. They were randomized to receive fixed combinations of either latanoprost/timolol maleate (Group 1 - 24 eyes of 12 patients or dorzolamid/timolol maleate (Group 2 - 24 eyes of 12 patients. Patients who achieved intraocular pressure of ≤ 21 mmHg 3 weeks after combined therapy were hospitalized and intraocular pressure was monitored at hour 06:00, 10:00, 14:00, 18:00, 22:00 and 02:00 for 24 hours. Diurnal and nocturnal fluctuations were determined by measurements done between 06:00 and 18:00 hours and between 22:00 and 02:00, respectively. Mean intraocular pressure and fluctuations of intraocular pressure between the two groups were compared. Re sults: There was no difference between the groups in terms of age, sex, visual acuity and cup/disc ratio (p>0.05. Three weeks after combined therapy, all patients achieved target intraocular pressure of ≤ 21 mmHg. There was no statistically significant difference between the two groups with regard to mean intraocular pressure over 24 hours (17.1±2.3 mmHg and 17.27±2.3 mmHg for Group 1 and Group 2, respectively; p>0.05. Diurnal fluctuations were 3.6 mmHg for Group 1 and 4.7 mmHg for Group 2; nocturnal fluctuations were 4.3 mmHg for Group 1 and 2.3 mmHg for Group 2. Diurnal fluctuations in Group 1 were lower than in Group 2, while nocturnal fluctuations were lower in Group 2 than in Group 1 (p<0.05. Dis cus si on: Both latanoprost/timolol maleate and dorzolamid/timolol maleate fixed combinations are effective for 24-hour intraocular pressure control. Latanoprost/timolol maleate fixed combination is superior to dorzolamid/timolol maleate in controlling diurnal fluctuations, while dorzolamid/timolol maleate is

  20. General Information about Rectal Cancer

    ... Treatment Genetics of Colorectal Cancer Age and family history can affect the risk of rectal cancer. Anything ... to flow from the body to a collection bag. After the cancer is removed, the surgeon will ...

  1. Treatment Option Overview (Rectal Cancer)

    ... Treatment Genetics of Colorectal Cancer Age and family history can affect the risk of rectal cancer. Anything ... to flow from the body to a collection bag. After the cancer is removed, the surgeon will ...

  2. The correlation factor analysis of the neonates abandoned in hospital less than 24 hours%住院不足24h放弃治疗出院新生儿相关因素分析

    易海英; 甘斌; 杨树杰; 汪珍珍; 何源; 王艳华

    2013-01-01

    Objective To investigate the relative factors of the neonates that were abandoned in hospital less than 24 hours,then the level of the local neonates medical service and the neonatal remedy skills and the life quality could be improved.Methods The clinical data of 379 cases of hospitalized neonates less than 24 hours from 2007 to 2011 were analyzed retrospectively.The correlation factors of the neonates abandoned in hospital less than 24 hours(122 cases) and hospitalized more than 24 hours (244 cases) were analyzed by single and multiple factor regression analysis.Results (1) There were 379 neonates who were in hospital less than 24 hours,among them,122 neonates were gave up the treatments.The differences of the gestational age and weight among abandon group,hospital referral group,improve group and uncured group were significant(P <0.01).(2) The numbers of neonates abandoned in hospital less than 24 hours were different significantly from 2007 to 2011 (P <0.05) and tendency was decreased year by year(chi-square trend test x2 =6.115,P =0.013).The uncured group was increased year by year (P < 0.05).The hospital referral group,improved group were fluctuation,but no descend or rise tendency(P >0.05).(3) The differences of the gestational age,birth weight,uterine-incision delivery,intrapartum asphyxia,intrauterine distress,birth hospital,family income less than twenty thousand yuan every year,father's culture level,diagnosed premature,very low birth weight infant,low birth weight infant,respiratory distress syndrome and brain injuries were significant between neonates in hospital less than 24 hours and more than 24 hours(P < 0.05).The differences of the male,intrapartum high risk factors,mother's morbid state and miscarriage were not significant(P >0.05).(4) The uterine-incision delivery,intrapartum asphyxia,birth in the county and below county hospital,family income less than twenty thousand yuan every year and diagnosed respiratory distress syndrome were

  3. Rectal examination in general practice.

    Hennigan, T W; Franks, P. J.; Hocken, D. B.; Allen-Mersh, T. G.

    1990-01-01

    OBJECTIVE--To investigate factors influencing a general practitioner's decision to do a rectal examination in patients with anorectal or urinary symptoms. DESIGN--Postal questionnaire survey. SETTING--General practices in inner London and Devon. SUBJECTS--859 General practitioners, 609 (71%) of whom returned the questionnaire. MAIN OUTCOME MEASURES--Number of rectal examinations done each month; the indication score, derived from answers to a question asking whether the respondent would do a ...

  4. The Effect of Biofeedback Therapy on Anorectal Function After the Reversal of Temporary Stoma When Administered During the Temporary Stoma Period in Rectal Cancer Patients With Sphincter-Saving Surgery

    Kye, Bong-Hyeon; Kim, Hyung-Jin; Kim, Gun; Yoo, Ri Na; Cho, Hyeon-Min

    2016-01-01

    Abstract We evaluated the effect of biofeedback therapy (BFT) on anorectal function after stoma closure when administered during the interval of temporary stoma after sphincter-preserving surgery for rectal cancer. Impaired anorectal function is common after lower anterior resections, though no specific treatment options are currently available to prevent this adverse outcome. Fifty-six patients who underwent neoadjuvant chemoradiation therapy after sphincter-preserving surgery with temporary stoma were randomized into 2 groups: group 1 (received BFT during the temporary stoma period) and group 2 (did not receive BFT). To evaluate anorectal function, anorectal manometry was performed in all patients and subjective symptoms were evaluated using the Cleveland Clinic Incontinence Score. The present study is a report at 6 months after rectal resection. Forty-seven patients, including 21 in group 1 and 26 in group 2, were evaluated by anorectal manometry. Twelve patients (57.1%) in group 1 and 13 patients (50%) in group 2 were scored above 9 points of Cleveland Clinic Incontinence Score, which is the reference value for fecal incontinence (P = 0.770). With time, there was a significant difference (P = 0.002) in the change of mean resting pressure according to time sequence between the BFT and control groups. BFT during the temporary stoma interval had no effect on preventing anorectal dysfunction after temporary stoma reversal at 6 months after rectal resection. However, BFT might be helpful for maintaining resting anal sphincter tone (NCT01661829). PMID:27149496

  5. The Effect of Biofeedback Therapy on Anorectal Function After the Reversal of Temporary Stoma When Administered During the Temporary Stoma Period in Rectal Cancer Patients With Sphincter-Saving Surgery: The Interim Report of a Prospective Randomized Controlled Trial.

    Kye, Bong-Hyeon; Kim, Hyung-Jin; Kim, Gun; Yoo, Ri Na; Cho, Hyeon-Min

    2016-05-01

    We evaluated the effect of biofeedback therapy (BFT) on anorectal function after stoma closure when administered during the interval of temporary stoma after sphincter-preserving surgery for rectal cancer.Impaired anorectal function is common after lower anterior resections, though no specific treatment options are currently available to prevent this adverse outcome.Fifty-six patients who underwent neoadjuvant chemoradiation therapy after sphincter-preserving surgery with temporary stoma were randomized into 2 groups: group 1 (received BFT during the temporary stoma period) and group 2 (did not receive BFT). To evaluate anorectal function, anorectal manometry was performed in all patients and subjective symptoms were evaluated using the Cleveland Clinic Incontinence Score. The present study is a report at 6 months after rectal resection.Forty-seven patients, including 21 in group 1 and 26 in group 2, were evaluated by anorectal manometry. Twelve patients (57.1%) in group 1 and 13 patients (50%) in group 2 were scored above 9 points of Cleveland Clinic Incontinence Score, which is the reference value for fecal incontinence (P = 0.770). With time, there was a significant difference (P = 0.002) in the change of mean resting pressure according to time sequence between the BFT and control groups.BFT during the temporary stoma interval had no effect on preventing anorectal dysfunction after temporary stoma reversal at 6 months after rectal resection. However, BFT might be helpful for maintaining resting anal sphincter tone (NCT01661829). PMID:27149496

  6. Evaluation of esophageal function in patients with esophageal motor abnormalities using multichannel intraluminal impedance esophageal manometry

    Yu Kyung Cho; Myung-Gyu Choi; Jae Myung Park; Jung Hwan Oh; Chang Nyol Paik; Joon Wook Lee; In Seok Lee; Sang Woo Kim; In-Sik Chung

    2006-01-01

    AIM: To evaluate the functional aspect of esophageal motility in healthy subjects and in patients who were referred for esophageal function testing using multichannel intraluminal impedance-esophageal manometry (MⅡ-EM), and to assess the clinical utility of MⅡ-EM.METHODS: From September 2003 to January 2004,we performed the MⅡ-EM on healthy volunteers and all the patients who were referred for esophageal function testing. Each patient received 10 liquid and 10 viscous swallows. We analyzed the results, the impedance and the manometric findings. Some of the subjects had additional ambulatory 24-h pH study performed to diagnose gastroesophageal reflux disease (GERD).RESULTS: Among 89 studied subjects, the MⅡ-EMfindings showed normal esophageal motility in 50(56.17%), ineffective esophageal motility (IEM) in 17(19.10%), nutcracker esophagus in 7 (7.86%), achalasia in 4 (4.49%), and scleroderma esophagus in 11 (12.35%)cases. The completeness and the speed of bolus transit were in the order of nutcracker esophagus, normal manometry and IEM. Some of the swallows showing normal manometry and IEM had incomplete transit. In the achalasia and scleroderma esophagus, almost all the swallows had incomplete transit. The body amplitudes were higher for the swallows with complete transit than for the swallows with incomplete transit. There was not a significant difference in the manometric and impedance findings between the subjects with and without GERD.CONCLUSION: MⅡ-EM is a useful tool in assessing the esophageal function in the patients having esophageal motility abnormality. The primary factors influencing the bolus transit are the amplitude of the esophageal body and normal peristalsis.

  7. Investigation of cattle methane production and emission over a 24-hour period using measurements of δ13C and δD of emitted CH4 and rumen water

    Bilek, R. S.; Tyler, S. C.; Kurihara, M.; Yagi, K.

    2001-07-01

    We have conducted a series of experiments to determine the effects different diets, including the addition of unsaturated fatty acids, had on isotopic signatures of CH4 emissions from dairy cattle. Measurements of emitted δ13CH4, δ13CO2, and δD-CH4 were made on gases collected over a 24-hour period from animal chambers containing individual Holstein cows. Some measurements of δD-H2O from samples collected directly from the rumen were also made. We observed variation in δ13CH4 values with time after feeding and a correlation in δ13C between emitted gases and diet. The average δ13CH4 value, which includes all samples of emitted gases, was -70.6±4.9‰ (n = 57). Measurements of δD-CH4 over the 24-hour sampling period had an average value of -357.8±15.0‰ (n = 56). These δD measurements are among the lightest reported for CH4 produced by cattle. Our cattle data indicate that hydrogen incorporated into the CH4 produced by CO2 reduction in high H2 concentration environments is fractionated to a greater degree than that incorporated in systems with relatively low H2 conditions, such as wetlands. Our results support bacterial studies that have demonstrated large hydrogen fractionation in high H2 concentration systems during methanogenesis.

  8. A flexible, highly sensitive catheter for high resolution manometry based on in-fibre Bragg gratings

    This work presents a fibre optic-based flexible catheter for high resolution manometry (HRM), with sensing pods located at a pitch of 10 mm and an overall diameter of 2.8 mm. In-fibre Bragg gratings act as the sensing elements within these sensing pods. Hydrodynamic pressure resolution of 0.2 mmHg is demonstrated in conjunction with insensitivity to occlusion pressure. This result is significant in the context of HRM where independent measurement of hydrodynamic pressure is clinically relevant. The sensing system is compact, robust and flexible. Crosstalk between individual sensors is characterized and a compensation scheme is developed and validated. (paper)

  9. Water syphon test and gastrooesophageal reflux during childhood (correlation with the clinical findings and oesophageal manometry)

    The water syphon test is a simple and easily performed method for demonstrating gastro-oesophageal reflux with a high degree of reliability. It is carried out following a conventional barium swallow. Compared with clinical findings and oesophageal manometry, the water syphon test is very reliable for demonstrating gastro-oesophageal reflux during childhood. Prolonged irradiation in order to see spontaneous reflux becomes unnecessary. This results in a significant reduction in radiation dose. Barium swallow and the water syphon test are the most useful initial examinations in children with symptoms which suggest reflux. (orig.)

  10. Water syphon test and gastrooesophageal reflux during childhood (correlation with the clinical findings and oesophageal manometry)

    Fotter, R.; Hoellwarth, M.

    1981-07-01

    The water syphon test is a simple and easily performed method for demonstrating gastro-oesophageal reflux with a high degree of reliability. It is carried out following a conventional barium swallow. Compared with clinical findings and oesophageal manometry, the water syphon test is very reliable for demonstrating gastro-oesophageal reflux during childhood. Prolonged irradiation in order to see spontaneous reflux becomes unnecessary. This results in a significant reduction in radiation dose. Barium swallow and the water syphon test are the most useful initial examinations in children with symptoms which suggest reflux.

  11. A Study of Anorectal Manometry in Patients with Chronic Idiopathic Constipation

    2000-01-01

    To study the changes of anorectal motility in patients with chronic idiopathic constipation, anorectal motility was investigated by water-perfused manometric system in 30 patients with chronic idiopathic constipation and 18 healthy subjects. Our results showed that there was no significant difference between the constipation group and the control group in anal sphincteric resting pressure and anal maximal squeezing pressure. The minimum relaxation volume, the rectal defecatory threshold, the rectal maximal tolerable volume and the rectal compliance in the patients were significantly higher than those in the controls (P< 0. 01 or P< 0. 05). It is concluded that patients with chronic idiopathic constipation have anorectal motility disturbances.

  12. Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids

    Schuster Anja

    2004-05-01

    Full Text Available Abstract Background Within the last years, stapled rectal mucosectomy (SRM has become a widely accepted procedure for second and third degree hemorrhoids. One of the delayed complications is a stenosis of the lower rectum. In order to evaluate the specific problem of rectal stenosis following SRM we reviewed our data with special respect to potential predictive factors or stenotic events. Methods A retrospective analysis of 419 consecutive patients, which underwent SRM from December 1998 to August 2003 was performed. Only patients with at least one follow-up check were evaluated, thus the analysis includes 289 patients with a mean follow-up of 281 days (±18 days. For statistic analysis the groups with and without stenosis were evaluated using the Chi-Square Test, using the Kaplan-Meier statistic the actuarial incidence for rectal stenosis was plotted. Results Rectal stenosis was observed in 9 patients (3.1%, eight of these stenoses were detected within the first 100 days after surgery; the median time to stenosis was 95 days. Only one patient had a rectal stenosis after more than one year. 8 of the 9 patients had no obstructive symptoms, however the remaining patients complained of obstructive defecation and underwent surgery for transanal strictureplasty with electrocautery. A statistical analysis revealed that patients with stenosis had significantly more often prior treatment for hemorrhoids (p Conclusion Rectal stenosis is an uncommon event after SRM. Early stenosis will occur within the first three months after surgery. The majority of the stenoses are without clinical relevance. Only one of nine patients had to undergo surgery for a relevant stenosis. The predictive factor for stenosis in the patient-characteristics is previous interventions for hemorrhoids, severe postoperative pain might also predict rectal stenosis.

  13. “Fast Track” nasogastric decompression of rectal cancer surgery

    Ka Li; Zongguang Zhou; Zengrong Chen; Yi Zhang; Cun Wang

    2011-01-01

    This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer.A randomized control trial was performed comparing the group with the fast track treatment (n =57) and the group with traditional nasogastric decompression (n =84).Preoperative characteristics and postoperative recovery indices were recorded and analyzed.The results indicate no significant differences in gender (P =0.614),age (P =0.653),tumor location (P =0.113),and TNM stages (P =0.054) were observed between the 2 groups.The differences in the type of resection,anastomosis,and adoption of protective colostomy were all not significant between the FT and the traditional group.During the first 24 hours after surgery,the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group (P =0.197).The initiation of test-meal (P =0.000),semiliquid diet (P =0.002),and ordinary diet (P =0.008)were all significantly shorter in the FT group.Furthermore,compared with the other group,the patients in the FT group enjoyed earlier removal of the abdominal drainage,urinary catheter,and shorter hospital stays (P =0.000).Based on a correlation test,the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet.The routine usage of nasogastric decompression in rectal surgery is unnecessary.The fast track procedure might help in facilitating postoperative functional and diet recovery,reducing the time of catheterization,and shortening hospital stay.

  14. Agurketid? SPOR 2008 - The 24 Hour Experiment

    Kristensen, Thomas Bjørnsten; Steffensen, Rasmus

    2008-01-01

    SPOR festivalen - en slags version 2.0 af den nu hedengange NUMUS-festival, der var en væsentlig platform for ny kompositionsmusik og lydkunst - løb i år af stablen i Musikhuset, Århus, fra 9-10 maj. Som NUMUS har SPOR til hensigt at skabe et seriøst forum for de mere avantgardistiske strømninger...

  15. 24-hour urinary aldosterone excretion rate

    ... RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; ... by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University ...

  16. WordPress 24-Hour Trainer

    Plumley, George

    2011-01-01

    The eagerly anticipated second edition, completely updated for WordPress 3.1 As an open source content management system, WordPress allows users to easily build feature-rich web sites with no programming experience. This unique book-and-video package is a friendly, self-paced beginners guide to the latest release of WordPress. Lessons are focused on practical, everyday tasks that users will need to create and maintain their sites: entering new content, creating new pages, managing menus, making content search-engine friendly. Plus you'll find lots of tips based on years of experience teaching

  17. Toys Remain Viral Playground for 24 Hours

    ... a new study shows. "People don't really think about getting viruses from inanimate objects," said study author Richard Bearden II, of Georgia State University. "They think about getting them from other people." The study ...

  18. Multichannel intraluminal impedance and esophageal manometry data for unrestricted swallowing: establishing normal values.

    Wilson, J A; Mainie, I; Tutuian, R; Agrawal, A; Castell, D O

    2008-01-01

    Standard esophageal manometric testing evaluates swallowing in the supine position using small boluses, with a recovery period imposed between swallows. Manometric tests of more physiologic unrestricted swallowing have had limited practical application due to highly variable results. The purpose of this study is to apply multichannel intraluminal impedance and manometry (MII-EM) to test esophageal function during unrestricted upright meal consumption, and to assess results in a normal healthy population. Ten healthy volunteers with normal esophageal impedance and manometry by published criteria underwent MII-EM testing using a combined 5-channel catheter. After transnasal placement of the catheter, each subject sat upright and consumed a meal that consisted of two pieces of toasted bread and two ounces of Gatorade. There were no restrictions placed on chewing, swallowing, or eating time. All data assessed by the MII-EM meal test were normally distributed. Impedance results with limited variability included the meal duration, number of swallows, postprandial emptying time and the percent of bolus presence times at 15, 10, and 5 cm above the lower esophageal sphincter. Manometric results with limited variability included the number of peristaltic sequences, mean time between these sequences and their distal esophageal amplitudes. MII-EM can be used to collect data with minimal variability in healthy subjects during unrestricted upright meal consumption. This technique may be used to identify abnormal motility patterns during physiologic swallowing. PMID:18197939

  19. Scintigraphy, radiology and pH-manometry in patients after anti-reflux surgery

    The purpose of this study was to evaluate the usefulness of the scintigraphic assessment of esophageal transit times in the diagnosis of the esophageal motor disorders after anti-reflux surgery for gastro-esophageal reflux. In particular, we studied 12 patients with scintigraphy, radiology and manometry. The patients were previously operated on with anti-reflux surgery. Two of them, after Nissen fundoplication, reported dysphagia. The esophagogram and the pH-manometric test did not demonstrate any esophageal motor abnormality. The study of the transit times with a dense bolus showed that both the esophageal transit time (ETT) and the regional emptying time (RET) were more prolonged than in nirmals, even though they were remarkebly better than in patients affected by gastro-esophageal reflux (GER) and not operated. On the basis of these results the Authors also estimate that a dysphagia is likely to be present for ETT greater then 30 sec. and RET greater then 20 sec. It must be specified, however, that while the diagnostic specificity of the ETT was 67%, for the RET it was 100%. This study confirms, therefore, the higher capability of scintigraphy for identifying esophageal motor disorders compared to radiology and pH-manometry

  20. Esophageal Transit Scintigraphy, Manometry, and Barium Swallow in Assessment of Response to Balloon Dilatation in Achalasia

    M.J. Ehsani Ardakani

    2006-08-01

    Full Text Available Background/Objective: Achalasia is a motility disorder of unknown etiology, characterized by absent esophageal peristalsis and loss of lower esophageal sphincter relaxation. Balloon dilatation is the most effective non-surgical treatment for patients with achalasia. Manometry, scintigraphy and radiology are three techniques that provide an objective measure of success after balloon dilatation. The objective of this study was to determine the best predictor of success after balloon dilatation in patients with achalasia. Patients and Methods: 17 patients with achalasia of cardia who referred to Taleghani Hospital in 2003, were evaluated, both symptomatically and objectively (esophageal manometry, timed barium esophagogram, and scintigraphic emptying index, before and after treating with pneumatic dilatation of esophagus. The degree of patient symptom improvements after treat-ment was recorded and correlated with improvement in some indices derived by the above-mentioned three methods. Results: 12 (70.6% of 17 patients had score improvements of ≥80%. All the pre-treatment diagnostic indices were significantly (P<0.05 different from those after therapy. There was no significant difference between the two groups in terms of improvement in symptoms according to the indices of barium swallow or scintigraphy. No association between the patient symptom scores and improvement in either the barium height or emptying index was found. Conclusion: In evaluation of efficacy of pneumatic dilatation of esophagus for treatment of achalasia, we should not only rely on transit or barium study.

  1. Drugs Approved for Colon and Rectal Cancer

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Colon and Rectal Cancer This page ... and rectal cancer that are not listed here. Drugs Approved for Colon Cancer Avastin (Bevacizumab) Bevacizumab Camptosar ( ...

  2. Study and practice on nursing skills training methods under 24 hours shift system%24h值班制护理技能训练方法的研究与实践

    王丽华; 胡野; 金庆跃; 吴玲玲; 周爱君

    2011-01-01

    目的 探讨护理专业校内实训基地开展24 h值班制护理技能训练的方法及效果.方法 将2007级高中升大专护理专业2个班级学生各60名分别列为对照班和实验班.对照班采用常规的护理技能教学方法,教师演示、单个项目训练、下临床实习前集中训练考核的方法.实验班除接受以上训练外于第4学期(即下临床实习前一学期),增加24 h值班制护理技能训练方法:教师设计好病案,按照临床要求排班,各班由1名教师带领4名学生(扮演护士)进行护理技能训练,其余学生扮演患者、家属、朋友,住在仿真病区.对2班的教学效果进行评价.结果 实验班与对照班,综合技能考核、毕业理论考核成绩比较均有显著差异.临床带教老师反映校内实训基地开展24 h值班制护理技能训练项目使学生提前适应临床护理工作,有利于提升学生的综合技能.结论 校内实训基地开展24 h值班制护理技能训练方法是行之有效的一种技能训练方法.%Objective To explore a new training method of nursing skills under 24 hours shift system in the practical training base in the college. Methods The practical training base in the college was rebuilt into a simulated hospital. 120 three-year-course nursing students in grade 2007 were divided into the control class and the experimental class with 60 students in each class. The control class adopted routine teaching method, including teacher demonstration, single project training, concentrated training before clinical practice. The experimental class participated in the tutoring mode of nursing skills under 24 hours shift system in simulated hospital. The cases were pre-designed and students acted as patients by tums. One teacher led 4 students into nursing skill training by day shift, evening shift and mid-night shift. The teaching effect was compared between two classes. Results There was significant difference between the two groups in

  3. Assessment of femoral head vascularity by technetium-99m antimony colloid bone marrow imaging within 24 hours of subcapital fracture: a prospective study of 30 patients followed for 2 years

    The rationale of preoperative imaging of bone marrow was based upon the demonstration of histochemical abnormalities secondary to ischaemia which first become apparent in marrow cells of the femoral head following interruption of the blood supply by subcapital fracture. These marrow abnormalities predate changes in bone cells by several days and may explain the absence of abnormality on conventional bone scans performed on avascular femoral heads within 24 hours of subcapital fracture. The use of an endoprosthesis for fresh femoral neck fractures in unselected patients results in high mortality, high infection rate, high incidence of thromboembolic disease and poor long term results. The successful prediction of avascular necrosis in 92% of 28 patients with active bone marrow in the femoral head in this study is sufficiently accurate to allow appropriate selection of patients for internal fixation or primary prosthetic replacement on the basis of preoperative Tc-99m antimony colloid imaging

  4. Reliability of an Automated High-Resolution Manometry Analysis Program across Expert Users, Novice Users, and Speech-Language Pathologists

    Jones, Corinne A.; Hoffman, Matthew R.; Geng, Zhixian; Abdelhalim, Suzan M.; Jiang, Jack J.; McCulloch, Timothy M.

    2014-01-01

    Purpose: The purpose of this study was to investigate inter- and intrarater reliability among expert users, novice users, and speech-language pathologists with a semiautomated high-resolution manometry analysis program. We hypothesized that all users would have high intrarater reliability and high interrater reliability. Method: Three expert…

  5. Correlation between the radiological observation of isolated tertiary waves on an esophagram and findings on high-resolution esophageal manometry.

    Halland, M; Ravi, K; Barlow, J; Arora, A

    2016-01-01

    Barium esophagrams are a frequently performed test, and radiological observations about potential abnormal esophageal motility, such as tertiary contractions, are commonly reported. We sought to assess the correlation between tertiary waves, and in particular isolated tertiary waves, on esophagrams and findings on non-synchronous high-resolution esophageal manometry. We retrospectively reviewed reports of esophagrams performed at a tertiary referral center and identified patients in whom tertiary waves were observed and a high-resolution esophageal manometry had been performed. We defined two groups; group 1 was defined as patients with isolated tertiary waves, whereas group 2 had tertiary waves and evidence of achalasia or an obstructing structural abnormality on the esophagram. We collected data on demographics, dysphagia score, associated findings on esophagram, and need for intervention. We reviewed the reports of 2100 esophagrams of which tertiary waves were noted as an isolated abnormality in 92, and in association with achalasia or a structural obstruction in 61. High-resolution manometry was performed in 17 patients in group 1, and five had evidence of a significant esophageal motility disorder and 4 required any intervention. Twenty-one patients in group 2 underwent manometry, and 18 had a significant esophageal motility disorder. An isolated finding of tertiary waves on an esophagram is rarely associated with a significant esophageal motility disorder that requires intervention. All patients with isolated tertiary waves who required intervention had a dysphagia to liquids. Tertiary contractions, in the absence of dysphagia to liquids, indicate no significant esophageal motility disorder. PMID:25327483

  6. Clinical value of 24-hour urinary sodium determination in children with postural tachycardia syndrome%体位性心动过速综合征患儿24h尿钠测定的临床意义

    李佳蔚; 张清友; 廖莹; 张春雨; 杜军保

    2015-01-01

    Objective To analyze the clinical value of 24-hour urinary sodium determination in children with postural tachycardia syndrome (POTS).Method Fifty-eight POTS children and 10 healthy children (control group) from Peking University First Hospital during June 2012 to May 2014 were enrolled.Their 24-hour urinary sodium and plasma sodium levels were compared.Correlation analysis was done between 24-hour urinary sodium and symptom scores in children with POTS.All patients were treated with oral rehydration salts.The POTS patients were divided into hyponatriuria group (urinary sodium < 124 mmol/24 h) and hypernatriuria group (urinary sodium ≥ 124 mmol/24 h).Kaplan-Meier curve was used to analyze the effects of different 24-hour urinary sodium levels in children with POTS receiving rehydration salts therapy.Result The 24-hour urinary sodium levels of children with POTS were significantly lower than that of control group ((110.0 ± 45.8) vs.(221.3 ± 103.6) mmol/24 h,t =3.339,P =0.008),while no statistical significance was found in plasma sodium between the two groups ((139.7 ± 2.1) vs.(139.7 ± 2.3) mmol/L,t =0.082,P =0.935).Pearson correlation analysis showed that 24-hour urinary sodium and severity of symptoms in children patients were negatively correlated (r =-0.654,P < 0.001).Urinary sodium < 124 mmol/24 h was used as the cut-off value,there were 43 cases in hyponatriuria group and 15 cases in hypernatriuria group.The symptom scores were significantly higher in hyponatriuria group (10.2 ± 3.7 vs.5.0 ± 1.8,P < 0.001),there was no significant difference in other basic information and hemodynamic data between groups (P > 0.05).Logistic regression analysis revealed that urine sodium < 124 mmol/24 h was independent risk factor for effectiveness of rehydration salts in POTS patients (OR =0.043,95% CI:0.004-0.499,P =0.012).Kaplan-Meier survival analysis showed the long-term effect of patients receiving oral rehydration salts in hyponatriuria group was

  7. IQGAP1 in rectal adenocarcinomas

    Holck, Susanne; Nielsen, Hans Jørgen; Hammer, Emilie;

    2015-01-01

    Treatment of rectal adenocarcinoma includes total mesorectal excision, which is preceded by radiochemotherapy (RCT) in cases of advanced disease. The response to RCT varies from total tumor regression to no effect but this heterogeneous response is unexplained. However, both radiation and treatment...... with 5-fluorouracil may induce treatment resistance through upregulation of the mitogen-activated protein kinase (MAPK) cascade. IQGAP1 is a scaffold protein that appears to be essential to MAPK signaling in cancers. We have therefore studied IQGAP1 protein expression in rectal adenocarcinomas before...

  8. Esophageal manometry

    ... have symptoms of: Heartburn or nausea after eating ( gastroesophageal reflux disease, or GERD ) Problems swallowing (feeling like food is stuck behind ... stomach ( achalasia ) A weak LES, which causes heartburn (GERD) Abnormal contractions of the esophagus muscles that do ...

  9. Esophageal manometry

    ... its ability to move food toward the stomach ( achalasia ) A weak LES, which causes heartburn (GERD) Abnormal contractions of the esophagus muscles that do not effectively move food to the stomach ( esophageal spasm )

  10. Thrombosed hemorrhoid mimicking rectal carcinoma at CT

    Ben-Chetrit, E.; Bar-Ziv, J. (Dept. of Medicine, Dept. of Radiology, Hadassah Univ. Hospital, Jerusalem (Israel))

    1992-09-01

    A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension. (orig.).

  11. Thrombosed hemorrhoid mimicking rectal carcinoma at CT

    A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension. (orig.)

  12. Penile metastasis from rectal carcinoma

    Murhekar K

    2007-01-01

    Full Text Available Penile metastases are infrequent and often originate from genitor-urinary organs including bladder and prostate. In the present communication, we report an unusual case of penile metastasis from rectal adenocarcinoma. Though uncommon, this presentation is not unknown. A review of literature of penile metastases in colorectal cancers is also summarized here.

  13. [The usefulness of manometry in the determination of the morphology of the anal canal].

    Gil-Vernet, J M; Asensio, M; Marhuenda, C; Broto, J; Lloret, J; Boix-Ochoa, J

    1997-07-01

    The appearance of the new lecture systems for the manometry studies by computer, like the Polygram by Synectics (vector volume), offer the possibility to see the circumferential pressure forces, that even in rest conditions as in voluntary contraction, they keep coaptation of the anal canal, and this will act as a continent closure system in the most distal part of the G.I. tract. The study is with the normal parameters obtained in 14 individuals, considered as normal, getting the mean +/- sd pressure of the anal canal convey in mm Hg, from de anal canal profile in rest as in voluntary contraction, and the maximum variability that could exist between the six profile waves, that are obtained in the same individual to develop an image of the anal canal. This valves will allow the author's to get to the bottom of fecal incontinence derivative from anorectal malformations, defining the pressure valves of muscular hypoplasia or surgical outcomes of the malformations. PMID:9376242

  14. New technologies in the gastrointestinal clinic and research: Impedance and high-resolution manometry

    John E Pandolfino; Peter J Kahrilas

    2009-01-01

    The last five years have been an exciting time in the study of esophageal motor disorders due to the recent advances in esophageal function testing. New technologies have emerged, such as intraluminal impedance,while conventional techniques, such as manometry,have enjoyed many improvements due to advances in transducer technology, computerization and graphic data presentation. While these techniques provide more detailed information regarding esophageal function,our understanding of whether they can improve our ability to diagnose and treat patients more effectively is evolving. These techniques are also excellent research tools and they have added substantially to our understanding of esophageal motor function in dysphagia. This review describes the potential benefits that these new technologies may have over conventional techniques for the evaluation of dysphagia.

  15. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry.

