obstetric anal sphincter: Topics by WorldWideScience.org

Pre-operative MRI of anorectal anomalies in the newborn period

Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter.

1982-09-01

Defecographic diagnosis of the puborectalis syndrome; Diagnosi mediante defecografia della sindrome del muscolo puborettale

Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a `low` lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly hyperintense T1 signal meconium was seen in all nine newborns, allowing for easy ...

1995-11-01

Defecographic diagnosis of the puborectalis syndrome

The puborectalis syndrome is a defecation disorder supported by the nonrelaxation of puborectalis sling with consequent dyschezia. They report on a series of 98 patients submitted to clinical examination, defecography, anorectal manometry, electromyography and intestinal transit time studies. The main symptoms of puborectalis syndrome in their patients were incomplete defecation (89 %) and intermittent evacuation (63 %); 28 % of patients turned to finger defecation. In all patients, defecography showed an abnormal increase in puborectalis impression on the posterior anorectal wall, reduced anorectal angle opening under straining (mean value: 113 deg) and prolonged expulsion time with barium pooling in the ampulla (mean evacuation time: 38 seconds). Such anorectal abnormalities as rectal mucosal prolapse (47 cases) and anterior rectocele (36 cases) were also associated. In 33 of 98 patients (34 % of cases), sling assessment by bidigital palpation at preliminary clinical examination ...

1997-04-01

Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary retention in women.

Physiologic aspects of continence after colectomy, mucosal proctectomy, and endorectal ileo-anal anastomosis.

A type of electromyographic activity, formerly referred to as "pseudomyotonia", can be recorded from the striated muscle of the urethral sphincter using a concentric needle electrode. There are two...Full Text Available

1985-10-01

Human papillomavirus infection and anal carcinoma. Retrospective analysis by in situ hybridization and the polymerase chain reaction.

We examined the physiology of continence in 12 patients at least four months after colectomy, mucosal proctectomy, and endorectal ileo-anal anastomosis for ulcerative colitis and familial polyposis....Full Text Available

1982-04-01

Congenital anal anomalies in two families with the Opitz G syndrome.

To examine the association of human papillomavirus (HPV) infection with anal squamous cell carcinoma, the authors applied the highly sensitive polymerase chain reaction (PCR) and in situ hybridization...Full Text Available

1992-06-01

Targeted doctors, missing patients: Obstetric health services and sectarian conflict in Northern Pakistan

Five children from two families presented to a regional neonatal surgical unit between 1959 and 1984 with congenital anal anomalies and other malformations resulting from an autosomal dominant inherited...Full Text Available

1987-11-01

British Library Electronic Table of Contents (United Kingdom)

The spectre of exclusionary medical service provision, restricted clinic access and physician targeting in sectarian-divided Iraq underscores the crucial and timely need for qualitative research into the inter-relationship between conflict, identity and health. In response, this paper provides a critical ethnography of obstetric service provision and patient access during Shia-Sunni hostilities in Gilgit Town, capital of Pakistans Northern Areas (2005). I analyse how services were embedded in and constrained by sectarian affiliation in ways that detrimentally impacted Sunni women patients and hospital staff, resulting in profoundly diminished clinic access, reduced physician coverage and a higher observed incidence of maternal morbidity and mortality. The paper first situates obstetric med...

2010-01-01

Dendroaspis natriuretic peptide is the most potent natriuretic peptide to cause relaxation of lower esophageal sphincter

British Library Electronic Table of Contents (United Kingdom)

Atrial natriuretic peptide (ANP) causes relaxation in the opossum lower esophageal sphincter. The effects of dendroaspis natriuretic peptide (DNP) and other natriuretic peptides in the lower esophageal sphincter were not known. We measured the relaxation of transverse strips from the guinea pig lower esophageal sphincter caused by DNP, ANP, brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and a natriuretic peptide receptor-C agonist des[Gln^1^8, Ser^1^9, Gly^2^0, Leu^2^1, Gly^2^2]ANP(4-23) amide (cANF(4-23)) in vitro. In resting strips of the guinea pig lower esophageal sphincter DNP and BNP caused marked relaxations. Furthermore, in both sarafotoxin S6c and carbachol-contracted lower esophageal sphincter strips, DNP caused marked and BNP caused moderate, concentration-de...

