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Sample records for anal canal carcinoma

  1. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  2. Presence of skin metastasis related to an epidermoid carcinoma of anal canal

    International Nuclear Information System (INIS)

    Danta Fundora, Debora; Collado Otero, Juan Carlos; Vazquez Gonzalez, Jose Manuel; Paredes Lopez, Dagmar

    2009-01-01

    Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum

  3. Radiotherapy for carcinomas of the anal canal Tenon hospital experience

    International Nuclear Information System (INIS)

    Touboul, E.; Moureau-Zabotto, L.; Lerouge, D.; Pene, F.; Deniaud-Alexandre, E.; Schlienger, M.; Laugier, A.; Tiret, E.; Parc, R.; Sezeur, A.; Houry, S.; Gallot, D.

    2003-01-01

    Since 1980, curative-intent radiation therapy of epidermoid carcinoma of the anal canal is the standard first line treatment. The combined concomitant chemotherapy and radiation therapy is presently established for locally advanced tumors more than 4 cm in length and/or with nodal involvement. We report the Tenon hospital experience since 1972 concerning the long term results after radiation therapy, the modifications of the radiation technique, and the evolution of treatment strategy. (author)

  4. Management of persistent anal canal carcinoma after combined-modality therapy: a clinical review.

    Science.gov (United States)

    Musio, Daniela; De Felice, Francesca; Raffetto, Nicola; Tombolini, Vincenzo

    2014-01-28

    Anal canal carcinoma is a rare gastro-intestinal cancer. Radiochemotherapy is the recommended primary treatment for patients with non-metastatic carcinoma; surgery is generally reserved for persistent or recurrent disease. Follow-up and surveillance after primary treatment is paramount to classify patients in those with complete remission, persistent or progressive disease. Locally persistent disease represents a clinically significant problem and its management remains subject of some controversy.The aim of this systematic review is to summarise recommendations for the primary treatment of anal canal carcinoma, to focus on the optimal time to consider residual disease as genuine persistence to proceed with salvage treatment, and to discern how this analysis might inform future clinical trials in management in this class of patients.

  5. Carcinoma espinocelular de canal anal: análise de 11 casos Squamous cell carcinoma of the canal anal: analysis of 11 patients

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    Ana Paula GUIMARÃES

    2001-01-01

    Full Text Available Racional - O câncer de canal anal é um tipo raro de neoplasia, sendo responsável por 4% dos tumores de intestino grosso. São descritos os aspectos clínicos e o tratamento dos pacientes com câncer escamoso desta região. Casuística - Analisaram-se, retrospectivamente, 11 pacientes com carcinoma espinocelular de canal anal. Nove pacientes eram do sexo feminino e dois do masculino. A idade média dos pacientes foi de 57,6 anos (variação 35-82 anos. Resultados - Os sintomas mais freqüentes foram sangramento retal, tumoração e dor local. Seis pacientes tinham lesão benigna prévia local e dois tinham doença metastática na ocasião do diagnóstico. Todos foram submetidos a quimioterapia sistêmica com 5-fluorouracil e mitomicina. Após o tratamento quimio e radioterápico, quatro apresentavam doença residual e foram submetidos a ressecção abdômino-perineal. Três pacientes apresentaram recidiva e quatro morreram pela evolução da própria doença. Conclusão - A maioria dos doentes era do sexo feminino. A químio e a radioterapia podem ser tratamentos curativos nos pacientes com doença localizada; no entanto, aqueles com doença residual devem ser submetidos a ressecção abdômino-perineal. Embora o câncer espinocelular de canal anal seja doença curável, quatro pacientes foram a óbito por terem sido diagnosticados em fase avançada.Background - Anal cancer is an uncommon malignancy accounting for only a small (4% percentage of intestinal cancer. The authors described the clinical aspects and the treatment of the patients with squamous cell carcinoma of the canal anal. Patients - Eleven patients with squamous cell carcinoma treated among 1995 and 1999, were analyzed retrospectively. Nine were women and two were men. The mean age was 57.6 years old (range 35-82 years old. Results - The most common symptoms were rectal bleeding, local tumor and pain. Six of them had previous anal benign disease and two had metastases at the

  6. ORGAN-SPARING TREATMENT IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE ANAL CANAL

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    Yu. A. Barsukov

    2014-01-01

    Full Text Available Objective: to improve the results of treatment in patients with squamous cell carcinoma of the anal canal, by creating a new combination treatment option, and to increase the rate of organ-sparing treatment.Subjects and methods. A new combination treatment option for squamous cell carcinoma of the anal canal was created, which involved a combination of radiotherapy and a multiple radio modification program (ultrahigh-frequency (UHF hyperthermia and local metronidazole (MZ injection and systemic polychemotherapy (RF patent No. 2427399 “A treatment option for squamous cell carcinoma of the anal canal” registered on 27 August 2011. To evaluate the created treatment option, the latter was analyzed in 157 patients with Т1–4N0–3M0 squamous cell carcinoma of the anal canal, who had been treated in 1990 to 2012. In 22 patients, radiotherapy was performed in combination with 3–5 sessions of local UHF hyperthermia (thermoradiotherapy (TRT; 88 patients received the latter in combination with polychemotherapy (thermoradiochemotherapy (TRCT; in addition to TRCT, 47 patients used MZ (TRCT + MZ.Results. In the TRT, TRCT, and TRCT + MZ groups, organ-sparing treatment was performed in 11 (50 %, 71 (80.7 %, and 44 (93.6 % patients, respectively. In these groups, the median follow-up was 18.6; 51.7, and 15.5 months, respectively. In the 3 groups, the three-year overall survival rates were 71.4; 90.0, and 96.3 % and the three-year relapse free survival rates were 46.7; 60.6, and 75.0 %, respectively.Conclusion. The created combination thermochemoradiotherapy involving a polymer combination with MZ (TRCT + MZ makes it possible to achieve organ-sparing treatment in 93.6 % of the patients and to slightly improve 3-year overall and relapse-free survival rates in patients with squamous cell carcinoma of the anal canal who have received organ-sparing treatment although there is only a tendency for statistical survival difference in this patient group.

  7. [Results of complex treatment of patients with squamous cell carcinoma of the anal canal using advanced radiotherapy technologies].

    Science.gov (United States)

    Glebovskaya, V V; Tkachev, S I; Rasulov, A O; Tsaryuk, V F; Gordeev, S S; Fedyanin, M Yu; Aliev, V A; Mamedly, Z Z; Kuzmichev, D V; Trofimova, O P; Borisova, T N; Yazhgunovich, I P

    2015-01-01

    During recent decades radiotherapy is the basis, on which it is built a medical complex that is the first-line treatment of patients with squamous cell carcinoma of the anal canal. An increase of overall and disease-free survival and quality of life of patients with squamous cell carcinoma of the anal canal at the present stage of development of a comprehensive medical treatment is largely due to the improvement of technical equipment of radiotherapy departments of oncology clinics. The use of modem linear electron accelerators and systems of computer dosimetric planning to create a 3D program of isodose distribution, diagnostic devices (computed tomography and magnetic resonance imaging) as well as a number of other conditions permit accurate summarizing of proposed dose, reducing of absorbed dose to critical structures, diminishing unplanned interruptions in chemoradiotherapy course by means of modern technologies of conformal radiotherapy (3D CRT, IMRT, VMAT). The paper presents the preliminary results of a comprehensive medical treatment of 14 patients with squamous cell carcinoma of the anal canal.

  8. Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

    International Nuclear Information System (INIS)

    Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

    2013-01-01

    Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose–volume histogram (DVH) doses were consistently lower. The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques

  9. 20 years of experience in the treatment of epidermoid carcinoma of anal canal

    International Nuclear Information System (INIS)

    Torres, M.

    2010-01-01

    Objectives: An experimental, longitudinal, prospective and descriptive study was designed (Phase II) with the purpose to evaluate the efficacy of concomitant chemoradiotherapy in local control, toxicity and survival squamous cell carcinoma Anal Canal. Material and Methods: Between 01/01/1989 and 31/12/2008, 120 consecutive patients were treated who had not received any cancer treatment, and did not show neoplasia simultaneously and all were HIV (-). The average age was 59.3 years (Range 34-74) and 80% were females; the performance status was 0-2 ECOG and the TNM (AJCC) classification in the distributed: T1, 36 (30%); T2, 43 (36%); T3 17 (14%); T4, 24 (20%); N0, 86 (72%); N1, 24 (20%); N2, 5 (4%); N3, 5 (4%); M0, 120 (100%). Radiotherapy megavoltage photons used as recommended ICRU-50 (GTV, CTV, PTV); a conventional fractionation was used with fractions 1.8 Gy daily, 5 times per week until 50.40 Gy, using multiple fields ( b ox technique ) ; CDDP chemotherapy was administered, 75 mg / m2 i / v 1 and 24 and 5-FU, 1000 mg / m2 continuous infusion i / v on days 1-5, and 24-28 the course of radiotherapy. The monitoring and the objective of the evaluation was performed according to the RTOG / EORTC and the Kaplan-Meyer recommendations. Results: Local control was : complete remission, 84%; partial remission, 2%; lesional stabilization, 6%; lesion progression, 8%; toxicity was cutaneous, gastrointestinal, and peripheral haematological, grades 2 and 3, and primarily acute neuropathy; There were no deaths due to the combined proceeding or increase colostomies. Survival Overall at 5, 10, 15 and 20 years it was 80%, 75%, 72% and 72% respectively. Conclusions: 1)The results of our study are comparable to those reported in the international literature; 2) Reconsider the current indications of the radiotherapy ( s plit-course, boost, total dose ) and chemotherapy ( i nduction adjuvant, new drugs ) ; 3) The concomitant radiochemotherapy remains the treatment universally accepted

  10. Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

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    Maurilio Toscano de Lucena

    2010-06-01

    Full Text Available Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses. Houve predomínio do gênero feminino (81,5% dos pacientes. A idade variou de 33 a 83 anos (média de 59 anos. O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6% dos casos. Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61% dos pacientes com carcinoma de células escamosas. O índice de resposta inicial completa foi de 89,8%. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (pObjectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients

  11. The prognostic value of HPV status and p16 expression in patients with carcinoma of the anal canal.

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    Gloria B Roldán Urgoiti

    Full Text Available BACKGROUND: In anal cancer studies, the detection frequency of high-risk HPV (human papillomavirus is variable, depending on the method used. There are limited data reporting results of different HPV detection techniques in the same clinical series, and very few correlating results with clinical outcome. OBJECTIVES: To evaluate tumor expression of p16/HPV16 using three different methods, and to determine their association with clinical outcome in patients with anal canal squamous cell carcinomas (SCC. DESIGN: This retrospective study included patients with anal canal SCC treated with definitive radiotherapy or chemoradiotherapy at a single institution between 1992 and 2005. Formalin-fixed paraffin-embedded tumor samples from 53 of the 89 (60% patient pre-treatment biopsies were adequate for tissue microarray construction. HPV status was determined using: p16 expression by conventional immunohistochemistry (IHC and quantitative IHC (AQUA, HPV genotype analysis by chromogenic in situ hybridization (CISH and HPV linear array sub-typing. Expression status was correlated with clinical outcome. RESULTS: 80% (28/35 of patient tumors had high p16 expression using conventional IHC. HPV16 CISH was positive in 81% (34/42 of tumors, and 78% (28/36 of tumors were HPV subtype 16. HPV16 CISH correlated with p16 evaluated by conventional IHC (correlation coefficient 0.46; p = 0.01 and by p16 AQUA score (correlation coefficient 0.49; p = 0.001. A subset of cases (15% had very high p16 quantitative IHC scores (>244 and were associated with a higher incidence of local or distant recurrence (p = 0.04. CONCLUSIONS: The vast majority (80% of anal canal SCC in our series were positive for HPV16/p16, regardless of the testing method used. The exploratory analysis of automated quantitative IHC scoring was the only technique to define a subset of patients with a worse prognosis by p16 expression status on univariate analysis. Further exploration of the molecular

  12. Chemotherapy and low-dose radiotherapy in the treatment of HIV-infected patients with carcinoma of the anal canal

    International Nuclear Information System (INIS)

    Peddada, Anuj V.; Smith, Damon E.; Rao, Aroor R.; Frost, Daniel B.; Kagan, A. Robert

    1997-01-01

    Purpose: To determine the efficacy and tolerance of a standardized protocol of chemotherapy and low-dose radiotherapy in the treatment of anal cancer in human immunodeficiency virus (HIV)-infected patients. Methods and Materials: Between 1987 and 1995, eight HIV-positive patients with squamous cell carcinoma of the anal canal, four of whom had acquired immunodeficiency syndrome (AIDS), received therapy at the Kaiser Permanente Medical Center. All patients were treated using a combined modality approach consisting of lowdose radiotherapy (30 Gy in 15 fractions delivered 5 days/week), and chemotherapy [1000 mg/m 2 of 5-fluorouracil (5-FU) delivered on days 1-4 and 29-32 as a continuous infusion over 96 h, and 10 mg/m 2 of mitomycin C delivered as a bolus injection on day 1]. Patients have been followed from 4 to 81 months (mean 41, median 38). Results: All eight patients completed the therapy with minor variations to the protocol, and all have attained a clinical complete response. Four patients are alive and free of disease, and four died as a result of complications of AIDS, but remained free of anal carcinoma. There were no mortalities from the protocol and the morbidity was acceptable. Only one patient each was noted to have Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Grade 4 hematologic and gastrointestinal acute toxicity, and no Grade 4 skin toxicity was noted. Conclusion: This combined therapy is effective for HIV-infected patients and appears to be tolerable with acceptable toxicities. It is best applied to patients who are HIV positive, or who have AIDS without concurrent major opportunistic infections. This approach is reasonable and affords patients a reasonably good chance at sphincter preservation by avoiding abdominoperineal resection. The optimal therapy for HIV-positive patients with advanced AIDS remains less well defined

  13. Human papillomavirus genotyping and p16 expression as prognostic factors for patients with American Joint Committee on Cancer stages I to III carcinoma of the anal canal

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Skovrider-Ruminski, Wojciech

    2014-01-01

    -specific survival (DSS) in patients diagnosed with American Joint Committee on Cancer (AJCC) stages I to III carcinoma of the anal canal. PATIENTS AND METHODS: HPV genotyping polymerase chain reaction (high-risk subtypes 16, 18, 31, 33, 45, 52, and 58) and immunohistochemical expression of p16 were analyzed......, p16 status, sex, T stage, N stage, and treatment, p16 positivity remained an independent prognostic factor for OS (hazard ratio [HR], 0.07; 95% CI, 0.01 to 0.61; P=.016) and DSS (HR, 0.07; 95% CI, 0.01 to 0.53; P=.011). CONCLUSION: p16 positivity is an independent prognostic factor for OS and DSS...... in patients with AJCC stages I to III carcinoma of the anal canal....