    Jadcherla, Sudarshan R; Pakiraih, Joanna F; Hasenstab, Kathryn A; Dar, Irfaan; Gao, Xiaoyu; Bates, D Gregory; Kashou, Nasser H

    2014-07-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (μmol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (μmol/l) between baseline 0.1 ± 0.4 vs. poststimulus -0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks. PMID:24789204

  16. Adesão ao tratamento e controle da pressão arterial por meio da monitoração ambulatorial de 24 horas Blood pressure treatment adherence and control through 24-hour ambulatory monitoring

    Guilherme Brasil Grezzana

    2013-04-01

    Full Text Available FUNDAMENTO: A hipertensão arterial sistêmica (HAS é um importante fator de risco cardiovascular, no entanto os níveis de controle pressórico persistem inadequados. A avaliação da adesão ao tratamento anti-hipertensivo com a utilização da monitoração ambulatorial da pressão arterial (MAPA de 24 horas pode representar um importante auxílio na busca de metas de controle da HAS. OBJETIVO: Avaliar a adesão ao tratamento anti-hipertensivo e a sua relação com os valores de PA obtidos pela MAPA de 24 horas entre pacientes hipertensos de centros de atenção primária à saúde (APS. MÉTODOS: Estudo transversal com 143 pacientes hipertensos de amostra representativa de serviço de APS do município de Antônio Prado, RS. Foi realizada aplicação do teste de Morisky e Green para avaliar a aderência ao tratamento e a verificação do número de medicamentos utilizados, seguida pela aplicação da MAPA de 24 horas. RESULTADOS: Observou-se que 65,7% da amostra foram considerados aderentes ao tratamento proposto, 20,3% eram moderadamente aderentes, enquanto somente 14% foram classificados como não aderentes. Do total de 143 pacientes avaliados, 79 (55,2% foram identificados como HAS controlada (130/80 mmHg, 103 (72% apresentaram ausência de descenso noturno da PA e 60 (41,9% não estavam controlados durante o período de vigília. CONCLUSÃO: Verificamos, no presente estudo, que não há um controle adequado da HAS, com consequente perda de oportunidade dos profissionais envolvidos na APS de ajuste adequado das metas de PA preconizados. Esse fato ocorre a despeito de apropriada adesão ao tratamento anti-hipertensivo dos pacientes vinculados ao ambulatório de APS.BACKGROUND: Although systemic arterial hypertension (SAH is an important cardiovascular risk factor, blood pressure level control often remains inadequate. Assessment of adherence to antihypertensive treatment through 24-hour ambulatory blood pressure monitoring (ABPM may

  17. A manometria anorretal (método do balão no diagnóstico diferencial da doença de Hirschsprung Effectiveness of anorectal manometry using the balloon method to identify the inhibitory recto-anal reflex for diagnosis of Hirschsprung's disease

    Mauro Batista de Morais

    2005-12-01

    chronic constipation. METHODS: Results of 372 anorectal manometries performed consecutively in children with chronic constipation were evaluated. The equipment (Proctosystem Viotti has two channels for pressure registration by the balloon method and is connected to a computer using specific software. Absence of the inhibitory recto-anal reflex was considered suggestive of Hirschsprung's disease and diagnosis was confirmed by traditional diagnostic methods. RESULTS: Absence of the inhibitory recto-anal reflex was found in 14 (3.8% of the 372 anorectal manometry examinations. Diagnosis of Hirschsprung disease was confirmed in 9 out of 14 patients by characterization of aganglionosis upon rectal biopsy. In the other 5 patients, rectal biopsy was not performed in view of a satisfactory evolution with the clinical treatment for constipation. In 4 out of the 5 patients the inhibitory recto-anal reflex was demonstrated with a second anorectal manometry examination. CONCLUSIONS: The equipment used for anorectal manometry presented a satisfactory performance. Diagnosis of Hirschsprung disease was discarded in 86.5% of the patients with chronic constipation because the inhibitory recto-anal reflex was detected. Manometric evaluation also made possible the identification of a small group of patients in which more than half had Hirschsprung's disease.

  18. 24小时食管pH监测对胃食管反流病的诊断意义研究%Investigation of Clinical Characteristics of 24-hour Esophageal pH Monitoring in Gastroesophageal Reflux Disease

    尤华强; 万橱根; 雷家才

    2009-01-01

    OBJECTIVE To discuss the relation between value of 24-hour esophageal pH monitoring and gastroesophageal reflux, and further more provide scientific basis for the clinic diagnosis and treatment of GERD. METHODS CTD-synecties dynamic pH instrument and computer procedure software were used to monitor and analyze 24h pH esophagus value of the 52 eases. Johson and DeMeester's 6 parameters were adopted to evaluate the patients' reflux degree. RESULTS The parameters were respectively between the two groups (P14.72,总阳性率为57.7%;以pH<4的反流次数诊断阳性率最高(57.7%),卧位pH<4的总时间诊断阳性率最低(15.4%).结论 24 h食管pH监测给反流性疾病的诊断和药物治疗提供了依据,提高了对胃食管反流疾病的认识和治疗效果.

  19. Video manometry of the sphincter of Oddi: a new aid for interpreting manometric tracings and excluding manometric artefacts

    Madácsy, L; Middelfart, H V; Matzen, Peter;

    2000-01-01

    develop a new method sphincter of Oddi video manometry-based on simultaneous ESOM and real-time endoscopic image analysis, and to investigate the usefulness of video manometry for detecting manometric artefacts during ESOM. PATIENTS AND METHODS: Seven consecutive patients who had undergone cholecystectomy...... of Oddi phasic contractions were identified, with an average amplitude of 153.9+/-85.0 mm Hg and a duration of 7.9+/-1.2 seconds. Visual analysis of the real-time endoscopic images, replayed in cine loop by the computer, revealed 236 separate duodenal contractions, with an average frequency of 3.......5+/-2.4/min (range: 1-12/min). On the ESOM tracing, 78% of the duodenal contractions had a corresponding pressure wave with an average duration of 2.8+/-0.4 seconds and an amplitude of 71.9+/-16.7 mm Hg. Other artefacts on the ESOM tracings, such as catheter movements, pseudocontractions, hyperventilation, or...

  20. Sleeping position and rectal temperature.

    Petersen, S A; Anderson, E.S.; Lodemore, M; Rawson, D.; Wailoo, M P

    1991-01-01

    The effects of sleeping position upon body temperature were assessed by continuous monitoring of rectal temperature in 137 babies sleeping at home under conditions chosen by their parents. There were three groups of subjects: (1) normal babies aged 12-22 weeks whose temperature rhythms were developed, (2) normal babies aged 6-12 weeks who were developing their night time temperature rhythms, and (3) babies the night after diphtheria, pertussis, and tetanus immunisation, whose temperature rhyt...

  1. Pathogenesis of tropical sprue: A pilot study of antroduodenal manometry, duodenocaecal transit time & fat-induced ileal brake

    Uday C Ghoshal; Sunil KUMAR; Misra, Asha; Choudhuri, Gourdas

    2013-01-01

    Background & objectives: Small intestinal bacterial overgrowth (SIBO) due to ileal brake-induced hypomotility may cause tropical sprue (TS). We evaluated effect of infusion of fat or placebo in duodenum randomly in patients with TS and healthy controls on antroduodenal manometry (ADM) and mediators of ileal brake, and duodenocaecal transit time (DCTT). Methods: ADM and DCTT (lactulose hydrogen breath test, HBT) were evaluated with placebo and fat in eight controls and 13 patients with TS (dia...

  2. Pathogenesis of tropical sprue: A pilot study of antroduodenal manometry, duodenocaecal transit time & fat-induced ileal brake

    Uday C Ghoshal; Sunil Kumar; Asha Misra; Gourdas Choudhuri

    2013-01-01

    Background & objectives: Small intestinal bacterial overgrowth (SIBO) due to ileal brake-induced hypomotility may cause tropical sprue (TS). We evaluated effect of infusion of fat or placebo in duodenum randomly in patients with TS and healthy controls on antroduodenal manometry (ADM) and mediators of ileal brake, and duodenocaecal transit time (DCTT). Methods: ADM and DCTT (lactulose hydrogen breath test, HBT) were evaluated with placebo and fat in eight controls and 13 patients with TS ...

  3. High Resolution Manometry Analysis of a Patient With Dysphagia After Occiput-C3/4 Posterior Fusion Operation

    Oh, Yoongul; Lee, Seok Tae; Ryu, Ju Seok

    2015-01-01

    Many reports of changes in cervical alignment after posterior occipitocervical (O-C) fusion causing dysphagia are available. The clinical course can range from mild discomfort to severe aspiration. However, the underlying pathogenesis is not well known. We report an 80-year-old female with videofluoroscopic swallowing study evidence of aspiration that developed after occiput-C3/4 posterior fusion. Pharyngeal pressure was analyzed using high resolution manometry (HRM). Impaired upper esophagea...

  4. Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

    Kacar, Sabite; Uysal, Selma; Kuran, Sedef; Dagli, Ulku; Ozin, Yasemin; Karabulut, Erdem; Sasmaz, Nurgul

    2007-01-01

    AIM: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER).

  5. [Rectal resection with colo-anal anastomosis for ergotamine-induced rectal stenosis].

    Panis, Y; Valleur, P; Kleinmann, P; Willems, G; Hautefeuille, P

    1990-01-01

    Anorectal ulcers due to ergotamine suppositories are extremely rare. We report the first case of rectal stenosis following regular abuse of ergotamine suppositories which required rectal resection and coloanal anastomosis, despite stopping the intoxication 1 year previously. The rectal eversion during the perineal procedure allowed a low anastomosis to be performed, on the dentate line. One year later, the functional result was considered to be good, demonstrating the place of coloanal anastomosis in benign rectal pathology. PMID:2100123

  6. Bioavailability of rectally administered carbamazepine mixture.

    Neuvonen, P J; Tokola, O.

    1987-01-01

    The relative bioavailability of carbamazepine mixture was studied after oral and rectal administration to healthy subjects. The absorption was significantly slower after the rectal than after the oral route but the total bioavailability was similar provided the mixture was not defaecated within 2 h of administration. We conclude that carbamazepine can be administered rectally, e.g. to postoperative patients in doses corresponding with oral doses.

  7. Advances in Multidisciplinary Treatment of Rectal Cancer

    Zhao, Changlin; Hongqin SUN; Yang, Yang

    2009-01-01

    To summarize the advances in the multidisciplinary treatment of rectal cancer and to analyze the existing problems and development prospects. The full text database retrieval system of MEDLINE and the periodicals of CHKD were searched. The words “rectal cancer, diagnosis, surgery, chemotherapy, radiotherapy, targeted therapy, analysis” were used as key words for retrieval of literature concerning the values and clinical significance of rectal cancer multidisciplinary treatment from January, 2...

  8. Chemoradiotherapy response in recurrent rectal cancer

    The efficacy of response to preoperative chemoradiotherapy (CRT) in recurrent versus primary rectal cancer has not been investigated. We compared radiological downsizing between primary and recurrent rectal cancers following CRT and determined the optimal size reduction threshold for response validated by survival outcomes. The proportional change in tumor length for primary and recurrent rectal cancers following CRT was compared using the independent sample t-test. Overall survival (OS) was calculated using the Kaplan–Meier product limit method and differences between survival for tumor size reduction thresholds of 30% (response evaluation criteria in solid tumors [RECIST]), 40%, and 50% after CRT in primary and recurrent rectal cancer groups. A total of 385 patients undergoing CRT were analyzed, 99 with recurrent rectal cancer and 286 with primary rectal cancer. The mean proportional reduction in maximum craniocaudal length was significantly higher for primary rectal tumors (33%) compared with recurrent rectal cancer (11%) (P < 0.01). There was no difference in OS for either primary or recurrent rectal cancer when ≤30% or ≤40% definitions were used. However, for both primary and recurrent tumors, significant differences in median 3-year OS were observed when a RECIST cut-off of 50% was used. OS was 99% versus 77% in primary and 100% versus 42% in recurrent rectal cancer (P = 0.002 and P = 0.03, respectively). Only patients that demonstrated >50% size reduction showed a survival benefit. Recurrent rectal cancer appears radioresistant compared with primary tumors for tumor size after CRT. Further investigation into improving/intensifying chemotherapy and radiotherapy for locally recurrent rectal cancer is justified

  9. Rectal function following prostate brachytherapy

    Purpose: Quality of life following therapeutic intervention for carcinoma of the prostate gland has not been well documented. In particular, a paucity of data has been published regarding bowel function following prostate brachytherapy. This study evaluated late bowel function in 209 consecutive prostate brachytherapy patients via a one-time questionnaire administered 16-55 months postimplant. Materials and Methods: Two hundred nineteen consecutive patients underwent permanent prostate brachytherapy from April 1995 through February 1998 using either 125I or 103Pd for clinical T1c-T3a carcinoma of the prostate gland. Of the 219 patients, 7 had expired. Of the remaining 212 patients (median follow-up, 28 months), each patient was mailed a self-administered questionnaire (10 questions) with a prestamped return envelope; 209 (98.6%) surveys were returned. Clinical parameters evaluated for bowel dysfunction included patient age, diabetes, hypertension, history of tobacco consumption, clinical T-stage, elapsed time since implant, and prostate ultrasound volume. Treatment parameters included utilization of neoadjuvant hormonal manipulation, utilization of moderate dose external beam radiation therapy prior to implantation, choice of isotope (125I vs. 103Pd), rectal dose (average, median and maximum doses), total implanted seed strength, values of the minimum dose received by 90% of the prostate gland (D90), and the percent prostate volume receiving 100%, 150%, and 200% of the prescribed minimum peripheral dose (V100, V150 and V200, respectively). Because detailed baseline bowel function was not available for these patients, a cross-sectional survey was performed in which 30 newly diagnosed prostate cancer patients of comparable demographics served as controls. Results: The total rectal function scores for the brachytherapy and control patients were 4.3 and 1.6, respectively, out of a total 27 points (p 103Pd resulted in lower radiation doses to the rectum, the choice of

  10. Apolo-Prometeu e Dioniso: dois perfis mitológicos do "homem das 24 horas" de Gaston Bachelard Apollo-Prometheus and Dionysus: two mythological profiles of Gaston Bachelard's "24-hour man"

    Alexander de Freitas

    2006-04-01

    relationship between the epistemology of science and the metaphysics of poetic imagination, two opposed, competing, and complementary traits of Bachelard's philosophy, often expressed by the epithets of "diurnal" and "nocturnal". To study the relationship between these two directions in Bachelard's thought, we start from the analysis of the ambivalence of the following pairs of concepts: epistemological obstacle & material imagination, and psychoanalysis of knowledge & phenomenological method, which structure, theoretically in the case of the former pair, and methodologically in the case of the latter pair, his epistemology of science and his metaphysics of poetic imagination. The results allow us to say that the joining of Bachelard's scientific epistemology and poetical metaphysics is represented in his concept of the "24-hour man". This complex, androgynous man, reader and thinker of the scientific ideas and of the poetical genesis, seems to be an image of the reconciliation of the antinomies expressed by the diurnal and nocturnal facets of the Bachelardian philosophy. Expanding on the imagetic analysis of the "24-hour man" through a myth-analytical hermeneutics, we find the two semblances of Bachelard's philosophy configured, respectively, in the myths of Apollo-Prometheus and Dionysus.

  11. Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

    2007-01-01

    AIM: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER).METHODS: In 45/500 patients, refluxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry.RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal reflux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6),and Group D: both PR/DR (n = 8)]; Group E: no reflux (n = 13); and Group F: hypersensitive esophagus (HSE) (n= 5). Groups B + D indicated total PR patients (n = 14),Groups E + F reflux-negatives with HSE (n = 18), and Groups A + F reflux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry findings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid reflux and/or pathologic manometry finding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PR between Groups B + D and E (AUC = 0.775, P = 0.015).CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study,but it was not diagnostic for CE WT.

  12. THE PLACE OF MECHANIC SUTURES IN MEDIUM AND LOW RECTAL CANCER

    C. Oprescu

    2013-03-01

    Full Text Available BACKGROUND: For medium and low rectal cancer the most common surgical procedures are: low anterior resection with mechanical or manual colorectal anastomosis and transanal rectosigmiod resection with abdominoendoanal intubation. METHODS: We have conducted an observational, retrospective single-center study on a number of consecutive patients operated between January 1st and June 31st, 2011 for malign pathology of the middle and low rectum in The Clinical Emergency Hospital Bucuresti. We included patients with medium and low rectal cancer who had been previously treated by radiotherapy. We practiced rectal resection with mechanical colorectal anastomosis or abdominoendoanal intubation with anal mucous membrane removal. We assessed a number of parameters in relation to surgical procedure, such as: anastomosis dehiscence (AD, anastomotic stenosis (AS, the number of defecations in 24 hours, nocturnal incontinence, delayed bowel movement, flatulence continence, postoperative complications, local tumour recurrence and mortality. RESULTS: The study comprises 53 patients divided into 2 groups: the 1st group, included 19 patients treated by rectal resection with abdominoendoanal intubation and anal mucous membrane removal, and the 2nd group, included 34 patients treated by rectal resection with mechanical colorectal anastomosis. AD was found in 5.26% (1/19 in group 1, respectively 20.5% (7/34 in group nr 2. At 6 months follow-up, one patient from the 1st group experienced AS (5.26%, as for the 2nd group, AS was present in 5 patients (14.7%; at 12 months after the procedure the number of patients with AS increased to 3 in group 1 (15.78% and to 6 in group 2 (17.64% respectively. After 12 months, the nocturnal incontinence evaluated between 11.00 pm and 06.00 am: 3 patients from group 1 had 1 night evacuation daily, in all days of the week; 1 patient from group 2 presented 2 night evacuations on week. After 12 months postoperative: 11 patients, (57

  13. Detection of myocardial viability by means of Single Proton Emission Computed Tomography (Perfused SPECT) dual 201 Tl (rest of 15 minutes, 24 late hours and 24 hours reinjection) and gated-SPECT 99m Tc-SESTAMIBI in effort or stimulation of the coronary reserves

    The objective of this work was to determine if the images of SPECT 201 TI in rest of 15 minutes, 24 late hours and Gated-SPECT 99m Tc-SESTAMIBI in effort or stimulation of coronary reservation correlate with the study of 24 hours post reinjection of 201TI to determine the presence of having knitted viable myocardium. Material and methods: 29 patients were studied with coronary arterial illness (EAC) to who are carried out SPECT 201 TI in rest with images of 15 minutes, 24 late hours and 24 hours reinjection, by means of the administration of 201TI to dose of 130 MBq and reinjection with 37 MBq. and Gated-SPECT 99mTc-SESTAMIBI in effort or stimulation of coronary reservation, later to the administration of 1110 MBq. Results: 29 patients were included according to inclusion approaches and exclusion, of those which 22 (75.86%) they correspond at the masculine sex and 7 (24.13%) to the feminine one, with an average of 62.1 year-old age, 2320 segments myocardial were analysed so much it is phase post-effort as rest; they were diagnosed a total of 264 segments with heart attack, of which viability myocardium was observed in 174 segments. The statistical tests are analysis of frequencies. The non parametric test of Wilcoxon and Mann-Whitney. Conclusions: the viability myocardial at the 24 late hours and 24 hours reinjection was similar; significant difference exists between the study of 15 minutes and 24 hours reinjection, ischemic illness was also demonstrated in territories different to the heart attack area in the studies of 15 minutes, late 24 hours and 24 hours reinjection. (Author)

  14. Influence of preoperative (hyperthermic) radiochemotherapy on manometric anal sphincter function in locally advanced rectal cancer

    Background and purpose: preoperative radiochemotherapy (RCT) followed by curative surgery is a well-accepted therapeutic option in the treatment of advanced rectal cancer. Usually, the anal sphincter is located in the irradiation area of a preoperative RCT regime. The aim of this study is to evaluate the influence of preoperative RCT on anal sphincter function. Patients and methods: between 1994 and 2000, 102 patients with rectal cancer stage uT3/uT4 were analyzed. All patients underwent radiotherapy with 45 Gy (5 x 1.8 Gy) including two cycles of 5-fluorouracil (5-FU)/leucovorin (folinic acid) chemotherapy. 46 patients were treated additionally with up to five sessions of locoregional hyperthermia. The sphincter function was analyzed by perfusion manometry before preoperative therapy and 4 weeks after pretreatment had been finished. For statistics, the Wilcoxon signed rank test and mann-whitney U-test were used (SPSS 9.0 for Windows trademark). Results: the mean value of all 102 patients showed a significant reduction of the mean maximum resting pressure from 97 to 89 mmHg (p = 0.02). For the mean maximal squeeze pressure no significant difference could be shown (178 vs. 176 mmHg). For patients with distal (≤ 7.5 cm from anal verge) tumors the difference was highly significant (92 vs. 79 mmHg). Locoregional hyperthermia had no additional influence on sphincter function. Conclusion: preoperative RCT impairs sphincter function especially in patients with distal tumors. In addition, RCT could have a negative influence on the continence of patients who received sphincter-preserving surgery. (orig.)

  15. Case mix, outcome and activity for patients with severe acute kidney injury during the first 24 hours after admission to an adult, general critical care unit: application of predictive models from a secondary analysis of the ICNARC Case Mix Programme Database

    Kolhe, Nitin V; Stevens, Paul E.; Crowe, Alex V; Lipkin, Graham W.; Harrison, David A

    2008-01-01

    Introduction This study pools data from the UK Intensive Care National Audit and Research Center (ICNARC) Case Mix Programme (CMP) to evaluate the case mix, outcome and activity for 17,326 patients with severe acute kidney injury (AKI) occurring during the first 24 hours of admission to intensive care units (ICU). Methods Severe AKI admissions (defined as serum creatinine ≥300 μmol/l and/or urea ≥40 mmol/l during the first 24 hours) were extracted from the ICNARC CMP database of 276,326 admis...

  16. Rectal cancer surgery: volume-outcome analysis.

    Nugent, Emmeline

    2010-12-01

    There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to rectal cancer surgery.

  17. Treatment of locally advanced rectal cancer

    Klaassen, RA; Nieuwenhuijzen, GAP; Martijn, H; Rutten, HJT; Hospers, GAP; Wiggers, T

    2004-01-01

    Historically, locally advanced rectal cancer is known for its dismal prognosis. The treatment of locally advanced rectal cancer is subject to continuous change due to development of new and better diagnostic tools, radiotherapeutic techniques, chemotherapeutic agents and understanding of the subject

  18. Severe rectal complications after prostate brachytherapy

    Purpose: Some investigators have reported severe rectal complications after brachytherapy. Due to the low number of such events, their relationship to dosimetric parameters has not been well characterized. Methods and materials: A total of 3126 patients were treated with low dose rate brachytherapy from 1998 through 2010. 2464 had implant alone, and 313 had implant preceded by 44–46 Gy supplemental external beam radiation (EBRT). Post-implant dosimetry was based on a CT scan obtained on the day of implant, generally within 30 min of the procedure. Every patient’s record was reviewed for occurrence of rectal complications. Results: Eight of 2464 patients (0.32%) treated with brachytherapy alone developed a radiation-related rectal fistula. Average prostatic and rectal dose parameters were moderately higher for fistula patients than for patients without a severe rectal complication. For instance, the average R100 was 1.2 ± 0.75 cc for fistula patients, versus 0.37 ± 0.88 cc for non-fistula patients. However, the fistula patients’ values were well within the range of values for patients without a rectal complication. Four patients had some attempt at repair or reconstruction, but long-term functional outcomes were not favorable. Conclusions: Rectal fistulas are a very uncommon potential complication of prostate brachytherapy, which can occur even in the setting of acceptable day 0 rectal doses. Their occurrence is not easily explained by standard dosimetric or clinical factors

  19. The Morphologic Assessment of Rectal Neuroendocrine Tumors

    Eun Ran Kim

    2014-04-01

    Conclusions: Endoscopic features such as hyperemic change, polypoid lesions, irregular contours, and surface ulcers with tumor size ≥10 mm in diameter are associated with metastasis in rectal NETs. In particular, atypical endoscopic features including hyperemic change, and surface ulcer with tumor size ≥10 mm in diameter may help to predict the risk of metastasis of rectal NETs.

  20. Evaluation of the embolic effect of polyvinyl alcohol foam particles according to particle size on the cerebral artery of a cat, focusing on T2 weighted MR images and pathologic study after 24 hours

    This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. A total of 21 cats were divided into three groups according to the PVA particle size injected: group I (n=3D7), embolized with 45-150μm PVA; group II (n=3D7), with 150-250μm PVA; and group III (n=3D7), with 350-500μm PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group I and in two of the seven (29%) II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 ± 1.37% in group I and 5.18 ± 1.77% in group II (P less than 0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries (MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II, No group III cat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175μm in Group I and 258μm in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. Small PVA particles has a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150μm in size are appropriate. (author)

  1. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury.

    Koufman, J A

    1991-04-01

    Occult (silent) gastroesophageal reflux disease (GER, GERD) is believed to be an important etiologic factor in the development of many inflammatory and neoplastic disorders of the upper aerodigestive tract. In order ot test this hypothesis, a human study and an animal study were performed. The human study consisted primarily of applying a new diagnostic technique (double-probe pH monitoring) to a population of otolaryngology patients with GERD to determine the incidence of overt and occult GERD. The animal study consisted of experiments to evaluate the potential damaging effects of intermittent GER on the larynx. Two hundred twenty-five consecutive patients with otolaryngologic disorders having suspected GERD evaluated from 1985 through 1988 are reported. Ambulatory 24-hour intraesophageal pH monitoring was performed in 197; of those, 81% underwent double-probe pH monitoring, with the second pH probe being placed in the hypopharynx at the laryngeal inlet. Seventy percent of the patients also underwent barium esophagography with videofluoroscopy. The patient population was divided into seven diagnostic subgroups: carcinoma of the larynx (n = 31), laryngeal and tracheal stenosis (n = 33), reflux laryngitis (n = 61), globus pharyngeus (n = 27), dysphagia (n = 25), chronic cough (n = 30), and a group with miscellaneous disorders (n = 18). The most common symptoms were hoarseness (71%), cough (51%), globus (47%), and throat clearing (42%). Only 43% of the patients had gastrointestinal symptoms (heartburn or acid regurgitation). Thus, by traditional symptomatology, GER was occult or silent in the majority of the study population. Twenty-eight patients (12%) refused or could not tolerate pH monitoring. Of the patients undergoing diagnostic pH monitoring, 62% had abnormal esophageal pH studies, and 30% demonstrated reflux into the pharynx. The results of diagnostic pH monitoring for each of the subgroups were as follows (percentage with abnormal studies): carcinoma (71

  2. TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler: a prospective multicenter trial

    José Vinicius Cruz

    2011-03-01

    Full Text Available CONTEXT: Since anorectocele is usually associated with mucosa prolapse and/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. OBJECTIVE: To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. METHODS: It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7% and grade 3 (73.3% anorectocele associated with mucosa prolapse and/or rectal intussusception (52.0% and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. RESULTS: All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3% patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%. Forty-nine patients (65.3% required 1 hospitalization day, the remainder (34.7% 2 days. Postoperatively, 3 (4.0% patients complained of persistent rectal pain and 7 (9.3% developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1, endoscopic stricturectomy with hot biopsy forceps (n = 3 and digital dilatation (n = 3. Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%. The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68 (6: n = 6 (7: n = 1 (P<0.0001. CONCLUSION: Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment

  3. Simultaneous videoradiography and pharyngeal solid state manometry (videomanometry) in 25 nondysphagic volunteers.

    Olsson, R; Nilsson, H; Ekberg, O

    1995-01-01

    Recent technological advances in manometry, including solid state transducers and computerized analysis, allows for reliable interpretation of intraluminal pharyngeal pressures. Simultaneous videoradiography (barium swallow) provides fluoroscopic control of the manometric sensors (videomanometry), thereby eliminating the uncertainty of sensor dislocation during laryngeal elevation. This is the first study describing normal manometric parameters in videomanometry during barium swallow. Seven manometric parameters and six videoradiographic parameters were analyzed. We included 25 nondysphagic volunteers with normal videoradiographic parameters in the study. The examination was performed in an upright physiologic position during 10-ml barium and dry swallows. Mean resting pressure in the upper esophageal sphincter was 89.6 +/- 32.6 (+/- 2 SD) mmHg. Mean residual pressure during relaxation of the upper esophageal sphincter was 7.2 +/- 8.0 (+/- 2 SD) mmHg during barium swallow and 3.8 +/- 6.2 (+/- 2 SD) mmHg during dry swallow. The mean duration of upper esophageal sphincter relaxation was 601 +/- 248 (+/- 2 SD) msec. The mean peristaltic contraction of the upper esophageal sphincter was 253.8 +/- 142.8 (+/- 2 SD) mmHg. Fourteen (56%) of the 25 had a measurable intrabolus pressure (mean 33.2 +/- 17.3 mmHg) at the level of the inferior pharyngeal constrictor. A specific finding was discovered when the epiglottis tilts down hitting the manometric sensor. This epiglottic tilt was identified in 7 subjects (28%) and caused pressures of around 600 mmHg. A standardized manometric technique is important in videomanometry, and normal values as described in this study are essential in clinical use. PMID:7859531

  4. Non-invasive measurement of local pulse pressure by pulse wave-based ultrasound manometry (PWUM)

    Central blood pressure (CBP) has been established as a relevant indicator of cardiovascular disease. Despite its significance, CBP remains particularly challenging to measure in standard clinical practice. The objective of this study is to introduce pulse wave-based ultrasound manometry (PWUM) as a simple-to-use, non-invasive ultrasound-based method for quantitative measurement of the central pulse pressure. Arterial wall displacements are estimated using radiofrequency ultrasound signals acquired at high frame rates and the pulse pressure waveform is estimated using both the distension waveform and the local pulse wave velocity. The method was tested on the abdominal aorta of 11 healthy subjects (age 35.7±16 y.o.). PWUM pulse pressure measurements were compared to those obtained by radial applanation tonometry using a commercial system. The average intra-subject variability of the pulse pressure amplitude was found to be equal to 4.2 mmHg, demonstrating good reproducibility of the method. Excellent correlation was found between the waveforms obtained by PWUM and those obtained by tonometry in all subjects (0.94 < r < 0.98). A significant bias of 4.7 mmHg was found between PWUM and tonometry. PWUM is a highly translational method that can be easily integrated in clinical ultrasound imaging systems. It provides an estimate of the pulse pressure waveform at the imaged location, and may offer therefore the possibility to estimate the pulse pressure at different arterial sites. Future developments include the validation of the method against invasive estimates on patients, as well as its application to other large arteries

  5. Electrogastrography: Poor correlation with antro-duodenal manometry and doubtful clinical usefulness in adults

    2007-01-01

    AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG)and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters.METHODS: We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years.RESULTS: We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r = -0.07, P = 0.39). The discriminatory power of EGG for underlying motility disorder was also low.Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7 ± 0.5vs 4.0 ± 0.5) and tachygastric (3.5 ± 0.4 vs 3.7 ± 0.4)regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)].CONCLUSION: EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.

  6. Interstitial irradiation of rectal carcinoma with rectal template

    Ikeda, Hiroshi; Nishiyama, Kinji; Tanaka, Ken; Nakanishi, Makoto; Inoue, Takehiro (Osaka Univ. (Japan). Faculty of Medicine)

    1984-06-01

    Using Iridium-192 wires through a rectal template after Syed, interstitial brachytherapy was conducted in a patient with inoperable adenocarcinoma of the rectum. A 67-year-old man with constipation and change in the stool caliber underwent external radiotherapy (4,000cGy/4W) to the whole pelvis including the perineum, followed by interstitial implant using a template, at the Department of Radiology, Osaka University Hospital. Marked tumor regression, marked circumferential fibrosis and a remarkable decline of CEA titers (pre-RT: 35.8ng/ml, post-RT: 6.2ng/ml) were observed until 7 months post-RT. The domestic production of Iridium-192 wires has made possible the intergrated use of brachytherapy in the perineal region in Japan.