2011-01-01

Magnetic resonance imaging of the urogenital diaphragma in comparison with conventional histomorphological findings (the controversy about the deep transverse muscle of perineum); Kernspintomographische Untersuchungen des Diaphragma urogenitale im Vergleich mit korrespondierenden histomorphologischen Befunden (der Streit um den Misculus transversus perinei profundus)

Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial

The transversus perinei profundus muscle is a well known structure in found anatomical textbook. Fibres of this muscle are believed to form the so-called external urethral sphincter (musculus sphincter urethrae). Recently histomorphologic investigations have shown that there is no muscular connection between the musculus sphincter urethrae (external sphincter) and the muscle system of the pelvic floor. Furthermore, the external sphincter was found to be divided into parts: The transversely striated part (musculus sphincter urethrae transversostriatus) and the smooth part (musculus sphincter urethrae glaber). Similar to histomorphologic investigations, contrast-enhanced MR imaging has shown the musculus sphincter urethrae to be surrounded by fatty and connective tissue only. Neither in MRI nor in anatomical slices can any ...

1997-01-01

Duration of human singleton pregnancies in Ibadan, Nigeria.

ObjectiveTo investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within...Full Text Available

2011-10-01

Idiopathic (primary) achalasia

Analysis of gestation length in an obstetric population of indigenous African women revealed a mean pregnancy duration of 274.8 days, which is similar to values recorded in women of African descent...Full Text Available

1997-09-01

MRT for operation planning in anal atresias

Idiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter (LES) relaxation in response to deglutition. It is a rare...Full Text Available

Sphincter preservation for distal rectal cancer - a goal worth achieving at all costs?

We evaluated in this study the value of preoperative examinations of anal atresia with an optimised MRI strategie. 13 patients with anorectal anomalies, most of them younger than one year, underwent an MRI examination of the pelvis. 10 of these patients were operated afterwards. Compared with the situs shown by the operation the results of the MRI examination were very exact in all cases in respect of the level of atresia and the development of the striateed muscle complex. Fistulas could be completely described in most cases. MRI demonstrated additional lesions in some patients which were of great importance for planning the further treatment of the patients. As a consequence MRI can give valid information on anal atresia for planning the operative treatment. (orig.).

Quality-of-Life and Surgical Treatments for Rectal Cancer-a Longitudinal Analysis Using the California Cancer Registry

To assess the merits of currently available treatment options in the management of patients with low rectal cancer, a review of the medical literature pertaining to the operative and non-operative management...Full Text Available

2011-02-21

Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer: Which is superior?

BackgroundHeterogeneous results for research investigating health-related quality of life (HRQL) in patients undergoing sphincter-ablating procedures for rectal cancer...Full Text Available

2010-08-01

The results of treatment of localized Ewing's sarcoma and reticulosarcoma in pediatric patients

The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy...Full Text Available

2011-02-21

[Dysspermia due to inflammation. The evaluation of sperm cultures].

The results of treatment of 53 cases of pediatric localized Ewing's sarcoma and bone reticulosarcoma were analized. Chemoradiotherapy is a procerdure of choice in bone marrow sarcoma treatment: while overall five-year survival was 28.4#+-#6.2%, it was as high as 64.9% in cases of combined treatment (total focal dose of at least 50 Gy+polychemotherapy). Two cases of osteo- and chondrosarcoma development in exposed bone are described.