  14. Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study.

    Science.gov (United States)

    Apinorasethkul, Ontida; Lenards, Nishele; Hunzeker, Ashley

    2016-01-01

    The purpose of this case study is to communicate a technique on treating the re-irradiation of squamous cell carcinoma (SCC) of anal canal with proton fields matched with electron fields to spare prostatic urethra. A 76-year old male presented with a secondary radiation-induced malignancy as a result of prostate brachytherapy seeds irradiation 10 years prior. A rectal examination revealed a bulky tumor at the top of the anal canal involving the left superior-most aspect of the anal canal extending superiorly into the rectum. The inferior extent was palpable approximately 3cm from the anal verge and the superior extent of the mass measured greater than 5cm in the superior-inferior dimension. Chemoradiation was suggested since the patient was opposed to abdominoperineal resection (APR) and colostomy. The use of proton therapy matching with electron fields in the re-irradiation setting could help reduce the complications. A 2 lateral proton beams were designed to treat the bulky tumor volume with 2 electron beams treating the nodal volumes. This complication of treatment fields helped spare the prostatic urethra and reduced the risk of urinary obstruction in the future. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  15. Radiochemotherapy of locally advanced anal canal carcinoma: Prospective assessment of early impact on the quality of life (randomized trial ACCORD 03)

    International Nuclear Information System (INIS)

    Tournier-Rangeard, Laetitia; Mercier, Mariette; Peiffert, Didier; Gerard, Jean-Pierre; Romestaing, Pascale; Lemanski, Claire; Mirabel, Xavier; Pommier, Pascal; Denis, Bernard

    2008-01-01

    Background and purpose: The aim of this study was to prospectively assess the quality of life (QOL) of patients treated by concomitant chemo radiation for locally advanced anal canal carcinoma. Materials and methods: We report on a subgroup of 119 patients enrolled in a 306-patient therapeutic intensification prospective trial (ACCORD 03). This trial evaluated the impact on colostomy-free survival of induction chemotherapy and/or high dose radiotherapy (factorial design 2 * 2 treatment arms). QOL was assessed both before and 2 months after treatment using the EORTC QLQ-C30 questionnaire as well as a questionnaire relating to anal sphincter conservative treatment (AS-CT). Results: Compared to pre-treatment scores, patients reported significant improvement in their emotional function (+8.4 points p = 0.002), global health status (+5.9 points p = 0.0007), as well as a decrease in insomnia (-13.8 points p < 0.0001), constipation (-12.0 points p < 0.0001), appetite loss (-10.3 points p < 0.0001) and pain (-9.6 points p = 0.0002). The AS-CT degree of satisfaction with intestinal functions score was increased (+11.2 points p < 0.0001). Conclusion: This is the first prospective study comparing QOL of patients with advanced anal canal carcinoma, before and 2 months after conservative treatment. Two months after treatment, QOL was improved. Induction chemotherapy and/or high dose radiotherapy did not provide a negative impact on QOL

  16. Definitive treatment of anal canal carcinoma with radiotherapy: Adverse impact of a pre-radiation resection. A retrospective study of 57 patients treated with curative intent

    International Nuclear Information System (INIS)

    Coquard, R.; Cenni, J.C.; Artru, P.; Lledo, G.; Chalabreysse, P.; Queneau, P.E.; Taieb, S.; Alessio, A.

    2009-01-01

    Purpose To describe retrospectively the overall survival, the cancer specific survival and the tumor control in an homogeneous series of patients with epidermoid carcinoma of the anal canal treated with definitive radiotherapy; to assess the impact of brachytherapy, chemotherapy and pre-radiotherapy resection on the risk of recurrence. Patients and methods From 1997 to 2007, 57 patients (pts) presenting with an epidermoid carcinoma of the anal canal (T1: 14, T2: 33, T3-4: 10, N0: 31, N1: 19, N2: 3, N3: 4, M0: 57) were treated with definitive radiotherapy by the same radiation oncologist. The treatment included an external beam irradiation (E.B.R.T.) given to the posterior pelvis (45 Gy/25 fractions) and, six weeks later, a boost delivered with interstitial brachytherapy (37/57) or external beam irradiation (20/57). Twelve pts had undergone a surgical resection of the tumour before radiotherapy. A belly board was used for E.B.R.T. in 13 pts. A concurrent platinum based chemotherapy was done in 42 pts. The mean follow-up was 57 months. Results The overall survival rate at 5 years was 89% with a cause specific survival of 96%. Five patients recurred (5-year rate: 12%: four had local relapse (5-year rate: 8%), four had groin recurrence, and distant metastases were seen in two. In univariate analysis, the risk of relapse was higher in patients who had undergone a pre-radiation excision (p = 0.018), in those who did not receive chemotherapy (p = 0.076) and in those who were irradiated on a belly board (p = 0.049). In multivariate analysis, a pre-radiotherapy resection (p = 0.084) had an inverse impact on the tumour control reaching the level of statistical significance and the use of a belly board was of marginal influence (p = 0.13). Conclusion Radiotherapy and chemo radiation with cisplatin-based chemotherapy cure a vast majority of patients with epidermoid carcinoma of the anal canal. Therapeutic factors that may interfere with the definition of the target volume and

  17. Tratamento do carcinoma do canal anal com radioterapia e quimioterapia concomitantes: resultados preliminares do Hospital do Câncer A. C. Camargo

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    Carlos Genésio Bezerra Lima Júnior

    Full Text Available OBJETIVO: Reportar os resultados preliminares do tratamento do carcinoma do canal anal com radioterapia e quimioterapia concomitantes. MÉTODOS: De janeiro de 1992 a maio de 1998, foram tratados 24 pacientes com diagnóstico histológico de carcinoma do canal anal, sendo 18 pacientes do sexo feminino e seis do sexo masculino (3:1. A idade dos mesmos variou de 35 a 74 anos e a média foi de 59 anos. A distribuição do número de pacientes por estádio clínico foi: I - 1, II - 13, III - 9 e IV - 1. A radioterapia foi realizada com dose de 45 Gy na pelve no Acelerador Linear de 4 MV, seguida de complementação de dose no canal anal até 55 Gy através de campo direto no cobalto. A quimioterapia foi realizada com 5-FU (1.000mg/m² em infusão contínua e mitomicina C (10mg/m² em bólus durante os cinco primeiros e os cinco últimos dias da radioterapia. RESULTADOS: O seguimento médio foi de 34 meses. Resposta completa ao tratamento foi obtida em 23 (95,8% pacientes. Quatorze (58,3% estão vivos sem doença, três (12% vivos com doença, cinco (20,8% mortos pelo câncer e um (4,2% morreu sem câncer. Recidivas locais ocorreram em cinco (20,8% pacientes e metástase a distância em quatro (16,6%. A função esfincteriana foi preservada em 18 (75% pacientes. Complicações agudas e crônicas foram observadas em 19 (79,2% e em nove (37,5% pacientes respectivamente. CONCLUSÕES: O tratamento foi efetivo em termos de controle local e preservação esfincteriana, porém com toxicidade aguda e tardia elevadas. Diminuição da dose de radioterapia em toda pelve representa uma estratégia razoável para diminuir os efeitos colaterais agudos e crônicos. Um maior número de pacientes e seguimento mais longo trarão mais informações sobre esta abordagem terapêutica.

  18. Long-term functional outcome of patients treated with chemoradiation therapy for carcinoma of the anal canal

    International Nuclear Information System (INIS)

    Ahmad, Neelofur R.; Nagle, Deborah

    1996-01-01

    PURPOSE: The advent of effective non-operative treatment for anal carcinoma with combined chemotherapy and radiation (CRT) has obviated the need for permanent colostomy in the majority of such patients. However, little is known about the long-term functional outcome of patients treated in this manner. The purpose of this analysis was to assess the outcome, including sphincter function and late toxicity, among anal cancer patients treated with definitive CRT. PATIENTS and METHODS: From 1978 to 1995, 47 anal cancer patients received CRT with curative intent at Thomas Jefferson University Hospital. Radiation (RT) dose to the primary tumor ranged from 30.0 to 72.7 Gy (median 46.8 Gy). RT dose to the pelvis ranged from 30.0 to 45.0 Gy. Chemotherapy consisted of concurrent infusional 5-FU and IV bolus Mitomycin-C. Patient outcome was analyzed with respect to tumor stage and radiation dose. Follow-up time ranged from 7 to 193 months (median 40 months). Actuarial local tumor control (LC), disease-specific survival (DSS) and colostomy + disease-free survival (CDFS) rates were calculated. Sphincter function was assessed among 17 of 20 evaluable patients (alive without colostomy with a minimum follow-up time of 1 year) using the FAIT-F (Version 3) quality of life assessment tool in conjunction with standard continence criteria. RESULTS: Thirty-two patients had Stage I or II disease and 15 had Stage III disease. Twenty-two patients received ≤ 45 Gy of RT and 25 patients received > 45 Gy. Only (3(22)) (14%) of patients receiving ≤ 45 Gy had Stage III disease, compared with(12(25)) (48%) of patients receiving > 45 Gy. The actuarial 5-year patient outcome analysis is summarized below: Overall, (3(47)) (6%) patients required a colostomy following treatment. In 2 patients, salvage abdominal perineal resection (APR) was performed at the time of local failure, and 1 patient who received 65 Gy of RT required a diverting colostomy due to a non-healing anal ulcer following treatment

  19. Nivolumab After Combined Modality Therapy in Treating Patients With High Risk Stage II-IIIB Anal Cancer

    Science.gov (United States)

    2018-03-02

    Anal Basaloid Carcinoma; Anal Canal Cloacogenic Carcinoma; Anal Margin Squamous Cell Carcinoma; Stage II Anal Canal Cancer AJCC v6 and v7; Stage III Anal Canal Cancer AJCC v6 and v7; Stage IIIA Anal Canal Cancer AJCC v6 and v7; Stage IIIB Anal Canal Cancer AJCC v6 and v7

  20. THE USE OF PACLITAXEL IN CHEMORADIOTHERAPY OF PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE ANAL CANAL: A PILOT STUDY

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    S. S. Gordeev

    2016-01-01

    Full Text Available Objectives: to assess the feasibility of a combination of the intensity-modulated radiation therapy (IMRT with a triplet chemotherapy with paclitaxel, capecitabine, and mitomycin C in the treatment of patients with anal cancer, and to evaluate the toxicity of the proposed treatment regimen.Materials and methods. All patients included in the study had stage I–IIIB anal cancer. All patients underwent IMRT radiotherapy 52–58 Gy (the dosage is calculated according T symbol by 1.8 to 2.2 Gy fractions daily. The proposed chemotherapy scheme includes mitomycin C 10 mg/m2 on day 1, paclitaxel 45 mg/m2 on days 3, 10, 17, 24, 31, capecitabine 625 mg/m2 during radiotherapy. A complete response to treatment after 26 weeks, and the compliance to the study protocol were the primary end points of the study.Results. The study included 38 patients. Among patients stage I anal cancer occurred in 1 (2.6 % case, II – in 5 (13.2 %, IIIA – 15 (39.5 % and IIIB – in 17 (44.7 %. A significant deviation from the protocol reported in 6 (15.8 % patients, in 11 (28.9 % patients a slight alteration from the treatment was documented, and 21 (55.3 % patients completed the treatment of chemoradiotherapy with full compliance to the study protocol. The high profile of toxicity (grade III–IV was recorded in 23 (60.5 % patients. An incomplete clinical response at 26 weeks after treatment was reported in 5 (13.2 % patients, one whom continued watchful waiting and achieved complete response at 9 months posttreatment. Median followup was 27 months. 1 patient developed a local recurrence 1 year posttreatment.Conclusions. The proposed triplet chemotherapy regimen using IMRT is feasible and has acceptable toxicity. For further assess the continuous research is needed. 