  7. Interstitial irradiation of rectal carcinoma with rectal template

    Using Iridium-192 wires through a rectal template after Syed, interstitial brachytherapy was conducted in a patient with inoperable adenocarcinoma of the rectum. 67-year-old man with constipation and change in the stool caliber underwent external radiotherapy (4,000cGy/4W) to the whole pelvis including the perineum, followed by interstitial implant using a template, at the Department of Radiology, Osaka University Hospital. Marked tumor regression, marked circumferential fibrosis and a remarkable decline of CEA titers (pre-RT: 35.8ng/ml, post-RT: 6.2ng/ml) were observed until 7 months post-RT. The domestic production of Iridium-192 wires has made possible the intergrated use of brachytherapy in the perineal region in Japan. (author)

  8. High-Resolution MRI in Rectal Cancer

    High-resolution MRI is the best method of assessing the relation of the rectal tumor with the potential circumferential resection margin (CRM). Therefore it is currently considered the method of choice for local staging of rectal cancer. The primary surgery of rectal cancer is total mesorectal excision (TME), which plane of dissection is formed by the mesorectal fascia surrounding mesorectal fat and rectum. This fascia will determine the circumferential margin of resection. At the same time, high resolution MRI allows adequate pre-operative identification of important prognostic risk factors, improving the selection and indication of therapy for each patient. This information includes, besides the circumferential margin of resection, tumor and lymph node staging, extramural vascular invasion and the description of lower rectal tumors. All these should be described in detail in the report, being part of the discussion in the multidisciplinary team, the place where the decisions involving the patient with rectal cancer will take place. The aim of this study is to provide the information necessary to understand the use of high resolution MRI in the identification of prognostic risk factors in rectal cancer. The technical requirements and standardized report for this study will be describe, as well as the anatomical landmarks of importance for the total mesorectal excision (TME), as we have said is the surgery of choice for rectal cancer. (authors)

  9. PET-MRI in Diagnosing Patients With Colon or Rectal Cancer

    2015-11-25

    Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage IIA Colon Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer

  10. Rectal Duplication Cyst: A Rare Cause of Rectal Prolapse in a Toddler.

    Khushbakht, Samreen; ul Haq, Anwar

    2015-12-01

    Rectal duplication cysts are rare congenital anomalies. They constitute only 4% of the total gastrointestinal anomalies. They usually present in childhood. The common presenting symptoms are mass or pressure effects like constipation, tenesmus, urinary retention, local infection or bleeding due to presence of ectopic gastric mucosa. We are reporting a rare presenting symptom of rectal duplication cyst in a 4-year-old boy/toddler who presented with rectal prolapse. He also had bleeding per rectum. Rectal examination revealed a soft mass palpable in the posterior rectal wall. CT scan showed a cystic mass in the posterior wall of the rectum. It was excised trans-anally and the postoperative recovery was uneventful. Biopsy report showed rectal duplication cyst. PMID:26691370

  11. Evidences in multidisciplinary management of rectal cancer

    In the last 10 years, a number of important European randomized published studies investigated the optimal management of rectal cancer. In order to define an evidence-based approach of the clinical practice based, an international consensus conference was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO) and European Society of Therapeutic Radiation Oncology (ESTRO). The aim of this article is to present highlights of multidisciplinary rectal cancer management and to compare the conclusions of the international conference on 'Multidisciplinary Rectal Cancer Treatment: looking for an European Consensus' (EURECA-CC2) with the new National Comprehensive Cancer Network (NCCN) guidelines. (authors)

  12. MRI staging of low rectal cancer

    Shihab, Oliver C.; Heald, Richard J. [Pelican Cancer Foundation, North Hampshire Hospital, Basingstoke (United Kingdom); Moran, Brendan J. [Colorectal Research Unit, North Hampshire Hospital, Basingstoke (United Kingdom); Quirke, Philip [St James' s Hospital, Leeds Institute for Molecular Medicine, Leeds (United Kingdom); Brown, Gina [Royal Marsden Hospital, Department of Radiology, Surrey (United Kingdom)

    2009-03-15

    Low rectal tumours, especially those treated by abdominoperineal excision (APE), have a high rate of margin involvement when compared with tumours elsewhere in the rectum. Correct surgical management to minimise this rate of margin involvement is reliant on highly accurate imaging, which can be used to plan the planes of excision. In this article we describe the techniques for accurate magnetic resonance imaging (MRI) assessment and a novel staging system for low rectal tumours. Using this staging system it is possible for the radiologist to demonstrate accurately tumour-free planes for surgical excision of low rectal tumours. (orig.)

  13. MRI staging of low rectal cancer

    Low rectal tumours, especially those treated by abdominoperineal excision (APE), have a high rate of margin involvement when compared with tumours elsewhere in the rectum. Correct surgical management to minimise this rate of margin involvement is reliant on highly accurate imaging, which can be used to plan the planes of excision. In this article we describe the techniques for accurate magnetic resonance imaging (MRI) assessment and a novel staging system for low rectal tumours. Using this staging system it is possible for the radiologist to demonstrate accurately tumour-free planes for surgical excision of low rectal tumours. (orig.)

  14. Effect of laser on the remnant liver after the first 24 hours following 70% hepatectomy in rats Efeito do laser no fígado remanescente nas primeiras 24 horas após hepatectomia a 70% em ratos

    Ailton Jose Barbosa

    2011-12-01

    Full Text Available PURPOSE: To evaluate the mitochondrial function of the remnant liver (RL in the early phase of liver regeneration in rats after 70% partial hepatectomy (PH. METHODS: Sixty male Wistar rats (200-250g submitted to 70% PH were divided into five groups according to the time of euthanasia and application or not of laser light: C = Control, time zero; 2 minutes, 4, 6 and 24 hours after PH. The dose of laser radiation was 22.5 J/cm², wavelength of 660 nm (visible/red, in the remnant liver. We studied the respiration activated by ADP (state 3, basal mitochondrial respiration (state 4, respiratory control ratio (RCR and mitochondrial membrane potential (MMP. RESULTS: The mitochondrial function of RL changed at 4 and 6 hours after PH, with a significant increase in state 3 and a concomitant increase in state 4 and with maintenance of RCR. MMP differed significantly between the groups biostimulated with laser radiation and the control group 4 hours after HP, with a substantial reduction in the non-laser groups. CONCLUSION: The laser light at the dose used in this study did not induce additional damage to the RL and seems to have delayed the hepatocellular metabolic overload of the remnant liver.OBJETIVO: Avaliar a função mitocondrial do fígado remanescente (FR na fase precoce da regeneração hepática em ratos após hepatectomia parcial (HP a 70%. MÉTODOS: Sessenta ratos machos Wistar (200 - 250g submetidos à HP a 70%, foram distribuídos em cinco grupos de acordo com o tempo de eutanásia e com aplicação ou não de luz laser: C= Controle,tempo zero; 2 minutos, 4, 6 e 24 horas após HP. O laser foi utilizado na dose 22.5 J/cm², 660 nm, no FR.Estudou-se o estado 3 (respiração ativada por ADP, estado 4 (respiração mitocondrial basal, razão de controle respiratório,estado 3/estado 4 (RCR e o potencial de membrana mitocondrial(PMM. RESULTADOS: A função mitocondrial do FR alterou-se no período de 4 e 6 horas após a HP com aumento

  15. Transvaginal ultrasonography of rectal endometriosis

    Egekvist, Anne Gisselmann; Seyer-Hansen, Mikkel; Forman, Axel

    Objectives: The aim of this present study was to evaluate the interobserver variation of transvaginal ultrasonographic measurements of endometriosis infiltrating the rectosigmoid wall. Methods: Transvaginal ultrasonography was performed independently by two observers. Observer 1 had several years...... of experience in ultrasonography while observer 2 was a medical student with no prior experience in ultrasonography or endometriosis. In 24 patient length, width and depth of endometriosis infiltrating the rectosigmoid bowel was measured. The differences between the observers were analysed by Bland...... ultrasonography for a relatively short period gives comparable scanning results between the two observers. It seems that transvaginal ultrasound could be used as a diagnostic tool for rectal endometriosis in most departments. However, the irregular morphology of the lesions makes the measurements very complex...

  16. How useful is rectal endosonography in the staging of rectal cancer?

    Taylan; Kav; Yusuf; Bayraktar

    2010-01-01

    It is essential in treating rectal cancer to have adequate preoperative imaging,as accurate staging can influence the management strategy,type of resection,and candidacy for neoadjuvant therapy.In the last twenty years,endorectal ultrasound(ERUS) has become the primary method for locoregional staging of rectal cancer.ERUS is the most accurate modality for assessing local depth of invasion of rectal carcinoma into the rectal wall layers(T stage) .Lower accuracy for T2 tumors is commonly reported,which could ...

  17. Low Rectal Cancer Study (MERCURY II)

    2016-03-11

    Adenocarcinoma; Adenocarcinoma, Mucinous; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Cystic, Mucinous, and Serous; Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Diseases; Rectal Diseases

  18. Wind sock deformity in rectal atresia

    Rectal atresia is a rare anorectal deformity. It usually presents with neonatal obstruction and it is often a complete membrane or severe stenosis. Windsock deformity has not been reported in rectal atresia especially, having been missed for 2 years. A 2-year-old girl reported only a severe constipation despite having a 1.5-cm anal canal in rectal examination with scanty discharge. She underwent loop colostomy and loopogram, which showed a wind sock deformity of rectum with mega colon. The patient underwent abdominoperineal pull-through with good result and follow-up. This is the first case of the wind sock deformity in rectal atresia being reported after 2 years of age. (author)

  19. Treatment Options by Stage (Rectal Cancer)

    ... Treatment Genetics of Colorectal Cancer Age and family history can affect the risk of rectal cancer. Anything ... to flow from the body to a collection bag. After the cancer is removed, the surgeon will ...

  20. Wind sock deformity in rectal atresia

    Hosseini Seyed

    2009-01-01

    Full Text Available Rectal atresia is a rare anorectal deformity. It usually presents with neonatal obstruction and it is often a complete membrane or severe stenosis. Windsock deformity has not been reported in rectal atresia especially, having been missed for 2 years. A 2-year-old girl reported only a severe constipation despite having a 1.5-cm anal canal in rectal examination with scanty discharge. She underwent loop colostomy and loopogram, which showed a wind sock deformity of rectum with mega colon. The patient underwent abdominoperineal pull-through with good result and follow-up. This is the first case of the wind sock deformity in rectal atresia being reported after 2 years of age.

  1. MicroRNA in rectal cancer

    Azizian, Azadeh; Gruber, Jens; Ghadimi, B. Michael; Gaedcke, Jochen

    2016-01-01

    In rectal cancer, one of the most common cancers worldwide, the proper staging of the disease determines the subsequent therapy. For those with locally advanced rectal cancer, a neoadjuvant chemoradiotherapy (CRT) is recommended before any surgery. However, response to CRT ranges from complete response (responders) to complete resistance (non-responders). To date we are not able to separate in advance the first group from the second, due to the absence of a valid biomarker. Therefore all pati...

  2. Initial experience with magnetic resonance fluoroscopy in the evaluation of oesophageal motility disorders. Comparison with manometry and barium fluoroscopy

    Panebianco, Valeria; Anzidei, Michele; Catalano, Carlo; Passariello, Roberto [University of Rome ' ' La Sapienza' ' , Department of Radiological Sciences, Rome (Italy); Habib, Fortunee I.; Tomei, Ernesto [University of Rome ' ' La Sapienza' ' , Division of Gastroenterology, Rome (Italy); Paolantonio, Pasquale; Laghi, Andrea [University of Rome ' ' La Sapienza' ' , Department of Radiological Sciences - Polo Didattico Pontino I.C.O.T, Rome (Italy)

    2006-09-15

    The aim of this paper was to assess the diagnostic value of magnetic resonance (MR) fluoroscopy in the study of oesophageal motility disorders and to compare MR fluoroscopy results with those of manometry and barium contrast radiography. Twenty-five subjects referred for dysphagia and three patients in follow-up after pneumatic dilatation of the lower oesophageal sphincter to treat severe achalasia underwent esophageal manometry, barium contrast radiography and MR fluoroscopy. Examinations were performed on a 1.5 T scanner. Dynamic turbo- fast low angle shot (turbo-FLASH) sequences acquired during oral contrast agent administration were used to perform MR fluoroscopy. MR fluoroscopy correctly diagnosed achalasia in nine patients, uncoordination of esophageal body motility in ten and scleroderma oesophagus in one. Diagnostic performance was satisfactory, with a sensitivity of 87.5% and a specificity of 100% in the general depiction of motility alterations. Our work demonstrates that MR fluoroscopic examination in subject affected by oesophageal motility disorders is feasible and can properly depict motility and morphology alterations, achieving correct diagnosis in the majority of cases. Studies on larger populations are necessary to obtain statistically significant results. (orig.)

  3. Initial experience with magnetic resonance fluoroscopy in the evaluation of oesophageal motility disorders. Comparison with manometry and barium fluoroscopy

    The aim of this paper was to assess the diagnostic value of magnetic resonance (MR) fluoroscopy in the study of oesophageal motility disorders and to compare MR fluoroscopy results with those of manometry and barium contrast radiography. Twenty-five subjects referred for dysphagia and three patients in follow-up after pneumatic dilatation of the lower oesophageal sphincter to treat severe achalasia underwent esophageal manometry, barium contrast radiography and MR fluoroscopy. Examinations were performed on a 1.5 T scanner. Dynamic turbo- fast low angle shot (turbo-FLASH) sequences acquired during oral contrast agent administration were used to perform MR fluoroscopy. MR fluoroscopy correctly diagnosed achalasia in nine patients, uncoordination of esophageal body motility in ten and scleroderma oesophagus in one. Diagnostic performance was satisfactory, with a sensitivity of 87.5% and a specificity of 100% in the general depiction of motility alterations. Our work demonstrates that MR fluoroscopic examination in subject affected by oesophageal motility disorders is feasible and can properly depict motility and morphology alterations, achieving correct diagnosis in the majority of cases. Studies on larger populations are necessary to obtain statistically significant results. (orig.)

  4. VRC01 antibody protects against vaginal and rectal transmission of human immunodeficiency virus 1 in hu-BLT mice.

    Sun, Ming; Li, Yue; Yuan, Zhe; Lu, Wuxun; Kang, Guobin; Fan, Wenjin; Li, Qingsheng

    2016-09-01

    Broadly neutralizing antibodies (bNAbs) represent a new generation of antiviral agents for the prevention and treatment of human immunodeficiency virus 1 (HIV-1) infection. A better understanding of the in vivo efficacy of HIV-1 bNAbs, such as VRC01, in preventing mucosal transmission of HIV-1 has important implications for HIV-1 vaccine design. In this study, we evaluated the efficacy of passively transferred VRC01 antibody in preventing HIV-1 vaginal and rectal transmission in humanized bone marrow/liver/thymus mice (hu-BLT mice). Mice were subcutaneously injected with VRC01 IgG, and 24 hours later, they were challenged intravaginally or intrarectally with HIV-1Ada. All hu-BLT mice receiving VRC01 IgG antibody were aviremic at 2 weeks after intravaginal (n = 3) or intrarectal (n = 6) challenge as measured by quantitative real-time RT-PCR. In contrast, mice receiving control IgG all became infected. By 5 and 6 weeks post-challenge, some of VRC01 aviremic mice in both the intravaginal and intrarectal challenge groups became viremic. Our results suggest that VRC01 antibody can be protective against HIV-1 vaginal and rectal transmission; however, a single administration of VRC01 cannot completely prevent mucosal infection. PMID:27343044

  5. The Effects of Single-Dose Rectal Midazolam Application on Postoperative Recovery, Sedation, and Analgesia in Children Given Caudal Anesthesia Plus Bupivacaine

    Sedat Saylan

    2014-01-01

    Full Text Available Background. This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to find out its adverse effects in children having lower abdominal surgery. Methods. 40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20 was given 5 mL saline, and Group M (n = 20 was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS of the patients were evaluated. The patients were observed for their analgesic need, first analgesic time, and adverse effects for 24 hours. Results. Demographic and hemodynamic data of the two groups did not differ. Postoperative sedation scores in both groups were significantly lower compared with the preoperative period. There was no significant difference between the groups in terms of sedation and sufficient analgesia. Conclusions. We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any differences. This trial is registered with ClinicalTrials.gov NCT02127489.

  6. Digital rectal examination and transrectal ultrasonography in staging of rectal cancer

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1994-01-01

    Staging of rectal carcinoma before surgical treatment was performed in a prospective blind study, comparing digital rectal exploration and transrectal linear ultrasonography (TRUS) with the resulting pathological examination. TRUS underestimated depth of penetration in 3 of 33 patients and overes...... surgery for cure....

  7. Importance of Preoperative Rectal Ultrasound and CT in Rectal Tumors

    Introduction: The reason of high mortality of colorectal carcinoma is above all the fact, that majority of diseases are detected in progressive stage. Radical change in this unfavorable mortality rate can be achieved only by targeted search for early stages of the disease. Early diagnostics consists in rectoscopy and colonoscopy. Regarding X-ray methods it is X-ray irigography. Regarding CT examinations it is CT irigography, virtual colonoscopy. Another examination can be USG examination of abdomen and endo sonographic examination of rectum. Materials and methods: In the period from June 2006 to December 2010, in 60 patients out of the total number 106 examined patients, tumorous affection of rectum CT examination of pelvis and abdomen separately or pelvisand abdomen at one session was made in 3186 patients. In 115 patients we discovered malign tumorous illness of colon. Metastatic affection in the form of distant metastases was proven n 63 patients. 403 patients had CT irigography examination. In 77 out of them we diagnosed colon carcinoma. CT colonoscopy did not discover in our group of 30 patients examined the presence of colon carcinoma. Results: In the group of 60 patients who were diagnosed rectal carcinoma, in 29 patients expansive infiltrative affection was evaluated in endorectal sonography, histologically confirmed in 28 patients - 96,5 %, expansive affection in 41 patients with histological verification in 100 %. With CT we diagnosed 52 expansive tumorous processes, histologically confirmed in 47 patients - 90,38 %. In 63 patients expansive infiltrative process was evaluated, histologically confirmed in 52 patients 82,53 %. In total of 115 examinations there was conformance with histological examination in 99 patients - 86,08 %. In CT irigography we diagnosed colon tumour in 77 patients. Expansive growth was evaluated in 40 patients, histologically confirmed in 37 patients - 92,5 %. Expansive infiltrative expansion was evaluated in 37 patients, with

  8. Distinct increased outliers among 136 rectal cancer patients assessed by γH2AX

    In recent years attention has focused on γH2AX as a very sensitive double strand break indicator. It has been suggested that γH2AX might be able to predict individual radiosensitivity. Our aim was to study the induction and repair of DNA double strand breaks labelled by γH2AX in a large cohort. In a prospective study lymphocytes of 136 rectal cancer (RC) patients and 59 healthy individuals were ex vivo irradiated (IR) and initial DNA damage was compared to remaining DNA damage after 2 Gy and 24 hours repair time and preexisting DNA damage in unirradiated lymphocytes. Lymphocytes were immunostained with anti-γH2AX antibodies and microscopic images with an extended depth of field were acquired. γH2AX foci counting was performed using a semi-automatic image analysis software. Distinct increased values of preexisting and remaining γH2AX foci in the group of RC patients were found compared to the healthy individuals. Additionally there are clear differences within the groups and there are outliers in about 12% of the RC patients after ex vivo IR. The γH2AX assay has the capability to identify a group of outliers which are most probably patients with increased radiosensitivity having the highest risk of suffering radiotherapy-related late sequelae

  9. A COMPARISON OF RECTAL DICLOFENAC WITH CAUDAL LEVOBUPIVACAINE FOR POST OPERATIVE PAIN RELIEF IN CHILDREN FOLLOWING LOWER ABDOMINAL OPERATION

    Supriya De

    2015-05-01

    Full Text Available INTRODUCTION: Pain is an unpleasant sensory and emotional experience. . Adequate pain relief reduces the stress response and pain relief through epidural route. Caudal epidural analgesia is very commonly practiced technique in children with levobupivacaine. Rectal administration of diclofenac in children is safe and convenient route and su s tained action of this drug provides analgesia in early and late post - operative period. AIMS: The aim of the study is to compare post - operative analgesic effect of rectal diclofenac with caudal levobupivacaine. MATERIALS AND METHODS : Hundred children were a llocated randomly in two groups in equal numbers using generated randomisation chart. All the patients underwent general anaesthesia. At the conclusion of surgery group A (n=50 received caudal injection of 1ml/kg of 0.25% levobupivacaine. The patients we re put left lateral and 23 gauge 25 mm long , short bevelled needle was used for this purpose. Group B (N=50 received a suppository of diclofenac sodium 2.5mg/kg. All anaesthesia , caudal block and suppository insertion was performed by the same anaesthet ist. No information on the method of analgesia or the study group to which the children belong was given to the ward nurse for post - operative observation. Syr. Paracetamol was as post - operative rescue analgesic as 15 mg/kg orally. The ward nurse assessed pain according to the observer pain scale. Assessment was undertaken in four occasions , 1 , 3 and 6 hours post operatively and overnight. If the patient were comfortable without any complain , they were discharged in the in following morning after completion of 24 hours. RESULT AND ANALYSIS: Statistical analysis of the data for pain and use of post - operative analgesic was done by chi - square test analysis with yati’s correction. Intergroup comparision of parametricv data were made by using student un paired t test. P<0.05 was considered to be significant.100 patients were grouped as Group C

  10. Preoperative chemoradiation therapy for lower rectal cancer

    Murotani, Masahiro; Tsujinaka, Toshimasa; Takami, Motohisa [Toyonaka Municipal Hospital, Osaka (Japan)] [and others

    1996-09-01

    To identify appropriate candidates with rectal cancer for preoperative chemoradiation therapy, the local recurrence rate and clinicopathological characteristics of 232 patients with rectal cancer undergoing curative resection in our department were investigated. The local recurrence rates were 3.8%, 10.8% and 16.5% in the Rs, Ra and Rb lesions, respectively. Regarding lower (Rb) rectal cancer, depth of lesion (>a{sub 1}) and nodal metastasis consisted of high factors for local recurrence. Basing on these results, entery criteria for preoperative chemoradiation therapy were established, and concurrent chemoradiation therapy with fluorouracil and cisplatin was delivered preoperatively in 9 primary cases of locally advanced rectal cancer and 3 cases with local recurrence. A partial response was obtained in 7 of 12 cases with a response rate of 58%, size-reduction of the distant metastatic lesions was found in 2 cases, and clinical symptoms were improved in all cases. The histological responses of the 6 resected cases were Grade 2 in 2 cases and Grade 1b in 4 cases. The toxicities of this chemoradiation regimen were well tolerable. As a postoperative complication, infection of the perineal wound was most frequent. Preoperative chemoradiation therapy with the present regimen would be a useful adjuvant treatment for advanced lower rectal cancer. (author)

  11. Only Half of Rectal Cancer Patients Get Recommended Treatment

    ... nlm.nih.gov/medlineplus/news/fullstory_158339.html Only Half of Rectal Cancer Patients Get Recommended Treatment: ... therapy for rectal cancer in the United States, only slightly more than half of patients receive it, ...

  12. Preoperative staging of rectal cancer.

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials. PMID:17957502

  13. Californium-252 brachytherapy for anal and ano-rectal carcinoma

    Surgery has historically been the standard treatment for anal, ano-rectal and rectal carcinoma but is prone to local or regional failure. Over the past 15 years there has been increasing interest in and success with radiation therapy and combined chemoradiotherapy for treatment of anal and ano-rectal cancers. Cf-252 brachytherapy combined with external beam teletherapy has been investigated for anal and ano-rectal lesions at the Univ. of Kentucky with encouraging results

  14. Masquerading Mycobacterium: Rectal Growth or Tuberculosis?

    Nabajit Choudhury

    2013-01-01

    Full Text Available A 37-year old male presented to us with history of lower abdominal pain for 6 months. His physical examination revealed a rectal mass of approximately 1centimeter. He was investigated for possible rectal growth with sigmoidoscopy and biopsy. The histopathological examination (HPE showed a non-specific chronic inflammation in the tissue from the mass. Another tissue from the mass was sent for polymerase chain reaction (PCR for tuberculosis, which turned out to be positive. The patient was started on standard anti tubercular (ATT regimen and responded completely to the treatment. We discuss the patient and review some of the available literature on the topic and discuss the issue of considering a diagnosis of tuberculosis in cases with rectal mass specially when it has become a major public health issue with increasing number of HIV (Human Immunodeficiency Virus infected patients.

  15. Anorectal function orientated surgery for rectal prolapse

    Until quite recently, rectal prolapse was regarded as being a simple condition to treat. Surgical control of the prolapse was largely regarded as a successful outcome. However, recent detailed clinical assessment indicate that many patients have a rectal prolapse which is successfully controlled by surgical operation, yet suffer severe symptoms of disordered defecation, which either persists, or develops as a result of operative treatment. Difficulty with rectal evacuation, persistent incontinence and continuing mucus discharge are recognized as important, despite successful repair of the prolapse itself. There are two major theory of the pathology; circumferential intussusception and sliding hernia. However, many other multifarious factors are concomitant with the condition. These factors often need to be balanced against one another. Usually, a single surgical procedure will not be able to solve the problems. Therefore, the choice of treatment tailored for the individual patient. (author)

  16. MRI Findings of Rectal Submucosal Tumors

    Kim, Hon Soul; Kim, Joo Hee; Lim, Joon Seok; Choi, Jin Young; Chung, Yong Eun; Park, Mi Suk; Kim, Myeong Jin; Kim, Ki Whang; Kim, Sang Kyum [Yonsei University Health System, Seoul (Korea, Republic of)

    2011-08-15

    Rectal submucosal lesions encompass a wide variety of benign and malignant tumors involving the rectum. With optical colonoscopy, any mass-like protrusion covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. Whereas the assessment of submucosal lesions may be limited with performing optical colonoscopy, cross-sectional imaging such as CT, transrectal ultrasonography and MRI allows the evaluation of perirectal tissues and pelvic organs in addition to the entire thickness of the rectum, and so this is advantageous for the assessment of rectal submucosal tumors. Among these, MRI is the best investigative modality for soft tissue characterization. Therefore, knowledge of the MRI features of rectal submucosal tumors can help achieve accurate preoperative diagnoses and facilitate the appropriate management.

  17. Rectal cancer treatment: Improving the picture

    2007-01-01

    Multidisciplinary approach for rectal cancer treatment is currently well defined. Nevertheless, new and promising advances are enriching the portrait. Since the US NIH Consensus in the early 90's some new characters have been added. A bird's-eye view along the last decade shows the main milestones in the development of rectal cancer treatment protocols. New drugs, in combination with radiotherapy are being tested to increase response and tumor control outcomes. However, therapeutic intensity is often associated with toxicity. Thus, innovative strategies are needed to create a better-balanced therapeutic ratio. Molecular targeted therapies and improved technology for delivering radiotherapy respond to the need for accuracy and precision in rectal cancer treatment.

  18. Assessment of T staging and mesorectal fascia status using high-resolution MRI in rectal cancer with rectal distention

    Rao, Sheng-Xiang; Zeng, Meng-Su; Xu, Jian-Ming; Qin, Xin-Yu; Chen, Cai-Zhong; Li, Ren-Chen; Hou, Ying-Yong

    2007-01-01

    AIM: To determine the accuracy of high-resolution magnetic resonance imaging (MRI) using phased-array coil for preoperative assessment of T staging and mesorectal fascia infiltration in rectal cancer with rectal distention.

  19. Primary Transanal Management of Rectal Atresia in a Neonate.

    M, Braiek; A, Ksia; I, Krichen; S, Belhassen; K, Maazoun; S, Ben Youssef; N, Kechiche; M, Mekki; A, Nouri

    2016-01-01

    Rectal atresia (RA) with a normal anus is a rare anomaly. We describe a case of rectal atresia in a newborn male presenting with an abdominal distension and failure of passing meconium. The rectal atresia was primarily operated by transanal route. PMID:27123404

  20. Using of modified irrigoscopy in the diagnosis of rectal prolaps and rectal intussusception

    Colonic X-ray findings in 39 patients with rectal prolapse are presented. Of them, 20 and 19 patients were found to have internal and external rectal prolapse, respectively. Studies were conducted by the modified irrigoscopy developed by the State Coloproctology Research Center, Ministry of Health of the Russian Federation, to explore the anatomic and functional status of the rectum and the fundus of the pelvis in patients with impaired defecation. The X-ray sign of circular invagination with oral enterography for external rectal prolapse could show associated changes, including enterocele and sigmocele

  1. Cyclical rectal bleeding in colorectal endometriosis.

    Levitt, M D; Hodby, K J; van Merwyk, A J; Glancy, R J

    1989-12-01

    Three case reports of cyclical rectal bleeding in endometriosis affecting rectum and sigmoid colon emphasize the close relationship between such cyclical bleeding and intestinal endometriosis. The cause of bleeding, however, is still unclear. The predilection of endometriotic deposits for the outer layers of the bowel wall suggests that mucosal involvement is not a prerequisite for rectal bleeding. The frequent absence of identifiable intramural haemorrhage casts doubt on the premise that intestinal endometriotic deposits 'menstruate'. The cause may simply be a transient tear in normal mucosa due to swelling of an underlying endometriotic deposit at the time of menstruation. PMID:2597100

  2. Clinical study on treatment of rectal carcinoma with Chinese herbal medicine and high dose fluorouracil emulsion via rectal infusion.

    王晨光

    1999-01-01

    Objective: To study the clinical significance of rectal infusion of Chinese herbal medicine (CHM) plus high dose fluorouracil emulsion in treating rectal carcinoma. Methods: 86 patients of rectal carcinoma were randomly divided into CHM plus chemotherapy group and single chemotherapy group, and the

  3. Correlation between the bleb morphology and the 24-hour intraocular pressure (IOP) following trabeculectomy in the early postoperative outcomes of primary angle-closure glaucoma (PACG)%原发性闭角型青光眼小梁切除早期滤过泡形态与24h眼压关系

    贾超; 翟刚; 解聪

    2012-01-01

    目的 观察原发性闭角型青光眼小梁切除术后1个月时结膜滤过泡形态与术后24h眼压(IOP)的关系.方法 对46例施行小梁切除术的原发性闭角型青光眼患者进行随访观察.采用IBAGS滤过泡分级系统(Indiana Bleb Grading Scale,IBAGS)对术后1个月的滤过泡进行记录,应用Goldmann压平眼压计进行眼压测量.采用线性回归分析方法检验滤过泡与24 h眼压的关系,采用t检验的方法对有无微囊结构滤过泡的24 h眼压进行比较.结果 线性回归分析显示滤过泡高度(H)每增加1分术后24 h眼压波动值将降低0.60 mm Hg(95%可信区间为-1.183~-0.024),滤过泡范围(E)每增加1分术后24 h眼压波动值将降低0.66 mm Hg(95%可信区间为-1.193~-0.122),滤过泡面积(即大小H+E)每增加1分术后24 h眼压波动值将降低0.43 mm Hg(95%可信区间为-0.756~-0.109),术后具有微囊结构的滤过泡其眼压波动范围较无微囊结构者平均降低1.02 mm Hg(95%可信区间为-1.876~-0.156).具有微囊特征滤过泡的患者上午10点的IOP、24h IOP平均值、波动值、24 h IOP 最大值及最小值均较无微囊者为理想(P值分别为0.0058、0.0039、0.0019、0.0014、0.0211.),差异有统计学意义.所有患者中仅有一例发生滤过泡渗漏.结论 滤过泡形态与术后24 h眼压具有一定的相关性.滤过泡的高度,范围及面积对术后24 h眼压的影响最明显.同时具有微囊结构滤过泡的病例术后24 h眼压控制良好.%Objective To observe the correlation of the morphologic appearance of blebs after trabeculectomy in the first postoperative month with the outcome of 24-hour IOP among patients with PACG after trabeculectomy.Methods A total of 46 patients of PACG were included for the analysis after trabeculectomy.The bleb morphology in the first month after trabeculectomy was graded with the Indian Bleb Appearance Grading Scale based on standard photos.IOP were measured by Goldmann

  4. Hemangioma colorretal Colon rectal hemangioma

    João Batista Pinheiro Barreto

    2007-06-01

    Full Text Available O hemangioma colorretal (HCR é uma lesão vascular benigna rara, com manifestação clínica geralmente entre 5 e 25 anos de idade. Faz parte do diagnóstico diferencial das causas de hemorragia digestiva baixa, sendo confundido, na maioria das vezes, com entidades mais comuns, como hemorróidas e doenças inflamatórias intestinais. O retardo do diagnóstico ocorre freqüentemente devido ao desconhecimento da doença, com taxas de mortalidade alcançando 40 a 50% na presença de sangramento importante. O caso relatado é de uma paciente de 17 anos de idade, admitida no Serviço de Colo-proctologia do Hospital Universitário - HUUFMA, em setembro de 2005, com anemia e sangramento retal, desde a infância, de forma intermitente e não dolorosa. Apresentado sua história clínica e propedêutica diagnóstica, realizada por meio de exames laboratoriais, endoscopia digestiva alta, colonoscopia e arteriografia de mesentéricas e ilíacas internas. O tratamento cirúrgico realizado foi retossigmoidectomia convencional com anastomose colorretal baixa, com boa evolução pós-operatória, tendo o exame histopatológico da peça cirúrgica ressecada, confirmado o diagnostico.The colon and rectum hemangioma is a rare benign vascular lesion, with clinical features usually between 5 and 25 years of age. It is included in the differential diagnose of the lower digestive bleeding causes, and has been frequently misdiagnosed with other more common entities, like hemorrhoids and bowel inflammatory disease. The late diagnose occurs usually because of the rarity of the disease, with mortality rates reaching 40 to 50% in presence of severe bleeding. We report a case of a 17 years old girl who was admitted at the Coloproctology Service of the Academic Hospital - HUUFMA, in September 2005, with anemia and intermittent rectal bleeding since childhood. Laboratorial findings included laboratorial exams, GI endoscopy, colonoscopy and arteriography of mesenteric and

  5. Rectal motility after sacral nerve stimulation for faecal incontinence

    Michelsen, H B; Worsøe, J; Krogh, K;

    2010-01-01

    Sacral nerve stimulation (SNS) is effective against faecal incontinence, but the mode of action is obscure. The aim of this study was to describe the effects of SNS on fasting and postprandial rectal motility. Sixteen patients, 14 women age 33-73 (mean 58), with faecal incontinence of various...... contractions, total time with cyclic rectal contractions, the number of aborally and orally propagating contractions, the number of anal sampling reflexes or rectal wall tension during contractions. Postprandial changes in rectal tone were significantly reduced during SNS (P < 0.02). Before SNS, median rectal...