Science.gov (United States)

The study evaluates 160 cases of positive spermioculture taken from 522 sterile individuals examined by the authors at the Couple Sterility Outpatient unit in Department A of the Institute of Gynecology and Obstetrics at Turin University during the period between January 1984 and December 1993. The germs responsible for infection were assayed in order to evaluate the strains which showed the highest incidence every year. Whereas there was no significant change in the absolute number of cases of sterility over the period, the number of cases caused by infection increased significantly during the second five-year period. It was found that the germs predominantly implicated in the genesis of male sterility formed part of the so-called mixed flora group, responsible in women for syndromes of often asymptomatic bacterial vaginosis which are not identified and consequently not treated. PMID:8559444

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Randomised, placebo-controlled trial to evaluate co-trimoxazole to reduce mortality and morbidity in HIV-infected post-natal women in Zambia (TOPAZ)

British Library Electronic Table of Contents (United Kingdom)

Summary Objective- To evaluate the role of prophylactic trimethoprim-sulfamethoxazole (co-trimoxazole) antibacterial prophylaxis in reducing morbidity and mortality in HIV-infected post-natal women in southern Africa. Methods- Double-blind placebo-controlled trial. HIV-infected women with WHO stage 2 or 3 HIV disease who had recently delivered in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia were randomised to receive daily co-trimoxazole (cotox) or matched placebo daily for the duration of the trial. Participants were followed up for a minimum of 1-year. Primary outcome measures were mortality from any cause or hospital admission and serious adverse events. Results- Of 600 women randomised, follow-up information was available from 355 (18...

2011-01-01

The cervicograph in labour management in the Highland of Papua New Guinea.

Science.gov (United States)

The use of the cervicograph with the incorporated action and alert lines in labour management in developing country obstetrics is now well established and patients in labour in Port Moresby have been thus managed since 1973. In this study the cerviograph was introduced in hospitals and health centres in Enga Province and the results analysed. Despite intensive tuition in its use, a large number of cervicographs were incorrectly constructed, especially in health centres, and its introduction made little difference to operative delivery or perinatal mortality rates. The proportion of patients crossing the action line was much higher than in Post Moresby but this difference was probably also largely due to the inaccuracy of many cervicographs. It is likely that these difficulties will not be overcome until many more nurses with intensive training in the use of the cervicograph are available and until more deliveries take place in health institutions to maintain ...

1981-12-01

Paravortex panopea n. sp. (Platyhelminthes: Rhabdocoela) on clams from the northern Patagonian coast, Argentina: pathogeny and specificity

British Library Electronic Table of Contents (United Kingdom)

Summary During a histopathological survey of the geoduck, Panopea abbreviata (Hiatellidae), and the razor clam, Ensis macha (Pharidae), in northern Patagonian gulfs (Argentina), turbellarian worms were found in the intestine lumen. In this work, we described a new species of Paravortex (Platyhelminthes, Graffillidae). We collected the hosts by scuba diving and dissected alive for studying the turbellarians. In this new species, the pharynx continues in a short esophagus and the latter in a saccular intestine. Gravid specimens have from 2 to 8 twin embryos in the parenchyma. A short penis papilla arises from the seminal vesicle and the gonopore presents a strong sphincter. This species resembled P. nicolli Szidat, 1965, which was described paraziting Mytilus edulis platensis in Buenos Aires...

2011-01-01

Beyond Acid Suppression: New Pharmacologic Approaches for Treatment of GERD

British Library Electronic Table of Contents (United Kingdom)

Proton pump inhibitors are highly successful in treating gastroesophageal reflux disease, but a significant proportion of patients have persistent symptoms from weakly or nonacidic reflux. Transient lower esophageal sphincter relaxation (TLESR) represents the dominant mechanism of gastroesophageal reflux and has therefore become the most intensely investigated therapeutic target. The triggering of TLESR involve the vagal pathways and the ?-aminobutyric type B (GABA(B)) and metabotropic glutamate type 5 (mGluR5) receptors. Baclofen is a GABA(B) receptor agonist that is effective in inhibiting TLESR and reducing the number of reflux episodes, but is associated with significant central nervous system (CNS) side effects. The newer GABA(B) agonists, such as AZD9343 and AZD3355, and mGluR5 antag...