  1. Seguimento dos doentes soropositivos e soronegativos para o HIV com carcinoma espinocelular do canal anal Follow-up for HIV negative and HIV-positive patients with anal squamous cells carcinoma

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-09-01

    Full Text Available A incidência do carcinoma espinocelular (CEC anal e das neoplasias intra-epiteliais anais (NIA é maior nos pacientes infectados pelo papilomavírus humano (HPV, e está relacionada à imunidade e à infecção pelo vírus da imunodeficiência humana (HIV. A associação com viroses de transmissão sexual indica que seja tumor sexualmente transmitido. A infecção pelo HIV mudou o perfil dos portadores do CEC anal. A doença que anteriormente acometia mulheres na 6ª década de vida, hoje atinge preferencialmente homens na 3ª e 4ª décadas. Nos Estados Unidos, a expectativa de diagnóstico desse tumor aumentou de 19/100.000, na época pré-HAART (1992-1995, para 48,3/100.000 no período pós-HAART imediato (1996-1999 e para 78,2/100.000 pessoas por ano, nos anos mais recentes (2000-2003. O tratamento do CEC anal, descrito por Nigro em 1974, combina radio e quimioterapia. Operações de resgate estão indicadas caso haja persistência ou recidiva da doença. Estudos comparando, respectivamente, doentes imunodeprimidos e imunocompetentes vêm mostrado envolvimento linfonodal em 60% e 17%, recidivas em 75% e 6%, boa resposta à radio e quimioterapia em 62% e 85%, toxicidade a esse tratamento em 80% e 30%, e sobrevivência global de 1,4 e 5,3 anos. A contagem sérica baixa de linfócitos T CD4 prediz mau prognóstico. Quando acima de 200/mm³, os resultados são comparáveis aos observados entre os imunocompetentes.Anal squamous cell carcinoma (ASCC and anal intra-epithelial neoplasia (AIN incidences are bigger among human papillomavirus (HPV infections, and are associated to immunity and to HIV infection. These viruses with sexual transmission in association suggested ASCC is a sexually transmitted tumor. HIV infection changed ASCC patient profile. This kind of tumor committed women in theirs sixties, but nowadays, affects mainly men in the third and forth decades of life. In the United States of America, ASCC was diagnosed in 19/100.000, in the

  2. Intensity-Modulated Radiotherapy (IMRT) vs Helical Tomotherapy (HT) in Concurrent Chemoradiotherapy (CRT) for Patients with Anal Canal Carcinoma (ACC): an analysis of dose distribution and toxicities

    International Nuclear Information System (INIS)

    Yeung, Rosanna; McConnell, Yarrow; Warkentin, Heather; Graham, Darren; Warkentin, Brad; Joseph, Kurian; Doll, Corinne M

    2015-01-01

    Intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) have been adopted for radiotherapy treatment of anal canal carcinoma (ACC) due to better conformality, dose homogeneity and normal-tissue sparing compared to 3D-CRT. To date, only one published study compares dosimetric parameters of IMRT vs HT in ACC, but there are no published data comparing toxicities. Our objectives were to compare dosimetry and toxicities between these modalities. This is a retrospective study of 35 ACC patients treated with radical chemoradiotherapy at two tertiary cancer institutions from 2008–2010. The use of IMRT vs HT was primarily based on center availability. The majority of patients received fluorouracil (5-FU) and 1–2 cycles of mitomycin C (MMC); 2 received 5-FU and cisplatin. Primary tumor and elective nodes were prescribed to ≥54Gy and ≥45Gy, respectively. Patients were grouped into two cohorts: IMRT vs HT. The primary endpoint was a dosimetric comparison between the cohorts; the secondary endpoint was comparison of toxicities. 18 patients were treated with IMRT and 17 with HT. Most IMRT patients received 5-FU and 1 MMC cycle, while most HT patients received 2 MMC cycles (p < 0.01), based on center policy. HT achieved more homogenous coverage of the primary tumor (HT homogeneity and uniformity index 0.14 and 1.02 vs 0.29 and 1.06 for IMRT, p = 0.01 and p < 0.01). Elective nodal coverage did not differ. IMRT achieved better bladder, femoral head and peritoneal space sparing (V30 and V40, p ≤ 0.01), and lower mean skin dose (p < 0.01). HT delivered lower bone marrow (V10, p < 0.01) and external genitalia dose (V20 and V30, p < 0.01). Grade 2+ hematological and non-hematological toxicities were similar. Febrile neutropenia and unscheduled treatment breaks did not differ (both p = 0.13), nor did 3-year overall and disease-free survival (p = 0.13, p = 0.68). Chemoradiotherapy treatment of ACC using IMRT vs HT results in differences in dose homogenity and

  3. Rare case of gastrointestinal stromal tumor of the anal canal

    Directory of Open Access Journals (Sweden)

    Madhu Kumar

    2013-01-01

    Full Text Available Gastrointestinal stromal tumor (GIST is a rare mesenchymal neoplasm of the gastrointestinal tract. GIST of anal canal is very rare representing only 3% of all anorectal mesenchymal tumors. We report an extremely rare case of GIST of the anal canal in 60-years-old man with history of irregular bowel habits with dark colored stool mixed with blood and constipation from 6 month. Diagnosis was made on the basis of histomorphological and immunohistochemical examination.

  4. The impact of gap duration on local control in anal canal carcinoma treated by split-course radiotherapy and concomitant chemotherapy

    International Nuclear Information System (INIS)

    Weber, Damien C.; Kurtz, John M.; Allal, Abdelkarim S.

    2001-01-01

    Purpose: To investigate the potential benefit of reducing the intersequence gap in patients with anal cancer treated with split-course chemoradiotherapy. Methods: The study group consisted of 90 patients with anal squamous carcinoma treated between 1981 and 1998, using concomitant chemotherapy (CT) and radiation (RT). Median age was 65 years (range 41-87). RT was delivered in a split course, with a median gap of 37.5 days (range 4-97) between sequences. First (pelvic) sequence delivered a median dose of 40 Gy (range 36-50.4), using AP/PA megavoltage photon beams. Boost treatment (median dose 20 Gy, range 13-26) consisted of either Iridium-192 implantation (49 patients) or external beam RT (41 patients). CT consisted of 1-2 cycles of a 5-day continuous infusion of 5-fluorouracil and bolus mitomycin C, usually administered during the first week of each RT course. Median follow-up was 76.2 months. Univariate and multivariate analyses were performed to determine the factors associated with locoregional control (LRC). Results: Five-year actuarial LRC was 72.5%. Factors associated with poorer LRC (univariate) were: age ≤65, male gender, and gap >37.5 days. Number of CT cycles (1 vs. 2 or more), boost technique (brachytherapy vs. external), and T-stage were not significantly associated with LRC. In multivariate analysis, only age (p=0.01), and gap (p=0.02) retained their significance. In patients older than 65 years, LRC was 92.3% and 75% for shorter and longer gaps, respectively. In younger patients, the corresponding values for LRC were 73.7% and 50%. Conclusion: In anal cancers, split-course RT with >50 Gy dose delivery is difficult to avoid because of acute toxicity. The present analysis suggests that shortening the gap contributes to optimizing LRC. Gaps longer than 5 weeks correlated with poorer LRC, with especially unsatisfactory results observed in younger patients

  5. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid

    2015-01-01

    the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...

  6. Gastrointestinal stromal tumor of the anal canal: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Chhanda Das

    2017-01-01

    Full Text Available Gastrointestinal stromal tumors (GISTs are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common site is stomach, followed by small intestine, colon, and esophagus. However, GIST from the anal canal is an extremely rare tumor. Here, we report an extremely rare case of GIST of the anal canal in a 40-year-old female with a history of irregular bowel habits mixed with blood and constipation for 4 months. Diagnosis was made on the basis of histopathological and immunohistochemical examination.

  7. Familial Peters Plus syndrome with absent anal canal, sacral ...

    African Journals Online (AJOL)

    Here we report an 8 month old boy with typical features of Peters Plus syndrome including eye anomalies, dysmorphic features, global developmental delay, growth retardation, bilateral talipes equinovarus, complex renal anomalies, absent anal canal, sacral agenesis and sensorineural hearing loss. To our knowledge, the ...

  8. Value of conventional cytology in the presence of macroscopic lesions of the anal canal

    OpenAIRE

    Barcellos, Lêda Pereira de; Russomano, Fábio; Coutinho, José Ricardo Hildebrandt

    2014-01-01

    OBJECTIVES: To verify the value of conventional cytology for the diagnosis of macroscopic lesions of the anal canal and to describe the limitations of the samples.METHOD: We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive) and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination.RESULTS: Of the total, 91.6% of samples were classified as adequate. Cellular elemen...

  9. Intensity-modulated radiation therapy for anal carcinoma

    International Nuclear Information System (INIS)

    Peiffert, D.; Moreau-Claeys, M.V.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V.

    2011-01-01

    Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

  10. Prevenção e diagnóstico de lesões HPV induzidas e carcinoma anal em mulheres atendidas na rede básica de saúde da cidade de Botucatu pelo método escovado do canal anal

    OpenAIRE

    Lusoli, Rita de Cássia [UNESP

    2013-01-01

    O Papiloma Vírus Humano (HPV), é considerado um problema mundial de saúde pública, sendo a doença sexualmente transmissível mais prevalente. Guarda uma relação direta com o risco e a incidência do câncer do canal anal. Seu diagnóstico, tratamento e seguimento são de extrema importância. Neste sentido o escovado do canal anal tem um papel fundamental no rastreamento e seguimento das lesões HPV induzidas e consequente evolução para o câncer anal. Determinar a ocorrência de lesão HPV induzida em...

  11. Anal canal duplication and triplication: a rare entity with different presentations.

    Science.gov (United States)

    Palazon, P; Julia, V; Saura, L; de Haro, I; Bejarano, M; Rovira, C; Tarrado, X

    2017-05-01

    Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication. Its treatment should be surgical excision, to avoid complications such as abscess, fistulization, or malignization. Anal canal triplication has never been described before.

  12. Cortical evoked potentials in response to rapid balloon distension of the rectum and anal canal

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2014-01-01

    healthy women received 30 RBDs in the rectum and the anal canal at intensities corresponding to sensory and unpleasantness thresholds, and response was recorded as cortical evoked potentials (CEPs) in 64-channels. The anal canal stimulations at unpleasantness level were repeated after 4 min to test...... the within-day reproducibility. CEPs were averaged, and to overcome latency variation related to jitter the spectral content of single sweeps was also computed. KEY RESULTS: Repeated stimulation of the anal canal generated CEPs with similar latencies but smaller amplitudes compared to those from the rectum...

  13. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    Falk, Alexander Tuan; Claren, Audrey; Benezery, Karen; François, Eric; Gautier, Mathieu; Gerard, Jean-Pierre; Hannoun-Levi, Jean-Michel

    2014-01-01

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  14. Dosimetric comparison of IMRT rectal and anal canal plans generated using an anterior dose avoidance structure

    Energy Technology Data Exchange (ETDEWEB)

    Leicher, Brian, E-mail: bleicher@wpahs.org [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA (United States); Day, Ellen [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA (United States); Colonias, Athanasios; Gayou, Olivier [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA (United States); Drexel University College of Medicine, Allegheny Campus, Philadelphia, PA (United States)

    2014-10-01

    To describe a dosimetric method using an anterior dose avoidance structure (ADAS) during the treatment planning process for intensity-modulated radiation therapy (IMRT) for patients with anal canal and rectal carcinomas. A total of 20 patients were planned on the Elekta/CMS XiO treatment planning system, version 4.5.1 (Maryland Heights MO) with a superposition algorithm. For each patient, 2 plans were created: one employing an ADAS (ADAS plan) and the other replanned without an ADAS (non-ADAS plan). The ADAS was defined to occupy the volume between the inguinal nodes and primary target providing a single organ at risk that is completely outside of the target volume. Each plan used the same beam parameters and was analyzed by comparing target coverage, overall plan dose conformity using a conformity number (CN) equation, bowel dose-volume histograms, and the number of segments, daily treatment duration, and global maximum dose. The ADAS and non-ADAS plans were equivalent in target coverage, mean global maximum dose, and sparing of small bowel in low-dose regions (5, 10, 15, and 20 Gy). The mean difference between the CN value for the non-ADAS plans and ADAS plans was 0.04 ± 0.03 (p < 0.001). The mean difference in the number of segments was 15.7 ± 12.7 (p < 0.001) in favor of ADAS plans. The ADAS plan delivery time was shorter by 2.0 ± 1.5 minutes (p < 0.001) than the non-ADAS one. The ADAS has proven to be a powerful tool when planning rectal and anal canal IMRT cases with critical structures partially contained inside the target volume.

  15. Dosimetric comparison of IMRT rectal and anal canal plans generated using an anterior dose avoidance structure

    International Nuclear Information System (INIS)

    Leicher, Brian; Day, Ellen; Colonias, Athanasios; Gayou, Olivier

    2014-01-01

    To describe a dosimetric method using an anterior dose avoidance structure (ADAS) during the treatment planning process for intensity-modulated radiation therapy (IMRT) for patients with anal canal and rectal carcinomas. A total of 20 patients were planned on the Elekta/CMS XiO treatment planning system, version 4.5.1 (Maryland Heights MO) with a superposition algorithm. For each patient, 2 plans were created: one employing an ADAS (ADAS plan) and the other replanned without an ADAS (non-ADAS plan). The ADAS was defined to occupy the volume between the inguinal nodes and primary target providing a single organ at risk that is completely outside of the target volume. Each plan used the same beam parameters and was analyzed by comparing target coverage, overall plan dose conformity using a conformity number (CN) equation, bowel dose-volume histograms, and the number of segments, daily treatment duration, and global maximum dose. The ADAS and non-ADAS plans were equivalent in target coverage, mean global maximum dose, and sparing of small bowel in low-dose regions (5, 10, 15, and 20 Gy). The mean difference between the CN value for the non-ADAS plans and ADAS plans was 0.04 ± 0.03 (p < 0.001). The mean difference in the number of segments was 15.7 ± 12.7 (p < 0.001) in favor of ADAS plans. The ADAS plan delivery time was shorter by 2.0 ± 1.5 minutes (p < 0.001) than the non-ADAS one. The ADAS has proven to be a powerful tool when planning rectal and anal canal IMRT cases with critical structures partially contained inside the target volume

  16. Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

    OpenAIRE

    Corti, Marcelo; Villafañe, María F.; Marona, Esteban; Lewi, Daniel

    2012-01-01

    Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain,...

  17. Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure : A Prospective Study with Long-Term Follow-Up

    NARCIS (Netherlands)

    de Jong, Johannes S.; Beukema, Jannet C.; van Dam, Gooitzen M.; Slart, Riemer; Lemstra, Clara; Wiggers, Theo

    2010-01-01

    Background. Selection of patients with anal cancer for groin irradiation is based on tumor size, palpation, ultrasound, and fine needle cytology. Current staging of anal cancer may result in undertreatment in small tumors and overtreatment of large tumors. This study reports the feasibility of the

  18. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Durot, Carole; Hoeffel, Christine [Dept. of Radiology, Centre Hospitalo-Universitaire de Reims, Reims (France); Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe [Dept. of Abdominal Imaging, Hopital Lariboisiere-APHP, Paris(France); Servois, Vincent [Dept. of Radiology and Nuclear Medicine, Institut Curie, Paris (France)

    2017-11-15

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.