  6. Expression and role of Tie-2 in rectal carcinoma

    2010-01-01

    Objective To investigate the expression of Tie-2 in rectal carcinoma and its relationship with invasion and metastasis in rectal carcinoma.Materials S-P immunohistochemical assay was used to detect the expression of Tie-2 in 40 cases of rectal carcinoma and 10 cases of normal rectal tissues.Results Tie-2 was mainly localized in the cytoplasm and nucleus of vascular endothelial cells in cancerous tissues and partly in the cytoplasm of some cancerous cells.The expression of Tie-2 in rectal carcinoma was signi...

  7. Comfort During Digital Rectal Examination - Patient Preference*

    Dziki Łukasz

    2015-09-01

    Full Text Available The sex and age of the physician performing the digital rectal examination (DRE procedure is one of the parameters influencing patients’ comfort. It is postulated that the stress related to DRE during admission to the surgical ward may affect the compliance.

  8. Preoperative chemoradiotherapy for advanced lower rectal carcinoma

    Preoperative chemoradiotherapy in combination with radiation of 30 Gy and chemotherapy with oral uracil-tegafur for 14 patients with advanced lower rectal carcinoma was performed. Tumors were located at RaRb in 5 cases, RbRa in 2, Rb in 3, and RbP in 4 with a mean diameter of 3.8 cm. Preoperative lymphnodes were diagnosed as cN0 in 8 cases, cN1 (metastases of perirectal nodes) in 4, cN1 (perirectal and along superior rectal artery nodes) in 1, and cN3 (perirectal and lateral nodes) in 1. Efficacy for primary carcinomas was evaluated as Partial Response in 9 cases, Stable Disease in 5 and perirectal nodes were down-sized in 4 without down-sizing of either along superior rectal artery nodes or lateral nodes. Margins of primary carcinomas to anal verge were prolonged in 7 cases with a mean prolongation of 0.81 cm. Autonomic nerve-preserving resections with lymphadenectomy of perirectal and along superior rectal artery nodes were performed. Histopathologically efficacy for primary tumors was diagnosed to as not effective in 9 cases, partially effective in 5, and all lymphnodes were combined with necroses and fibrosis. Preoperative chemoradiotherapy is safe for preserving autonomic nerves and serves to preserve the sphincter. A forthcoming study with more appropriate radiation, chemotherapy and lymphadenectomy is being considered. (author)

  9. Effect of rectal distension on abdominal girth.

    Marino, B; Ogliari, C; Basilisco, G

    2004-08-01

    It has been postulated that a viscerosomatic reflex activated by gut distension and inhibiting abdominal wall muscle tone may be one of the mechanisms underlying functional abdominal distension. Any demonstration of such a reflex has to take into account the fact that gut distension may increase abdominal girth as a result of volume displacement. As biomechanical and sensory rectal responses vary at different rates of rectal distension, we hypothesized that different rates of rectal distension might reveal different changes in abdominal girth. Abdominal girth was continuously recorded in 14 healthy subjects using a previously validated extensometer. The rectal distensions were made in a randomized order at rates of 100 mL min(-1) or 10 mL min(-1) up to 150 mL, and sham distensions were used as controls. An increase in abdominal girth was observed at the end of both distensions (P

  10. Current management of locally recurrent rectal cancer

    Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

    2011-01-01

    ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web of...

  11. Ergotamine-induced solitary rectal ulcer.

    Shpilberg, O; Ehrenfeld, M.; Abramowich, D.; Samra, Y.; Bat, L.

    1990-01-01

    A rare case of ergotamine-induced solitary rectal ulcer is described in a 41 year old woman who used high doses of ergotamine tartrate-containing suppositories for severe migraine headaches. Complete recovery of the ulcer was noticed after cessation of treatment with the suppositories. The relevant literature is discussed.

  12. Management of synchronous rectal and prostate cancer.

    Kavanagh, D O

    2012-11-01

    Although well described, there is limited published data related to management on the coexistence of prostate and rectal cancer. The aim of this study was to describe a single institution\\'s experience with this and propose a treatment algorithm based on the best available evidence.

  13. Comparación entre las biopsias gástricas sin fijar 24 horas frente a la biopsia convencional para el diagnóstico de Helicobacter pylori en un hospital de referencia de Perú Comparison between gastric biopsies without fixation for 24 hours and conventional biopsy for the diagnosis of Helicobacter pylori in a reference hospital in Peru

    César Tadeo Vela-Velásquez

    2011-03-01

    Full Text Available Objetivos. Comparar biopsias gástricas fijadas inmediatamente con formol al 10% frente a biopsias fijadas tras 24 horas en la detección de Helicobacter pylori (Hp en un hospital de referencia en Perú. Materiales y métodos. Se realizó un estudio de test diagnóstico sobre las biopsias gástricas de 72 pacientes que acudieron al Servicio de Gastroenterología del Hospital Essalud Alberto Sabogal en el Callao. Las muestras de cada paciente fueron repartidas en dos frascos de vidrio, una de ellas se fijó inmediatamente con formol al 10% y a la otra se fijó luego de 24 horas. Se procesaron ambos grupos de muestras con la técnica convencional de inclusión en parafina y coloración con hematoxilina-eosina. Resultados. Se evidenció Hp en 56,9% del grupo de biopsias fijadas inmediatamente y en el 79,2% del grupo de biopsias fijadas tras 24 horas, encontrándose diferencia estadística (pObjectives. To compare gastric biopsies immediately fixed with 10% formalin with biopsies fixed after 24 hours for the detection of Helicobacter pylori (Hp in a reference hospital in Peru. Materials and methods. A diagnostic test study on gastric biopsies from 72 patients attending the Gastroenterology service of hospital Essalud Alberto Sabogal in Callao was performed. Samples from each patient were divided into two glass jars, one of which was fixed immediately with 10% formalin and the other was fixed after 24 hours. Both groups of samples were processed with the conventional technique of paraffin embedding and staining with hematoxylin-eosin. Results. Hp was found in 56.9% of the group of biopsies which were inmediatly fixed and in 79.2% of the group of biopsies fixed after 24 hours, showing statistical difference (p <0.001. Conclusions. There is an increased frequency of diagnosis of Hp in the samples that were fixed after 24 hours, which may suggest that this would act as a biological culture for Hp, which would facilitate its diagnosis.

  14. 妊娠期高血压疾病患者24 h尿蛋白含量与动态血压的关系%Relationship between 24-hour urine protein content and ambulatory blood pressure in patients with hypertensive disorder complicating pregnancy

    程琪辉; 林晓峰

    2011-01-01

    Objective: To study the relationship between 24 - hour urine protein content and ambulatory blood pressure in order to guide clinical practice. Methods: 16 patients with hypertensive disorder complicating pregnancy (HDCP) and 16 normotensive women received 24 -hour urine protein test, ambulatory blood pressure determination in day and night, the correlation between urine protein and ambulatory blood pressure was analyzed. Results: The urine protein content in cases with HDCP was significantly higher than that in normotensive women ( P < 0.01 ) . The contractive pressure, diastolic pressure and mean arterial pressure in day and night in cases with HDCP were significantly higher than those in normotensive women ( P < 0.05 ) . The contractive pressure and mean arterial pressure in day in cases with HDCP and normotensive women were significantly higher than those in night (P < 0.05 ) . There was no correlation between blood pressure and 24 - hour urine protein in cases with HDCP and normotensive women ( P > 0. 05 ) . Conclusion: The 24 - hour urine protein content in cases with HDCP increases, but circadian rhythm of blood pressure exists.%目的:研究妊娠期高血压疾病患者24 h尿蛋白含量与动态血压的关系,以指导临床.方法:对16例妊娠期高血压疾病患者和16例正常女性分别进行24 h尿蛋白测定,白天和晚上的动态血压检测,分析尿蛋白与动态血压的相关性.结果:妊娠期高血压疾病患者的尿蛋白含量明显大于正常人(P0.05).结论:妊娠期高血压疾病患者24 h尿蛋白含量升高,但是血压昼夜节律还是存在的.

  15. Rectal cancer radiotherapy: Towards European consensus

    Background and purpose. During the first decade of the 21st century several important European randomized studies in rectal cancer have been published. In order to help shape clinical practice based on best scientific evidence, the International Conference on 'Multidisciplinary Rectal Cancer Treatment: Looking for an European Consensus' (EURECA-CC2) was organized. This article summarizes the consensus about imaging and radiotherapy of rectal cancer and gives an update until May 2010. Methods. Consensus was achieved using the Delphi method. Eight chapters were identified: epidemiology, diagnostics, pathology, surgery, radiotherapy and chemotherapy, treatment toxicity and quality of life, follow-up, and research questions. Each chapter was subdivided by topic, and a series of statements were developed. Each committee member commented and voted, sentence by sentence three times. Sentences which did not reach agreement after voting round no 2 were openly debated during the Conference in Perugia (Italy) December 2008. The Executive Committee scored percentage consensus based on three categories: 'large consensus', 'moderate consensus', 'minimum consensus'. Results. The total number of the voted sentences was 207. Of the 207, 86% achieved large consensus, 13% achieved moderate consensus, and only three (1%) resulted in minimum consensus. No statement was disagreed by more than 50% of members. All chapters were voted on by at least 75% of the members, and the majority was voted on by >85%. Considerable progress has been made in staging and treatment, including radiation treatment of rectal cancer. Conclusions. This Consensus Conference represents an expertise opinion process that may help shape future programs, investigational protocols, and guidelines for staging and treatment of rectal cancer throughout Europe. In spite of substantial progress, many research challenges remain

  16. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry

    Sato, H; Kodama, T; Takaaki, J; Tatsumi, Y.; Maeda, T; Fujita, S; Fukui, Y.; H. Ogasawara; Mitsufuji, S

    1997-01-01

    Background—Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated. 
Aim—To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function. 
Patients and methods—The papillary function of 10 patients with CBD stones was studied using endoscopic manometry befo...

  17. 授权护理组长24h负责制在综合外科护理管理中的应用%The Application of Authorizing Nurse Team Leaders to Take Charge for 24 Hours in Surgical Nursing Management

    曾芝云; 张锦莲; 韩秋丽

    2013-01-01

    Objective To explore the feasibility of the system that nurse team leaders are responsibility for 24 hours in surgical nursing management. Methods We adopted various methods, such as grouping in the department, developing open job recruitment and dynamic management, to authorize nurse team leaders to take charge of ward-nursing management. Results Showed that the division nursing quality has been improved, so has the satisfaction of patients, doctors and nurses. Conclusions In summary, the new management system authorizing the nurse team leaders to be responsibility for 24 hours promoted the constant improvement of nursing management.%  目的探索授权护理组长24h负责制在外科护理管理的可行性。方法采用科内分组、公开竞聘、责权分明、动态管理的方法,授权护理组长24h负责病房护理管理。结果实行护理组长24h负责制后,科室整体护理质量有了提升,医、护、患三方满意度优于实施前。结论授权护理组长24h负责的管理模式,在外科护理管理中有很好的促进作用。

  18. Quality of care indicators in rectal cancer.

    Demetter, P; Ceelen, W; Danse, E; Haustermans, K; Jouret-Mourin, A; Kartheuser, A; Laurent, S; Mollet, G; Nagy, N; Scalliet, P; Van Cutsem, E; Van Den Eynde, M; Van de Stadt, J; Van Eycken, E; Van Laethem, J L; Vindevoghel, K; Penninckx, F

    2011-09-01

    Quality of health care is a hot topic, especially with regard to cancer. Although rectal cancer is, in many aspects, a model oncologic entity, there seem to be substantial differences in quality of care between countries, hospitals and physicians. PROCARE, a Belgian multidisciplinary national project to improve outcome in all patients with rectum cancer, identified a set of quality of care indicators covering all aspects of the management of rectal cancer. This set should permit national and international benchmarking, i.e. comparing results from individual hospitals or teams with national and international performances with feedback to participating teams. Such comparison could indicate whether further improvement is possible and/or warranted. PMID:22103052

  19. Transanal Evisceration Caused by Rectal Laceration

    Torres Sánchez, María Teresa; Richart Aznar, Jose Manuel; Martí Martínez, Eva María; Martínez-Abad, Manuel

    2014-01-01

    Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained. PMID:24639971

  20. Evidence and research in rectal cancer

    The main evidences of epidemiology, diagnostic imaging, pathology, surgery, radiotherapy, chemotherapy and follow-up are reviewed to optimize the routine treatment of rectal cancer according to a multidisciplinary approach. This paper reports on the knowledge shared between different specialists involved in the design and management of the multidisciplinary ESTRO Teaching Course on Rectal Cancer. The scenario of ongoing research is also addressed. In this time of changing treatments, it clearly appears that a common standard for large heterogeneous patient groups have to be substituted by more individualised therapies based on clinical-pathological features and very soon on molecular and genetic markers. Only trained multidisciplinary teams can face this new challenge and tailor the treatments according to the best scientific evidence for each patient

  1. UFT (tegafur-uracil) in rectal cancer

    Casado, E; Pfeiffer, P; Feliu, J; González-Barón, M; Vestermark, L; Jensen, Helle Anita

    2008-01-01

    abstracts relating to clinical studies of UFT in the treatment of locally advanced rectal cancer (LARC). Pre- and postoperative studies carried out in patients with newly diagnosed or recurrent disease were included. RESULTS: The combination of UFT and radiotherapy was effective and well tolerated in the......BACKGROUND: Major achievements in the treatment of localised rectal cancer include the development of total mesorectal excision and the perioperative administration of radiotherapy in combination with continuous infusion (CI) 5-fluorouracil (5-FU). This multimodal approach has resulted in extended...... survival and lower local relapse rates, with the potential for sphincter-preserving procedures. However, CI 5-FU is inconvenient for patients and is costly. Oral fluoropyrimidines like UFT (tegafur-uracil) offer a number of advantages over 5-FU. METHODS: We undertook a review of published articles and...

  2. Management of radiation-induced rectal bleeding.

    Laterza, Liboria; Cecinato, Paolo; Guido, Alessandra; Mussetto, Alessandro; Fuccio, Lorenzo

    2013-11-01

    Pelvic radiation disease is one of the major complication after radiotherapy for pelvic cancers. The most commonly reported symptom is rectal bleeding which affects patients' quality of life. Therapeutic strategies for rectal bleeding are generally ignored and include medical, endoscopic, and hyperbaric oxygen treatments. Most cases of radiation-induced bleeding are mild and self-limiting, and treatment is normally not indicated. In cases of clinically significant bleeding (i.e. anaemia), medical therapies, including stool softeners, sucralfate enemas, and metronidazole, should be considered as first-line treatment options. In cases of failure, endoscopic therapy, mainly represented by argon plasma coagulation and hyperbaric oxygen treatments, are valid and complementary second-line treatment strategies. Although current treatment options are not always supported by high-quality studies, patients should be reassured that treatment options exist and success is achieved in most cases if the patient is referred to a dedicated centre. PMID:24101202

  3. Clinical value of the esophageal scintigraphy in multi-swallow technique comparing to esophageal manometry; Bedeutung der parametrisierten Oesophagusszintigraphie in Mehrfachschlucktechnik im Vergleich zur Oesophagusmanometrie

    Eising, E.G. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Essen (Germany); Holtmann, G. [Abt. fuer Gastroenterologie, Medizinische Klinik, Univ. Essen (Germany); Reiners, C. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Essen (Germany)

    1996-06-01

    Diagnosis of esophageal motility disorders is difficult due to the large physiologic variability of bolus transport. With the help of a parametric multiple swallow technique (introduced by Tatsch), using `condensed images` of each single sallow action before creating a `mean image` of six swallows, this problem can be solved. For testing this relatively new method, 12 patients underwent 16 pairs of parametric esophagel scintigraphy and esophageal manometry. This collective of patients consisted of 4 with achalasia and secondary hypomobility of the tubular esophagus, 7 with unspecific esophageal dysfunction confirmed by manometry and 1 with clinical dysphagia and normal status in manometry. Fourteen of 15 pathological manometric findings could be confirmed with parametric scintigraphy. Esophageal monometry was false negative in one case and esophageal scintigraphy in another one case. The calculated emptying rates 10 and 12 s after beginning of swallowing are (mean{+-}SD) 56{+-}34% and 60{+-}34% respectively for solid meal and 54{+-}25% 57{+-}22% respectively for liquid meal. Of 60 emptying rates, 48 are in the pathologic range of less than 80%. As expected, no significant difference was found between emptying rates after 10 and 12 s (two-tailed matched pairs t-test, 5% significance level). In conclusion, parametric esophageal multiple swallow scintigraphy has been proven to be a non-invasive and sensitive tool for pre- and posttherapeutic care of patients with esophageal motility disorders. It should be mentioned that esophageal scintigraphy can give additional information in some cases of normal esophageal manometry. (orig.) [Deutsch] Die parametrisierte Oesophagusszintigraphie in Mehrfachschlucktechnik nach Tatsch (unter Verwendung sog. kondensierter Einzelschluckbilder und einem daraus errechneten Summationsbild) laesst eine sichere Erfassung pathologischer oesophagealer Motilitaetsstoerungen trotz der hohen physiologischen Variabilitaet des Schluckaktes

  4. Importance of surgical margins in rectal cancer.

    Mukkai Krishnamurty, Devi; Wise, Paul E

    2016-03-01

    Distal resection margin (DRM) and circumferential resection margin (CRM) are two important considerations in rectal cancer management. Although guidelines recommend a 2 cm DRM, studies have shown that a shorter DRM is adequate, especially in patients receiving neoadjuvant chemoradiation. Standardization of total mesorectal excision has greatly improved quality of CRM. Although more patients are undergoing sphincter-saving procedures, abdominoperineal resection is indicated for very distal tumors, and pelvic exenteration is often necessary for tumors involving pelvic organs. PMID:27094456

  5. MicroRNA in rectal cancer

    Azizian, Azadeh; Gruber, Jens; Ghadimi, B Michael; Gaedcke, Jochen

    2016-01-01

    In rectal cancer, one of the most common cancers worldwide, the proper staging of the disease determines the subsequent therapy. For those with locally advanced rectal cancer, a neoadjuvant chemoradiotherapy (CRT) is recommended before any surgery. However, response to CRT ranges from complete response (responders) to complete resistance (non-responders). To date we are not able to separate in advance the first group from the second, due to the absence of a valid biomarker. Therefore all patients receive the same therapy regardless of whether they reap benefits. On the other hand almost all patients receive a surgical resection after the CRT, although a watch-and-wait procedure or an endoscopic resection might be sufficient for those who responded well to the CRT. Being highly conserved regulators of gene expression, microRNAs (miRNAs) seem to be promising candidates for biomarkers. Many studies have been analyzing the miRNAs expressed in rectal cancer tissue to determine a specific miRNA profile for the ailment. Unfortunately, there is only a small overlap of identified miRNAs between different studies, posing the question as to whether different methods or differences in tissue storage may contribute to that fact or if the results simply are not reproducible, due to unknown factors with undetected influences on miRNA expression. Other studies sought to find miRNAs which correlate to clinical parameters (tumor grade, nodal stage, metastasis, survival) and therapy response. Although several miRNAs seem to have an impact on the response to CRT or might predict nodal stage, there is still only little overlap between different studies. We here aimed to summarize the current literature on rectal cancer and miRNA expression with respect to the different relevant clinical parameters. PMID:27190581

  6. Primary rectal melanoma - a case report

    Somak Das

    2015-01-01

    Full Text Available The most common site for malignant melanoma is skin, then eye and third is anorectal region. Primary anorectal malignant melanoma is still very uncommon. It is usually very aggressive and presents with altered bowel habit and rectal bleeding. Proctoscopy shows non-pigmented or lightly pigmented polypoid lesion. Histopathology is confirmatory. Early radical excision is mandatory. A 56 year-old female was presented with malignant melanoma of the lower third of rectum. We report this case for its rarity.

  7. Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility.

    Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

    2015-10-01

    The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance-manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is < 450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

  8. The Reliability of Pharyngeal High Resolution Manometry with Impedance for Derivation of Measures of Swallowing Function in Healthy Volunteers

    Taher I. Omari

    2016-01-01

    Full Text Available Purpose. We evaluated the intra- and interrater agreement and test-retest reliability of analyst derivation of swallow function variables based on repeated high resolution manometry with impedance measurements. Methods. Five subjects swallowed 10×10 mL saline on two occasions one week apart producing a database of 100 swallows. Swallows were repeat-analysed by six observers using software. Swallow variables were indicative of contractility, intrabolus pressure, and flow timing. Results. The average intraclass correlation coefficients (ICC for intra- and interrater comparisons of all variable means showed substantial to excellent agreement (intrarater ICC 0.85–1.00; mean interrater ICC 0.77–1.00. Test-retest results were less reliable. ICC for test-retest comparisons ranged from slight to excellent depending on the class of variable. Contractility variables differed most in terms of test-retest reliability. Amongst contractility variables, UES basal pressure showed excellent test-retest agreement (mean ICC 0.94, measures of UES postrelaxation contractile pressure showed moderate to substantial test-retest agreement (mean Interrater ICC 0.47–0.67, and test-retest agreement of pharyngeal contractile pressure ranged from slight to substantial (mean Interrater ICC 0.15–0.61. Conclusions. Test-retest reliability of HRIM measures depends on the class of variable. Measures of bolus distension pressure and flow timing appear to be more test-retest reliable than measures of contractility.

  9. The Reliability of Pharyngeal High Resolution Manometry with Impedance for Derivation of Measures of Swallowing Function in Healthy Volunteers

    Omari, Taher I.; Savilampi, Johanna; Kokkinn, Karmen; Schar, Mistyka; Lamvik, Kristin; Doeltgen, Sebastian; Cock, Charles

    2016-01-01

    Purpose. We evaluated the intra- and interrater agreement and test-retest reliability of analyst derivation of swallow function variables based on repeated high resolution manometry with impedance measurements. Methods. Five subjects swallowed 10 × 10 mL saline on two occasions one week apart producing a database of 100 swallows. Swallows were repeat-analysed by six observers using software. Swallow variables were indicative of contractility, intrabolus pressure, and flow timing. Results. The average intraclass correlation coefficients (ICC) for intra- and interrater comparisons of all variable means showed substantial to excellent agreement (intrarater ICC 0.85–1.00; mean interrater ICC 0.77–1.00). Test-retest results were less reliable. ICC for test-retest comparisons ranged from slight to excellent depending on the class of variable. Contractility variables differed most in terms of test-retest reliability. Amongst contractility variables, UES basal pressure showed excellent test-retest agreement (mean ICC 0.94), measures of UES postrelaxation contractile pressure showed moderate to substantial test-retest agreement (mean Interrater ICC 0.47–0.67), and test-retest agreement of pharyngeal contractile pressure ranged from slight to substantial (mean Interrater ICC 0.15–0.61). Conclusions. Test-retest reliability of HRIM measures depends on the class of variable. Measures of bolus distension pressure and flow timing appear to be more test-retest reliable than measures of contractility. PMID:27190520

  10. Intraoperative radiotherapy in primary rectal cancer

    According to the results of several studies intraoperative radiotherapy seems to influence local control for primary rectal cancer in UICC-Stage II / III positively, though recommendations in therapy cannot be given as studies of high evidence level do not exist. As IORT is rarely available and makes patient recruitment difficult, prospective randomised trials have not been carried out yet. This emphasizes the importance of non-randomised trials for an evaluation of IORT. A comparison of 21 patients with locally advanced rectal cancer who had been treated with intraoperative radiation therapy and 21 similar cases without an application of IORT could not show any significant improvements in prognosis (recurrences, metastases and disease-specific survival). Nevertheless the employment of intraoperative radiation showed a trend in improvement of local control. This hast been shown by several other studies before. Thus the application of IORT in patients with locally advanced rectal cancer is considered a useful part in multimodal treatment and should further be evaluated in specialized centres. In case-control studies 1:1-matching leads to a good comparability of groups and renders conclusions of high internal validity possible. To gain a sufficient power, this type of trials should however primarily be carried out by centres with a high number of cases.

  11. Function-preserving surgery for rectal cancer

    When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future. (author)

  12. Rectal Sedation with Thiopental in Children

    Objective: to determine the effectiveness of a rectal sedation protocol with sodium thiopental in children undergoing diagnostic imaging studies in a level-four-complexity health care facility. Materials and Methods: this case series observational study was developed between the months of January and March 2004 in the Fundacion clinica Valle del Lili. All pediatric patients between the ages of three months and eight years of age who underwent an imaging study were included. A dose of 25-40 mg/kg of sodium thiopental was administered rectally. Successful sedation was defined as one that allowed the successful completion of the study with the least number of motion artifacts. The features of the sedation and the adverse effects were evaluated. Results: the study population included 103 children with a median age of two years. The imaging studies were successfully concluded in 97% of the patients. The average total time until complete awakening was 2.9 hours. With respect to the interruption of sedation, we found statistically significant differences between the children who were kept awake the night before the procedure and those who were not. The most common adverse effect was diarrhea, which was recorded in 13 patients. Five of the patients required a supplemental dose of the sedative. There were two cases of increased salivation and one of vomiting, yet they resolved spontaneously. Conclusions: this rectal sodium thiopental protocol is a safe and effective procedure for the completion of diagnostic imaging studies in the pediatric population at our health care center.

  13. Value of protective stoma in rectal cancer surgery

    Fratrić Ivana; Radovanović Zoran; Radovanović Dragana; Vicko Ferenc; Petrović Tomislav; Nikin Zoran

    2016-01-01

    Introduction. Anastomotic leakage is the most serious surgical complication in rectal surgery. The aim of this study was to find out whether a protective stoma was capable of lowering the rate of clinical anastomotic leakage and to evaluate the rate of anastomotic leakages requiring re-surgery. Material and Methods. A retrospective study included a sample of 149 consecutive patients with rectal cancer who had undergone elective rectal resection with primary ...

  14. Rapid Dissemination of SIV Follows Multisite Entry after Rectal Inoculation

    Ribeiro dos Santos, Patricia; Rancez, Magali; Prétet, Jean-Luc; Michel-Salzat, Alice; Messent, Valérie; Bogdanova, Anna; Couëdel-Courteille, Anne; Souil, Evelyne; Cheynier, Rémi; Butor, Cécile

    2011-01-01

    Receptive ano-rectal intercourse is a major cause of HIV infection in men having sex with men and in heterosexuals. Current knowledge of the mechanisms of entry and dissemination during HIV rectal transmission is scarce and does not allow the development of preventive strategies. We investigated the early steps of rectal infection in rhesus macaques inoculated with the pathogenic isolate SIVmac251 and necropsied four hours to nine days later. All macaques were positive for SIV. Control macaqu...

  15. Preserving the superior rectal artery in laparoscopic [correction of laparoscopis] anterior resection for complete rectal prolapse.

    Ignjatovic, D; Bergamaschi, R

    2002-01-01

    Anterior resection for the treatment of full thickness rectal prolapse has been around for over four decades. 1 However, its use has been limited due to fear of anastomotic leakage and related morbidity. It has been shown that high anterior resection is preferable to its low counterpart as the latter increases complication rates. 2 Although sparing the inferior mesenteric artery in sigmoid resection for diverticular disease has been shown to decrease leak rates in a randomized setting, 3 vascular division is current practice. We shall challenged this current practice of dividing the mesorectum in anterior resection for complete rectal prolapse developing a technique that allows the preservation of the superior rectal artery. PMID:12587465

  16. Response of the structure of rat kidney and inflammatory factors to Blackcurrant Extract at 24 hours after exhaustive exercise%力竭运动后24 h模型大鼠肾脏结构和炎症因子对黑加仑提取物干预的反应

    刘霞; 蒋嘉烨; 陆海英; 顾翠英; 蔡美琴

    2014-01-01

    背景:急性运动后肾脏组织易出现运动性肾缺血再灌注现象,自由基生成增加,发生炎症反应,导致肾功能异常。目的:观察黑加仑提取物对力竭运动后24 h大鼠肾脏结构、肿瘤坏死因子α和核因子κB表达的影响。方法:30只雄性Wistar健康大鼠随机分为3组,每组10只,黑加仑提取物组给予0.44 g/kg黑加仑提取物灌胃,安静对照组、力竭运动后24 h组灌服同等体积的蒸馏水,连续灌胃6周。力竭运动后24 h组和黑加仑提取物组于末次灌胃后进行无负重游泳运动直至力竭疲劳,于24 h后取材,电镜和光镜观察肾脏组织形态和超微结构变化,免疫组化法检测肿瘤坏死因子α蛋白和核因子κB蛋白表达,RT-PCR检测肿瘤坏死因子α mRNA和核因子κB mRNA的表达。结果与结论:与安静对照组比较,力竭运动后24 h组中肾脏核因子κB蛋白和肿瘤坏死因子α蛋白高表达,核因子κB mRNA和肿瘤坏死因子α mRNA表达水平极显著增加(P <0.01);与力竭运动后24 h组比较,黑加仑提取物组中肾脏核因子κB蛋白和肿瘤坏死因子α蛋白低表达,核因子κB mRNA表达水平显著性降低(P <0.05);肿瘤坏死因子α mRNA表达水平极显著性下降(P<0.01)。力竭运动后24 h组大鼠肾脏发生明显的形态变化和超微结构损伤,黑加仑提取物组大鼠肾脏结构趋于正常。结果表明黑加仑提取物可修复力竭运动后24 h肾脏组织结构,减少炎症因子的表达,防止肾脏发生炎症性损伤。%BACKGROUND:The kidney tissues easily affected exercise ischemia reperfusion, increased free radicals and inflammation, resulted in abnormal renal function after acute exercise. OBJECTIVE:To observe the influence of Blackcurrant Extract on the structure of kidney and expression of tumor necrosis factor-α and nuclear factor-κB at 24 hours after exhaustiveexercise. METHODS:A total of 30 male Wistar rats

  17. Rectal Diclofenac Versus Rectal Paracetamol: Comparison of Antipyretic Effectiveness in Children

    Sharif, Mohammad Reza; Haji Rezaei, Mostafa; Aalinezhad, Marzieh; Sarami, Golbahareh; Rangraz, Masoud

    2016-01-01

    Background Fever is the most common complaint in pediatric medicine and its treatment is recommended in some situations. Paracetamol is the most common antipyretic drug, which has serious side effects such as toxicity along with its positive effects. Diclofenac is one of the strongest non-steroidal anti-inflammatory (NSAID) drugs, which has received little attention as an antipyretic drug. Objectives This study was designed to compare the antipyretic effectiveness of the rectal form of Paracetamol and Diclofenac. Patients and Methods This double-blind controlled clinical trial was conducted on 80 children aged six months to six years old. One group was treated with rectal Paracetamol suppositories at 15 mg/kg dose and the other group received Diclofenac at 1 mg/kg by rectal administration (n = 40). Rectal temperature was measured before and one hour after the intervention. Temperature changes in the two groups were compared. Results The average rectal temperature in the Paracetamol group was 39.6 ± 1.13°C, and 39.82 ± 1.07°C in the Diclofenac group (P = 0.37). The average rectal temperature, one hour after the intervention, in the Paracetamol and the Diclofenac group was 38.39 ± 0.89°C and 38.95 ± 1.09°C, respectively (P = 0.02). Average temperature changes were 0.65 ± 0.17°C in the Paracetamol group and 1.73 ± 0.69°C in the Diclofenac group (P < 0.001). Conclusions In the first one hour, Diclofenac suppository is able to control the fever more efficient than Paracetamol suppositories. PMID:26889398

  18. Low rectal cancer : aspects of surgical techniques and treatment results

    Anderin, Claes

    2012-01-01

    Rectal cancer is the 7th most common form of cancer in Sweden, both for men and women. About one third of all patients diagnosed with rectal cancer have a low tumour (i.e. 0-5 cm from the anal verge). Abdominoperineal excision (APE) is the most common surgical procedure in low rectal cancer, performed in approximately 80% of patients. While oncological outcomes in rectal cancer have improved in recent decades, the outcome after APE has remained poor and local recurrence rates have been report...

  19. 24-hour secretory pattern of dehydroisoandrosterone and dehydroisoandrosterone sulfate

    Dehydroisoandrosterone (DHA) and cortisol were measured by radioimmunoassay and protein binding techniques respectively in plasma from blood taken at 20-min intervals over 24-h periods in 3 normal men, 2 women with Stein-Leventhal syndrome, and a man with a benign adrenocortical adenoma. In all subjects but the latter, DHA and cortisol were episodic and synchronous throughout the entire day; in this patient, continuous secretion of cortisol by the tumor apparently abolished stimulation of the contralateral adrenal, and DHA production was negligible. Dehydroisoandrosterone sulfate analyses in plasma displayed a pattern which, probably because of its origin both by secretion and sulfation and its long half-life, showed less synchronicity with DHA and cortisol and less fluctuation than did the free hormones. (U.S.)