2010-01-01

Selection of optimum method for slope stability analysis in view of new mining technologies. Izbor optimalne metode analize stabilnosti u funkciji novih rudarskih tehnologija

Prevalence and Incidence of HCV Infection among Vietnam Heroin Users with Recent Onset of Injection

Deals with slope stability problems met in the D coalfield of the Tamnava-Iztok surface coal mine where 171 Mt of brown coal have been excavated and 520 Mm{sup 3} of overburden. Six geomechanical methods were used to verify the reliability of slope angels (Hoek, Froehlich, Janbu, Bishop, Reame and Swase) along with the theory of finite elements. All calculations were accomplished by means of computers. It was found that the Ream method (combined Bishop and Fellenius method) provides the most reliable results in determining general slope angles. The Janbu method is mostly suited for locations with complicated geological conditions (multi-layer benches); the Swase method may be considered as most reliable for locations with simple geological conditions and for spoil banks. 5 refs.

1989-01-01

British Library Electronic Table of Contents (United Kingdom)

HCV infection continues to spread at an alarming rate among IDU populations. The available evidence suggests that HCV is acquired relatively quickly following onset of injection. However, there are few prospective studies of HCV acquisition, particularly among IDU populations in resource-poor settings. A sample of young male heroin injectors with recent onset of injection (<4?years) was recruited in Hanoi, Vietnam for a prospective assessment of the early course of injection (n?=?179). Both behavioral and biological assessments (including detailed retrospective assessment of injection initiation) were conducted at baseline and repeated at 6-month intervals for a period of 16?months. Variables associated with HCV infection (p value?p value?=?0.0005). In multivariate logistic regression anal...

2010-01-01

Morphology of the first instar of Calliphora vicina, Phormia regina and Lucilia illustris (Diptera, Calliphoridae)

British Library Electronic Table of Contents (United Kingdom)

Abstract. Scanning electron microscopy documentation of first instar Calliphora vicina Robineau-Desvoidy, Phormia regina (Meigen) and Lucilia illustris (Meigen) (Diptera: Calliphoridae) is presented for the first time, and the following morphological structures are documented: pseudocephalon; antenna; maxillary palpus; facial mask; labial lobe; thoracic and abdominal spinulation; spiracular field; posterior spiracles, and anal pad. Light microscopy documentation and illustrations are provided for the cephaloskeleton in lateral and ventral views. New diagnostic features are revealed in the configuration of the facial mask, cephaloskeleton and posterior spiracles. The first instar morphology of C. vicina, Ph. regina and L. illustris is discussed in the light of existing knowledge about early...

2008-01-01

Fecal incontinence in operated cases for anorectal malformations

The Results of Curative Concurrent Chemoradiotherapy for Anal Carcinoma

In spite of great progress in surgical treatment of anorectal malformations, fecal incontinence is still, in variable degrees, a frequent and unpleasant postsurgical sequela. The most frequent causes of incontinence are: 1) the incorrect placement of the pulled-through colon in the levator ani and sphincteric muscular complex during abdomino-perineal surgical procedures; 2) the poor development of sphinteric musculature; 3) the associated sacral anomalies. Postoperative CT helps to evaluate all the above-mentioned conditions, in view of possible new surgical procedure for improving continence (besides postoperative CT can help in choosing the more suitable surgical technique). Nine patients, aged 3 to 13 years (2 with good continence and 7 with various degrees of incontinence), were studied with pelvic postoperative CT. In the cases (2) with good continence the CT picture was: good development of sphincteric musculature and neo-anorectum ...

1989-01-01

Chemoradiotherapy in patients with anal cancer: Impact of length of unplanned treatment interruption on outcome

To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39-89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0-64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. The median follow--up time was 62 months (2-202 months).The 5-year overall survival, locoregional relapse-free survival, disease-free survival, and colostomy-free survival rates were 86.0%, 71.7%, 71.7%, 78.2%, respectively. Regarding ...

2010-11-15

Pelvic CT for the prognostic evaluation of anorectal malformation

The aim of this retrospective analysis was to evaluate feasibility and effectiveness of definitive chemoradiotherapy without split-course technique in anal cancer patients. From 1993 to 2003, 81 patients were treated; 13 were excluded due to various chemotherapeutic regimes, thus 68 patients were analysed. In case of acute grade 3 toxicities, treatment was halted until improvement or resolution independent of dose. Short interruption was defined as completing treatment without exceeding eight cumulative treatment days beyond scheduled plan, other patients were considered to have had prolonged interruption. Median follow-up was 46 months. Median overall treatment time was 53 days corresponding to an interruption of eight cumulative treatment days. Thirty-five patients (51%) had treatment interruption of <8 days. No acute grade 4 toxicities were observed; one fatality occurred during treatment due to ileus-like symptoms according to acute grade 5 toxicity. ...