  19. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    International Nuclear Information System (INIS)

    Durot, Carole; Hoeffel, Christine; Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe; Servois, Vincent

    2017-01-01

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases

  20. Anal Canal Cancer: Management of Inguinal Nodes and Benefit of Prophylactic Inguinal Irradiation (CORS-03 Study)

    International Nuclear Information System (INIS)

    Ortholan, Cécile; Resbeut, Michel; Hannoun-Levi, Jean-Michel; Teissier, Eric; Gerard, Jean-Pierre; Ronchin, Philippe; Zaccariotto, Audrey; Minsat, Mathieu; Benezery, Karen; François, Eric; Salem, Naji; Ellis, Steve; Azria, David; Champetier, Cédric; Gross, Emmanuel; Cowen, Didier

    2012-01-01

    Purpose: To evaluate the benefit of prophylactic inguinal irradiation (PII) in anal canal squamous cell carcinoma (ASCC). Methods and Materials: This retrospective study analyzed the outcome of 208 patients presenting with ASCC treated between 2000 and 2004 in four cancer centers of the south of France. Results: The population study included 35 T1, 86 T2, 59 T3, 20 T4, and 8 T stage unknown patients. Twenty-seven patients presented with macroscopic inguinal node involvement. Of the 181 patients with uninvolved nodes at presentation, 75 received a PII to a total dose of 45–50 Gy (PII group) and 106 did not receive PII (no PII group). Compared with the no PII group, patients in the PII group were younger (60% vs. 41% of patients age 2 toxicity of the lower extremity was observed. Conclusion: PII with a dose of 45 Gy is safe and highly efficient to prevent inguinal recurrence and should be recommended for all T3-4 tumors. For early-stage tumors, PII should also be discussed, because the 5-year inguinal recurrence risk remains substantial when omitting PII (about 10%).

  1. Prognostic impact of tumour burden assessed by metabolic tumour volume on FDG PET/CT in anal canal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gauthe, Mathieu [Institut Curie, Medecine Nucleaire, Saint-Cloud (France); Hopital Tenon, Medecine Nucleaire, Paris (France); Richard-Molard, Marion [Institut Curie, Radiotherapie, Saint-Cloud (France); Fayard, Juliette; Cacheux, Wulfran [Institut Curie, Oncologie Medicale, Saint-Cloud (France); Alberini, Jean-Louis [Institut Curie, Medecine Nucleaire, Saint-Cloud (France); Lievre, Astrid [Institut Curie, Oncologie Medicale, Saint-Cloud (France); CHU Pontchaillou, Service des Maladies de l' Appareil Digestif, Rennes (France); Universite Rennes 1, Rennes (France)

    2017-01-15

    The aim of this study was to confirm the prognostic value of metabolic tumour volume (MTV) at the primary site on initial work-up FDG PET/CT in patients with squamous cell carcinoma (SCC) of the anal canal. Patients with a recent diagnosis of SCC of the anal canal without metastases undergoing PET/CT for initial work-up and treated with (chemo)radiotherapy were retrospectively reviewed. Computer-aided MTV and SUVmax were determined. Survival rates were estimated using the Kaplan-Meier method. Cox regression analysis was used to evaluate prognostic variables of progression-free survival and overall survival (OS). The study group comprised 75 patients who had an initial work-up PET/CT. Five patients (6.7 %) had stage I disease, 22 (29.3 %) stage II disease, 20 (26.7 %) stage IIIA disease, and 28 (37.3 %) stage IIIB disease. Median follow-up was 51 months (range 10 - 117 months). Global 4-year OS was 82.7 %, ranging from 100 % in patients with stage I disease to 75 % in patients with stage IIIB disease. MTV at the primary site was significantly and independently correlated with OS (p < 0.05), as patients with MTV less than 7 cm{sup 3} had a better prognosis. SUVmax was not correlated with survival parameters. Metabolic involvement of the inguinal lymph nodes was also correlated with a poor outcome in the univariate analysis (p < 0.05). MTV at the primary site is a prognostic biomarker in anal canal cancer. Hypermetabolic inguinal lymph nodes also appear to be correlated with survival. (orig.)

  2. Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat.

    Science.gov (United States)

    Sudharsanan, Sundaramurthi; Vijayakumar, Chellappa; Manish, Kumar; Elamurugan, T P; Manwar, Ali S

    2017-07-13

    Gas gangrene is one of the most serious infections of traumatic and surgical wounds. The importance lies in the fact that, if not managed at the right time, the condition is fatal. Though perianal cellulitis and gangrene are commonly reported in immunocompromised patients, we report the case of a patient with gas gangrene involving only the anal canal extending to the rectum, a rare presentation to be reported in literature.  An 18-year-old lady, a patient of aplastic anaemia - immunodeficiency, developed gas gangrene of the anal canal possibly due to faecal contamination of anal fissures. The patient was managed with surgical debridement and intravenous antibiotics.  The clinical manifestations of gas gangrene are due to the liberation of toxins by Clostridium perfringens. The infection spreads rapidly and results in necrosis and devitalisation of tissues, unless intervened surgically. The clinical manifestations are more rapid and a high index of suspicion is needed for the diagnosis.

  3. Anal carcinoma and HIV infection: is it time for screening?

    Science.gov (United States)

    Herranz-Pinto, P; Sendagorta-Cudós, E; Bernardino-de la Serna, J I; Peña-Sánchez de Rivera, J M

    2014-03-01

    A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented? Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-09-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  5. Primary radiation therapy in the treatment of anal carcinoma

    International Nuclear Information System (INIS)

    Cantril, S.T.; Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-01-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N 0 patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease

  6. Evaluation of radiotherapy and chemoradiotherapy for anal canal epidermoid cancer in our center

    International Nuclear Information System (INIS)

    Obara, Kunihiko; Sahara, Rikisaburo; Yamana, Tetsuro; Okamoto, Kinya; Takahashi, Tomoko; Furukawa, Satomi; Okada, Daisuke; Kaneko, Yasushi; Matsumoto, Atsuo

    2008-01-01

    The efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT) for anal canal epidermoid cancer were evaluated. Twenty-four patients with anal canal epidermoid cancer were treated in our center between 1988 and 2006, consisting of 13 patients treated by RT and 11 by CRT. In these patients, the efficacy and safety of RT and CRT were evaluated in terms of adverse events, 5-year local control rates, 5-year disease-free survival rates, and 5-year survival rates. No grade 3 or higher adverse events were noted in patients receiving RT. In contrast, anorexia, diarrhea, neutropenia, and anemia were observed in 33.3%, 10%, 33.3%, and 10%, respectively, of the patients receiving CRT. The anal preserving rate, 5-year local control rate, 5-year disease-free survival rate, and 5-year survival rate were 66.7%, 73%, 77.5%, and 88.4%, respectively. RT and CRT for anal canal epidermoid cancer should be first-line treatments because of their safety and efficacy. (author)

  7. RTOG 0529: A Phase 2 Evaluation of Dose-Painted Intensity Modulated Radiation Therapy in Combination With 5-Fluorouracil and Mitomycin-C for the Reduction of Acute Morbidity in Carcinoma of the Anal Canal

    Energy Technology Data Exchange (ETDEWEB)

    Kachnic, Lisa A., E-mail: lisa.kachnic@bmc.org [Department of Radiation Oncology, Boston University Medical Center, Boston, Massachusetts (United States); Winter, Kathryn [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Myerson, Robert J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Goodyear, Michael D. [Department of Medicine, Dalhousie University, Halifax (Canada); Willins, John [Department of Radiation Oncology, Boston University Medical Center, Boston, Massachusetts (United States); Esthappan, Jacqueline [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Rotman, Marvin [Department of Radiation Oncology, State University of New York—Downstate Medical Center, Brooklyn, New York (United States); Parikh, Parag J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Safran, Howard [Department of Medicine, Brown University, Providence, Rhode Island (United States); Willett, Christopher G. [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States)

    2013-05-01

    Purpose: A multi-institutional phase 2 trial assessed the utility of dose-painted intensity modulated radiation therapy (DP-IMRT) in reducing grade 2+ combined acute gastrointestinal and genitourinary adverse events (AEs) of 5-fluorouracil (5FU) and mitomycin-C (MMC) chemoradiation for anal cancer by at least 15% compared with the conventional radiation/5FU/MMC arm from RTOG 9811. Methods and Materials: T2-4N0-3M0 anal cancer patients received 5FU and MMC on days 1 and 29 of DP-IMRT, prescribed per stage: T2N0, 42 Gy elective nodal and 50.4 Gy anal tumor planning target volumes (PTVs) in 28 fractions; T3-4N0-3, 45 Gy elective nodal, 50.4 Gy ≤3 cm or 54 Gy >3 cm metastatic nodal and 54 Gy anal tumor PTVs in 30 fractions. The primary endpoint is described above. Planned secondary endpoints assessed all AEs and the investigator’s ability to perform DP-IMRT. Results: Of 63 accrued patients, 52 were evaluable. Tumor stage included 54% II, 25% IIIA, and 21% IIIB. In primary endpoint analysis, 77% experienced grade 2+ gastrointestinal/genitourinary acute AEs (9811 77%). There was, however, a significant reduction in acute grade 2+ hematologic, 73% (9811 85%, P=.032), grade 3+ gastrointestinal, 21% (9811 36%, P=.0082), and grade 3+ dermatologic AEs 23% (9811 49%, P<.0001) with DP-IMRT. On initial pretreatment review, 81% required DP-IMRT replanning, and final review revealed only 3 cases with normal tissue major deviations. Conclusions: Although the primary endpoint was not met, DP-IMRT was associated with significant sparing of acute grade 2+ hematologic and grade 3+ dermatologic and gastrointestinal toxicity. Although DP-IMRT proved feasible, the high pretreatment planning revision rate emphasizes the importance of real-time radiation quality assurance for IMRT trials.

  8. Anal canal cancer: management of inguinal nodes and benefit of prophylactic inguinal irradiation (CORS-03 Study).

    Science.gov (United States)

    Ortholan, Cécile; Resbeut, Michel; Hannoun-Levi, Jean-Michel; Teissier, Eric; Gerard, Jean-Pierre; Ronchin, Philippe; Zaccariotto, Audrey; Minsat, Mathieu; Benezery, Karen; François, Eric; Salem, Naji; Ellis, Steve; Azria, David; Champetier, Cédric; Gross, Emmanuel; Cowen, Didier

    2012-04-01

    To evaluate the benefit of prophylactic inguinal irradiation (PII) in anal canal squamous cell carcinoma (ASCC). This retrospective study analyzed the outcome of 208 patients presenting with ASCC treated between 2000 and 2004 in four cancer centers of the south of France. The population study included 35 T1, 86 T2, 59 T3, 20 T4, and 8 T stage unknown patients. Twenty-seven patients presented with macroscopic inguinal node involvement. Of the 181 patients with uninvolved nodes at presentation, 75 received a PII to a total dose of 45-50 Gy (PII group) and 106 did not receive PII (no PII group). Compared with the no PII group, patients in the PII group were younger (60% vs. 41% of patients age groups. Median follow-up was 61 months. Fourteen patients in the no PII group vs. 1 patient in the PII group developed inguinal recurrence. The 5-year cumulative rate of inguinal recurrence (CRIR) was 2% and 16% in PII and no PII group respectively (p = 0.006). In the no PII group, the 5-year CRIR was 12% and 30% for T1-T2 and T3-T4 respectively (p = 0.02). Overall survival, disease-specific survival, and disease-free survival were similar between the two groups. In the PII group, no Grade >2 toxicity of the lower extremity was observed. PII with a dose of 45 Gy is safe and highly efficient to prevent inguinal recurrence and should be recommended for all T3-4 tumors. For early-stage tumors, PII should also be discussed, because the 5-year inguinal recurrence risk remains substantial when omitting PII (about 10%). Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Anal metastasis from recurrent breast lobular carcinoma: A case report

    Science.gov (United States)

    Puglisi, Maria; Varaldo, Emanuela; Assalino, Michela; Ansaldo, Gianluca; Torre, Giancarlo; Borgonovo, Giacomo

    2009-01-01

    We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later, she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis. According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic. PMID:19294770

  10. FDG-PET/CT imaging for staging and target volume delineation in conformal radiotherapy of anal carcinoma

    International Nuclear Information System (INIS)

    Krengli, Marco; Inglese, Eugenio; Milia, Maria E; Turri, Lucia; Mones, Eleonora; Bassi, Maria C; Cannillo, Barbara; Deantonio, Letizia; Sacchetti, Gianmauro; Brambilla, Marco

    2010-01-01

    FDG-PET/CT imaging has an emerging role in staging and treatment planning of various tumor locations and a number of literature studies show that also the carcinoma of the anal canal may benefit from this diagnostic approach. We analyzed the potential impact of FDG-PET/CT in stage definition and target volume delineation of patients affected by carcinoma of the anal canal and candidates for curative radiotherapy. Twenty seven patients with biopsy proven anal carcinoma were enrolled. Pathology was squamous cell carcinoma in 20 cases, cloacogenic carcinoma in 3, adenocarcinoma in 2, and basal cell carcinoma in 2. Simulation was performed by PET/CT imaging with patient in treatment position. Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) were drawn on CT and on PET/CT fused images. PET-GTV and PET-CTV were respectively compared to CT-GTV and CT-CTV by Wilcoxon rank test for paired data. PET/CT fused images led to change the stage in 5/27 cases (18.5%): 3 cases from N0 to N2 and 2 from M0 to M1 leading to change the treatment intent from curative to palliative in a case. Based on PET/CT imaging, GTV and CTV contours changed in 15/27 (55.6%) and in 10/27 cases (37.0%) respectively. PET-GTV and PET-CTV resulted significantly smaller than CT-GTV (p = 1.2 × 10 -4 ) and CT-CTV (p = 2.9 × 10 -4 ). PET/CT-GTV and PET/CT-CTV, that were used for clinical purposes, were significantly greater than CT-GTV (p = 6 × 10 -5 ) and CT-CTV (p = 6 × 10 -5 ). FDG-PET/CT has a potential relevant impact in staging and target volume delineation of the carcinoma of the anal canal. Clinical stage variation occurred in 18.5% of cases with change of treatment intent in 3.7%. The GTV and the CTV changed in shape and in size based on PET/CT imaging

  11. Melanoma de canal anal simulando doença hemorroidária: relato de caso Melanoma of the anal canal simulating hemorrhoidal disease: case report

    Directory of Open Access Journals (Sweden)

    Lorena Reuter Motta Gama

    2010-09-01

    Full Text Available O Melanoma Anorretal é um tumor maligno raro com a possibilidade de simular uma doença anorretal, tornando o diagnóstico difícil. Tem baixos índices de cura e elevados índices de mortalidade em curto prazo. Os autores descrevem um caso de melanoma de canal anal cuja interpretação por parte do paciente tratava-se de uma doença hemorroidária que exteriorizava às evacuações. Os autores fazem uma extensa revisão da literatura dando ênfase aos sintomas e a melhor opção terapêutica a ser instituída.Anorectal melanoma is a rare malignant tumor with the small chance of simulating anorectal disease, making the diagnosis hard. There is a low rate of cure and high rate of short term mortality. The authors describe a case of anal melanoma which by the patient's interpretation was hemorrhoid disease that exteriorized evacuations. The authors do an extensive evaluation of the literature, giving emphasis to the symptoms and the best therapeutic option to be used.