  20. Human spontaneous photon emission in 24 hour period

    Cifra, Michal; Van Wijk, E.; Van Wijk, R.

    Praha: České vysoké učení technické. Fakulta bimedicínského inženýrství, 2007 - (Szabó, Z.; Holčík, J.), s. 269-272 ISBN 978-80-01-03777-5. [Česko-slovenská konference Trendy v biomedicínském inženýrství /7./. Kladno (CZ), 11.09.2007-13.09.2007] Institutional research plan: CEZ:AV0Z20670512 Keywords : bioluminescence * photons * skin Subject RIV: BO - Biophysics

  1. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P < .0001 to P < .05). The nighttime blood pressures...... were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P < .0001) and at night (80 vs. 64/min, P < .0001). Consequently, the reduction in blood pressure and HR from daytime to...

  2. Response to inhaled histamine and 24 hour sodium excretion.

    Burney, P G; Britton, J. R.; Chinn, S; Tattersfield, A. E.; Platt, H S; Papacosta, A O; Kelson, M C

    1986-01-01

    A relation between the prevalence of asthma and economic development has been suggested by studies in migrants and other surveys in developing countries. That this correlation might be partially explained by an increased intake of salt in the diet is supported by the observation that sales of table salt in the different regions of England and Wales are independently correlated with mortality from asthma for men and for children. As part of a wider survey of asthma 138 men living in two Hampsh...

  3. Collection of a 24-Hour Urine Specimen (Beyond the Basics)

    ... OR REPRESENTATIONS MADE BY ANY OTHER PERSON OR ENTITY ARE VOID. YOU ASSUME ALL RISK AS TO THE QUALITY, FUNCTION, PERFORMANCE, AND ACCURACY OF THE LICENSED MATERIALS. LIMITATION OF LIABILITY: IN NO EVENT WILL UPTODATE OR ANY OTHER ...

  4. SharePoint 2010 Business Intelligence 24-Hour Trainer

    Jorgensen, Adam; Knight, Devin; LeBlanc, Patrick; Schacht, Brad

    2011-01-01

    Learn to build and deliver SharePoint BI applications Written by a team of leading SharePoint and Business Intelligence (BI) experts, this unique book-and-DVD package shows you how to successfully build and deliver BI applications using SharePoint 2010. Assuming no previous SharePoint experience, the authors deliver a clear explanation of what SharePoint will do for your BI and information management capabilities. Each lesson in the book is reinforced with a helpful tutorial on the DVD and cover topics such as interactive reporting with Excel, document sharing for collaborative reporting, and

  5. Nutrition habits in 24-hour mountain bike racers.

    Chlíbková, Daniela; Knechtle, Beat; Rosemann, Thomas; Tomášková, Ivana; Chadim, Vlastimil; Shortall, Marcus

    2014-01-01

    We investigated seventy-four ultra-mountain bikers (MTBers) competing in the solo category in the first descriptive field study to detail nutrition habits and the most common food before during and after the 24 hour race using questionnaires. During the race, bananas (86.5%), energy bars (50.0%), apples (43.2%) and cheese (43.2%) were the most commonly consumed food, followed by bread (44.6%), rice (33.8%) and bananas (33.8%) after the race. Average fluid intake was 0.5 ± 0.2 l/h. The main beverage was isotonic sports drink (82.4%) during and pure water (66.2%) after the race. The most preferred four supplements in the four weeks before, the day before, during and after the race were vitamin C (35.1%), magnesium (44.6%), magnesium (43.2%) and branched-chain amino acids (24.3%), respectively. Total frequency of food intake (30.6 ± 10.5 times/24 hrs) was associated with fluid intake (r = 0.43, P = 0.04) and both were highest at the beginning of the race and lower during the night hours and the last race segment in a subgroup of twenty-three ultra-MTBers. Supplement intake frequency (6.8 ± 8.4 times/24 hrs) was highest during the night hours and lower at the beginning and end of the race. Elevated food and fluid intake among participants tracked across all race segments (P < 0.001). In conclusion, the nutrition strategy employed by ultra-MTBers was similar to those demonstrated in previous studies of ultra-cyclists with some exceptions among selected individuals. PMID:25674455

  6. The 24-hour night shift : Astronomy from microlensing monitoring networks

    Sackett, PD; Brainerd, TG; Kochanek, CS

    2001-01-01

    Scores of on-going microlensing events are now announced yearly by the microlensing discovery teams OGLE, MACHO and EROS. These early warning systems have allowed other international microlensing networks to focus considerable resources on intense photometric and occasionally spectroscopic - monitor

  7. Multi-sensory stimulation in 24-hour dementia care

    Weert, J.C.M. van

    2004-01-01

    This thesis starts with a review of relevant literature with regard to the effects of psychosocial interventions, including snoezelen, on apathetic, depressed and aggressive behaviour of demented persons. Then, a study with a quasi-experimental pre-test and post-test design is described, comparing s

  8. PHP and MySQL 24-Hour Trainer

    Tarr, Andrea

    2011-01-01

    Step-by-step lessons for using PHP and MySQL in a unique book-and-video combination Assuming no previous experience with PHP or MySQL, this book-and-video package is ideal reading for anyone who wants to go beyond HTML/CSS in order to provide clients with the most dynamic web sites possible. The approachable tone breaks down the basics of programming and PHP and MySQL in individual lessons starting with the installation of the programs necessary to run PHP. You begin with a static web site and then watch and learn as PHP functionality is added as you work through the lessons. When working w

  9. SharePoint Server 2010 Administration 24 Hour Trainer

    Crider, Bill; Richardson, Clint

    2012-01-01

    Get quickly up to speed on SharePoint Server 2010! Covering all aspects of the SharePoint technology, this unique book-and-DVD combination provides expert guidance within each lesson in the book, which is then supplemented on the instructional DVD. The authors expose you to a variety of SharePoint Server 2010 topics, from organization concerns to training plans to programmer best practices, all aimed at helping you effortlessly find your way around SharePoint without a deep knowledge of the technology. You’ll quickly learn to configure and administer a site or site collection using this

  10. Duplicate 24-hour diet study 1994 organochlorine and organophosphorous pesticides

    Baumann RA; Hoogerbrugge R; Zoonen P van; LOC

    1999-01-01

    Duplicate diet samples collected in 1994 were analysed for organochlorine and organophosphorous pesticides. It was not possible to evaluate wether dietary intake exceeded the established Acceptable Daily Intake (ADI). For the other organophosphorous compounds as well as for the organoclorine pestic

  11. Comparison of dietary survey,frequency and 24 hour urinary Na methods in evaluation of salt intake in the population%称重法、频率法与24h尿钠法评估人群食盐摄入量的比较

    李剑虹; 鹿子龙; 颜流霞; 张吉玉; 唐俊利; 蔡小宁; 郭晓雷; 马吉祥; 徐爱强

    2014-01-01

    目的:比较称重法、频率法与24 h尿钠法评估人群食盐摄入量的差异和相关性。方法于2011年6—9月在山东省采用多阶段分层随机抽样方法抽取18~69岁居民作为调查对象,共计2184名。分别采用24 h尿钠法、称重法和频率法进行食盐摄入量调查。同时记录3 d内家庭用餐人员(包括客人)的性别、年龄、就餐情况、劳动强度。采用问卷调查个人膳食习惯。结果24 h尿钠法、称重法和频率法调查的食盐摄入量分别为14.0、12.0和10.5 g/d。与24 h尿钠法相比,称重法和频率法每天食盐平均摄入量分别低2.0 g和3.4 g,分别低估了14.3%和24.3%;利用称重法和频率法低估和高估食盐摄入量的个体比例分别为42.4%(856/2020)、55.3%(1117/2020)和20.7%(418/2020)、16.3%(329/2020),即分别有36.9%(745/2020)和28.4%(574/2020)的个体其食盐摄入量在24 h尿钠法结果的±25%以内。称重法和频率法调查的食盐摄入量均与24 h尿钠法呈正相关(P<0.01),相关系数分别为0.13和0.07。采用三种方法调查的食盐摄入量均随着调查对象自我感觉咸淡口味的加重而逐渐增加。自认为口味偏淡、适中和偏咸的三组人群采用三种方法调查的平均食盐摄入量分别为:24 h尿钠法为13.6、13.6和14.7 g/d;称重法为11.0、12.0和12.7g/d;频率法为9.3、10.2和11.9 g/d,差异均有统计学意义(24 h尿钠法:F=0.47,P<0.05;称重法:F=5.83, P<0.05;频率法:F=12.53,P<0.01)。结论与24 h尿钠法相比,称重法和频率法均低估了实际食盐摄入量,通过调整低估率可以更准确地评估人群食盐摄入水平。%Objective To compare the difference and correlation between dietary salt intakes assessed by 24 hours urinary Na method, food weighted record method

  12. Conservative treatment of premature rectal cancer

    Objectives: The largest radical resections in rectal cancer with significant morbidity and mortality (Urinary dysfunction, sexual dysfunction, permanent colostomy, etc.), on certain occasions and with high selectivity, they can be avoided with the implementation of local resections. Our intention is to assess the results of conservative treatment of rectal cancer early. Material and Methods: Between 01.01.89 and 31.12.09 14 consecutive patients were treated carriers rectal adenocarcinoma who had never received prior cancer treatment and a second simultaneous showed no neoplasia. The age of the patients presented a range between 44 and 72 years with a mean of 60.4 years; sex similarly partitioned and according to ECOG performance status was 0≤2. All patients were operated through a anal resection of which 4 were performed a submucosal tumor excision (T1) and 10 excision was entire rectal wall and tumor invaded the muscularis propria (T2). For this one type of surgery patients were selected the following criteria: tumor ≤6 cm. the anal verge, size ≤3 cm., GH I-II, vegetative, mobile, and T1-2, N0 by EER. After intervention, the pathological examination of the surgical specimen showed that 4 patients GH III, lymphovascular invasion and / or peri neural, or close surgical margins (+) (≤3 mm.) And T3, so underwent Miles operation (March 1 T1 and T2). Subsequently the rest of the patients (10) underwent concomitant radio chemotherapy. Radiation therapy was similar all using megavoltage photons (CO-60, 18mV) to the entire pelvic volume in a normofraccionamiento to complete 50.40 Gy (1.8 Gy / 28) using multiple fields (box technique). Chemotherapy was prepared 5FU + LV in the first patient (4), in following (4) was used 5FU continuous infusion (1st and 5th week) and the remaining (2) Capecitabine. Follow up was complete. Results: In our sample we extract local failure was 4 (29%), distant failure 3 (20%) and two local and distant failures (14%) so it follows that

  13. 降血压最重要的是控制晨峰高血压和24小时血压平稳达标%Blood pressure is the most important to control blood pressure and morning peak24 hour blood pressure is stable

    韩君华; 朱志芳

    2014-01-01

    降压治疗、保持血压平稳对于高血压病人来说有重要的意义。而在降压治疗的过程中,最重要的是控制晨峰高血压,并保持24小时血压平稳达标。因此,本文就此展开论述。%antihypertensive treatment, keep blood pressure has an important significance for hypertensive patients. And in the process of treatment, the most important thing is to control the morning peak high blood pressure, and maintain a 24-hour blood pressure stable. therefore, this article discusses three.

  14. 时代需求与文化担当——图书馆24小时自助服务十年回望与思考%Revisitation of the Self-service 24-hour Library: Requirements of the Times and Culture Responsibility

    李东来

    2015-01-01

    This paper reviews the rise and development of self-service 24-hour library in the past decade, and that theself-service library is a demand of social development and a consumer demand of the era of social transformation. The combination of service hour breakthrough and self-service style reveals the huge potential of library service expansion and technological integration. From the perspective of the library career, 24-hour self-service library and its service is a spirit reflection of library following the times development, expanding career areas and accepting responsibility more proactive. It also reflects library to take on cultural responsibility for the social development.%文章回顾了十年来24小时自助图书馆的兴起与发展状况,认为24小时自助图书馆是社会发展的需求、消费社会转型的时代需求的因应产物. 服务时间的突破与自助方式的结合, 揭示着图书馆服务拓展与科技融合的巨大潜能. 站在图书馆职业的角度来看,这是图书馆积极主动跟进时代发展、拓展职业领域、承担社会职责的精神体现,是对社会发展的一种文化担当.

  15. Assessment of energy and macronutrient intake in young men: a comparison of 4-day food record and 24-hour dietary recall Quantificação do consumo energético e de macronutrientes em homens jovens: uma comparação de 4 dias de registros alimentares e recordatório alimentar de 24 horas

    Selma Coelho Liberato

    2009-10-01

    Full Text Available OBJECTIVE: The objective was to assess the quantitative agreement between a 4-day food record and a 24-hour dietary recall in young men. METHODS: Thirty-four healthy men aged 18-25 years had their food intake estimated by 4-day food record within one week following 24-hour dietary recall in a cross-sectional study. Resting metabolic rate was assessed by indirect calorimetry and Energy Expenditure was estimated by physical activity records completed simultaneously with food intake records. The validity of food records was determined by direct comparison of Energy Intake and Energy Expenditure (95% confidence interval for Energy Intake/Energy Expenditure. RESULTS: There were good agreements between the measurements of energy and macronutrient intakes by 24-hour dietary recall and 4-day food record at the group level, but not at the individual level. Compared to energy expenditure, about 20% and 9% of participants underreported their Energy Intake by 4-day food record and 24-hour dietary recall, respectively. Over 30% of underreporters of Energy Intake estimated by 24-hour dietary recall underreported Energy Intake estimated by 4-day food record. CONCLUSION: Both diet methods, 24-hour dietary recall and 4-day food record, may be used to collect data at the group level, but not at the individual level. Both methods, however, appear to underestimate Energy Intake. Underreporting may be subject-specific and appears that is more difficult to retrieve valid dietary data from some people than others.OBJETIVO: Medir a concordância qualitativa entre registros alimentares, obtidos durante 4 dias, e recordatório alimentar de 24 horas em homens jovens. MÉTODOS: Em um estudo com delineamento transversal, o consumo alimentar de 34 homens saudáveis com idades entre 18 e 25 anos foi medido por meio do recordatório alimentar de 24 horas e uma semana depois, por meio de 4 dias de registros alimentares. O gasto energético em repouso foi medido por calorimetria

  16. Measurement of variceal pressure with a computerized endoscopic manometry: validation and effect of propranolol therapy in cirrhotic patients.

    De-Run Kong

    Full Text Available BACKGROUND AND PURPOSE: Recently, we invented a computerized endoscopic balloon manometry (CEBM to measure variceal pressure (VP in cirrhotic patient. The purpose of this study was to evaluate the reliability and feasibility of this method, and whether this technique provided further information to pharmacological therapy. PATIENTS AND METHODS: VP measurements were performed in 83 cirrhotic patients and compared with HVPG as well as endoscopic bleeding risk parameters. Furthermore, VP was assessed before and during propranolol therapy in 30 patients without previous bleeding. RESULTS: VP measurements were successful in 96% (83/86 of all patients. Of the 83 patients, the VP correlated closely with the HVPG (P<0.001. The presence of red colour signs and the size of varices were strongly associated with VP. Patients with previous bleeding had higher VP than those who had not yet experienced bleeding. In univariate analysis, the level of VP, the size of varices, and red color signs predicted a higher risk of bleeding. The multiple logistic regression model revealed that VP was the major risk factor for bleeding. In 30 patients receiving propranolol, VP significantly decreased from 21.1 ± 3.5 mmHg before therapy to 18.1 ± 3.3 mmHg after 3 months and to 16.3 ± 4.0 mmHg after 6 months. Comparing the mean decrease in VP with that in hepatic venous pressure gradient (HVPG, the decrease in VP was more obvious than HVPG response to propranolol. CONCLUSIONS: This study showed that CEBM is safe and practical to assess VP in cirrhotic patient. It has the potential to be used as a clinical method to assess the risk of variceal bleeding and the effects of pharmacological therapy. TRIAL REGISTRATION: Effect of vasoactive drugs on esophageal variceal hemodynamics in patients with portal hypertension. Chinese Clinical Trial Registry -TRC-08000252.

  17. Pathogenesis of tropical sprue: A pilot study of antroduodenal manometry, duodenocaecal transit time & fat-induced ileal brake

    Uday C Ghoshal

    2013-01-01

    Full Text Available Background & objectives: Small intestinal bacterial overgrowth (SIBO due to ileal brake-induced hypomotility may cause tropical sprue (TS. We evaluated effect of infusion of fat or placebo in duodenum randomly in patients with TS and healthy controls on antroduodenal manometry (ADM and mediators of ileal brake, and duodenocaecal transit time (DCTT. Methods: ADM and DCTT (lactulose hydrogen breath test, HBT were evaluated with placebo and fat in eight controls and 13 patients with TS (diagnostic criteria: tests showing malabsorption of two unrelated substances, abnormal duodenal histology, absence of other causes, response to antibiotics and folate. Results: Patients with TS (6 had SIBO by glucose HBT were similar in age and gender with controls. After fat infusion, proximal gut motility index (MI was reduced compared to fasting state in TS, and DCTT was longer in TS than controls (200 min, 120-380 vs. 130, 70-160, P=0.001, though comparable after placebo (70 min, 30-140 vs. 60, 40-90. TS patients had higher PYY and neurotensin than controls after fat infusion. DCTT after fat infusion correlated with plasma level of PYY in TS but not in controls. Post-fat PYY and neurotensin levels were higher in TS with lower BMI (<16 kg/m [2] than those with higher BMI. Parameters of ileal brake (post-fat DCTT, PYY and neurotensin were higher in patients with than without SIBO. Interpretation & conclusions: Fat infusion reduced proximal gut MI, increased DCTT, PYY, and neurotensin among patients with TS. Malabsorbed fat might cause exaggerated ileal brake reducing gut motility, promoting SIBO and bacterial colonization and malabsorption in TS.

  18. Botulinum toxin injection for hypercontractile or spastic esophageal motility disorders: may high-resolution manometry help to select cases?

    Marjoux, S; Brochard, C; Roman, S; Gincul, R; Pagenault, M; Ponchon, T; Ropert, A; Mion, F

    2015-01-01

    Endoscopic injections of botulinum toxin in the cardia or distal esophagus have been advocated to treat achalasia and spastic esophageal motility disorders. We conducted a retrospective study to evaluate whether manometric diagnosis using the Chicago classification in high-resolution manometry (HRM) would be predictive of the clinical response. Charts of patients with spastic and hypertensive motility disorders diagnosed with HRM and treated with botulinum toxin were retrospectively reviewed at two centers. HRM recordings were systematically reanalyzed, and a patient's phone survey was conducted. Forty-five patients treated between 2008 and 2013 were included. Most patients had achalasia type 3 (22 cases). Other diagnoses were jackhammer esophagus (8 cases), distal esophageal spasm (7 cases), esophagogastric junction outflow obstruction (5 cases), nutcracker esophagus (1 case), and 2 unclassified cases. Botulinum toxin injections were performed into the cardia only in 9 cases, into the wall of the distal esophagus in 19 cases, and in both locations (cardia and distal esophagus) in 17 cases. No complication occurred in 31 cases. Chest pain was noticed for less than 7 days in 13 cases. One death related to mediastinitis occurred 3 weeks after botulinum toxin injection. Efficacy was assessed in 42 patients: 71% were significantly improved 2 months after botulinum toxin, and 57% remained satisfied for more than 6 months. No clear difference was observed in terms of response according to manometric diagnosis; however, type 3 achalasia previously dilated and with normal integrated relaxation pressure (4s-integrated relaxation pressure esophageal motility disorders. The manometric Chicago classification diagnosis does not seem to predict the results. Prospective randomized trials are required to identify patients most likely to benefit from esophageal botulinum toxin treatment. PMID:25212219

  19. Inter-observer agreement for diagnostic classification of esophageal motility disorders defined in high-resolution manometry.

    Fox, M R; Pandolfino, J E; Sweis, R; Sauter, M; Abreu Y Abreu, A T; Anggiansah, A; Bogte, A; Bredenoord, A J; Dengler, W; Elvevi, A; Fruehauf, H; Gellersen, S; Ghosh, S; Gyawali, C P; Heinrich, H; Hemmink, M; Jafari, J; Kaufman, E; Kessing, K; Kwiatek, M; Lubomyr, B; Banasiuk, M; Mion, F; Pérez-de-la-Serna, J; Remes-Troche, J M; Rohof, W; Roman, S; Ruiz-de-León, A; Tutuian, R; Uscinowicz, M; Valdovinos, M A; Vardar, R; Velosa, M; Waśko-Czopnik, D; Weijenborg, P; Wilshire, C; Wright, J; Zerbib, F; Menne, D

    2015-01-01

    High-resolution esophageal manometry (HRM) is a recent development used in the evaluation of esophageal function. Our aim was to assess the inter-observer agreement for diagnosis of esophageal motility disorders using this technology. Practitioners registered on the HRM Working Group website were invited to review and classify (i) 147 individual water swallows and (ii) 40 diagnostic studies comprising 10 swallows using a drop-down menu that followed the Chicago Classification system. Data were presented using a standardized format with pressure contours without a summary of HRM metrics. The sequence of swallows was fixed for each user but randomized between users to avoid sequence bias. Participants were blinded to other entries. (i) Individual swallows were assessed by 18 practitioners (13 institutions). Consensus agreement (≤ 2/18 dissenters) was present for most cases of normal peristalsis and achalasia but not for cases of peristaltic dysmotility. (ii) Diagnostic studies were assessed by 36 practitioners (28 institutions). Overall inter-observer agreement was 'moderate' (kappa 0.51) being 'substantial' (kappa > 0.7) for achalasia type I/II and no lower than 'fair-moderate' (kappa >0.34) for any diagnosis. Overall agreement was somewhat higher among those that had performed >400 studies (n = 9; kappa 0.55) and 'substantial' among experts involved in development of the Chicago Classification system (n = 4; kappa 0.66). This prospective, randomized, and blinded study reports an acceptable level of inter-observer agreement for HRM diagnoses across the full spectrum of esophageal motility disorders for a large group of clinicians working in a range of medical institutions. Suboptimal agreement for diagnosis of peristaltic motility disorders highlights contribution of objective HRM metrics. PMID:25185507

  20. Is rectal MRI beneficial for determining the location of rectal cancer with respect to the peritoneal reflection?

    An objective method for determining the location of the cancer with respect to peritoneal reflection would be helpful to decide the treatment modality for rectal cancer. This study was designed to evaluate the accuracy and usefulness of rectal MRI to determine spatial relations between the peritoneal reflection and rectal cancer and to compare these with operative findings. Patients that underwent a rectal cancer operation after a rectal MRI check between November 2008 and June 2010 were considered for the study. The patients that received preoperative concurrent chemoradiation or trans-anal local excision were excluded. Fifty-four patients constituted the study cohort. By comparing surgical and radiologic findings, the accuracy for predicting tumour location in relation to the peritoneal reflection by rectal MRI in all patients was 90.7%. In terms of tumour location in relation to peritoneal reflection, the accuracy of rectal MRI was 93.5% in patients with a tumour located above the peritoneal reflection, 90.0% in patients with a tumour located on the peritoneal reflection, and 84.6% in patients with a tumour located below the peritoneal reflection (p=0.061). When the cohort was subdivided by gender, body mass index (BMI), operative findings, or tumour size, no significant difference was observed among subgroups. Rectal MRI could be a useful tool for evaluating the relation between rectal cancer and peritoneal reflection especially when tumour size is less than 8cm. Rectal MRI can provide information regarding the location of rectal cancer in relation to the peritoneal reflection for treatment planning purposes

  1. Laparoscopic versus open surgery for rectal cancer (COLOR II)

    van der Pas, Martijn Hgm; Haglind, Eva; Cuesta, Miguel A;

    2013-01-01

    Laparoscopic surgery as an alternative to open surgery in patients with rectal cancer has not yet been shown to be oncologically safe. The aim in the COlorectal cancer Laparoscopic or Open Resection (COLOR II) trial was to compare laparoscopic and open surgery in patients with rectal cancer....

  2. Single-port laparoscopic rectal surgery - a systematic review

    Lolle, Ida; Rosenstock, Steffen; Bulut, Orhan

    2014-01-01

    INTRODUCTION: Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection are sparse. This review aimed to evaluate the feasibility, safety and complication profile of SPLS for rectal diseases. METHODS: A systematic literature search...

  3. VMAT planning study in rectal cancer patients

    To compare the dosimetric differences among fixed field intensity-modulated radiation therapy (IMRT), single-arc volumetric-modulated arc therapy (SA-VMAT) and double-arc volumetric-modulated arc therapy (DA-VMAT) plans in rectal cancer. Fifteen patients with rectal cancer previously treated with IMRT in our institution were selected for this study. For each patient, three plans were generated with the planning CT scan: one using a fixed beam IMRT, and two plans using the VMAT technique: SA-VMAT and DA-VMAT. Dose prescription to the PTV was 50 Gy in 2 Gy per fraction. Dose volume histograms (DVH) for the target volume and the organs at risk (small bowel, bladder, femoral heads and healthy tissue) were compared for these different techniques. Monitor units (MU) and delivery treatment time were also reported. DA-VMAT achieved the highest minimum planning target volume (PTV) dose and the lowest maximal dose, resulting in the most homogeneous PTV dose distribution. DA-VMAT also yielded the best CI, although the difference was not statistically significant. Between SA-VMAT and IMRT, the target dose coverage was largely comparable; however, SA-VMAT was able to achieve a better V95 and V107. VMAT showed to be inferior to IMRT in terms of organ at risk sparing, especially for the small bowel. Compared with IMRT, DA-VMAT increased the V15 of small bowel nearly 55 cc. The MU and treatment delivery time were significantly reduced by the use of VMAT techniques. VMAT is a new radiation technique that combines the ability to achieve highly conformal dose distributions with highly efficient treatment delivery. Considering the inferior role of normal tissue sparing, especially for small bowel, VMAT need further investigation in rectal cancer treatment

  4. Rectal Plasmocytoma: cases report and literature revision

    Plasma cell neoplasia occur in the malignant transformation of the early cell β precursors and plasma cells may group together in isolation in bones and other soft tissues without systemic manifestations; they are called plasmocytomas. Plasmocytomas outside the marrow are a rare presentation of plasma cell neoplasia. Only l % of these tumors present outside the bone marrow, two cases of rectal plasmocytoma are discussed, one of which was treated by pelvic radiotherapy and the other with surgical resection; at the time or this publication, neither shows any evidence of systemic disease

  5. High resolution MRI via endorectal coil. Results in rectal tumors

    10 volunteers and in 31 patients with suspected rectal tumors were examined. In 17 patients (n=17) with rectal carcinoma, of which 15 subsequently underwent radical surgery, the preoperatively obtained tumor stage was compared with histology. In 12 patients (n=12) with rectal adenoma (severe and medium graded epithelial dysplasias according to the WHO) who underwent endoscopy the results of the endorectal surface coil examination were compared with endoscopy and histology. In 4 patients (n=4) with large rectal adenomas the surface coil was used before and as follow-up after endoscopic electro laser resection and the absence of adenoma after therapy also in the deeper layers of the rectal wall could be confirmed. Visualization of anatomical structures of rectum and adjacent structures is improved by the use of the endorectal surface coil. The diagnosis of carcinoma and adenoma of the rectum and the documentation of the exact extension can be reached with high accuracy (85%). (orig./MG)

  6. Anatomo surgical study on radical mesorectum excision in rectal cancer.

    Alejandro A. Gorodner

    2010-11-01

    Full Text Available Knowledge of surgical anatomy of the mesorectum is essential for cancer surgery in rectal cancer. Radical mesorectal excision allows an appropriate surgery, preserving the pelvic nerves of the autonomic system, preventing postsurgical morbidity. The aim of this paper is to describe the anatomy of the mesorectum as a cornerstone to achieve a careful and detailed technique on rectal cancer surgery. 10 (ten adult formalized cadavers were dissected (nine male and one female specimen. Anatomical elements, both nervous and vascular were explored, in order to recognize those elements that should be preserved in rectal cancer surgery with radical mesorectal excision. The dissection of corpses may be an experimental model to test this type of cancer surgery. Samples were photographed and compared with those made in vivo. Rectal resection with its corresponding mesorectum, accordingly to the location of the tumor improves survival of patients with rectal cancer. Knowledge of the anatomy of the pelvic neurovascular elements significantly reduces postsurgical morbidity.

  7. Rectal dexmedetomidine in rats: evaluation of sedative and mucosal effects

    Volkan Hanci

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. METHODS: Male Wistar albino rats weighing 250-300 g were divided into four groups: Group S (n = 8 was a sham group that served as a baseline for the normal basal values; Group C (n = 8 consisted of rats that received the rectal application of saline alone; Group IPDex (n = 8 included rats that received the intraperitoneal application of dexmedetomidine (100 µg kg-1; and Group RecDex (n = 8 included rats that received the rectal application of dexmedetomidine (100 µg kg-1. For the rectal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min were measured. Two hours after rectal administration, 75 mg kg-1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. RESULTS: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05. In the Group RecDex, the administration of dexmedetomidine induced mild-moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. CONCLUSION: Although 100 µg kg-1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our histopathological evaluations showed that the rectal administration of 100 µg kg-1 dexmedetomidine led to mild-moderate damage to the mucosal structure of the

  8. Conservative management of anal and rectal cancer

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

  9. Application of 24 Hour Holter Monitoring in Assessment of Heart Rate Variability in Breath Holding Children%动态心电图监测对屏气发作患儿心率变异性的评估价值

    胡蔓莉

    2015-01-01

    【目的】分析24 h动态心电图监测屏气发作(BHS)患儿心率变异性(HRV),评估自主神经失调对BHS患儿的影响。【方法】选择本院收治的36例BHS患儿,根据入院后患儿的表观体征将其分为紫绀型组( n =24)和苍白型组( n =12),选择同期本院健康体检的24例健康婴幼儿为对照组。通过24 h动态心电图观察受试者的 HRV相关指标,评估BHS患儿自主神经失调对BHS患儿的影响。【结果】苍白型组患儿心率显著低于紫绀型组及对照组,差异具有统计学意义( P <00.5);苍白型组患儿 HRV时域和频域相关指标所有N‐N间期标准差、5 m in内N‐N间期标准差的平均值、高频功率谱、低频功率谱与高频功率谱比值与紫绀型组及对照组比较差异均具有统计学意义( P <00.5)。【结论】24 h动态心电图监测BHS患儿HRV ,特别对苍白型BHS患儿心脏节律变化的评估至关重要。%Objective] To analyze the heart rate variability (HRV) in breath‐holding children by using 24 hour Holter monitoring and evaluate the effect of autonomic dysregulation on children with breath‐holding spells (BHS) .[Methods]36 children with BHS were enrolled and allocated to the cyanotic group ( n =24) and the pallid group ( n =12) according to the symptoms .At the same time ,24 healthy children were also chosen as the control group .By recording the HRV indexes with 24 hour Holter monitoring ,the effect of the auto‐nomic function on the children with BHS was assessed .[Results] The heart rates of the children in pallid group were significantly lower than those of the cyanotic group and the control group ;the difference was sta‐tistically significant ( P <0 0.5) .The time domain and frequency domain indexes for HRV ,including standard deviation of all N‐N intervals ,mean of the standard deviations of all N‐N intervals for all 5‐minute segments , high frequency power spectrum

  10. The solitary rectal ulcer syndrome: diagnosis with defecography.

    Goei, R; Baeten, C; Janevski, B; van Engelshoven, J

    1987-11-01

    The solitary rectal ulcer syndrome is an uncommon entity consisting of a rectal abnormality caused by straining during defecation and characterized by specific histologic changes. Endoscopy may show single or multiple ulcers or a preulcerative phase consisting of mucosal thickening. Findings on barium enema may be normal or nonspecific, consisting of a thickened valve of Houston, nodularity, and rectal stricture. Pathologic changes consist of replacement of the lamina propria by fibroblasts and smooth muscle fibers with marked hypertrophy of the muscularis mucosae. In five patients with histologically proved solitary rectal ulcer syndrome, defecography was performed to evaluate the accompanying defecation disorder. Two patients showed the spastic pelvic floor syndrome, characterized by failure of relaxation of the pelvic floor musculature during straining. In the remaining three, defecography showed an infolding of the rectal wall toward the rectal lumen increasing gradually to form an intussusception. The results indicate that defecography is useful to show the underlying disorder of defecation in the solitary rectal ulcer syndrome. PMID:3499797

  11. Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

    Zaporowska-Stachowiak I

    2014-10-01

    Full Text Available Iwona Zaporowska-Stachowiak,1,2 Grzegorz Kowalski,3 Jacek Łuczak,2 Katarzyna Kosicka,4 Aleksandra Kotlinska-Lemieszek,3 Maciej Sopata,3 Franciszek Główka4 1Chair and Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland; 2Palliative Medicine In-patient Unit, University Hospital of Lord's Transfiguration, Poznan University of Medical Sciences, Poznan, Poland; 3Palliative Medicine Chair and Department, Poznan University of Medical Sciences, Poznan, Poland; 4Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland Background: Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III "pain ladder" drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient's refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective: Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures, and to evaluate the effect of the mode of administration (intrathecal versus rectal on the bupivacaine plasma concentration.Cases: We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours. The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 m

  12. Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

    To evaluate the impact of four different rectum contouring techniques and rectal toxicities in patients with treated with 3D conformal radiotherapy (3DCRT). Clinical and dosimetric data were evaluated for 94 patients who received a total dose 3DCRT of 70 Gy, and rectal doses were compared in four different rectal contouring techniques: the prostate-containing CT sections (method 1); 1 cm above and below the planning target volume (PTV) (method 2); 110 mm starting from the anal verge (method 3); and from the anal verge to the sigmoid flexure (method 4). The percentage of rectal volume receiving RT doses (30–70 Gy) and minimum, mean rectal doses were assessed. Median age was 69 years. Percentage of rectal volume receiving high doses (≥ 70 Gy) were higher with the techniques that contoured smaller rectal volumes. In methods 2 and 3, the percentage of rectal volume receiving ≥ 70 Gy was significantly higher in patients with than without rectal bleeding (method 2: 30.8% vs. 22.5%, respectively (p = 0.03); method 3: 26.9% vs. 18.1%, respectively (p = 0.006)). Mean rectal dose was significant predictor of rectal bleeding only in method 3 (48.8 Gy in patients with bleeding vs. 44.4 Gy in patients without bleeding; p = 0.02). Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (≥ 70 Gy) and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3

  13. Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

    Yavuz Melek

    2009-05-01

    Full Text Available Abstract Background To evaluate the impact of four different rectum contouring techniques and rectal toxicities in patients with treated with 3D conformal radiotherapy (3DCRT. Methods Clinical and dosimetric data were evaluated for 94 patients who received a total dose 3DCRT of 70 Gy, and rectal doses were compared in four different rectal contouring techniques: the prostate-containing CT sections (method 1; 1 cm above and below the planning target volume (PTV (method 2; 110 mm starting from the anal verge (method 3; and from the anal verge to the sigmoid flexure (method 4. The percentage of rectal volume receiving RT doses (30–70 Gy and minimum, mean rectal doses were assessed. Results Median age was 69 years. Percentage of rectal volume receiving high doses (≥ 70 Gy were higher with the techniques that contoured smaller rectal volumes. In methods 2 and 3, the percentage of rectal volume receiving ≥ 70 Gy was significantly higher in patients with than without rectal bleeding (method 2: 30.8% vs. 22.5%, respectively (p = 0.03; method 3: 26.9% vs. 18.1%, respectively (p = 0.006. Mean rectal dose was significant predictor of rectal bleeding only in method 3 (48.8 Gy in patients with bleeding vs. 44.4 Gy in patients without bleeding; p = 0.02. Conclusion Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (≥ 70 Gy and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3.