2006-09-15

Elective ilioingunial lymph node irradiation

The anatomical patterns of anorectal malformations have so far been studied according to the principles which inspire Pena's technique for the surgical treatment of anorectal anomalies. Thus, the diagnostic study of anorectal malformation has by the authors been considered a work of classification, but of identification. Among the diagnostic procedures in use in author's Institute, preoperative CT of pelvis is performed to assess the presence and to define the development of muscular sphincteric structure towards prognostic evaluation of continence, the major long-term goal. Seven patients, aged 1-30 months, with anorectal anomalies were studied with preoperative CT of the pelvis. CT scans showed well-developed sphinteric muscles in 3 patients (2 with recto-ureteral and 1 with recto-vestibular fistulas), poorly-developed muscular structure in 3 patients (with recto-vaginal, cloacal and prostatic fistulas), absence of muscular structure in 1 case (with recto-vesical ...

1989-01-01

Laparoskopisk kolecystektomi

Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One ...

DEFF Research Database (Denmark)

Forty-one patients with uncomplicated gall stone disease were laparoscopied with the object of cholecystectomy. The procedure was accomplished in 36 patients, but the operation had to be transformed to a conventional open operation in five: Fibrosis made dissection of the gall bladder hazardous in four and bleeding during the procedure made immediate laparotomy necessary in one patient, whose postoperative course was uneventful. The median operating time was 100 minutes, range was 60-250 minutes. The only operative complication was bleeding from a trocar puncture hole on the first postoperative day which stopped spontaneously in one patient. Eighteen were sent home on the first postoperative day and 12 patients on the second day. Peroperative cholangiography was performed employing the Olsen-Reddick cholangiography forceps. We have designed a special catheter, which greatly facilitates the procedure. The procedure was accomplished in 27 of 32 planned cases. Two patients had common bile ...

1993-01-01

The risk of ano-genital malignancies in dialysis and transplant patients.

Science.gov (United States)

The incidence of anogenital malignancies is greatly increased in patients who have received a renal transplant, but this has not been well studied in patients receiving maintenance dialysis. Our aim was to assess the incidence of these malignancies in patients on dialysis and compare these to transplanted patients. The age standardized incidence ratio (SIR) for anogenital malignancies was calculated by comparing the observed number of malignancies to the expected number. The expected number was calculated by multiplying the age specific incidence rates for each malignancy by the person years at risk in 5-year age cohorts. Of 15,820 patients in the Australia and New Zealand data base, 8,215 had received a renal transplant. A total of 39,750 person years at risk were contributed by patients who had received a renal transplant, while 29,276 person years at risk were contributed by dialysis patients who had not received a renal transplant. For dialysis patients, vulval cancer occurred more ...

1994-02-01

Digital subtraction angiography (DSA) using Fuji computed radiography (FCR)

Transpositions and malpositions of the great arteries

A vessel phantom suitable for evaluation of spatial and contrast resolution of FCRDSA (Fuji Computed Radiography, digital subtraction angiography) has been developed and used for determining resolution. The effects of iodine concentration, low dose exposure, and acryl thickness on the resolution were evaluated in FCRDSA, and FCRDSA images were compared with film substraction with use of this phantom. It has been proven that limitation of resolution of FCRDSA was 5 % 1 mm and about 1/4 dose exposure compared with conventional film exposure was clinically acceptable. Dye dilution method was useful to determine a program of IVDSA with imaging plate. It has been proven that time to appearance and time to peak of time-concentration curve of dye dilution method closely correlate to time to appropriate image of DSA in the neck, the chest, and the abdomen. 106 cases of IVDSA and 130 cases of IADSA using FCR in Tohoku University Hospital from January through December 1984 were ...

1984-12-01