  12. Quanto a escova deve ser introduzida no canal anal para avaliação citológica mais eficaz? How deep must the brush be introduced in the anal canal for a more effective cytological evaluation?

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-01-01

    Full Text Available OBJETIVO: A sensibilidade da citologia anal varia amplamente na literatura, entre 45% e 98%, o que pode ocorrer devido à falta de padronização quanto à distância que a escova deve ser introduzida no canal anal. Desta forma, nosso objetivo foi investigar se o local de coleta influencia no resultado desse exame. MÉTODOS: Colhemos amostras com escova introduzida 4 cm no canal anal de 114 doentes (Grupo A e 2 cm em outros 94 pacientes (Grupo B, antes do exame proctológico. Realizamos cinco rotações com a escova antes de retirá-la e a esfregar sobre lâmina de vidro, posteriormente submetida ao exame citopatológico padrão. Todos os doentes são HIV-positivo. Submetemos os resultados à avaliação estatística. RESULTADOS: No Grupo A, 39 doentes possuíam condilomas no canal anal e a citologia foi positiva em 29 deles (74,3%. Também observamos alterações citológicas em 30 de 75 doentes (40% sem lesões clínicas no canal anal. No Grupo B, havia 54 doentes com condilomas no canal anal e em 13 (24,1% houve confirmação citológica. Em 40 outros, sem lesões clínicas pelo HPV, notamos que em nove (22,5% havia anormalidades citológicas. Os testes estatísticos revelaram que os exames realizados nos doentes do Grupo A foram mais eficientes. CONCLUSÃO: Os espécimes coletados com escovas inseridas mais profundamente no canal anal melhoraram a eficácia do exame.OBJECTIVE: In literature, sensitivity of Pap smears ranges widely from 45 to 98%. Possibly this is because there is no standard for how far the brush should be introduced into the anal canal. The aim was to evaluate whether the sampling site has an influence on the results of anal Pap smears. Design and setting. This is a non-randomized, non-blinded, retrospective review carried out in the Proctology and Pathology Sectors, Emilio Ribas Infectious Diseases Institute. METHOD: We obtained specimens with brushes introduced 4 cm into the anal canal in 114 patients (Group A and 2 cm in

  13. Transrectal ultrasound color Doppler in the evaluation of recurrence of anal canal cancer

    International Nuclear Information System (INIS)

    Drudi, Francesco M.; Giovagnorio, Francesco; Raffetto, Nicola; Ricci, Paolo; Cascone, Fiammetta; Santarelli, Mario; Trippa, Francesca; Passariello, Roberto

    2003-01-01

    Objective: aim was to obtain elements for a differential diagnosis between post-radiation fibrosis and residual tumor or local relapse in anal canal cancer through detection of presence/absence of intralesional blood flow. Transrectal ultrasound and color Doppler were compared. Methods: 43 patients underwent transrectal ultrasound sonography and color Doppler before and after therapy to assess intralesional blood flow and flow pattern (spotty and linear signals). All diagnostic imaging results were compared to histological analysis. Specificity was submitted to statistical analysis using McNemar test. Results: before therapy 34 lesions (79%) showed color signal; no signal in 9 (21%), which were excluded from our analysis. Eighteen of the 34 patients considered, presented complete response to therapy, 14 partial response and two no response. After therapy, signal disappeared in 17 patients (94%); one false-positive (6%) presented spotty signals; 16 of 34 patients presented changed color signal. Color Doppler showed higher specificity than grey scale transrectal ultrasound in the differentiation of fibrosis from tumor. Response was confirmed by histological examination, considered gold standard. McNemar test demonstrated the significance of color Doppler (P<0.0001). Conclusion: color Doppler considerably increases transrectal ultrasound specificity in differentiating tumor relapse from fibrosis in anal canal cancer

  14. Resultados do tratamento do carcinoma espinocelular anal e do seu precursor em doentes HIV-positivos Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2007-08-01

    Full Text Available OBJETIVO: A incidência de carcinomas espinocelulares anais vem aumentando nos doentes HIV-positivos. O tratamento consiste de radio e/ou quimioterapia, eventualmente seguidos pela ressecção do tumor. O objetivo é avaliar o seguimento desses doentes para verificar as recidivas e a evolução do NIAA para câncer. Apresentação da casuística da Equipe Técnica de Proctologia do Instituto de Infectologia Emílio Ribas, de São Paulo. MÉTODOS: Acompanhamos 45 doentes HIV-positivos portadores de carcinoma espinocelular anal e seu precursor no período de 1996 a 2006. Eram 30 neoplasias intra-epiteliais anais de alto grau (NIAA, tratadas com ressecção local e 15 carcinomas invasores do canal anal. Nove das 15 lesões invasivas foram submetidas ao esquema de Nigro isolado ou associado à ressecção local, amputação abdominoperineal ou colostomia para derivação. RESULTADOS: No seguimento ambulatorial das NIAA tivemos recidiva em 16,7% e não observamos evolução para carcinoma, num período mínimo de três anos. Entre os nove tumores submetidos ao esquema de Nigro, com ou sem operação complementar, cinco estão livres de tumor. Nenhum tratamento foi feito em cinco doentes. Em três, devido às péssimas condições clínicas, e em dois, pois recusaram tratamento. Outro teve diagnóstico na vigência de oclusão intestinal sendo submetido à colostomia de derivação. CONCLUSÃO: Concluímos que a NIAA pode reincidir após excisão local em doentes HIV-positivos, mas não evolui para carcinoma invasor e que os doentes de câncer anal invasor podem ser tratados da mesma maneira que a população soronegativa para o HIV desde que as condições clínicas o permitam.OBJECTIVE: Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients. Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection. The objective was to evaluate the follow-up of such patients to verify recurrences

  15. Carcinoma epidermoide del margen anal contra calidad de vida

    Directory of Open Access Journals (Sweden)

    Miguel A Reyes Argudín

    Full Text Available La calidad de vida de los pacientes debe tenerse en cuenta. Esta representa el resultado final de la actuación médica desde la perspectiva del paciente. En ocasiones solo nos basamos en este criterio para tomar decisiones terapéuticas ante determinadas enfermedades, como el carcinoma epidermoide de margen anal en estadío terminal. El tratamiento y conducta con fines paliativos tiene como objetivo mejorar la calidad de vida de estas personas. Presentamos el caso de paciente varón de 48 años de edad que acude a consulta por presentar lesión en el ano que no le permitía sentarse y después de realizársele todo el estudio necesario para determinar su diagnóstico definitivo (carcinoma epidermoide de ano evaluarlo y determinar el tratamiento requerido para el grado de la enfermedad, nos percatamos que el tratamiento radical no cambiaba la evolución de su estado y se decide tratamiento paliativo para mejorar la calidad de vida. En ocasiones acuden a consulta pacientes que al culminar su estudio, obtienen el diagnóstico de una enfermedad avanzada y es, a partir de este momento, que nuestro pensamiento médico debe cambiar y encaminar nuestros esfuerzos a mejorar la calidad de vida y no llevarlos a un final tormentoso con el objetivo de revertir la evolución de una enfermedad que no tiene regresión.

  16. Sacral nerve stimulation increases activation of the primary somatosensory cortex by anal canal stimulation in an experimental model.

    LENUS (Irish Health Repository)

    Griffin, K M

    2011-08-01

    Sacral and posterior tibial nerve stimulation may be used to treat faecal incontinence; however, the mechanism of action is unknown. The aim of this study was to establish whether sensory activation of the cerebral cortex by anal canal stimulation was increased by peripheral neuromodulation.

  17. Current therapeutic strategies for anal squamous cell carcinoma in Japan

    International Nuclear Information System (INIS)

    Takashima, Atsuo; Shimada, Yasuhiro; Hamaguchi, Tetsuya

    2009-01-01

    In Western countries, chemoradiotherapy (CRT) is well established as the standard therapy for stages II/III anal squamous cell carcinoma (ASCC). In Japan, the therapeutic modalities for and outcomes of this disease have not been clarified because ASCC is quite rare. The Colorectal Cancer Study Group of the Japan Clinical Oncology Group (JCOG-CCSG) conducted a survey to determine the current therapeutic strategies for ASCC in Japan. In July 2006, a questionnaire was sent to 49 institutions affiliated with the JCOG-CCSG to gather information on numbers of cases, therapeutic modalities, and outcomes. The target subjects were patients with stages II/III ASCC, diagnosed from January 2000 to December 2004, who were 20-80 years of age with normal major organ function and no severe complications. Replies were received from 40 institutions. A total of 59 patients satisfied the subject criteria. Detailed information was obtained for 55 subjects; 25 (45%) had stage II ASCC and 30 (55%) had stage III ASCC. CRT was performed in 25 patients (45%); surgery in 17 (31%); surgery combined with radiotherapy (RT), chemotherapy, or CRT in 8 (15%); and RT in 5 (9%). Complete response rate in CRT was 80% (20/25). The 3-year progression-free survival rates for all subjects and for CRT-only subjects were 67% and 77%, respectively. From 2000 to 2004, only 59 patients with ASCC were identified in the JCOG-CCSG survey and about half of them underwent CRT. (author)

  18. Balloon cell melanoma of the anal canal: A wolf in sheep′s clothing?

    Directory of Open Access Journals (Sweden)

    Munita Meenu Bal

    2013-01-01

    Full Text Available Balloon cell melanoma (BCM is a rare histologic variant of cutaneous malignant melanoma with exceptional reports of occurrences at non-cutaneous sites. Herein we present a case of primary amelanotic BCM of anal canal, a heretofore undescribed location. Histologically, the tumor was characterized by sheets of pale cells that bore striking resemblance to foamy macrophages. Presence of rare atypical mitoses confirmed the malignant nature of the cells. Neoplastic cells were immunoreactive for S100, Melan-A, and focally for HMB-45 while were negative for myogenic, gastrointestinal stromal tumor, epithelial and neuroendocrine markers. Resemblance to foamy macrophages, bland cytology and absence of pigment imparts this tumor a deceptively benign histological appearance making it prone to diagnostic pitfalls. Awareness of this rare entity and judicious employment of immunohistochemistry is imperative in segregating it from its diverse mimics.

  19. Anal canal duplication associated with presacral teratoma in a 5-year old girl

    Directory of Open Access Journals (Sweden)

    Jinyoung Park

    2017-04-01

    Full Text Available This report describes an extremely rare case of anal canal duplication associated with presacral teratoma in a 5-year-old girl who presented with perineal pain and constipation. Abdominopelvic computed tomography (CT revealed a multiloculated heterogeneous mass measuring 5 cm in the presacral area. T2-weighted magnetic resonance imaging (MRI showed a 4.5-cm sized multilocular cystic lesion with high signal intensity. The mass was surgically removed with coccyx. Histologically, the tumor showed components of bronchial and gastrointestinal mucosa, squamous epithelium, cartilage, fibrofatty tissue, and some exocrine glands. The histopathological diagnosis was mature teratoma. Eight months after surgery, the patient is doing well, with no recurrence of tumor.

  20. Rastreamento de lesões precursoras do carcinoma espino-celular anal em indivíduos portadores do HIV Tracking precursor lesions of anal squamous cell carcinoma in individuals with HIV

    Directory of Open Access Journals (Sweden)

    Caio Sergio Rizkallah Nahas

    2011-06-01

    Full Text Available INTRODUÇÃO: O carcinoma espino-celular do canal anal é doença que atinge os adultos de meia idade e corresponde a 4% dos cânceres do trato gastrointestinal baixo. Na população geral a incidência é de 1 em 100.000 habitantes, e entre os homens que fazem sexo com homens essa incidência atinge 35 por 100.000 habitantes, sendo que os portadores de HIV têm esse risco duplicado (70 por 100.000 habitantes. MÉTODO: Foi realizada revisão da literatura com consulta nos periódicos das bases Medline/Pubmed, Scielo e Lilacs cruzando os descritores Rastreamento, Lesões pré-cancerosas, Neoplasias do ânus e HIV. Além da revisão bibliográfica, foi adicionada a este trabalho a experiência pessoal dos autores, e a obtida no Departamento de Gastroenterologia - Divisão Cirúrgica, no ICESP - Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira, no Departamento de Moléstias Infeciosas - Casa da AIDS e no Serviço de Coloproctologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brasil. CONCLUSÕES: HIV+ é um grande fator de risco no desenvolvimento de carcinoma espino-celular anal em indivíduos infectados por HPV. A avaliação desses pacientes não deve se restringir à erradicação de condilomas, mas principalmente incluir o rastreamento de lesões displásicas subclínicas potencialmente neoplásicas. Apesar dos métodos de rastreamento ainda não serem ideais, o grande benefício do rastreamento baseia-se no fato de oferecer acompanhamento rigoroso, tornando possível à prevenção ou detecção cada vez mais precoce do carcinoma espino-celular anal.INTRODUCTION: Squamous cell carcinoma of the anal canal is a disease that affects the middle-aged adults and accounts for 4% of cancers of the gastrointestinal tract below. In the general population the incidence is 1 in 100,000, and among men who have sex with men the incidence is 35 per 100,000 inhabitants, those with HIV have doubled this risk (70 per 100

  1. Metastatic anal sac carcinoma with hypercalcaemia and associated ...

    African Journals Online (AJOL)

    Tulyasys

    2015-05-07

    May 7, 2015 ... carcinoma, prostatic carcinoma, renal carcinoma, renal ... Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy ... treatment. Two months later, the patient again developed hypercalcaemia with severe increase in size of the sublumbar lymph nodes. On physical ...