  14. Differences in microbial signatures between rectal mucosal biopsies and rectal swabs

    Araújo-Pérez, Félix; Amber N McCoy; Okechukwu, Charles; Carroll, Ian M.; Smith, Kevin M.; Jeremiah, Kim; Sandler, Robert S.; Asher, Gary N; Keku, Temitope O

    2012-01-01

    There is growing evidence the microbiota of the large bowel may influence the risk of developing colorectal cancer as well as other diseases including type-1 diabetes, inflammatory bowel diseases and irritable bowel syndrome. Current sampling methods to obtain microbial specimens, such as feces and mucosal biopsies, are inconvenient and unappealing to patients. Obtaining samples through rectal swabs could prove to be a quicker and relatively easier method, but it is unclear if swabs are an ad...

  15. Benign (solitary) ulcer of the rectum - another cause for rectal stricture

    Chapa, H.J.; Smith, H.J.; Dickinson, T.A.

    1981-01-15

    Benign rectal ulcer syndrome is an uncommon cause of lower gastrointestinal bleeding. Patients may present with mild, often recurrent, rectal bleeding frequently ascribed to hemorrhoids. Barium enema may be normal during the early, nonulcerative phase of proctitis. Single (or multiple) ulcers with or without rectal stricture are the hallmarks of the radiographic diagnosis. Radiologic demonstration of the ulcer(s) is not required, however, for the diagnosis. Benign rectal ulcer should be included in the differential diagnosis of benign-appearing rectal strictures.

  16. Significance of thermoradiotherapy for rectal cancer

    Ike, Hideyuki; Fukano, Masahiko; Yamaguchi, Sigeki [Yokohama City Univ. (Japan). School of Medicine] [and others

    1997-05-01

    In patients with rectal cancer, results of 27 cases receiving thermoradiotherapy and of 68 cases, radiotherapy before operation were compared with those of 119 cases receiving expanded radical operation. Radiotherapy was done with 10 MV X-ray generated by linear-accelerator at 2.0 Gy x 5/week and 60 Gy in total. Hyperthermotherapy was performed with the capacitive heating method with 8 MHz radiofrequency (Thermotoron RF8) twice/week x 5. Every thermotherapy was done for 40 min at 42degC-43degC within 1 hr after the radiotherapy. Good results were observed in cases whose cancer was disappeared by either preoperative therapy. However, results in survival and recurrence rates were not always improved when compared with those receiving surgery alone. (K.H.)

  17. 'Microerosions' in rectal biopsies in Crohn's disease

    Poulsen, Steen Seier

    1984-01-01

    Small (less than 1 mm), superficial erosions ('microerosions') have been observed stereo-microscopically in surface-stained rectal biopsies in Crohn's disease (CD). Biopsy specimens from 97 patients with CD, 225 with ulcerative colitis (UC), and a control material of 161 patients were investigated...... exclusively. Granulomas were identified in 62% of the biopsies with microerosions and by examination of two consecutive biopsies from each of these patients, in 85% indicating a positive correlation. In patients with microerosions and a primary diagnosis of UC, granulomas were found in 38% and by examination...... of two biopsies in 54%. Patients with granulomas and a few other patients were reclassified as CD, but there still remained some patients with microerosions, who most probably had UC. In conclusion, microerosions are observed mainly in CD with colonic involvement. There is a high incidence of...

  18. [Organ preserving strategies for rectal cancer treatment].

    Vendrely, V; Denost, Q; Amestoy, F; Célérier, B; Smith, D; Rullier, A; Rullier, É

    2015-10-01

    For rectal cancers, the current standard of care consists of chemoradiation followed by radical surgery with total mesorectal excision. Oncologic results are good, especially regarding local recurrence rates, but at the cost of high morbidity rates and poor anorectal, urinary and sexual function results. Since chemoradiation yields 15 to 25% pathological complete response, the role of radical surgery is questioned for patients presenting with good response after chemoradiation and two organ preservation strategies have been offered: watch and wait strategy and local excision strategy. The aim of this review is to give the results of organ preservation after chemoradiotherapy series and to highlight different questions regarding initial patient's selection, complete clinical response definition, risk of mesorectal nodal involvement, follow-up modalities as well as oncologic and functional results. PMID:26278990

  19. Expression and clinical significance of cellular prion protein in rectal cancer and adenoma

    Wei-ping LI

    2015-07-01

    Full Text Available Objective To determine the expressions of cellular prion protein (PrPC in normal rectal mucosa, rectal adenoma and rectal carcinoma tissues, and to study the relationship of PrPC with development and progression of rectal carcinoma. Methods Immunohistochemical method (SP method was used to determine the expressions of PrPC in rectal carcinoma (60 samples, rectal adenoma (20 samples and normal rectal mucosa (20 samples, and the correlations between the expression of PrPC in rectal carcinoma tissue, and clinical pathological parameters including sex, tumor differentiation, clinical stages, lymph node metastasis, etc. were analyzed. Results PrPC was expressed in normal rectal mucosa, rectal adenoma and rectal carcinoma tissues. The positive rate of PrPC expression in rectal carcinoma (65% was significantly higher than that in rectal adenoma (35% and normal rectal mucosa (15% with statistical significance (P0.05. Conclusion PrPC may play an important role in the process of development, progression and metastasis of rectal carcinoma. DOI: 10.11855/j.issn.0577-7402.2015.07.12

  20. Efficiency of Non-Contrast-Enhanced Liver Imaging Sequences Added to Initial Rectal MRI in Rectal Cancer Patients.

    Gene-hyuk Kwon

    Full Text Available The purpose of this study was to estimate the value of addition of liver imaging to initial rectal magnetic resonance imaging (MRI for detection of liver metastasis and evaluate imaging predictors of a high risk of liver metastasis on rectal MRI.We enrolled 144 patients who from October 2010 to May 2013 underwent rectal MRI with T2-weighted imaging (T2WI and diffusion-weighted imaging (DWI (b values = 50, 500, and 900 s/mm2 of the liver and abdominopelvic computed tomography (APCT for the initial staging of rectal cancer. Two reviewers scored the possibility of liver metastasis on different sets of liver images (T2WI, DWI, and combined T2WI and DWI and APCT and reached a conclusion by consensus for different analytic results. Imaging features from rectal MRI were also analyzed. The diagnostic performances of CT and an additional liver scan to detect liver metastasis were compared. Multivariate logistic regression to determine independent predictors of liver metastasis among rectal MRI features and tumor markers was performed. This retrospective study was approved by the Institutional Review Board, and the requirement for informed consent was waived.All sets of liver images were more effective than APCT for detecting liver metastasis, and DWI was the most effective. Perivascular stranding and anal sphincter invasion were statistically significant for liver metastasis (p = 0.0077 and p = 0.0471, while extramural vascular invasion based on MRI (mrEMVI was marginally significant (p = 0.0534.The addition of non-contrast-enhanced liver imaging, particularly DWI, to initial rectal MRI in rectal cancer patients could facilitate detection of liver metastasis without APCT. Perivascular stranding, anal sphincter invasion, and mrEMVI detected on rectal MRI were important imaging predictors of liver metastasis.

  1. Rectal absorption of homatropine [14C] methylbromide in the rat

    Homatropine [14C]methylbromide (HMB-14C) was administered to rats by intramuscular injection, oral gavage and rectal suppository. Plasma concentrations of 14C were measured over the subsequent 12 h. Peak plasma concentrations were higher and achieved more rapidly after rectal administration than by other routes whether HMB-14C was administered in a water-soluble suppository base or in aqueous solution. Twelve h after the suppositories were inserted and retained 28% of the 14C had been excreted in the urine while 56% remained in the large intestine. Unlabelled HMB, given in rectal suppositories to anaesthetized rats, caused prompt blockade of the effects of vagal stimulation on pulse rate and of intravenous acetylcholine on blood pressure. These results confirm the rapid rectal absorption of the drug. (author)

  2. Postoperative adjuvant chemotherapy in rectal cancer operated for cure

    Petersen, Sune Høirup; Harling, Henrik; Kirkeby, Lene Tschemerinsky;

    2012-01-01

    Colorectal cancer is one of the most common types of cancer in the Western world. Apart from surgery - which remains the mainstay of treatment for resectable primary tumours - postoperative (i.e., adjuvant) chemotherapy with 5-fluorouracil (5-FU) based regimens is now the standard treatment...... in Dukes´ C (TNM stage III) colon tumours i.e. tumours with metastases in the regional lymph nodes but no distant metastases. In contrast, the evidence for recommendations of adjuvant therapy in rectal cancer is sparse. In Europe it is generally acknowledged that locally advanced rectal tumours receive...... preoperative (i.e., neoadjuvant) downstaging by radiotherapy (or chemoradiotion), whereas in the US postoperative chemoradiotion is considered the treatment of choice in all Dukes´ C rectal cancers. Overall, no universal consensus exists on the adjuvant treatment of surgically resectable rectal carcinoma...

  3. [Rectal prolapse revealing a tumor: The role of abdominal ultrasound].

    Bequet, E; Stiennon, L; Lhomme, A; Piette, C; Hoyoux, C; Rausin, L; Guidi, O

    2016-07-01

    Rectal prolapse is rare in children and usually benign. However, there are various diseases that can be associated with it, such as cystic fibrosis or other causes of increased abdominal pressure. Here, we review the various underlying conditions that pediatricians or pediatric gastroenterologists should consider in the case of rectal prolapse. We report on three cases of children with a rectal prolapse and intra-abdominal tumors. Current recommendations and practice do not include a systematic check via abdominal imaging in cases of rectal prolapse. However, in some situations, imaging is indicated to detect a possible expansive process. Thus, in the presence of recurrent prolapse or of associated urinary or neurological signs, imaging is justified so as to allow for an early diagnosis and treatment of these neoplasms. Given its lack of radiation exposure and good sensitivity in children, ultrasound imaging is the first choice. PMID:27265581

  4. Rectal bacteriotherapy for recurrent Clostridium difficile-associated diarrhoea

    Tvede, M; Tinggaard, M; Helms, M

    2015-01-01

    Clostridium difficile infection is one of the most common nosocomial infections. Among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from...

  5. Laparoscopic resection for low rectal cancer: evaluation of oncological efficacy.

    Moran, Diarmaid C

    2011-09-01

    Laparoscopic resection of low rectal cancer poses significant technical difficulties for the surgeon. There is a lack of published follow-up data in relation to the surgical, oncological and survival outcomes in these patients.

  6. Higher rectal temperatures in co-sleeping infants.

    Tuffnell, C S; Petersen, S A; Wailoo, M P

    1996-01-01

    The effect on deep body temperature of infants co-sleeping (with either or both parents) is investigated in this case control study. Overnight continuous recordings of rectal temperature were made from 34 babies co-sleeping with one or both parents throughout the night and 34 infants matched for age, feeding regimen, parental smoking, thermal environment, sleeping position, and sex who slept alone. The co-sleeping infants had significantly higher rectal temperatures from two hours after bedti...

  7. RECTAL DUPLICATION CYST IN PREVIOUS ANORECTAL MALFORMATION AND DOWN SYNDROME

    A. Burgio

    2012-12-01

    Full Text Available Gastrointestinal (GI tract duplications are rare congenital malformations. Most of them occur in the ileum and only 1-5%, of all duplication, were in the rectum. Different clinical features including chronic constipation, rectal prolapsed or polips. We report on a 4-years-old girl with Down syndrome and anorectal malformation (ARM who was found to have a rectal duplication cyst.

  8. Direct costs of radiotherapy for rectal cancer: a microcosting study

    Hanly, Paul; Céilleachair, Alan Ó; Skally, Máiréad; O’Neill, Ciaran; Sharp, Linda

    2015-01-01

    Background Radiotherapy provides significant benefits in terms of reducing risk of local recurrence and death from rectal cancer. Despite this, up-to-date cost estimates for radiotherapy are lacking, potentially inhibiting policy and decision-making. Our objective was to generate an up-to-date estimate of the cost of traditional radiotherapy for rectal cancer and model the impact of a range of potential efficiency improvements. Methods Microcosting methods were used to estimate total direct r...

  9. Functional MR imaging for response prediction in rectal cancer treatment

    Intven, M.P.W.

    2015-01-01

    The standard of care treatment for locally advanced rectal cancer is neoadjuvant chemoradiation followed by total mesorectal excision. In recent years, organ-sparing treatments, instead of standard total mesorectal excision, are gradually introduced in the treatment of rectal cancer for patients with good response after neoadjuvant therapy. However, patient selection for organ-sparing treatments is still challenging as no optimal restaging modality is available after neoadjuvant chemoradiatio...

  10. Plasma concentrations of clonazepam after single rectal administration.

    Rylance, G W; Poulton, J; Cherry, R C; Cullen, R E

    1986-01-01

    Clonazepam was administered rectally to six children aged 1.4 to 4.7 years in a dose of 0.05 mg/kg and to five children aged 1.4 to 4.1 years in a dose of 0.1 mg/kg. Plasma concentrations indicate that it is rapidly absorbed, and it may therefore be an alternative to rectal administration of diazepam in continuing convulsions.

  11. MRI in children following surgery for anal and rectal atresia

    MRI of the pelvis was performed in 17 children following surgical correction of anal and rectal atresias and in five children without ano-rectal malformations. A muscle score was used to characterize the muscles of the pelvic floor and their relationship to the rectum. There was close agreement between the MRI muscle score and clinical continence. MRI provided additional information that should improve continence following conservative and surgical treatment. (orig.)

  12. Ultrastructural pathology of the rectal mucosa in Shigella dysentery.

    Mathan, M M; Mathan, V I

    1986-01-01

    Colonocyte damage in the rectal mucosa in shigellosis is the result of bacterial invasion and leads to ulceration. Additional factors in colonocyte damage may be the Shigella cytotoxin and, especially in colonic crypt cells, bacterial endotoxin. A vascular lesion was present in the lamina propria of the rectal mucosa, which resembled endothelial damage secondary to bacterial endotoxins. In patients with longer duration of symptoms, relative vascular insufficiency, activated lymphocytes, eosin...

  13. Congenital cystic polypoid rectal hamartoma in a newborn foal.

    Dunkel, B; Shokek, A B; Wilkins, P A

    2004-11-01

    A neonatal foal with signs of rectal bleeding was diagnosed with an intraluminal rectal mass and intussusception on surgical exploration of the abdomen. Histologically, the mass consisted of cystic spaces lined by simple columnar epithelium with numerous goblet cells and was surrounded by thin bands of smooth muscle in a myxomatous stroma. Although the mass shared similarities with retrorectal cystic hamartoma (tailgut cyst) and juvenile polyps, described in human medicine, location and histologic findings were not entirely consistent with either condition. PMID:15557082

  14. The rectal cancer microRNAome - microRNA expression in rectal cancer and matched normal mucosa

    Gaedcke, Jochen; Grade, Marian; Camps, Jordi;

    2012-01-01

    PURPOSE: miRNAs play a prominent role in a variety of physiologic and pathologic biologic processes, including cancer. For rectal cancers, only limited data are available on miRNA expression profiles, whereas the underlying genomic and transcriptomic aberrations have been firmly established. We...... therefore, aimed to comprehensively map the miRNA expression patterns of this disease. EXPERIMENTAL DESIGN: Tumor biopsies and corresponding matched mucosa samples were prospectively collected from 57 patients with locally advanced rectal cancers. Total RNA was extracted, and tumor and mucosa mi......RNA expression profiles were subsequently established for all patients. The expression of selected miRNAs was validated using semi-quantitative real-time PCR. RESULTS: Forty-nine miRNAs were significantly differentially expressed (log(2)-fold difference >0.5 and P < 0.001) between rectal cancer and normal rectal...

  15. Rectal toxicity after intensity modulated radiotherapy for prostate cancer: Which rectal dose volume constraints should we use?

    Background: To define rectal dose volume constraints (DVC) to prevent ⩾grade2 late rectal toxicity (LRT) after intensity modulated radiotherapy (IMRT) for prostate cancer (PC). Material and methods: Six hundred thirty-seven PC patients were treated with primary (prostate median dose: 78 Gy) or postoperative (prostatic bed median dose: 74 Gy (adjuvant)–76 Gy (salvage)) IMRT while restricting the rectal dose to 76 Gy, 72 Gy and 74 Gy respectively. The impact of patient characteristics and rectal volume parameters on ⩾grade2 LRT was determined. DVC were defined to estimate the 5% and 10% risk of developing ⩾grade2 LRT. Results: The 5-year probability of being free from ⩾grade2 LRT, non-rectal blood loss and persisting symptoms is 88.8% (95% CI: 85.8–91.1%), 93.4% (95% CI: 91.0–95.1%) and 94.3% (95% CI: 92.0–95.9%) respectively. There was no correlation with patient characteristics. All volume parameters, except rectal volume receiving ⩾70 Gy (R70), were significantly correlated with ⩾grade2 LRT. To avoid 10% and 5% risk of ⩾grade2 LRT following DVC were derived: R40, R50, R60 and R65 <64–35%, 52–22%, 38–14% and 5% respectively. Conclusion: Applying existing rectal volume constraints resulted in a 5-year estimated risk of developing late ⩾grade2 LRT of 11.2%. New rectal DVC for primary and postoperative IMRT planning of PC patients are proposed. A prospective evaluation is needed

  16. Alternative procedure to shorten rectal barostat procedure for the assessment of rectal compliance and visceral perception: a feasibility study

    Vanhoutvin, S.A.L.W.; Troost, F. J; Kilkens, T. O. C.; Lindsey, P. J.; Jonkers, D.M.A.E.; Venema, K.; Masclee, A.; Brummer, R-J M

    2012-01-01

    Background Barostat methodology is widely used for assessing visceral perception. Different barostat protocols are described with respect to the measurement of rectal compliance and visceral perception. The choice of protocols affects the duration, which is normally 60–90 min, and accuracy of the procedure. This study aimed to shorten the procedure by using the semi-random distension protocol for both compliance and visceral perception measurement and a correction based on rectal capacity (RC...

  17. Alternative procedure to shorten rectal barostat proecure for the assessment of rectal compliance and visceral perception: a feasibility study

    Vanhoutvin, S.A.; Troost, F. J; Kilkens, T.O.; Lindsey, P. J.; Jonkers, D.M.; Venema, K.; Masclee, A.; Brummer, R J

    2012-01-01

    BACKGROUND: Barostat methodology is widely used for assessing visceral perception. Different barostat protocols are described with respect to the measurement of rectal compliance and visceral perception. The choice of protocols affects the duration, which is normally 60-90 min, and accuracy of the procedure. This study aimed to shorten the procedure by using the semi-random distension protocol for both compliance and visceral perception measurement and a correction based on rectal capacity (R...

  18. Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit

    English, James, Jr.; Sajid, Muhammad S; Lo, Jenney; Hudelist, Guy; Baig, Mirza K.; Miles, William A.

    2014-01-01

    Background. The management of symptomatic rectal endometriosis is a challenging condition that may necessitate limited stripping or limited segmental anterior rectal resection (LSARR) depending upon the extent and severity of the disease. Objective. To report the efficacy of LSARR in terms of pain, quality of life and short- and long-term complications—in particular, those pertaining to bowel function. Methods. The case notes of all patients undergoing LSARR were reviewed. The analysed variab...

  19. Radioimmunoscintigraphy using 99mTc-anti-CEA F(ab's)2 fragment in rectal cancer and a pilot study for radioimmunoguided surgery

    This prospective study was performed to evaluate the usefulness of preoperative radioimmunoscintigraphy and intraoperative scintimetric examination (radioimmunoguided surger: RIGS) using99mTc-anti-CEA F(ab')2 fragment. Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of 99mTc-anti-CEA F(ab')2 fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioactivities from excised tumor and lymph nodes were also measured and compared with pathology. All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology. Preoperative radioimmunoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it could not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity. However, radioactivity from excised tumor was higher than normal rectum (T/B ratio; 3,47±2.25). When excised lymph node activity/background activity ratio >1.5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. Radioimmunoscintigraphy using 99mTc-anti-CEA F(ab')2 has no additional value for preoperative staging and use of early RIGS using 99mTc-anti-CEA F(ab')2 is inappropriate. For early RIGS using 99mTc labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.=20

  20. Preserving the superior rectal artery in laparoscopic sigmoid resection for complete rectal prolapse.

    Bergamaschi, R; Lovvik, K; Marvik, R

    2004-01-01

    Sigmoid resection is indicated in the treatment of complete rectal prolapse (CRP) in patients with prolonged colorectal transit time (CTT). Its use however has been limited due to fear of anastomotic leakage. This study challenges the current practice of dividing the mesorectum by prospectively evaluating the impact of sparing the superior rectal artery (SRA) on leak rates after laparoscopic sigmoid resection (LSR) for CRP. During 30 months data on 33 selected patients with CRP were prospectively collected. Three patients were withdrawn from the analysis, as they had neither resection nor anastomosis. Twenty-nine women and one man (median age 55 range 21-83 years) underwent LSR with preservation of SRA for a median CRP of 8 (3-15) cm. There were 20 ASA I and 10 ASA II patients. Ten patients had undergone previous surgery. Four patients complained of dyschezia, whereas incontinence was present in 26 patients. Anal ultrasound showed isolated internal sphincter defects in two patients. Four young adults (21-32 years) had normal CTT, whereas 26 older patients had a median CTT of 5 (4-6) days. Defecography demonstrated 10 enteroceles, two sigmoidoceles, and one rectal hernia through the levator ani muscle. Mortality was nil. Median operating room time was 180 (120-330) min, suprapubic incision length 5 (3-7) cm, estimated blood loss 150 (50-500) ml, specimen length 20 (12-45) cm, solid food resumption 3 (1-6) days, and length of stay 4.5 (2-7) days. Thirty-day complications were not related to anastomosing and occurred in 20% of the patients. Although the evidence provided by the present study suggests that sparing SRA has a favorable impact on anastomotic leak rates, these nonrandomized results need further evaluation. The division of the mesorectum at the rectosigmoid junction seems not necessary, and its sparing should therefore be considered as it may contain anastomotic leak rates. PMID:15771289

  1. 非动脉炎性前部缺血性视神经病变24h动态血压的初步分析%Preliminary analysis on 24-hour ambulatory blood pressure monitoring of 19 patients with non-arteritic anterior ischemic optic neuropathy

    梅晓白; 范坷; 魏世辉

    2012-01-01

    OBJECTIVE To conduct the preliminary analysis of the characteristics of 24-hour ambulatory blood pressure monitoring (ABPM) of the 19 patients with non-arteritic anterior ischemic optic neuropathy (NAION).METHODS Chose 19 cases of NA10N group and normal control group respectively, and recorded its 24-hour systolic, diastolic and mean arterial pressure, then portrayed the curve and analyzed the morning blood pressure surge (MBPS). RESULTS The daytime systolic blood pressure of 19 cases with NAION was lower than the normal group(P<0.01); The diastolic blood pressure of the day and the night was higher than the normal group(P<0.01); The blood pressure curves concluded seven non-dippers and eleven reverse-dippers. MBPS values were measured (MBPS==35 mmHg, 3cases; 10 mmHg =MBPS<35 mmHg, llcases; 0=MBPS<10 mmHg, 2cases, MBPS<0, 3cases). CONCLUSIONS NAION patients with low systolic blood pressure in the daytime, high diastolic blood pressure in the day and the night, reverse-dippers and non-dippers of the blood pressure curve, low morning blood pressure surge were all the possible risk factors damaging target organ, and further researches are needed.%目的 初步分析非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischaemic optic neuropathy,NAION)患者的24h动态血压(ambulatory blood pressure monitoring,ABPM)特点.方法 选取NAION患者19例作为病例组,同期健康体检者19例作为正常对照组,分别记录其24h的收缩压、舒张压和平均动脉压,描绘其动态曲线并分类,分析血压晨峰情况.结果 19例NAION患者日间收缩压低于正常对照组(P<0.01),昼夜的舒张压均高于正常组(P<0.01);血压变化曲线中有7例为非勺型,其余均为反勺型;血压晨峰(morning blood pressure surge,MBPS)值>35mmHg者3例,≥10mmHg~<35mmHg者11例,≥0mmHg~<10mmHg者2例,<0mmHg者3例.结论 NAION患者的日间低收缩压、昼夜高舒张压、反勺型和非勺型血压曲线、低血

  2. Protocolo de actuación preventiva para riesgo debido a alteraciones del ritmo circadiano en médicos de urgencias que trabajan en turnos de 24 horas Preventive action protocol for risk due to circadian rhythm disturbances in emergency physicians working in 24 hours shifts

    Loreto Fillat de Acosta

    2009-12-01

    Full Text Available La autora analiza la situación patológica de los médicos de urgencias con turnos de 24 horas que alteran el ritmo circadiano, el estudio describe las condiciones de trabajo que afectan el ritmo biológico sueño-vigilia y las tareas intelectuales y de habilidades mecánicas desempeñadas por este personal, los daños a prevenir (accidentes in itinere, accidentes por manipulación de material biológico, enfermedades somáticas y psíquicas y el riesgo para los pacientes. Se propone un protocolo de actuación preventiva que abarca la mayor parte del trabajo, cuándo actuar, revisión de recursos, actuaciones a realizar en una unidad de salud laboral y sistema de comunicación al resto del hospital, Servicio de Prevención de Riesgos Laborales y Sistema Nacional de Salud.The author analyzes the pathological situation concerning to emergency physicians with 24-hour shifts which disturb their circadian rhythms, the study describes the working conditions that affect the biological sleep-wake rhythm and intellectual tasks and mechanical skills performed by these staff, damage to be prevented (commuting accidents, accidents caused by handling of biological material, somatic and psychic diseases and the risk to patients. After that, it's developed a proposal of preventive action protocol covering most of the work and finally when to act, available resources and actions to be taken in an occupational health unit, in addition to the communication system to the rest of the hospital, Occupational and Hazard Preventive Service and the National Health System.

  3. 老年2型糖尿病患者认知功能与血压昼夜节律变化特点%Relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in the patients of elderly type 2 diabetes

    徐军霞; 王建军; 詹开宇; 吴海棠; 张冬梅

    2011-01-01

    Objective To study the relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in the patients of elderly type 2 diabetes.Methods Two hundred and seventy elderly patients of type 2.diabetes were performed 24-hour ambulatory blood pressure monitoring (ABPM), and divided into dipper group (n=95), non-dipper group (n=86), super-dipper group (n=47) and reverse-dipper group (n=42).100 healthy subjects served as control.Cognition function were evaluated by Mini-Mental State Examination(MMSE).Results MMSE of type 2 diabetes group was significantly lower than that of control (24.34±2.51 vs.control: 28.88±3.02, P<0.05).MMSE of non-dipper group, super-dipper group and reverse-dipper group were significantly lower than that of dipper group, super-dipper group and reverse-dipper group were also lower than that of non-dipper group (non-dipper.24.77±2.53 vs.super-dipper: 23.34±2.41 vs.reverse- dipper:23.03±2.26 vs.dipper: 26.03±2.68 ,respectively P<0.05),but there was no significant difference between super-dipper and reverse-dipper group.Pearson correlation analysis showed that,MMSE was negatively correlated with 24hSBP(r=-0.73),24hDBP(r=-0.60),24hPP(r=-0.54)and 24hMBP(r=-0.56)(all P<0.05).Conclusions The decrease on cognition function in the patients of elderly type 2 diabetes may be related with the attenuation or disappearance of 24-hour ambulatory blood pressure circadian rhythm.%目的 探讨老年2型糖尿病(T2DM)患者认知功能与24h动态血压昼夜节律变化特点.方法 选择270例老年T2DM患者为糖尿病组,另选择同期健康体检者100例为对照组.对两组行24 h动态血压监测,根据夜间血压下降率(△MBP)分为杓型(△MBP 10%~20%,n=95)、非杓型(△MBP 0%~<10%,n=86)、超杓型(△MBP>20%,n=47)和反杓型(△MBP<0%,n=42);用中文版简易智能状态检查表(MMSE)对所有受试者进行认知功能调查,比较各组间MMSE得分的差异.结果

  4. Oral Chloral Hydrate Compare with Rectal Thiopental in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial

    Reza Azizkhani

    2014-03-01

    Full Text Available Introduction: The increasing use of diagnostic imaging in pediatric medicine has resulted in growing need for procedural sedation and analgesia (PSA to minimize motion artifacts during procedures. The drug of choice in pediatric PSA was not introduced till now. The aim of the present study was comparison of oral chloral hydrate (OCH and rectal sodium thiopental (RST in pediatric PSA.Methods: In the present randomized clinical trial, 2-6 years old pediatrics who referred for performing brain computed tomography scan was enrolled and were randomly divided in to two groups. OCH (50mg/kg and RST (25mg/kg were prescribed and a trained nurse recorded the time from drug prescription to receiving the conscious sedation (onset of action, the total time period which the patient has the Ramsay score≥4 (duration of action, and adverse effect of agents. Mann-Whitney U test and chi-squared test, and Non-parametric analysis of covariance (ANCOVA were used for comparisons. Results: One hundred and forty children were entered to two groups of OCH and RST, randomly. The patients of two groups had similar age, sex, weight, and baseline vital signs except for diastolic blood pressure (p<0.001. The onset of action in OCH and RST groups were 24.5±6.1and 28.7±5.2 minutes, respectively (p<0.001. Duration of action in OCH and RST groups were 12.9±2.8 minutes and 13.7±2.6 minutes, respectively (p=0.085. Non parametric ANCOVA revealed that only diastolic blood pressure was affected by drug prescription (p=0.001. In 11(15.7% patients in RST group, diarrhea was observed during 24 hours (p=0.001. Oxygen desaturation was observed only in two patients, both in OCH group. Conclusion: Each of the sedative has advantages and disadvantages that should be considered when selecting one for inducing short-term sedation. It seems that rectal sodium thiopental and oral chloral hydrate are equally effective in pediatric PSA and based on patient’s condition we can administrate

  5. Detection of myocardial viability by means of Single Proton Emission Computed Tomography (Perfused SPECT) dual {sup 201} Tl (rest of 15 minutes, 24 late hours and 24 hours reinjection) and gated-SPECT {sup 99m} Tc-SESTAMIBI in effort or stimulation of the coronary reserves; Deteccion de viabilidad miocardica mediante tomografia por emision de foton unico (SPECT perfusorio) dual {sup 201} Talio (Reposo de 15 minutos, 24 horas tardio y 24 horas reinyeccion) y gated-SPECT {sup 99m} Tc-SESTAMIBI en esfuerzo o estimulo de reserva coronaria

    Mendoza V, R

    2004-07-01

    The objective of this work was to determine if the images of SPECT {sup 201} TI in rest of 15 minutes, 24 late hours and Gated-SPECT {sup 99m} Tc-SESTAMIBI in effort or stimulation of coronary reservation correlate with the study of 24 hours post reinjection of {sup 201}TI to determine the presence of having knitted viable myocardium. Material and methods: 29 patients were studied with coronary arterial illness (EAC) to who are carried out SPECT {sup 201} TI in rest with images of 15 minutes, 24 late hours and 24 hours reinjection, by means of the administration of {sup 201}TI to dose of 130 MBq and reinjection with 37 MBq. and Gated-SPECT {sup 99m}Tc-SESTAMIBI in effort or stimulation of coronary reservation, later to the administration of 1110 MBq. Results: 29 patients were included according to inclusion approaches and exclusion, of those which 22 (75.86%) they correspond at the masculine sex and 7 (24.13%) to the feminine one, with an average of 62.1 year-old age, 2320 segments myocardial were analysed so much it is phase post-effort as rest; they were diagnosed a total of 264 segments with heart attack, of which viability myocardium was observed in 174 segments. The statistical tests are analysis of frequencies. The non parametric test of Wilcoxon and Mann-Whitney. Conclusions: the viability myocardial at the 24 late hours and 24 hours reinjection was similar; significant difference exists between the study of 15 minutes and 24 hours reinjection, ischemic illness was also demonstrated in territories different to the heart attack area in the studies of 15 minutes, late 24 hours and 24 hours reinjection. (Author)

  6. Intersphincteric Resection for Low Rectal Cancer – Case Report

    Russu Cristian

    2016-03-01

    Full Text Available Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

  7. Patterns of metastasis in colon and rectal cancer.

    Riihimäki, Matias; Hemminki, Akseli; Sundquist, Jan; Hemminki, Kari

    2016-01-01

    Investigating epidemiology of metastatic colon and rectal cancer is challenging, because cancer registries seldom record metastatic sites. We used a population based approach to assess metastatic spread in colon and rectal cancers. 49,096 patients with colorectal cancer were identified from the nationwide Swedish Cancer Registry. Metastatic sites were identified from the National Patient Register and Cause of Death Register. Rectal cancer more frequently metastasized into thoracic organs (OR = 2.4) and the nervous system (1.5) and less frequently within the peritoneum (0.3). Mucinous and signet ring adenocarcinomas more frequently metastasized within the peritoneum compared with generic adenocarcinoma (3.8 [colon]/3.2 [rectum]), and less frequently into the liver (0.5/0.6). Lung metastases occurred frequently together with nervous system metastases, whereas peritoneal metastases were often listed with ovarian and pleural metastases. Thoracic metastases are almost as common as liver metastases in rectal cancer patients with a low stage at diagnosis. In colorectal cancer patients with solitary metastases the survival differed between 5 and 19 months depending on T or N stage. Metastatic patterns differ notably between colon and rectal cancers. This knowledge should help clinicians to identify patients in need for extra surveillance and gives insight to further studies on the mechanisms of metastasis. PMID:27416752

  8. Lamellipodin-Deficient Mice: A Model of Rectal Carcinoma

    Miller, Cassandra L.; Muthupalani, Sureshkumar; Shen, Zeli; Drees, Frauke; Ge, Zhongming; Feng, Yan; Chen, Xiaowei; Gong, Guanyu; Nagar, Karan K.; Wang, Timothy C.; Gertler, Frank B.; Fox, James G.

    2016-01-01

    During a survey of clinical rectal prolapse (RP) cases in the mouse population at MIT animal research facilities, a high incidence of RP in the lamellipodin knock-out strain, C57BL/6-Raph1tm1Fbg (Lpd-/-) was documented. Upon further investigation, the Lpd-/- colony was found to be infected with multiple endemic enterohepatic Helicobacter species (EHS). Lpd-/- mice, a transgenic mouse strain produced at MIT, have not previously shown a distinct immune phenotype and are not highly susceptible to other opportunistic infections. Predominantly male Lpd-/- mice with RP exhibited lesions consistent with invasive rectal carcinoma concomitant to clinically evident RP. Multiple inflammatory cytokines, CD11b+Gr1+ myeloid-derived suppressor cell (MDSC) populations, and epithelial cells positive for a DNA damage biomarker, H2AX, were elevated in affected tissue, supporting their role in the neoplastic process. An evaluation of Lpd-/- mice with RP compared to EHS-infected, but clinically normal (CN) Lpd-/- animals indicated that all of these mice exhibit some degree of lower bowel inflammation; however, mice with prolapses had significantly higher degree of focal lesions at the colo-rectal junction. When Helicobacter spp. infections were eliminated in Lpd-/- mice by embryo transfer rederivation, the disease phenotype was abrogated, implicating EHS as a contributing factor in the development of rectal carcinoma. Here we describe lesions in Lpd-/- male mice consistent with a focal inflammation-induced neoplastic transformation and propose this strain as a mouse model of rectal carcinoma. PMID:27045955

  9. Sexual Function in Males After Radiotherapy for Rectal Cancer

    Purpose: Knowledge of sexual problems after pre- or postoperative radiotherapy (RT) with 50 Gy for rectal cancer is limited. In this study, we aimed to compare self-rated sexual functioning in irradiated (RT+) and nonirradiated (RT-) male patients at least 2 years after surgery for rectal cancer. Methods and Materials: Patients diagnosed with rectal cancer from 1993 to 2003 were identified from the Norwegian Rectal Cancer Registry. Male patients without recurrence at the time of the study. The International Index of Erectile Function, a self-rated instrument, was used to assess sexual functioning, and serum levels of serum testosterone were measured. Results: Questionnaires were returned from 241 patients a median of 4.5 years after surgery. The median age was 67 years at survey. RT+ patients (n = 108) had significantly poorer scores for erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction with sex life compared with RT- patients (n = 133). In multiple age-adjusted analysis, the odds ratio for moderate-severe erectile dysfunction in RT+ patients was 7.3 compared with RT- patients (p <0.001). Furthermore, erectile dysfunction of this degree was associated with low serum testosterone (p = 0.01). Conclusion: RT for rectal cancer is associated with significant long-term effects on sexual function in males.

  10. Bladder and rectal complications following radiotherapy for cervix cancer

    One-hundred and thirty-two patients with cervix carcinoma who were treated with whole pelvis irradiation and two intracavitary applications had bladder and rectal dosimetry during brachytherapy with contrast agents placed into the bladder and rectum prior to orthogonal simulator radiographs. Doses were computer calculated at points A and B, F (bladder), R1 (rectum), and R2 (rectosigmoid). Late occurring bladder and rectal complications were graded on a severity scale of 1 to 3, and 14% had grade 2 or 3 injuries (9% developed fistulas). Statistical evaluation of the data showed that severe bladder and rectal injuries occur more commonly in stage IIIA and IIIB disease and in those receiving high external beam doses (5000 rad +). Analysis of variance tests revealed a significant correlation of brachytherapy dose to points R1 and R2 with severe rectal injuries but there was not a correlation of dose to F with bladder injuries. Nor was there correlation of injuries with dose to point A or the milligram-hour dose. We conclude that our technique for rectal dosimetry is adequate but that an improved technique of bladder dosimetry is needed. Also, when combining whole pelvis irradiation with two intracavitary applications (4000 rad to point A), the whole pelvis dose should probably not exceed 4000-4500 rad

  11. Toward Restored Bowel Health in Rectal Cancer Survivors.

    Steineck, Gunnar; Schmidt, Heike; Alevronta, Eleftheria; Sjöberg, Fei; Bull, Cecilia Magdalena; Vordermark, Dirk

    2016-07-01

    As technology gets better and better, and as clinical research provides more and more knowledge, we can extend our ambition to cure patients from cancer with restored physical health among the survivors. This increased ambition requires attention to grade 1 toxicity that decreases quality of life. It forces us to document the details of grade 1 toxicity and improve our understanding of the mechanisms. Long-term toxicity scores, or adverse events as documented during clinical trials, may be regarded as symptoms or signs of underlying survivorship diseases. However, we lack a survivorship nosology for rectal cancer survivors. Primarily focusing on radiation-induced side effects, we highlight some important observations concerning late toxicity among rectal cancer survivors. With that and other data, we searched for a preliminary survivorship-disease nosology for rectal cancer survivors. We disentangled the following survivorship diseases among rectal cancer survivors: low anterior resection syndrome, radiation-induced anal sphincter dysfunction, gut wall inflammation and fibrosis, blood discharge, excessive gas discharge, excessive mucus discharge, constipation, bacterial overgrowth, and aberrant anatomical structures. The suggested survivorship nosology may form the basis for new instruments capturing long-term symptoms (patient-reported outcomes) and professional-reported signs. For some of the diseases, we can search for animal models. As an end result, the suggested survivorship nosology may accelerate our understanding on how to prevent, ameliorate, or eliminate manifestations of treatment-induced diseases among rectal cancer survivors. PMID:27238476

  12. Changing practice of rectal cancer surgery in Pakistan

    Objective: To describe the presentation and pathology of rectal cancer, and to evaluate the local experience after total meso rectal excision at a tertiary care hospital in Pakistan. Methodology: A retrospective study of two hundred cases of carcinoma rectum that had undergone total meso rectal excision at Liaquat University Hospital Jamshoro Pakistan was carried out from January 1998 to December 2007.The cases were admitted through outpatient and emergency departments. The demographic details of each patient and variables such as clinical presentation, tumor location, Dukes staging, TNM staging, operations and complications were recorded on proformas. Each patient was followed up at two months for one year, every four months for three years and annually thereafter. Results: Male to female ratio being almost equal 1.6:1, Age ranged from 14-70 years. Site of tumor at upper one third 25%, middle one third 30% and lower one third 45%. Majority of patients (more than 62%) were in Dukes B Group.There were no postoperative deaths, complications occurred in a total of 59 (29.5%) patients, which were mostly colostomy related (13.0%). The abdominal wound infection 5%, anastomotic dehiscence 1.0%, urinary tract infection 5%, and impotence occurred in 1.5%. In 20% patients local recurrence was detected. Conclusion: Total meso rectal excision is a safe and feasible technique for rectal cancer surgery with acceptable perioperative morbidity and adequate local disease control. (author)

  13. Quantitative analysis of methylation of genomic loci in early-stage rectal cancer predicts distant recurrence.

    Maat, M.F. de; Velde, C.J. van de; Werff, M.P. van der; Putter, H.; Umetani, N.; Klein-Kranenbarg, E.M.; Turner, R.R.; Krieken, J.H.J.M. van; Bilchik, A.; Tollenaar, R.A.; Hoon, D.S.

    2008-01-01

    PURPOSE: There are no accurate prognostic biomarkers specific for rectal cancer. Epigenetic aberrations, in the form of DNA methylation, accumulate early during rectal tumor formation. In a preliminary study, we investigated absolute quantitative methylation changes associated with tumor progression

  14. Improved quality of care for patients undergoing an abdominoperineal excision for rectal cancer

    Bokkerink, G.M.J.; Buijs, E.F.; Ruijter, W. de; Rosman, C.; Sietses, C.; Strobel, R.; Heisterkamp, J.; Nagtegaal, I.D.; Bremers, A.J.A.; Wilt, J.H.W. de

    2015-01-01

    INTRODUCTION: New diagnostics, the emergence of total mesorectal excision and neoadjuvant treatments have improved outcome for patients with rectal cancer. Patients with distal rectal cancer undergoing an abdominoperineal excision seem to do worse compared to those treated with sphinctersparing tech

  15. Indication for radiotherapy in rectal carcinoma

    Surgery and radiotherapy complete each other in local control of suffering from rectal carcinoma. A radiotherapeutic effect on tumor is secured often. The adjuvant radiotherapy is the most interesting indication, though the most controversial as present too. Analysing all data and with experiences of an own irradiation study we have not any doubt that the indication is qualified for a combined therapy, if the therapeutic aim with priority is to prevent a local relapse as the most frequent and complaintful form of therapeutic failure. In this problem, radical irradiation forms, as pre- and accumulating irradiation (sandwich-technique) and after-irradiation, render superior to an exclusive preirradiation. In result of this tudy we practise a preirradiation of 25 Gy with immediately following operation and an accumulating irradiation to 50 Gy in proved high-risk-stage (T≥3N0M0.TxN1-3M0). If there is a primary local incurability by tumor invasion into the neighbourhood a pre-irradiation is done with 50Gy and following explorative laparatomy within 4-6 weeks. Nearly 60% of these tumors become operably after thast. Likewise we practise in unirradiated patients with locoregional tumor recurrence. Also here the exstirpation quote of recurred tumor can be doubled approximately. The 5-years-survival is 20-30% in both indication groups. In patients with general or systematic incurability, that a stoma construction is required in, we carry out a transanal tumor reduction and irradiate with 50Gy after that. Especially this therapeutic principle has proved its worth in patients that are past eighty. Here with acceptable living quality and avoiding a stoma construction a survival can be reached that corresponds to the statistical survival of this stage of life. (orig.)

  16. [Current MRI staging of rectal cancer].

    Wietek, B M; Kratt, T

    2012-11-01

    Colorectal carcinoma is the second most prevalent cause for cancer, and has very variable outcomes. Advancements in surgery, the change from adjuvant to neo-adjuvant radio-chemo-therapies as well as in clinical diagnostics have improved the prognosis for patients in a multi-modal therapy concept. An accurate primary staging including a reliable prediction of the circumferential resection margin (CRM) has established MR Imaging (MRI) beside intraluminal endoscopic ultrasound (EUS). MRI facilitates the selection of patients likely to benefit from a preoperative therapy, especially in cases of unfavorable factors. Currently the relationship of the tumor to the mesorectal fascia has become a more important prognostic factor than the T-staging, particularly for surgical therapy. In addition further prognostic factors like the depth of infiltration into the perirectal fat and the extramural venous infiltration (EMVI) have important impact on therapy and prognosis. High resolution MRI has proved useful in clarifying the relationship between the tumor and the mesorectal fascia, which represents the CRM at the total mesorectal excision (TME) especially in the upper and middle third. Preoperative evaluation of the other prognostic factors as well as the nodal status is still difficult. It is used increasingly not only for primary staging but also progressively for the monitoring of neoadjuvant therapy. The addition of diffusion weighted imaging (DWI) is an interesting option for the improvement of response evaluation. The following overview provides an introduction of MRI diagnosis as well as its importance for the evaluation of the clinically relevant prognostic factors leading to an improvement of therapy and prognosis of patients with rectal carcinoma. PMID:22893486

  17. Risk factors of circumferential resection margin involvement in the patients with extraperitoneal rectal cancer

    Oh, Sung Jin; Shin, Jin Yong

    2012-01-01

    Purpose Currently, circumferential resection margins (CRM) are used as a clinical endpoint in studies on the prognosis of rectal cancer. Although the concept of a circumferential resection margin in extraperitoneal rectal cancer differs from that in intraperitoneal rectal cancer due to differences in anatomical and biologic behaviors, previous reports have provided information on CRM involvement in all types of rectal cancer including intraperitoneal lesions. Therefore, the aim of this study ...

  18. Efeito do tratamento com diflubenzuron na hematologia de jundiás, Rhamdia quelen (Pimelodidae infestados por Lernaea cyprinacea (Copepoda em banhos de imersão de 24 horas = Effect of the treatment with diflubenzuron in the hematology of Jundiás Rhamdia quelen (Pimelodidae infected by Lernaea cyprinacea (Copepoda in 24-hour immersion baths

    Rodrigo Gasparoto Mabilia

    2006-04-01

    Full Text Available Na aqüicultura brasileira, formulações à base de diflubenzuron para uso agrícola são utilizadas indiscriminadamente no controle de ectoparasitas de peixes. Na ausência de formulações para uso em peixes cultivados, surgem protocolos terapêuticos repletos de incertezas quanto à sua eficácia, impacto ambiental e perfil hematológico dos peixes. O objetivo deste trabalho foi avaliar o efeito do diflubenzuron sobre os seguintes parâmetros hematológicos de jundiás (Rhamdia. quelen infestados por Lernaea cyprinacea: número total de eritrócitos, número total de leucócitos, hematócrito e contagem diferencial de leucócitos. Jundiás divididos em 4 grupos foram expostos a banhos de imersão de 24 horas com diflubenzuron nas concentrações: 0,0 mg.L-1 , 0,01 mg.L-1, 0,1 mg.L-1 e 1,0 mg.L-1. Essas concentrações não apresentaram diferenças significativas na hematologia (teste Tukey pThere are no specific formulations of diflubenzuron for the treatment of ectoparasities in freshwater fishes. Many therapeutics protocols of untested efficacy, environmental impact and unknown hematological effects have been introduced in Brazilian aquaculture. The aim of this study was evaluate the diflubenzuron effect on the hematological parameters (total number of erythrocytes, hematocrit, total number ofleucocytes and differential count of leucocytes of “Jundias” (Rhamdia. quelen infected by Lernaea cyprinacea. Four groups of jundias were exposed to a 24 hour immersion bath containing diflubenzuron in concentrations: 0.0 mg.L-1, 0.01 mg.L-1, 0.1 mg.L-1 and 1.0 mg.L-1. These concentrations of diflubenzuron did not show any significant difference in the basal parameters of hematology (Tukey test p<0.05 of Jundias. More studies about the effect of diflubenzuron on the hematology of infected fishes exposed to a long period of treatment are needed to test chronic effects.

  19. Assessment of T staging and mesorectal fascia status using high-resolution MRI in rectal cancer with rectal distention

    Sheng-Xiang Rao; Meng-Su Zeng; Jian-Ming Xu; Xin-Yu Qin; Cai-Zhong Chen; Ren-Chen Li; Ying-Yong Hou

    2007-01-01

    AIM: To determine the accuracy of high-resolution magnetic resonance imaging (MRI) using phased-array coil for preoperative assessment of T staging and mesorectal fascia infiltration in rectal cancer with rectal distention.METHODS: In a prospective study of 67 patients with primary rectal cancer, high-resolution magnetic resonance imaging (in-plane resolution, 0.66 × 0.56)with phased-array coil were performed for T-staging and measurement of distance between the tumor and the mesorectal fascia. The assessment of MRI was compared with postoperative histopathologic findings. Sensitivity,specificity, accuracy, positive predictive value, and negative predictive value were evaluated.RESULTS: The overall magnetic resonance accuracy was 85.1% for T staging and 88% for predicting mesorectal fascia involvement. Magnetic resonance sensitivity, specificity, accuracy, positive predictive value,and negative predictive value was 70%, 97.9%, 89.6%,93.3% and 88.5% for ≤ T2 tumors, 90.5%, 76%,85.1%, 86.4% and 82.6% for T3 tumors, 100%, 95.2%,95.5%, 62.5% and 100% for T4 tumors, and 80%,90.4%, 88%, 70.6% and 94% for predicting mesorectal fascia involvement, respectively.CONCLUSION: High-resolution MRI enables accurate preoperative assessment for T staging and mesorectal fascia infiltration in rectal cancer with rectal distention.

  20. Comparison between two perineal procedures for treatment of rectal prolaps

    Ahmed Mohamed Abozid, Nabila Mohamed A. Shams, , Yahia Hassan

    2001-09-01

    Full Text Available The optimal surgical procedures for the management of rectal prolapse is still under debate so comparison between two operations were done in our series. Eighteen patients with complete rectal prolaps were treated surgically through the perineum they were divided into two groups. First group were treated by recto-segmoidectomy and levatroplasty to fortify the pelvic floor, the second group were treated by rectopexy using prolene mesh and levetroplasty to fortify the pelvic floor, the mesh was inserted between the rectum and sacrum and fixed through perineal incision. The recurrence rate !""#$$!%$ &significant difference in hospital stay among both groups. Also there were no other cases of postoperative complications such as anastomotic leak or stricture, affection of the bladder dysfunction in both groups. Aim of work The aim of this work was to compare the short-term outcome of two different perineal operative procedures in patients with full thickness rectal prolaps.

  1. Rectal cancer: Possibilities of MRI in detection of local recurrence

    Miučin-Vukadinović Ivana

    2008-01-01

    Full Text Available Introduction Treatment of rectal cancer, which includes periodic evaluations, may lead to earlier identification of recurrent local infiltration. Differentiation between local recurrence and other post radiation changes is frequently rather difficult. Pelvic MR examination was performed in 30 patients (20 men, 10 women at the Institute of oncology, Sremska Kamenica. All patients underwent surgical resection of rectal cancer at the same institution. Preoperative or postoperative radiation therapy was administrated in 29 patients (93%. Criteria for detection of local recurrent tumors were based on morphologic changes, such as the presence of tumor infiltration, size increase of the mass and the change of the mass shape. Recurrent tumor infiltration was detected in 50% patents. Tumors of low differentiation histological type was predominantly found within 10 months after surgery, while moderately differentiated and high differentiated types were detected within 20 months and after 20 months after resection, respectively. Pelvic MR examination represents important diagnostic modality for recurrent rectal cancer identification.

  2. Treatment of advanced rectal cancer after renal transplantation

    Hai-Yi Liu; Xiao-Bo Liang; Yao-Ping Li; Yi Feng; Dong-Bo Liu; Wen-Da Wang

    2011-01-01

    Renal transplantation is a standard procedure for end-stage renal disease today. Due to immunosuppressive drugs and increasing survival time after renal trans-plantation, patients with transplanted kidneys carry an increased risk of developing malignant tumors. In this case report, 3 patients with advanced rectal can-cer after renal transplantation for renal failure were treated with anterior resection or abdominoperineal resection plus total mesorectal excision, followed by adjuvant chemotherapy. One patient eventually died of metastasized cancer 31 mo after therapy, although his organ grafts functioned well until his death. The other 2 patients were well during the 8 and 21 mo follow-up periods after rectal resection. We therefore strongly argue that patients with advanced rectal cancer should receive standard oncology treatment, including opera-tion and adjuvant treatment after renal transplantation. Colorectal cancer screening in such patients appears justified.

  3. Rectal cancer in pregnancy: A diagnostic and therapeutic challenge

    Introduction: The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature. Case report: A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible recto sigmoidoscopy showed a large ulcerative mass located in the recto sigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient’s pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micro metastatic disease. Conclusion: This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.

  4. Ultrasound tomography in the diagnosis of rectal carcinoma relapses

    The results of ultrasonography in 616 patients after radical surgery of rectal carcinomas are committed. In the first group, patients with clinical symptoms of a relapse, the method detected tumors in 146 (80.2%) of 182 patients. The error rate was 12.1. In the second group, patients with unfavourable postoperative prognosis, ultrasound follow-up detected relapses previous to their clinical manifestation in 73 (16.8%) of 434 patients. The method turned out to be effective even for the detection of small (less than 3 cm) recurrences after rectal exstirpation. For intraintestinal recurrences after rectal resection ultrasonography can determine the degree of infiltration outside the organ. Real-time scans can prevent some of the errors that occur with compound scans. (author)

  5. [Robot-assisted rectal surgery: hype or progress?].

    Becker, T; Egberts, J E; Schafmayer, C; Aselmann, H

    2016-07-01

    Minimally invasive laparoscopic surgery for rectal cancer has undergone a significant evolution during the last decades and has become the standard approach in specialized centers with better short-term and comparable oncological outcome to open surgery. The laparoscopic approach remains challenging and has various inherent technical challenges particularly associated with rectal cancer resection. Robotic colorectal surgery using the da Vinci® surgical system has been successfully introduced into clinical practice during recent years and provides specific technical advantages. Studies have shown that the robotic approach in colorectal surgery is safe and feasible with comparable results. It is associated with low conversion rates, more R0 situations for low rectal cancer with larger tumors and more neoadjuvant treatment compared to standard laparoscopy. Robot-assisted surgery is an attractive development of minimally invasive surgery and should also be further evaluated with mandatory monitoring of outcome parameters in registries in Germany. PMID:27334630

  6. Neorectal hyposensitivity after neoadjuvant therapy for rectal cancer

    Background and purpose: Preoperative radiotherapy for rectal cancer has a detrimental effect on long-term anorectal function and quality of life, additional to that observed after rectal resection. The exact physiological mechanisms for the excess impairment remain unknown. We aimed to investigate neorectal and anal sphincter properties in patients treated with neoadjuvant therapy (NT) prior to total mesorectal excision (TME). Material and methods: Sixteen patients (NT+ patients) were examined by multimodal neorectal stimulation and standard anorectal physiological testing. Data were compared to the results of 23 patients, who underwent TME without NT (NT− patients). Results: NT+ patients had elevated sensory thresholds to heat (median temperature, 60 vs. 55 °C; p 2O; p = 0.05). Conclusions: Pelvic radiotherapy causes neorectal hyposensitivity to mechanical and thermal stimuli in patients receiving NT prior to TME surgery for rectal cancer, possibly due to impaired afferent nerve function

  7. Rare case of huge rectal and uterovaginal prolapse

    Manisha M. Laddad

    2013-04-01

    Full Text Available A case of combined genital prolapse and rectal prolapse in a 60-year-old multipara is reported. The treatment of mixed prolapse remains surgical and should be treated the genital prolapse by vaginal hysterectomy with pelvic floor repair and the rectal prolapse by means of the Delorme operation. The mortality and morbidity rates are zero if this operation is used and the relapse rate is only 8 to 11% for the rectal prolapse. It would appear that the two approaches are rarely associated by the authors and would seem to be interesting to reconsider this question by indicating mixed treatment of the two prolapses whenever possible. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 237-239

  8. Critical appraisal of laparoscopic vs open rectal cancer surgery

    Tan, Winson Jianhong; Chew, Min Hoe; Dharmawan, Angela Renayanti; Singh, Manraj; Acharyya, Sanchalika; Loi, Carol Tien Tau; Tang, Choong Leong

    2016-01-01

    AIM: To evaluate the long-term clinical and oncological outcomes of laparoscopic rectal resection (LRR) and the impact of conversion in patients with rectal cancer. METHODS: An analysis was performed on a prospective database of 633 consecutive patients with rectal cancer who underwent surgical resection. Patients were compared in three groups: Open surgery (OP), laparoscopic surgery, and converted laparoscopic surgery. Short-term outcomes, long-term outcomes, and survival analysis were compared. RESULTS: Among 633 patients studied, 200 patients had successful laparoscopic resections with a conversion rate of 11.1% (25 out of 225). Factors predictive of survival on univariate analysis include the laparoscopic approach (P = 0.016), together with factors such as age, ASA status, stage of disease, tumor grade, presence of perineural invasion and vascular emboli, circumferential resection margin oncologic outcomes when compared to OP. Laparoscopic conversion does not confer a worse prognosis. PMID:27358678

  9. Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding

    Purpose: To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding. Methods and materials: The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V30, V50, V80, and V90, respectively) on the incidence of rectal bleeding was evaluated. Results: Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (p 30 ≥ 60%, V50 ≥ 40% (p 80 ≥ 25%, and V90 ≥ 15% (p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (p < 0.05). Conclusion: A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding

  10. Correction of rectal sacculation through lateral resection in dogs with perineal hernia - technique description

    P.C. Moraes

    2013-06-01

    Full Text Available The occurrence of perineal hernias in dogs during routine clinical surgery is frequent. The coexistence of rectal diseases that go undiagnosed or are not correctly treated can cause recurrence and postoperative complications. The objective of this report is to describe a surgical technique for treatment of rectal sacculation through lateral resection in dogs with perineal hernia, whereby restoring the rectal integrity.

  11. The Clinical Utility of Rectal Gas Distension F-18 FDG PET/CT

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-12-15

    The aim of this study was to evaluate the clinical value of rectal gas distension F-18 FDG PET/CT imaging for the differentiation of the rectal focal uptake lesions. Twenty four patients (M:F=11:13, Age 62.8{+-}12.4 years) underwent rectal gas distension F-18 FDG PET/CT, prospectively: initial image at 50-60 min after the intravenous injection of F-18 FDG and rectal distension image after the infusion of air through the anus. Focally increased uptake lesions on initial images but disappeared on rectal distension images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on rectal distension images, colonoscopy and histopathologic examination were performed. Among the 24 patients, 27 lesions of focal rectal uptake were detected on initial images of F-18 FDG PET/CT. Of these, 7 lesions were able to judge with physiological uptake because the focal increased uptake disappeared from rectal distension image. Remaining 3 lesions were non-rectal lesions (2 lesions: rectovesical space, 1 lesion: uterine myoma). Among 17 lesions which was showed persistent increased uptake in rectal distension image, 15 lesions were confirmed as the malignant tumor (SUVmax=15.9{+-}6.8) and 2 lesions were confirmed as the benign lesions including adenoma and inflammatory disease. The rectal distension F-18 FDG PET/CT imaging could be an important noninvasive method for the differentiation of malignant and benign focal rectal uptake lesions including physiologic uptake.

  12. Quality of life after rectal resection for cancer, with or without permanent colostomy

    Pachler, Jørn; Wille-Jørgensen, Peer

    2012-01-01

    For almost one hundred years abdominoperineal excision has been the standard treatment of choice for rectal cancer. With advances in the techniques for rectal resection and anastomosis, anterior resection with preservation of the sphincter function has become the preferred treatment for rectal ca......, patients having sphincter-preserving operations may experience symptoms affecting their quality of life that are different from stoma-patients....

  13. Human Collagen Injections to Reduce Rectal Dose During Radiotherapy

    Objectives: The continuing search for interventions, which address the incidence and grade of rectal toxicities associated with radiation treatment of prostate cancer, is a major concern. We are reporting an investigational trial using human collagen to increase the distance between the prostate and anterior rectal wall, thereby decreasing the radiation dose to the rectum. Methods: This is a pilot study evaluating the use of human collagen as a displacing agent for the rectal wall injected before starting a course of intensity-modulated radiotherapy (IMRT) for prostate cancer. Using a transperineal approach, 20 mL of human collagen was injected into the perirectal space in an outpatient setting. Computerized IMRT plans were performed pre- and postcollagen injection, and after a patient completed their radiotherapy, to determine radiation dose reduction to the rectum associated with the collagen injection. Computed tomography scans were performed 6 months and 12 months after completing their radiotherapy to evaluate absorption rate of the collagen. All patients were treated with IMRT to a dose of 75.6 Gy to the prostate. Results: Eleven patients were enrolled into the study. The injection of human collagen in the outpatient setting was well tolerated. The mean separation between the prostate and anterior rectum was 12.7 mm. The mean reduction in dose to the anterior rectal wall was 50%. All men denied any rectal symptoms during the study. Conclusions: The transperineal injection of human collagen for the purpose of tissue displacement is well tolerated in the outpatient setting. The increased separation between the prostate and rectum resulted in a significant decrease in radiation dose to the rectum while receiving IMRT and was associated with no rectal toxicities.

  14. Microstructure imaging of human rectal mucosa using multiphoton microscopy

    Liu, N R; Chen, J X; Zhuo, S M; Zheng, L Q; Jiang, X S [Institute of Laser and Optoelectronics Technology, Fujian Provincial Key Laboratory for Photonics Technology, Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou (China); Chen, G [Department of Pathology, Fujian Provincial Tumor Hospital, Fuzhou (China); Yan, J, E-mail: chenjianxin@fjnu.edu.cn, E-mail: ynjun@yahoo.com [Department of Surgery, Fujian Provincial Tumor Hospital, Fuzhou (China)

    2011-01-01

    Multiphoton microscopy (MPM) has high resolution and sensitivity. In this study, MPM was used to image microstructure of human rectal mucosa. The morphology and distribution of the main components in mucosa layer, absorptive cells and goblet cells in the epithelium, abundant intestinal glands in the lamina propria and smooth muscle fibers in the muscularis mucosa were clearly monitored. The variations of these components were tightly relevant to the pathology in gastrointestine system, especially early rectal cancer. The obtained images will be helpful for the diagnosis of early colorectal cancer.

  15. Per-rectal portal scintigraphy in chronic liver diseases

    Portal circulation has been evaluated by per-rectal portal scintigraphy in 21 controls and in 30 pts affected by chronic liver diseases. Tc99m-pertechnetate (10 mci) was given through a Nelaton's catheter in the upper rectum; a per-rectal portal shunt index (SI) was calculated. A relevant overlap is evident between controls and CHP pts; no overlap exists between controls and B or C graded cirrhosis. We conclude that the technique may be suggested to monitor the course of chronic liver diseases and different therapeutic regimens. (orig.)