  2. What drives the number of high-risk human papillomavirus types in the anal canal in HIV-positive men who have sex with men?

    NARCIS (Netherlands)

    del Amo, Julia; González, Cristina; Geskus, Ronald B.; Torres, Montse; del Romero, Jorge; Viciana, Pompeyo; Masiá, Mar; Blanco, Jose R.; Hernández-Novoa, Beatriz; Ortiz, Marta; Peña, Alejandro; García, Federico; Torres, Montserrat; Ocampo, Antonio; Da Silva, Alfredo Rodríguez; Miralles, Celia; Mauricio Iribarren, Gustavo; Madrid, Nadia; Dronda, Fernando; Benito, Amparo; Sanz, Itziar; Vera, Mar; Rodríguez, Carmen; Martín Alegre, Carmen; Carlos Carrió, Juan; Raposo, Montse; Trastoy, Mónica; Fontillón, Maria; Robledano, Catalina; Gutierrez, Félix; Padilla, Sergio; Andrada, Encarna; Cervero, Miguel; Ramón Blanco, José; Pérez, Laura; Portilla, Joaquín; Portilla, Irene; Angel Vonwichmann, Miguel; Antonio Iribarren, José; Camino, Xabier; Sendagorta, Elena; Herranz, Pedro; Rodríguez, Patricia; Luis Gómez, Juan; Rosado, Dacil; Alejos, Belén; Angeles Rodríguez, Maria

    2013-01-01

    We estimated the effect of sexual behavior, age, and immunodeficiency on the number of high-risk human papillomavirus (HR-HPV) types in the anal canal among human immunodeficiency virus-positive men who have sex with men (MSM). Anal samples were genotyped with the Linear Array HPV Genotyping Test,

  3. Impact of therapeutic factors on local control in T2-T3 anal carcinoma treated by radiation or radiochemotherapy

    International Nuclear Information System (INIS)

    Allal, Abdelkarim S.; Mermillod, Bernadette; Kurtz, John M.; Marti, Marc-Claude

    1996-01-01

    Purpose: To investigate the influence of therapeutic parameters on local control in T2-T3 anal carcinoma treated by chemo-radiotherapy or radiation therapy alone. Materials and Methods: From 1976 to 1993, 137 patients with anal carcinoma staged T2 (85) or T3 (52) completed curative sphincter-conservating treatment, 54 with radiotherapy alone and 83 with concomitant chemo-radiotherapy. Radiation therapy was delivered in two sequences with a median gap of 46 days. The two main techniques used for the first sequence were a direct perineal cobalt field ± a sacral arc field with a median dose of 30 Gy/10 fractions/19 days (27.7%) and two antero-posterior opposed pelvic fields (≥ 6 MV photons) with a median dose of 40 Gy/20 fractions/31 days (62%). Iridium-192 implant boost was used in 116 patients (median dose 20 Gy, Paris system) and external radiation boost in 21 patients (median dose 20 Gy/10 fractions/13 days). Generally the chemoradiotherapy patients received starting on day 1 an IV bolus of Mitomycin-C (0.4 mg/kg, maximum 20 mg) and a 5-day continuous infusion of 5-fluorourcil 600-800 mg/m 2 /day. For surviving patients median follow-up was 65 months. Univariate and multivariate analyses were carried out to determine therapeutic parameters affecting local control after adjustment for clinical factors. Results: The 5-year actuarial local control was 77%. Factors associated with a decrease of local control in univariate analysis included: age less than 66 years (67% vs 85%), male gender (65% vs 81%), tumor extension more than (1(3)) circumference of the anal canal (68% vs 90%), lymph node involvement (64% vs 81%), use of external irradiation for the boost (62% vs 79%), and overall treatment time more than 74 days (69% vs 85%). In a multivariate analysis none of the therapeutic parameters remained significant when adjusted for the four significant clinical factors. The only therapeutic factor which might have had an impact was overall treatment time (p = .09

  4. Rapid tumor progression in a patient with HPV type 16 associated anal squamous cell carcinoma suffering from long-standing Crohn's disease: A case report

    Directory of Open Access Journals (Sweden)

    Fischer AK

    2016-10-01

    Full Text Available Background and aim: Squamous cell carcinoma (SCC is the most common cancer of the anal region, typically associated with high-risk (hr HPV infection. Furthermore, there is evidence that Crohn's disease predisposes to adenocarcinoma in patients with perianal disease. Materials and methods: A 57-year old patient presenting with long history of Crohn's disease since the age of mid-twenties, went through several surgeries including ileocolectomy and anal fistula resection, combined with immunosuppressive therapy additionally periodically since 2008. One year before death (in 2015 a painful fistula was diagnosed with extensive high grade anal intraepithelial neoplasia (AIN-HG and evidence of invasive growth as non-keratinizing SCC. Tissue samples from several previous and current resection specimens were re-evaluated and extensively investigated for Crohn´s type inflammation, dysplasia and HPV both by immunohistochemistry (p16/Ki67 and molecular subtyping of HPV. Results: AIN-HG and invasive anal squamous cell carcinoma turned out to be strongly positive for p16/Ki67 staining and molecular analysis disclosed a HPV-16 subtype. In contrast, HPV-analysis was negative in all available previous tissue samples including one anal fistula resected five years before (in 2009 which was lined by non-keratinized squamous epithelium without any evidence of dysplasia. Thus, the patient was diagnosed as Crohn's disease with hr-HPV infection that rapidly (< 5ys progressed to AIN-HG and anal SCC. Finally, osseous metastases occurred and the patient died shortly after. Conclusions: This case of a patient diagnosed with SCC of the anal canal in combination with Crohn's disease as well as HPV Type 16 infection, points to the pathomechanism leading to dysplasia and finally cancer. We assume that immunosuppressive therapy in Crohn's disease may predispose to both persistent HPV infection and HPV related invasive anal carcinoma. The accelerated progression of HPV

  5. Adenoid cystic carcinoma of the external auditory canal

    Directory of Open Access Journals (Sweden)

    Shao-Cheng Liu

    2012-06-01

    Full Text Available Primary cancers of the external auditory canal (EAC are rare and most are squamous cell carcinomas. We report the case of a 78-year-old man who visited our institution with a 5-month history of right-side intermittent otalgia and ear fullness. Otoscopic examination showed a bulging mass arising from the superior and posterior aspects of the right EAC, and incision biopsy confirmed the lesion as adenoid cystic carcinoma (ACC. Lateral temporal bone resectionin conjunction with total parotidectomy and neck dissection was subsequently performed. Postoperative adjuvant radiotherapy was administered and no recurrence was noted at a 26-month follow-up. We review the medical literature on the topic and suggest that early diagnosis is still the best option for successful treatment of this neoplasm. ACC arising in the EACmust be removed using radical procedures to increase the chance of local control. Subsequent metastasis that tends to develop in the lungs and regional lymph nodes is best evaluated regularly using computed tomography examination.

  6. Intensity-modulated conformal radiotherapy in the anal canal cancer. Report of technological assessment. Updating of the 2006 report

    International Nuclear Information System (INIS)

    2015-07-01

    As intensity-modulated conformal radiotherapy (IMCR) has already been technologically assessed in 2006 with a positive opinion for some treatments and a negative one for others, and as this technique displays some interesting properties for the treatment of pelvic cancers (optimisation of dose distribution, preservation of sane tissues, reduction of secondary effects during irradiation), this report proposes an assessment of clinical safety and efficiency of IMCR in the treatment of an anal canal cancer. After a discussion of generalities, of histological and epidemiological data, and of knowledge regarding treatment and follow-up of this cancer, the report presents the IMCR technique, some regulatory aspects, and its applications to the considered cancer. The methodology adopted for this assessment is then presented. Based on various studies and clinical results, the IMCR clinical safety and efficiency in the treatment of the anal canal cancer are discussed and assessed. Recommendations produced by different medical professional bodies are reported. Opinion of experts and a synthesis of stakeholders are then proposed

  7. Elevated risk of human papillomavirus-related second cancers in survivors of anal canal cancer.

    Science.gov (United States)

    Nelson, Rebecca A; Lai, Lily L

    2017-10-15

    Over the last decade, the causal link between human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA) has been well described. Because HPV infection in one site is often associated with other sites of infection, it then follows that patients with SCCA may have an increased risk of additional HPV-related cancers. Identifying and targeting at-risk sites through cancer screening and surveillance may help to guide best practices. The current study sought to ascertain sites and risk of HPV-related second primary malignancies (SPMs) in survivors of SCCA. Using population-based data from 1992 through 2012, the authors identified patients with SCCA and determined their risk of HPV-related SPMs, including anal, oral, and genital cancers. Standardized incidence ratios (SIRs), defined as observed to expected cases, were calculated to determine excess risk. Of 10,537 patients with SCCA, 416 developed HPV-related SPMs, which corresponded to an overall SIR of 21.5 (99% confidence interval [99% CI], 19.0-24.2). Men were found to have a higher SIR (35.8; 99% CI, 30.7-41.6) compared with women (12.8; 99% CI, 10.4-15.5). SIRs for a second SCCA were markedly higher in men (127.5; 99% CI, 108.1-149.2) compared with women (47.0; 99% CI, 34.7-62.1), whereas SIRs for oral cavity and pharyngeal cancers were elevated in men (3.1; 99% CI, 1.5-5.7) and women (4.4; 99% CI, 1.5-9.7). SIRs for sex-specific sites also were elevated, with male genital cancers having an SIR of 19.6 (99% CI, 8.7-37.6) and female genital cancers an SIR of 8.3 (99% CI, 6.1-11.0). Patients with index SCCA are at an increased risk of subsequent HPV-related SPMs. The elevated risk is most striking in patients with second primary SCCAs; however, the risk of second cancers also appears to be increased in other HPV-related sites. Cancer 2017;123:4013-21. © 2017 American Cancer Society. © 2017 American Cancer Society.

  8. Retrospective study about 71 patients with anal carcinoma, treated with a uniform radiochemotherapy

    International Nuclear Information System (INIS)

    Wiesmeth, Alfred J.

    2013-01-01

    The aim of this retrospectively prospective study was to examine the outcome (over all survival, tumorspecific survival, local control, colostomy free survival as well as sideeffects of the tumorspecific treatment) on a roughly homogenous and compared to other studies appropriate large group of 71 patients with diagnosed anal carcinoma. All patients underwent primary radiochemotherapy during the period of 1991 to 2010 in a municipal hospital. The median follow-up consisted of 38 month.

  9. Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

    Directory of Open Access Journals (Sweden)

    C. Ciriza de los Ríos

    2010-12-01

    Full Text Available Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL, squeeze maximum pressure (SMP, squeeze pressure duration (SPD, first sensation, urge and maximum tolerated volume (MTV. Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA, presión de máxima contracción voluntaria (PMCV, duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT. Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001, la presión de reposo (p < 0,001, la LCA (p < 0,001 y la PMCV (p < 0,01 en el grupo de IA con

  10. Acute motor axonal neuropathy associated with anal carcinoma: Paraneoplastic neurological syndrome or coincidence?

    International Nuclear Information System (INIS)

    Lopez, J. L.; Amezcua, S.; Pascual, J.; Algara, M.

    2011-01-01

    Aim: Assessment of the association of an acute motor axonal neuropathy with a squamous cell anal carcinoma. Background: Paraneoplastic neurologic syndromes are not a direct consequence of neither primary tumor nor its metastasis. They often parallel the course of the malignancy but may be the presenting sign of an occult cancer. Sometimes it is very difficult to distinguish if it is a paraneoplastic syndrome or just a coincidence. Materials and methods: We report a 60-year-old man that presented with an acute motor deficit of the four limbs. Clinical examination found a pure and severe motor deficit in the four limbs. No sensory abnormality was found and all motor nerves were unexcitable. Electromyography suggested the diagnosis of acute motor axonal neuropathy (AMAN). Four months after developing the AMAN, blood in the stool revealed anal carcinoma. The patient was treated with concurrent chemoradiotherapy. Radiation was given to the tumor and to the pelvis, including inguinal nodes, over a five-week period plus fluorouracil and mitomycin. We investigated the presence of anti ganglioside antibodies as studies suggest that carcinomas can express antigens shared with Schwann cells. Results: Anti-GM1 IgG antibodies were detected by an enzyme-linked immunosorbent assay method. Other antibodies, including antinuclear nucleoprotein antibody (anti-Hu), anti-Tr, anti-Ri, anti-CV2, anti-amphiphysin and anti-Yo, were negative. Clinical improvement of the motor state was observed at the fourth week of oncologic treatment. Conclusion: The presence of anti-GM1 IgG antibodies and the clinical improvement of the motor state after concurrent chemoradiotherapy lead us to believe there is an association between anal carcinoma and this severe impairment. (authors)

  11. Anal carcinoma - Survival and recurrence in a large cohort of patients treated according to Nordic guidelines

    DEFF Research Database (Denmark)

    Leon, Otilia; Guren, Marianne; Hagberg, Oskar

    2014-01-01

    OBJECTIVE: To evaluate treatment outcome in a large population-based cohort of patients with anal cancer treated according to Nordic guidelines. MATERIAL: Clinical data were collected on 1266 patients with anal squamous cell carcinoma diagnosed from 2000 to 2007 in Sweden, Norway and Denmark. 886......-inclusion into a protocol were all independent factors associated with worse outcome. Among patients treated according to any of the protocols, the 3-year recurrence-free survival ranged from 63% to 76%, with locoregional recurrences in 17% and distant metastases in 11% of patients. The highest rate of inguinal recurrence...... of the patients received radiotherapy 54-64Gy with or without chemotherapy (5-fluorouracil plus cisplatin or mitomycin) according to different protocols, stratified by tumor stage. RESULTS: High age, male gender, large primary tumor, lymph node metastases, distant metastases, poor performance status, and non...

  12. Low acute toxicity of radiotherapy and radiochemotherapy in patients with cancer of the anal canal and HIV-infection

    International Nuclear Information System (INIS)

    Hoecht, S.; Wiegel, T.; Hinkelbein, W.; Kroesen, A.J.; Runkel, N.; Berdel, W.E.

    1997-01-01

    Although not an AIDS-defining malignancy, anal cancer is an evolving problem in HIV-infected patients. Treatment-tolerance to radiotherapy as well as to chemotherapy is supposed to be reduced in patients with HIV-infection. From January 1995 to January 1997, four patients with epidermoid cancer of the anal canal and a long history of HIV-infection but without symptoms of AIDS or repeated severe infections were treated with radiotherapy (n=1) or radiochemotherapy (n=3). External beam radiotherapy with 45 Gy to the tumor and pelvic as well as inguinal lymphatic drainage was administered. In tumors larger than T2 N0 lesions an additional boost of 9 Gy was given. Chemotherapy consisted of 5-fluorouracil 1000 mg/m 2 /24 h, d 1-4 two cycles and Mitomycin C either 1 x 15 mg/m 2 , d 1 in the first, or 2 x 10 mg/m 2 , d 1, in the first and fifth week of radiotherapy. Acute reactions were mild to moderate in all patients and all but one treatment could be given as scheduled (1 patient with a delay of 4 days). No excessive acute reactions were seen. Because of the short follow-up, late reactions and local control are not yet evaluable. (orig.)

  13. External resection of a giant sigmoid lipoma causing colonic intussusception and prolapse through the anal canal.

    Science.gov (United States)

    Tony, Jose; Saji, Sebastian; Sandesh, K; Sunilkumar, K; Ramachandran, T M; Thomas, Varghese

    2007-01-01

    We depict the case of an 80-year-old female patient who presented to us with a history of protruding mass per anum. Sigmoidoscopy revealed a large globular pedunculated polyp at 22 cm from the anal verge resulting in a sigmoidorectal intussusception. Endoscopic polypectomy was not technically possible due to the large size of the polyp. At the time of prolapse the polyp was tied at its pedicle with thread and resected surgically. The patient is asymptomatic on follow-up.

  14. Rectal squamous cell carcinoma in immunosuppressed populations: is this a distinct entity from anal cancer?

    Science.gov (United States)

    COGHILL, Anna E.; SHIELS, Meredith S.; RYCROFT, Randi K.; COPELAND, Glenn; FINCH, Jack L.; HAKENEWERTH, Anne M.; PAWLISH, Karen S.; ENGELS, Eric A.

    2015-01-01

    Objective Squamous cell carcinoma (SCC) of the rectum is rare, but as with anal cancer, risk may be increased among immunosuppressed individuals. We assessed risk of rectal SCC in HIV-infected people. Design Population-based registry Methods We utilized the HIV/AIDS Cancer Match, a linkage of US HIV and cancer registries (1991–2010), to ascertain cases of anal SCC, rectal SCC, rectal non-SCC, and colon non-SCC. We compared risk in HIV-infected persons to the general population using standardized incidence ratios (SIRs) and evaluated risk factors using Poisson regression. We reviewed cancer registry case notes to confirm site and histology for a subset of cases. Results HIV-infected persons had an excess risk of rectal SCC compared to the general population (SIR=28.9; 95%CI 23.2–35.6), similar to the increase for anal SCC (SIR=37.3). Excess rectal SCC risk was most pronounced among HIV-infected men who have sex with men (MSM, SIR=61.2). Risk was not elevated for rectal non-SCC (SIR=0.88) or colon non-SCC (SIR=0.63). Individuals diagnosed with AIDS had higher rectal SCC rates than those with HIV-only (incidence rate ratio=1.86; 95%CI 1.04–3.31). Based on available information, one-third of rectal SCCs were determined to be misclassified anal cancer. Conclusions HIV-infected individuals, especially with advanced immunosuppression, appear to have substantially elevated risk for rectal SCC. As for anal SCC, rectal SCC risk was highest in MSM, pointing to involvement of a sexually transmitted infection such as human papillomavirus. Site misclassification was present, and detailed information on tumor location is needed to prove that rectal SCC is a distinct entity. PMID:26372482

  15. Carcinoma of the apocrine glands of the anal sac in dogs: 113 cases (1985-1995).

    Science.gov (United States)

    Williams, Laurel E; Gliatto, John M; Dodge, Richard K; Johnson, Jeffrey L; Gamblin, Rance M; Thamm, Douglas H; Lana, Susan E; Szymkowski, Mary; Moore, Antony S

    2003-09-15

    To characterize the signalment, clinical signs, biological behavior, and response to treatment of carcinoma of the apocrine glands of the anal sac in dogs. Retrospective study. 113 dogs with histologically confirmed carcinoma of the apocrine glands of the anal sac. Data on signalment, clinical signs, and staging were reviewed and analyzed along with treatment modality for potential association with survival time. Sex distribution was approximately equal (54% female, 46% male). One hundred four dogs underwent treatment consisting of surgery, radiation therapy, chemotherapy, or multimodal treatment. Median survival for treated dogs was 544 days (range, 0 to 1,873 days). Dogs treated with chemotherapy alone had significantly shorter survival (median, 212 days) than those receiving other treatments (median, 584 days). Dogs not treated with surgery had significantly shorter survival (median, 402 days) than those that underwent surgery as part of their treatment (median, 548 days). Dogs with tumors > or = 10 cm2 had significantly shorter survival (median, 292 days) than dogs with tumors dogs, and those dogs had significantly shorter survival (median, 256 days), compared with those that were normocalcemic (median, 584 days). Dogs with pulmonary metastasis had significantly shorter survival (median, 219 days) than dogs without evidence of pulmonary metastasis (median, 548 days). Unlike most previous reports, this study revealed an approximately equal sex distribution, and results suggest a more favorable prognosis.

  16. Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

    International Nuclear Information System (INIS)

    Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

    2010-01-01

    Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

  17. Surgical Procedures for External Auditory Canal Carcinoma and the Preservation of Postoperative Hearing

    Directory of Open Access Journals (Sweden)

    Hiroshi Hoshikawa

    2012-01-01

    Full Text Available Carcinoma of the external auditory canal (EAC is an unusual head and neck malignancy. The pathophysiology of these tumors is different from other skin lesions because of their anatomical and functional characteristics. Early-stage carcinoma of the EAC can be generally cured by surgical treatment, and reconstruction of the EAC with a tympanoplasty can help to retain hearing, thus improving the patients’ quality of life. In this study, we present two cases of early-stage carcinoma of the EAC treated by canal reconstruction using skin grafts after lateral temporal bone resection. A rolled-up skin graft with a temporal muscle flap was useful for keeping the form and maintaining the postoperative hearing. An adequate size of the skin graft and blood supply to the graft bed are important for achieving a successful operation.

  18. Avaliação dos resultados do tratamento de 14 doentes de carcinoma espinocelular anal

    Directory of Open Access Journals (Sweden)

    Luís Augusto Palma Dallan

    2006-03-01

    Full Text Available A radioquimioterapia (RT/QT tornou-se o tratamento de escolha para o carcinoma espinocelular anal (CEC. Na recidiva local ou na persistência da doença, deve-se instituir o tratamento cirúrgico. OBJETIVO: O objetivo deste estudo retrospectivo foi analisar os resultados do tratamento de doentes de CEC anal. MÉTODO: Acompanhamos 17 pacientes com diagnóstico anátomo-patológico de carcinoma espinocelular anal. Eram 14 (82,3% do sexo feminino e três (17,8% do masculino. A idade variou de 36 a 78 anos, com média de idade de 59,1 anos. Utilizando a classificação TNM, tivemos quatro (23,6% no estádio I, seis (35,2% no II, quatro (23,6% no IIIa e três (17,6% no IIIb. Todos foram submetidos a tratamento inicial com RT/QT, exceto um submetido a ressecção local. Definimos que a biópsia negativa, realizada entre 12 e 16 semanas após esse tratamento, determinaria o controle local da doença. RESULTADOS: Perdemos seguimento de três doentes (17,6%. Seguimos os 14 restantes (82,3% entre um e cinco anos. Todos os doentes nos estádios I e II (10 apresentaram regressão total da doença, enquanto que três (75% nos estádios IIIa e IIIb tiveram remissão completa. Realizamos a amputação abdomino-perineal de resgate em dois doentes e ressecção local em outros dois. A recidiva local ocorreu em dois (20% nos estádios I e II e em dois (75% nos estádios mais avançados (IIIa e IIIb. A sobrevivência em 3 anos foi de 100% nos que se encontravam nos estádios I e II, embora o controle da doença fosse atingido em oito (80%. Nos quatro doentes que estavam nos estádios IIIa e IIIb, a sobrevivência em um ano foi de 75% e em três anos foi de 25%. Esse último permanece livre da doença. Complicações do tratamento radioterápico ocorreram em oito doentes (57,1%. Nenhum óbito foi constatado durante o tratamento RT/QT. Os dois doentes, (14,3% com sorologia positiva para HIV, apresentavam infecção anal pelo Papilomavírus humano (HPV. CONCLUSÃO: A

  19. Alpha, beta and gamma Human Papillomaviruses in the anal canal of HIV-infected and uninfected men who have sex with men.

    Science.gov (United States)

    Donà, Maria Gabriella; Gheit, Tarik; Latini, Alessandra; Benevolo, Maria; Torres, Montserrat; Smelov, Vitaly; McKay-Chopin, Sandrine; Giglio, Amalia; Cristaudo, Antonio; Zaccarelli, Mauro; Tommasino, Massimo; Giuliani, Massimo

    2015-07-01

    Anal infection by cutaneous Human Papillomaviruses (HPV) has been rarely investigated. We aimed to assess the prevalence, genotype diversity, and determinants of mucosal (alpha) and cutaneous (beta and gamma) anal HPV infection in men who have sex with men (MSM). Anal samples were collected with a Dacron swab. Alpha HPVs were detected using the Linear Array HPV genotyping test, while beta and gamma HPVs using a PCR combined with Luminex technology. A total of 609 MSM (437 HIV-uninfected and 172 HIV-infected, most of which were undergoing cART) were enrolled. Alpha, beta, and gamma HPVs were detected in 78.0%, 27.6% and 29.3% of the participants. Only alpha HPV prevalence was significantly higher among HIV-infected compared to uninfected MSM (93.0% vs. 72.1%, p < 0.0001). Beta2 and gamma10 represented the most frequent cutaneous HPV species, with no significant differences between HIV-infected and uninfected individuals. The most common alpha, beta, and gamma genotypes were HPV16, HPV111, HPV121, respectively. Alpha HPV infection was significantly associated with lifetime number of partners, receptive anal sex, and HIV status. Beta and/or gamma HPV infection showed no significant association with HIV status, socio-demographic or sexual behavioral factors. A wide spectrum of mucosal and cutaneous HPV types is present in the anal canal. Only mucosal HPV prevalence increased significantly in cases of concomitant HIV infection. Copyright © 2015. Published by Elsevier Ltd.

  20. Cutaneous Neuroendocrine Carcinoma of the External Auditory Canal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Yi-Ke Li

    2012-01-01

    Full Text Available Cutaneous neuroendocrine carcinoma (cNEC is rarely seen in the external ear. In this paper, we newly describe a patient with cNEC in his right external auditory canal, followed by a further discussion on the clinical features, diagnosis, and treatments of cNEC of the external ear. A review of the literature showed that cNEC of the external auditory canal generally presents as asymptomatic and that pathology yields the most confirmative diagnosis. A wide resection with adjuvant radiotherapy and chemotherapy is recommended. The overall prognosis of this condition is poor.

  1. Esophageal carcinoma extending into the spinal canal - case report and review of the literature

    International Nuclear Information System (INIS)

    Urban, Linei A.B.D.; Rogacheski, Enio; Ledesma, Jorge A.; Zaparolli, Mauricio; Duarte, Maria Cecilia B.; Sakamoto, Danielle G.

    2002-01-01

    The authors report the case of a 62-year-old male with a 4 month history of weight loss and a 2 day complaint of weakness and paraesthesia on the lower limbs. A computed tomography myelogram revealed a mass in the posterior mediastinum associated with destruction of the vertebral body, spinal canal extension and irregular esophageal wall thickening. The patient was later submitted to a barium esophagogram that showed an irregular filling defect. A biopsy confirmed the presence of a squamous cell carcinoma. This is the first report in the Latin-American literature (Lilacs) of a patient with an esophageal carcinoma with spinal canal extension and spinal cord compression syndrome at initial presentation. (author)

  2. The value of radiotherapy in colorectal and anal carcinomas, judged on the basis of radiation results obtained in Wuerzburg between 1977 and 1985

    International Nuclear Information System (INIS)

    Aydin, H.

    1987-01-01

    Investigations were carried out into the effectiveness of radiotherapy in colorectal and anal carcinomas as well as metastases formed by those tumours. The relevance of changes in CT findings and CEA values is discussed in detail. (MBC) [de

  3. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  4. Ciclooxygenase inhibitor and metronomic chemotherapy association for the treatment of metastatic anal sac carcinoma in dog: case report

    OpenAIRE

    Teixeira, N.C.T.; Bicalho, A.P.C.V.; Vasconcelos, A.V.; Horta, R.S.; Cunha, R.M.C.; Lavalle, G.E.

    2016-01-01

    ABSTRACT Metronomic chemotherapy consists of an anticancer modality treatment. It is applicable in patients at an advanced stage, with the objective of increasing overall survival. The aim of this study was to report an anal sac apocrine carcinoma case in a dog with lymph node metastasis treated with metronomic chemotherapy sequential to surgery and conventional chemotherapy using gemcitabine and carboplatin. Metronomic chemotherapy was associated with cyclooxygenase-2 (COX-2) inhibitors, due...