  16. Rectal fist insertion. An unusual form of sexual behavior.

    Shook, L L; Whittle, R; Rose, E F

    1985-12-01

    Rectal fist insertion (fist fucking) is an uncommon and potentially dangerous sexual practice. This is usually a homosexual activity, but can also be a heterosexual or an autoerotic practice. One known death has been reported associated with rectal fist insertion, in which the complications of anal and colonic tears and bleeding had occurred (see Editor's note). The possibility of drug overdose is also probable, as drugs and alcohol are commonly introduced into the rectum to promote sphincter relaxation and to ease the discomfort of anal dilatation. PMID:4072987

  17. The correlation between the body mass index (BMI) and 24-hour urine chemical composition in the population of kidney stone patients%肾结石患者身体质量指数与24h尿液化学成分的相关性

    葛广成; 李中兴; 冯瑞; 吴丹; 沈斌; 王星

    2015-01-01

    目的 研究肾结石患者的身体质量指数(BMI)和24h尿液化学成分之间的关系.方法 收集220例肾结石患者的尿液进行24h尿化学成分分析.利用四分位法,分别将男女患者按照BMI进行分层.使用单因素方差分析法和多重线性回归分析法,分析BMI和24h尿液化学成分各数值间的相互关系.结果 单因素方差分析结果显示,在男性患者中,BMI的增加与尿钠、钙、柠檬酸、尿酸、镁、草酸钙的增加呈正比例关系,与pH值的下降呈反比例关系.在女性患者中,BMI与尿钠、尿酸、草酸的增加呈正比例关系,与pH值的下降呈反比例关系.多重线性回归分析显示:在男性患者中,BMI与尿钠、草酸钙的增加以及pH值的降低呈正比例关系;在女性患者中,BMI和尿钠、肌酐、磷酸盐、柠檬酸以及硫酸盐呈正比例关系,与尿柠檬酸、硫酸盐呈反比关系.结论 本研究的结果显示,BMI的增加和许多肾结石患病风险因素有显著相关性,包括:男性患者中增加的尿钠和尿酸、降低的pH;女性患者中升高的尿酸、尿钠和降低的尿柠檬酸.建议肾结石患者积极减肥、低盐饮食、少食动物蛋白.%Objectives To assess the relationship between the body mass index(BMI) and 24-hour urine chemical composition in the population of kidney stone patients.Methods To collect and analysis 220 cases of kidney stone patients'24-hour urine.Patients were divided into quartiles of body mass index and stratified by gender.Using bivariate and multivariate linear regression explored the relationship between body mass index(BMI) and urine parameters.Results The bivariate analysis shows that BMI increased with urinary sodium,calcium,citrate,uric acid,magnesium,calcium oxalate,uric acid increased significantly correlated,pH value decreased with a significant negative correlation in men.BMI was associated with significantly increased urinary sodium,uric acid,oxalic acid increased

  18. Health-Related Quality of Life after surgery for primary advanced rectal cancer and recurrent rectal cancer

    Thaysen, Henriette Vind; Jess, Per; Laurberg, Søren

    2012-01-01

    Aim: A review of the literature was undertaken to provide an overview of Health-related quality of life (HRQoL) after surgery for primary advanced or recurrent rectal cancer and to outline proposals for future HRQoL studies in this area. Method: A systematic literature search was undertaken. Only...... studies concerning surgery for primary advanced or recurrent rectal cancer and describing methods used for measuring HRQoL were considered. Results Seven studies were identified including two prospective longitudinal, three cross-sectional and two based on qualitative data. Global quality of life...... time of impaired HRQoL and also if this is different after surgery for locally advanced or recurrent disease than after total mesorectal excision used for earlier tumours.. Conclusion Several aspects of HRQoL are impaired for a variable time after treatment for locally advanced or recurrence of rectal...

  19. Benign (solitary) ulcer of the rectum - another cause for rectal stricture

    Benign rectal ulcer syndrome is an uncommon cause of lower gastrointestinal bleeding. Patients may present with mild, often recurrent, rectal bleeding frequently ascribed to hemorrhoids. Barium enema may be normal during the early, nonulcerative phase of proctitis. Single (or multiple) uclers with or without rectal stricture are the hallmarks of the radiographic diagnosis. Radiologic demonstration of the ulcer(s) is not required, however, for the diagnosis. Benign rectal ulcer should be included in the differential diagnosis of benign-appearing rectal strictures. (orig.)

  20. Association between polycyclic aromatic hydrocarbons and human rectal tumor or liver cancer

    Guohong Jiang; Limin Lun; Liyuan Cong

    2012-01-01

    Objective: The aim of this study was to investigate the effect of polycyclic aromatic hydrocarbons (PAHs) in rectal carcinoma and hepatocarcinoma genesis. Methods: The PAHs in the human rectal cancer and liver cancer tissues, the adjacent tissues and homologous tissues without rectal cancer or liver cancer were extracted by ultrasonic wave. The extracts were then cleaned up and enriched by solid phase extraction, analyzed by high performance liquid chromatography (HPLC) with fluorescence spectroscopy. Results: Four kinds of PAHs were detected in human rectal and hepatic tissues. The contents of pyrene, 2-methylanthracene and benzo (a) pyrene in both rectal cancer tissues and adjacent homologous tissues were higher than rectal tissues without rectal cancer, the differences were statistically significant (P 0.05). The differences of the content of each PAHs between rectal cancer and adjacent tissue were not significant (P > 0.05). The contents of the four PAHs in the three kinds of liver tis-sues were not statistically significant (P > 0.05). Conclusion: PAHs are found in human rectal tissues or hepatic tissues. The contents of PAHs in human rectal tissue may have an effect on the occurrence of human rectal cancer while the contents of PAHs in human hepatic tissues may have not ones.

  1. Rectal angiolipoma: A case report and review of literature

    Sabite Kacar; Sedef Kuran; Tulay Temucin; Bulent Odemis; Nilufer Karadeniz; Nurgul Sasmaz

    2007-01-01

    Angiolipoma is a rare vascular variant of the benign lipomatous tumors and is generally seen in subcutaneous tissues. We report a 70-year-old female with abdominal distension not related to rectal small polypoid mass with peduncule described as angiolipoma by histologically,and review the literature.

  2. Treatment of locally advanced rectal cancer: Controversies and questions

    Atthaphorn Trakarnsanga; Suthinee Ithimakin; Martin R Weiser

    2012-01-01

    Rectal cancers extending through the rectal wall,or involving locoregional lymph nodes (T3/4 or N1/2),have been more difficult to cure.The confines of the bony pelvis and the necessity of preserving the autonomic nerves makes surgical extirpation challenging,which accounts for the high rates of local and distant relapse in this setting.Combined multimodality treatment for rectal cancer stage Ⅱ and Ⅲ was recommended from National Institute of Health consensus.Neoadjuvant chemoradiation using fluoropyrimidine-based regimen prior to surgical resection has emerged as the standard of care in the United States.Optimal time of surgery after neoadjuvant treatment remained unclear and prospective randomized controlled trial is ongoing.Traditionally,6-8 wk waiting period was commonly used.The accuracy of studies attempting to determine tumor complete response remains problematic.Currently,surgery remains the standard of care for rectal cancer patients following neoadjuvant chemoradiation,whereas observational management is still investigational.In this article,we outline trends and controversies associated with optimal pre-treatment staging,neoadjuvant therapies,surgery,and adjuvant therapy.

  3. Whither papillon? Future directions for contact radiotherapy in rectal cancer

    Lindegaard, J; Gerard, J P; Sun Myint, A;

    2007-01-01

    Although contact radiotherapy was developed 70 years ago, and is highly effective with cure rates of over 90% for early rectal cancer, there are few centres that offer this treatment today. One reason is the lack of replacement of ageing contact X-ray machines, many of which are now over 30 years...

  4. Sexual function in females after radiotherapy for rectal cancer

    Background. Knowledge about female sexual problems after pre- or postoperative (chemo-)radiotherapy and radical resection of rectal cancer is limited. The aim of this study was to compare self-rated sexual functioning in women treated with or without radiotherapy (RT+ vs. RT?), at least two years after surgery for rectal cancer. Methods and materials. Female patients diagnosed from 1993 to 2003 were identified from a national database, the Norwegian Rectal Cancer Registry. Eligible patients were without recurrence or metastases at the time of the study. The Sexual function and Vaginal Changes Questionnaire (SVQ) was used to measure sexual functioning. Results. Questionnaires were returned from 172 of 332 invited and eligible women (52%). The mean age was 65 years (range 42-79) and the time since surgery for rectal cancer was 4.5 years (range 2.6-12.4). Sexual interest was not significantly impaired in RT+ (n=62) compared to RT? (n=110) women. RT+ women reported more vaginal problems in terms of vaginal dryness (50% vs. 24%), dyspareunia (35% vs. 11%) and reduced vaginal dimension (35% vs. 6%) compared with RT? patients; however, they did not have significantly more worries about their sex life. Conclusion. An increased risk of dyspareunia and vaginal dryness was observed in women following surgery combined with (chemo-)radiotherapy compared with women treated with surgery alone. Further research is required to determine the effect of adjuvant therapy on female sexual function

  5. Laparoscopic surgery for lower rectal cancer with neoadjuvant preoperative chemoradiotherapy

    Neoadjuvant chemoradiotherapy (NACRT) is an accepted standard treatment for low rectal advanced cancer to improve the local control in western countries. Recently laparoscopy has been recognized as an excellent tool from a view point of its magnification. Therefore, we have performed many laparoscopic surgeries for locally advanced rectal cancer after NACRT, We evaluated our results in this study. We studied 100 patients underwent surgery for locally advanced low rectal cancer after NACRT. Rate of sphincter preserving surgery was 74%. Rate of laparoscopic surgery was 95%. Positive distal resection margins were not identified in all patients. Positive circumferencial resection margins were identified in only two patients. The pathological complete response rate was 15%. The rate of postoperative complications was 15%. Complications were as follows: wound infection (9%), pelvic abscess (2%), ileus (2%) and others (2%), however without mortality. Anastomotic leakage was not observed in all cases, even though we routinely created diverting stoma. Laparoscopic surgery for low rectal cancer after NACRT is considered to be a safe and feasible procedure. (author)

  6. Multicenter evaluation of rectal cancer reimaging post neoadjuvant (MERRION) therapy.

    Hanly, Ann M

    2014-04-01

    The aim of this study was to evaluate the utility of reimaging rectal cancer post-CRT (chemoradiotherapy) with magnetic resonance (MR) imaging of the pelvis for local staging and computed tomography of thorax, abdomen, and pelvis (CT TAP) to identify distant metastases.

  7. Single-Access Laparoscopic Rectal Surgery Is Technically Feasible

    Siripong Sirikurnpiboon

    2013-01-01

    Full Text Available Introduction. Single-access laparoscopic surgery (SALS has been successfully introduced for colectomy surgery; however, for mid to low rectum procedures such as total mesorectal excision, it can be technically complicated. In this study, we introduced a single-access technique for rectum cancer operations without the use of other instruments. Aims. To show the short-term results of single-access laparoscopic rectal surgery in terms of pathologic results and immediate complications. Settings and Design. Prospective study. Materials and Methods. We selected middle rectum to anal canal cancer patients to undergo single-access laparoscopic rectal resection for rectal cancer. All patients had total mesorectal excisions. An umbilical incision was made for the insertion of a single multichannel port, and a mesocolic window was created to identify the inferior mesenteric artery and vein. Total mesorectal excision was performed. There were no perioperative complications. The mean operative time was 269 minutes; the median hospital stay was 7 days; the mean wound size was 5.5 cm; the median number of harvested lymph nodes was 15; and all patients had intact mesorectal capsules. Statistical Analysis Used. Mean, minimum–maximum. Conclusion. Single-access laparoscopic surgery for rectal cancer is feasible while oncologic principles and patient safety are maintained.

  8. Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis

    Eirik Søfteland

    2014-01-01

    Full Text Available In a clinical setting, diabetic autonomic complications (cardiac, gastrointestinal, urogenital, etc. are often handled as separate entities. We investigated rectal sensitivity to heat, mechanical distension, and electrical stimulations in 20 patients with diabetes and symptoms of gastroparesis, to evaluate the extent of visceral neuronal damage. Furthermore, to evaluate the relation between the nervous structures we examined gastric emptying and cardiac autonomic function with the hypothesis being an association between these. We found that 60% of patients had delayed gastric empting. Rectal hyposensitivity was a general finding as they tolerated 67% higher thermal, 42% more mechanical, and 33% higher electrical current intensity compared to healthy controls. In patients, most heart rate variability parameters were reduced; they reported significantly more gastrointestinal symptoms and a reduced quality of life in all SF-36 domains. Shortened RR interval correlated with reduced rectal temperature sensitivity, and gastric retention rate was negatively associated with symptoms of nausea and vomiting. To conclude, in these patients with signs and symptoms of diabetic gastroparesis, rectal sensitivity was reduced, and heart rate variability was impaired. Thus, we suggest regarding diabetic autonomic neuropathy as a diffuse disorder. Symptoms of widespread autonomic dysfunction and sensory disorders should be expected and treated in these patients.

  9. Patient factors may predict anastomotic complications after rectal cancer surgery

    Dana M. Hayden

    2015-03-01

    Conclusion: Our study identifies preoperative anemia as possible risk factor for anastomotic leak and neoadjuvant chemoradiation may lead to increased risk of complications overall. Further prospective studies will help to elucidate these findings as well as identify amenable factors that may decrease risk of anastomotic complications after rectal cancer surgery.

  10. Teste ergométrico e o Holter de 24 horas na detecção de arritmias ventriculares complexas em diferentes estádios da cardiopatia chagásica crônica Exercise testing and 24 hours Holter monitoring in the detection of complex ventricular arrhythmias in different stages of chronic Chagas' heart disease

    Roberto Coury Pedrosa

    2004-10-01

    Full Text Available Comparou-se o teste ergométrico com Holter de 24 horas na detecção de arritmias ventriculares complexas em diferentes estádios da cardiopatia chagásica crônica. Avaliados 71 pacientes sem outras doenças associadas, idade=51±10,3, metade mulheres. Divididos em quatro grupos conforme o grau de acometimento cardíaco. A estatística esta discriminada no corpo do trabalho. Ao Holter, no grupo IA as arritmias ventriculares complexas foram detectadas em 4,3%, IB em 25%, II em 55% e no grupo III em 90%. Nos grupos II e III não houve diferença entre os exames na detecção de arritmias ventriculares complexas (p=NS. Nos grupos IA e IB, houve uma concordância de 100% no teste ergométrico na não detecção de arritmias ventriculares complexas entre dois observadores. No grupo II, a concordância foi de 70% (kappa=0,368, p=0,003 e de 90% (kappa=0,78, p=0,002 no grupo III. Foi observado diferenças na presença de arritmias ventriculares complexas entre os pacientes dos grupos em fase inicial e avançada da cardiopatia chagásica crônica. Nos pacientes dos grupos II e III não houve diferença entre os dois exames na detecção das arritmias ventriculares complexas. Pacientes dos grupos IA e IB é razoável indicar Holter e/ou o teste ergométrico na ocorrência de progressão da doença.To detect complex ventricular arrhythmias in different stages of chronic chagasic cardiopathy, the results of exercise testing to 24 hours Holter monitoring have been compared. We evaluated a group of 71 patients, half women, aged 51±10.3, with no others associated diseases. These patients were separated in 4 groups according to degree of cardiac involvement. Statistical data can be found elsewhere in the study. In group IA, Holter monitoring detected 4.3% of complex ventricular arrhythmias, group IB 25%, group II 55% and group III 90%. We found no difference between Holter and exercise testing in the detection of complex ventricular arrhythmias in groups II

  11. 泥鳅粉对训练小鼠游泳力竭24h后心肌S100A4蛋白表达的影响%Effects of Raw Loach to Expression of S100A4 in Mycardium of Mice with Swimming Training at 24 Hours after Exhaustive Exercise

    刘祥梅; 施孟

    2014-01-01

    目的从心肌S100A4蛋白表达变化探讨生泥鳅干预对游泳训练力竭小鼠心肌的作用。方法24只健康雄性ICR小鼠分为安静组(C)、运动组(T)、泥鳅运动组(N),T组和N组游泳训练3w后进行力竭运动,24h后取材检测血清CK-MB,HE染色光镜下观察心肌组织,免疫组化法检测心肌P53和S100A4蛋白的表达。结果①N组力竭游泳时间显著地长于T组(<0.01),血清CK-MB活性显著地低于T组和C组(<0.05)。②T组的心肌细胞界限模糊、可见心肌纤维断裂和间质水肿,而N组无明显病理表现。③与C组比较,T组心肌P53蛋白的表达显著增高(﹤0.05);S100A4蛋白N组显著增高(﹤0.05)。结论负荷游泳训练并力竭24 h后小鼠的心肌细胞存在损害,生泥鳅干预能上调S100A4表达和减弱P53表达而降低损害。%Objective This study was to observe ef ects of raw loach on myocardium by expression of S100A4. Methods 24 healthy male ICR mouse were divided into control group (C), exercise-trained group(T)and exercise+raw loach group (N). The exhaustive exercise time of mice was recorded after three week exercise-trained. Activity of serum MB isoenzyme of creatine kinase (CK-MB) was detected. The myocardium were observed by microscope after HE taining.The expressions of S100A4 protein were detected with immunohistochemistry. Results①The time of exercise exhaustive were longer than group T ( ﹤0.01), the activity of CK-MM were lower than group T and C ( <0.05) in group N.②There was not obviously tissue damage in group N.③Compared with group C, the expression of P53 protein increased significantly in group T( <0.05) and the expression of S100A4 protein was increased significantly in group N( P<0.05). Conclusion There was myocardial injury in mice with load swimming training at 24 Hours after exhaustive exercise. But raw loach can reduce the damage of myocardia by increased the expression of S100A4 protein.

  12. Resposta imune à vacinação contra hepatite B em recém-nascidos pré-termo, iniciada no primeiro dia de vida Immune response of preterm infants to hepatitis B vaccine administered within 24 hours after birth

    Lilian S. R. Sadeck

    2004-04-01

    Full Text Available OBJETIVO: Investigar a resposta imune à vacina contra hepatite B em recém-nascidos pré-termo visando determinar a taxa de soroproteção, analisar a relação desta com a idade gestacional e o peso de nascimento. MÉTODOS: A vacina recombinante contra hepatite B (5 µg por dose foi aplicada em 35 recém-nascidos pré-termo e 21 recém-nascidos a termo, no primeiro dia, a 1 mês e aos 6 meses de vida. Foram determinados os títulos de anti-HBs em todos os recém-nascidos com 6, 9 e 12 meses. RESULTADOS: Aos 9 meses, as taxas de soroproteção (anti-HBs > 10 mUI/mL foram de 92,6 e 100% nos recém-nascidos pré-termo e a termo, respectivamente (p > 0,05. Nos recém-nascidos com peso de nascimento 1.500 g, as taxas foram de 75 e 100%, respectivamente. Nos recém-nascidos com idade gestacional OBJECTIVE: To investigate the immune response of preterm infants to hepatitis B vaccination. METHODS: Three doses of recombinant hepatitis B vaccine (5 µg dose were administered to 35 preterm and 21 full-term infants within 24 hours after birth and at one and six months of postnatal age. RESULTS: A protective antibody response (anti-HB > 10 mUI/mL was observed three months after the last dose in 92.6% and 100% of preterm and full-term infants (p > 0.05, respectively. Newborns with gestational age below 34 weeks presented lower antibody responses in all three periods. However, gestational age was not important to determine the antibody response in the three periods analyzed. When antibody response was analyzed in terms of birth weight, it was observed that a protective response was present in 75 and 100% of newborns with birth weight 1,500 g, respectively. Birth weight was shown to be a relevant factor in determining a protective antibody response at six months of postnatal age. Nonresponders received a fourth vaccine dose and an adequate antibody response was obtained in 100%. CONCLUSION: The antibody response of preterm infants was similar to that of term

  13. La glucemia de las primeras 24 horas no es un factor pronóstico de mortalidad en pacientes críticos Blood glucose levels in the first 24 hours of admission is not a risk factor for mortality in critical care patients

    A.L. Blesa Malpica

    2011-06-01

    following variables: initial glycemia, mean glycemia during the first 24 hours and number of determinations performed. We used the mean value in the admission day of the remaining analytical and monitoring variables and the number of test performed on this first day. The sample was stratified in two groups for the statistical analysis: a General Sample (MG and b sample excluding patients admitted after a programmed surgery (EQP. In both cases the effect of initial and averaged glycemia was checked. Group b was divided in two, according to the number of determinations b1 a single blood glucose determination group (EQP1 and b2 a multiple determination group (EQPM. From this group of non-programmed surgical patients the study was repeated in those patients who stayed at the ICU 3 or more days (EQP3D. Chi-square and Mantel-Haenzel test for the ODD ratio determination were performed for qualitative variables; quantitative variables were examined with the Mann-Whitney test. At each analysis level, logistic regression was performed using mortality as the dependent variable, including those variables with p-values 110 mg/dl or in two (normal values 60 to 110 mg/dl and unusual figures 110 mg/dl. These significant differences were lost when a logistic model was applied. From the remaining variables, renal function and NEMS showed to be mortality risks factors in this sample. Conclusions: Hyperglycemia is a predominant phenomenon in critically ill patients. Hypoglycemia is less frequent and is associated with higher mortality rates. Initial glucose blood level, by itself, was not a mortality risk factor in the multivariate study and at none of the studied levels. Average glycemia did not add any prediction power. The changes in glucose blood levels seemed to be an adaptation process, which determined by itself a risk for the patient's discharge, at least in the first 24 hours period after ICU admission.

  14. TAMIS for rectal tumors: advancements of a new approach.

    Rega, Daniela; Pace, Ugo; Niglio, Antonello; Scala, Dario; Sassaroli, Cinzia; Delrio, Paolo

    2016-03-01

    TAMIS allows transanal excision of rectal lesions by the means of a single-incision access port and traditional laparoscopic instruments. This technique represents a promising treatment of rectal neoplasms since it guarantees precise dissection and reproducible approaches. From May 2010 to September 2015, we performed excisions of rectal lesions in 55 patients using a SILS port. The pre-operative diagnosis was 26 tumours, 26 low and high grade displasias and 3 other benign neoplasias. 11 patients had a neoadjuvant treatment. Pneumorectum was established at a pressure of 15-20 mmHg CO2 with continuous insufflation, and ordinary laparoscopic instruments were used to perform full thickness resection of rectal neoplasm with a conventional 5-mm 30° laparoscopic camera. The average operative time was 78 min. Postoperative recovery was uneventful in 53 cases: in one case a Hartmann procedure was necessary at two postoperative days due to an intraoperative intraperitoneal perforation; in another case, a diverting colostomy was required at the five postoperative days due to an intraoperative perforation of the vaginal wall. Unclear resection margins were detected in six patients: thereafter five patients underwent radical surgery; the other patient was unfit for radical surgery, but is actually alive and well. Patients were discharged after a median of 3 days. Transanal minimally invasive surgery is an advanced transanal platform that provides a safe and effective method for low rectal tumors. The feasibility of TAMIS also for malignant lesions treated in a neoadjuvant setting could be cautiously evaluated in the future. PMID:27052544

  15. Rectal premedication in pediatric anesthesia: midazolam versus ketamine

    Moshirian N

    2008-06-01

    Full Text Available Background: Premedication is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. The rectal route is one of the most commonly accepted means of drug administration. The aim of our study was to investigate and compare the efficacy of rectally administered midazolam versus that of ketamine as a premedication in pediatric patients.Methods: We performed a prospective randomized double-blinded clinical trial in 64 children, 1 to 10 years of age, randomly allocated into two groups. The midazolam group received 0.5 mg/kg rectal midazolam and the ketamine group received 5 mg/kg rectal ketamine. The preoperative sedation scores were evaluated on a three-point scale. The anxiolysis and mask acceptance scores were evaluated separately on a four-point scale, with ease of parental separation, based on the presence or lack of crying, evaluated on a two-point scale. Results: Neither medication showed acceptable sedation (>75%, with no significant difference in sedation score between the two groups (P=0.725. Anxiolysis and mask acceptance using either midazolam or ketamine were acceptable, with  midazolam performing significantly better than ketamine (P=0.00 and P=0.042, respectively. Ease of parental separation was seen in both groups without significant difference (P=0.288 and no major adverse effects, such as apnea, occurred in either group.Conclusions: Rectal midazolam is more effective than ketamine in anxiolysis and mask acceptance. Although they both can ease separation anxiety in children before surgery, we found neither drug to be acceptable for sedation.

  16. p53 expression in human rectal tissue after radiotherapy: upregulation in normal mucosa versus functional loss in rectal carcinomas

    Purpose: In vitro, ionizing radiation of epithelial cells leads to upregulation of wild-type p53 and subsequent induction of p21waf1. The effect of radiotherapy (RT) on the expression of these proteins in patients is unknown. We assessed the influence of RT on the expression of p53 and p21waf1 in normal mucosa and rectal carcinomas in vivo. Methods: Tumor and normal tissue samples were derived from rectal cancer patients randomized in a clinical trial in which the value of preoperative RT was evaluated. p53 and p21waf1 expression was determined in 51 irradiated and 52 nonirradiated patients using immunohistochemistry. Results: In normal mucosa, both p53 and p21waf1 were strongly upregulated after RT compared with the expression in unirradiated normal tissue (p waf1 was found in the irradiated vs. nonirradiated group. In the few rectal tumors with wild-type p53, induction of p53 after RT did not necessarily lead to upregulation of p21waf1. Conclusion: These findings demonstrate that in normal mucosa, a functional p53-p21waf1 pathway is present, whereas in tumor cells it is defective in almost all cases because of either p53 mutation or down- or upstream disruption in tumors with wild-type p53. Therefore, we believe that the role of p53 expression as a single prognostic marker in rectal cancer needs reconsideration

  17. Effect of rectal enemas on rectal dosimetric parameters during high-dose-rate vaginal cuff brachytherapy. A prospective trial

    Sabater, Sebastia; Andres, Ignacio; Sevillano, Marimar; Berenguer, Roberto; Aguayo, Manuel; Villas, Maria Victoria [Complejo Hospitalario Universitario de Albacete (CHUA), Department of Radiation Oncology, Albacete (Spain); Gascon, Marina; Arenas, Meritxell [Hospital Universitari Sant Joan, Department of Radiation Oncology, Reus (Spain); Rovirosa, Angeles; Camacho-Lopez, Cristina [University of Barcelona, IDIBAPS, Gynecological Cancer Unit, Radiation Oncology Department, ICMHO, Hospital Clinic, Barcelona (Spain)

    2016-04-15

    To evaluate the effects of rectal enemas on rectal doses during postoperative high-dose-rate (HDR) vaginal cuff brachytherapy (VCB). This prospective trial included 59 patients. Two rectal cleansing enemas were self-administered before the second fraction, and fraction 1 was considered the basal status. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Statistical analyses used paired and unpaired t-tests. Despite a significant 15 % reduction in mean rectal volume (44.07 vs. 52.15 cc, p = 0.0018), 35.6 % of patients had larger rectums after rectal enemas. No significant rectal enema-related DVH differences were observed compared to the basal data. Although not statistically significant, rectal cleansing-associated increases in mean rectal DVH values were observed: D{sub 0.1} {sub cc}: 6.6 vs. 7.21 Gy; D{sub 1} {sub cc}: 5.35 vs. 5.52 Gy; D{sub 2} {sub cc}: 4.67 vs. 4.72 Gy, before and after rectal cleaning, respectively (where D{sub x} {sub cc} is the dose to the most exposed x cm {sup 3}). No differences were observed in DVH parameters according to rectal volume increase or decrease after the enema. Patients whose rectal volume increased also had significantly larger DVH parameters, except for D{sub 5} {sub %}, D{sub 25} {sub %}, and D{sub 50} {sub %}. In contrast, in patients whose rectal volume decreased, significance was only seen for D{sub 25} {sub %} and D{sub 50} {sub %} (D{sub x} {sub %} dose covering x % of the volume). In the latter patients, nonsignificant reductions in D{sub 2} {sub cc}, D{sub 5} {sub cc} and V{sub 5} {sub Gy} (volume receiving at least 5 Gy) were observed. The current rectal enemas protocol was ineffective in significantly modifying rectal DVH parameters for HDR-VCB. (orig.) [German] Beurteilung der Auswirkungen von rektalen Dosen waehrend postoperativer High-Dose-Rate-(HDR-)Brachytherapie an der Scheidenmanschette (''vaginal cuff brachytherapy'', VCB). An

  18. Morphology of the middle rectal arteries. A study of 30 cadaveric dissections.

    DiDio, L J; Diaz-Franco, C; Schemainda, R; Bezerra, A J

    1986-01-01

    The middle rectal arteries were studied in 30 cadavers of adult and older individuals (29 Caucasians and one Negro) of both sexes (15 males and 15 females). The middle rectal artery was present in 56.7% of the cases, bilaterally (36.7%) or unilaterally (20%), originating from the internal pudendal (40%), inferior gluteal (26.7%), internal iliac (16.8%), and less frequently from other pelvic branches. The average external diameter of the middle rectal artery was found to be 1.7 mm, its average length about 7 cm, and the point of penetration in the rectal wall about 6 cm (average) superior to the anus. The most frequent sites of the rectal wall pierced by the middle rectal arteries were the anterior (50% of the cases) and posterior (45%) quadrants of the rectum, whether isolated or combined (43.3%). These anatomical features justify, when needed and possible, the preservation of the middle rectal artery in surgical interventions on related organs. The term middle rectal arteries in Nomina Anatomica should be changed to inferior rectal arteries and indented under internal pudendal artery; the current term inferior rectal arteries should be changed to anal arteries to follow the already adopted division of the terminal intestine into rectum and anal canal. PMID:3107146

  19. The Prognostic Value of Circumferential Resection Margin Involvement in Patients with Extraperitoneal Rectal Cancer.

    Shin, Dong Woo; Shin, Jin Yong; Oh, Sung Jin; Park, Jong Kwon; Yu, Hyeon; Ahn, Min Sung; Bae, Ki Beom; Hong, Kwan Hee; Ji, Yong Il

    2016-04-01

    The prognostic influence of circumferential resection margin (CRM) status in extraperitoneal rectal cancer probably differs from that of intraperitoneal rectal cancer because of its different anatomical and biological behaviors. However, previous reports have not provided the data focused on extraperitoneal rectal cancer. Therefore, the aim of this study was to examine the prognostic significance of the CRM status in patients with extraperitoneal rectal cancer. From January 2005 to December 2008, 248 patients were treated for extraperitoneal rectal cancer and enrolled in a prospectively collected database. Extraperitoneal rectal cancer was defined based on tumors located below the anterior peritoneal reflection, as determined intraoperatively by a surgeon. Cox model was used for multivariate analysis to examine risk factors of recurrence and mortality in the 248 patients, and multivariate logistic regression analysis was performed to identify predictors of recurrence and mortality in 135 patients with T3 rectal cancer. CRM involvement for extraperitoneal rectal cancer was present in 29 (11.7%) of the 248 patients, and was the identified predictor of local recurrence, overall recurrence, and death by multivariate Cox analysis. In the 135 patients with T3 cancer, CRM involvement was found to be associated with higher probability of local recurrence and mortality. In extraperitoneal rectal cancer, CRM involvement is an independent risk factor of recurrence and survival. Based on the results of the present study, it seems that CRM involvement in extraperitoneal rectal cancer is considered an indicator for (neo)adjuvant therapy rather than conventional TN status. PMID:27097629

  20. Pelvic lymphoscintigraphy: contribution to the preoperative staging of rectal cancer

    Preservation of the lower rectal sphincters has been the main concern of colorectal surgeons in an attempt to avoid colostomy. Various proposed procedures contradict the oncological principles of the operation's radicality, especially pelvic lymphadenectomy. Prior knowledge of this space is therefore, an important factor in choosing the operative technique: radical (amputation), or conservative. The introduction of ultrasound, computed tomography and magnetic resonance imaging, have provided preoperative information about the anatomic nature of the region. The morphological and functional study supplied by lymphoscintigraphy of this space supplements the data furnished by the other imaging techniques. The objective of this prospective of this prospective study was threefold: to standardize lymphoscintigraphy, to differentiate patients with rectal cancer from those with other coloproctological diseases and to asses the lymphonodal involvement in the former by utilizing the anatomopathological and surgical correlation. The study included 60 patients with various coloproctological diseases seen on the Department of Gastroentorology, Hospital da Clinicas, University of Sao Paulo School of Medicine, from September 1990 to August 1993. Thirty were cases of rectal cancer and the remainder were other colorectal diseases. The method consisted of injecting 0.5 of a dextran solution market with radioactive technetium in the perineal region and obtaining images by a gamma camera. In the rectal cancer patients, the tracer progresses unilaterally or is absent; in the others, it is bilateral and symmetrical, although its progress may be slow. The statistical data demonstrated that in rectal cancer, lymphoscintigraphy asseses the nodal involvement approximaltely as that obtained by the sun of the anatomapathological and surgical findings. Based on the results, the following conclusioons were possible: lymphoscintigraphy is a standardized, painless and harmless test that can be