  5. Anal squamous cell carcinoma - State of the art management and future perspectives.

    Science.gov (United States)

    Martin, Daniel; Balermpas, Panagiotis; Winkelmann, Ria; Rödel, Franz; Rödel, Claus; Fokas, Emmanouil

    2018-02-22

    Anal squamous cell carcinoma (ASCC) is associated with infection with high-risk strains of human papilloma virus (HPV) in 70-90% of cases and a rise in incidence has been observed in the last decades. Definitive chemoradiotherapy (CRT) using 5-fluorouracil and mitomycin C constitutes the standard treatment for localized disease, but about 30% of patients do not respond or relapse locally. Phase I/II trials testing targeted agents, such as epidermal-growth-factor receptor (EGFR) inhibitors, have failed to improve clinical outcome and resulted in increased toxicities. Modern imaging methods and biomarkers, also in the context of HPV status, should be further explored to improve patient stratification. In the present review, we will discuss the current clinical evidence and future perspectives in the management of ASCC. HPV-positive ASCC is more immunogenic with a higher density of tumor infiltrating lymphocytes that correlate with better response to CRT and more favorable prognosis compared to HPV-negative tumors. Immunotherapies including immune checkpoint inhibitors have brought new hope and promising results were recently demonstrated in metastatic ASCC. The addition of immunotherapies to CRT for localized disease is tested in early phase trials, and these results could have a profound impact on the way we treat ASCC in near future. Further research and novel approaches are expected to enhance our understanding of tumor biology and immunology, and improve patient stratification and treatment adaptation in the context of personalized medicine. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort

    International Nuclear Information System (INIS)

    Bentzen, Anne Gry; Guren, Marianne G.; Wanderås, Eva H.; Frykholm, Gunilla; Tveit, Kjell M.; Wilsgaard, Tom; Dahl, Olav; Balteskard, Lise

    2012-01-01

    Purpose: To evaluate treatment results, elucidate whether national guidelines were followed, and identify areas demanding further treatment optimization. Methods and Material: Between July 2000 and June 2007, 328 patients were treated with curatively intended chemoradiotherapy (CRT) for nonmetastatic squamous cell carcinoma of the anal region, according to national treatment guidelines based on tumor stage. Results: Complete response after CRT was obtained in 87% of patients, rising to 93% after salvage surgery. Chemotherapy, elective irradiation of the groin and salvage surgery were performed to a lesser extent in elderly patients, mainly because of frailty and comorbidity. Recurrence occurred in 24% of the patients, resulting in a 3- and 5-year recurrence-free survival (RFS) of 79% and 74%, respectively. Locoregional recurrences dominated, most commonly in the primary tumor site. Recurrence was treated with curative intent in 45% of the cases. The 3- and 5-year overall survival were 79% and 66%, and cancer-specific survival (CSS) were 84% and 75%, respectively. The risk of adverse outcome increased significantly with more locally advanced tumors and for male gender in multivariable analyses for RFS and CSS. Conclusions: The treatment results are in accordance with similar cohorts. The primary treatment control rate was high, but there was a significant risk of locoregional recurrence in advanced tumors. The loyalty to national guidelines was broad, although individual adjustments occurred. However, caution to avoid toxicity must not lead to inadequate treatment. Male gender seems to have inferior outcome.

  7. Experimental reproduction of the papilloma-carcinoma complex of the alimentary canal in cattle.

    Science.gov (United States)

    Campo, M S; O'Neil, B W; Barron, R J; Jarrett, W F

    1994-08-01

    Bovine papillomavirus type 4 (BPV-4) is the aetiological agent of epithelial papillomas of the upper alimentary canal in cattle. These benign tumours can become a focus for transformation to squamous cell carcinomas in animals feeding on bracken fern. Strong epidemiological evidence suggests that the progression to malignancy is due to the interplay between BPV-4 and mutagenic and immunosuppressing chemicals present in the fern. The carcinomas of the upper alimentary canal are often accompanied by adenomas and adenocarcinomas of the lower intestine and bracken-grazing animals are also heavily immunosuppressed. To elucidate the individual roles and the concerted action of the viral and chemical factors involved in tumorigenesis and malignant conversion, we attempted to reproduce experimentally the cancer syndrome observed in the field. Florid persistent papillomatosis of the upper alimentary canal was reproduced in animals infected with BPV-4 and immunosuppressed either by a diet of bracken or by treatment with azathioprine; cancer of the upper alimentary tract or of the lower intestine developed only in animals infected with virus and fed on bracken fern. As in field cases, BPV-4 DNA was detected in papillomas but not in cancers. We conclude that immunosuppression is necessary for persistence and spread of viral papillomas, that the fern mutagens are responsible for neoplastic conversion of papilloma cells, and that continuous expression of viral functions is not required for the maintenance of the malignant state.

  8. Synchronous Malignant Otitis Externa and Squamous Cell Carcinoma of the External Auditory Canal

    Directory of Open Access Journals (Sweden)

    R. Y. Chin

    2013-01-01

    Full Text Available Objectives. To discuss the management of a squamous cell carcinoma in the presence of malignant otitis externa. Study Design. We present only the third reported case in the literature of a synchronous tumour with malignant otitis externa in the literature. Methods. A case report and review of malignant otitis externa and squamous cell carcinomas of the external auditory canal are discussed. Results. A 66-year-old female is presented here with a 2-month history of a painful, discharging left ear refractory to standard antibiotic therapy. Computerised tomography, magnetic resonance imaging, technetium 99 m, and gallium citrate Ga67 scans were consistent with malignant otitis externa. Biopsy in the operating theatre revealed a synchronous squamous cell carcinoma of the external auditory canal. Primary resection of the tumour and surrounding tissues was performed with concomitant treatment with intravenous antibiotics. Conclusions. This is only the third case to be reported in the literature and highlights several important diagnostic and management issues of these two rare conditions. Both conditions may present in a similar manner on clinical assessment and radiological investigations. Aggressive management with surgical resection and treatment with appropriate intravenous antibiotics is necessary to give the best chance for cure.

  9. Derivación analítica del tiempo de llegada en modelos de canal basados en geometría para sistemas inalámbricos

    Directory of Open Access Journals (Sweden)

    M.R. Arias

    2007-11-01

    Full Text Available Este artículo presenta una propuesta analítica para derivar la función de densidad de probabilidad de potencia (PDF, por sus siglas en ingles del tiempo de llegada (TOA, por sus siglas en inglés y su aplicación en los modelos de canal estadísticos basados en geometría para ambientes urbanos. En éste artículo proponemos un modelo de canal utilizando el método por agrupamiento, y lo empleamos para derivar la PDF del tiempo de llegada de la señal de multitrayectorias. Para evaluar la PDF teórica propuesta por agrupamiento en el dominio del tiempo, hacemos simulaciones por computadora del modelo de canal basado en geometría propuesto y lo comparamos con los resultados experimentales publicados en la literatura. La comparación con los resultados experimentales revelan una buena aproximación. La PDF por agrupamiento derivada se puede utilizar para simular la dispersión temporal de la señal de multitrayectorias agrupadas para una variedad de condiciones de propagación en ambientes urbanos para cuantificar parámetros estadísticos de segundo orden, es decir, la difusión de retardo para una forma elíptica específica dada por el grupo de señales de multitrayectorias.

  10. Complete Resolution of a Recurrent Canine Anal Sac Squamous Cell Carcinoma with Palliative Radiotherapy and Carboplatin Chemotherapy.

    Science.gov (United States)

    Giuliano, Antonio; Dobson, Jane; Mason, Sarah

    2017-09-14

    Anal sac squamous cell carcinoma (SCC) is a rare tumor in dogs. Only eight cases have been described in the literature, and previous reports of treatment only describe surgery or palliative treatment with non-steroidal anti-inflammatory drugs. We report a case of a 12-year-old female neutered Labrador with locally advanced anal sac SCC. The dog was treated with four cycles of carboplatin 300 mg/m² and four weekly fractions of 8.5 Gy radiation. The dog achieved a complete response, and one year later the dog is still alive and well with no evidence of tumor recurrence. Radiotherapy in combination with carboplatin chemotherapy was effective in the long-term control of this rare disease.

  11. Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-06-01

    Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

  12. Anal carcinoma – Survival and recurrence in a large cohort of patients treated according to Nordic guidelines

    International Nuclear Information System (INIS)

    Leon, Otilia; Guren, Marianne; Hagberg, Oskar; Glimelius, Bengt; Dahl, Olav; Havsteen, Hanne; Naucler, Gisela; Svensson, Christer; Tveit, Kjell Magne; Jakobsen, Anders; Pfeiffer, Per; Wanderås, Eva; Ekman, Tor; Lindh, Birgitta; Balteskard, Lise; Frykholm, Gunilla; Johnsson, Anders

    2014-01-01

    Objective: To evaluate treatment outcome in a large population-based cohort of patients with anal cancer treated according to Nordic guidelines. Material: Clinical data were collected on 1266 patients with anal squamous cell carcinoma diagnosed from 2000 to 2007 in Sweden, Norway and Denmark. 886 of the patients received radiotherapy 54–64 Gy with or without chemotherapy (5-fluorouracil plus cisplatin or mitomycin) according to different protocols, stratified by tumor stage. Results: High age, male gender, large primary tumor, lymph node metastases, distant metastases, poor performance status, and non-inclusion into a protocol were all independent factors associated with worse outcome. Among patients treated according to any of the protocols, the 3-year recurrence-free survival ranged from 63% to 76%, with locoregional recurrences in 17% and distant metastases in 11% of patients. The highest rate of inguinal recurrence (11%) was seen in patients with small primary tumors, treated without inguinal irradiation. Conclusions: Good treatment efficacy was obtained with Nordic, widely implemented, guidelines for treatment of anal cancer. Inguinal prophylactic irradiation should be recommended also for small primary tumors

  13. What drives the number of high-risk human papillomavirus types in the anal canal in HIV-positive men who have sex with men?

    Science.gov (United States)

    del Amo, Julia; González, Cristina; Geskus, Ronald B; Torres, Montse; Del Romero, Jorge; Viciana, Pompeyo; Masiá, Mar; Blanco, Jose R; Hernández-Novoa, Beatriz; Ortiz, Marta

    2013-04-15

    We estimated the effect of sexual behavior, age, and immunodeficiency on the number of high-risk human papillomavirus (HR-HPV) types in the anal canal among human immunodeficiency virus-positive men who have sex with men (MSM). Anal samples were genotyped with the Linear Array HPV Genotyping Test, and risk factors were investigated with Poisson regression. Of 586 MSM, 69% were Spanish, and 25.6% were Latin American; the median age was 34.9 years (interquartile range [IQR], 30.1-40.8). The median number of recent sex partners was 6 (IQR, 2-24 sex partners), and the median CD4(+) T-cell count was 531.5 cells/mm(3) (IQR, 403-701 cells/mm(3)). The prevalence of any and multiple HR-HPV infections was 83.4% and 60.5%, respectively. The most common types were HPV-16 (42%), HPV-51 (24%), HPV-39 (23.7%), and HPV-59 (23.5%). Age had a statistically significant, nonlinear association with the number of types, with the highest number detected around 35 years of age (P linear association on the log scale (P = .033). The high prevalence of HR-HPV types is associated with recent sexual behavior and age.

  14. Quantificação da função esfincteriana pela medida da capacidade de sustentação da pressão de contração voluntária do canal anal Sphincteric function quantification by measuring the capacity to sustain the squeeze pressure of the anal canal

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Cury Saad

    2002-10-01

    Full Text Available RACIONAL: Tem sido demonstrado que a pressão máxima de contração voluntária e a pressão média de repouso não refletem a real situação clínica do paciente portador de incontinência fecal, não traduzem a realidade funcional do canal anal, além de poder estar comprometendo a conduta a ser tomada devido ao não-encaminhamento à terapêutica específica. OBJETIVO: Com a hipótese de que contrair e manter a contração é mais importante que simplesmente contrair, mesmo com pico momentaneamente elevado de pressão, analisou-se a capacidade de sustentação da pressão de contração voluntária do canal anal com o intuito de quantificar a função esfincteriana relativa à continência fecal. MATERIAL E MÉTODOS: Submeteram-se a exame manométrico anorretal 72 pacientes (56 mulheres portadores de incontinência fecal de vários graus e 15 (9 mulheres indivíduos continentes (normais, avaliando-se a pressão média de repouso, a pressão máxima de contração voluntária e a capacidade de sustentação da pressão de contração voluntária. RESULTADOS: Os indivíduos continentes apresentaram valores normais de pressão média de repouso e de pressão máxima de contração voluntária, além de adequada capacidade de sustentação da pressão de contração voluntária. Os pacientes incontinentes apresentaram pressão média de repouso e pressão máxima de contração voluntária com valores pressóricos normais ou abaixo do normal e perfil semelhante de capacidade de sustentação da pressão de contração voluntária, ou seja, moderada na fase inicial e ruim nas fases intermediária e final, com queda da mesma superior a 35% em 78% dos pacientes. A pressão máxima de contração voluntária apresenta excelente especificidade (100% porém, sensibilidade baixa (46% para incontinência fecal. Comparativamente, a capacidade de sustentação da pressão de contração voluntária apresenta elevadas especificidade (93% e sensibilidade

  15. Surveillance of anal carcinoma after radiochemotherapy. A retrospective analysis of 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Sauter, Matthias; Vavricka, Stephan R. [Triemli Hospital, Department of Medicine, Division of Gastroenterology, Zurich (Switzerland); University Hospital Zurich, Division of Gastroenterology and Hepatology, Zurich (Switzerland); Keilholz, Georg; Kranzbuehler, Helmut; Lombriser, Norbert [Triemli Hospital, Division of Radiation-Oncology, Zurich (Switzerland); Heinrich, Henriette; Misselwitz, Benjamin [University Hospital Zurich, Division of Gastroenterology and Hepatology, Zurich (Switzerland); Winder, Thomas [University Hospital Zurich, Department of Oncology, Zurich (Switzerland)

    2017-08-15

    Surveillance after radiochemotherapy of anal carcinoma (ACa) with curative intent is recommended in guidelines, but data regarding the effectiveness of follow-up are lacking. We aimed to assess the performance of an ACa surveillance program in a real-life setting. We retrospectively summarized clinical history, physical findings, and follow-up investigations (endoanal ultrasound, endoscopy, CT scan) obtained during 42 months (±27 months) from 80 patients after radiochemotherapy of ACa. In 7/80 cases (8.8%) an incomplete response to therapy was identified at or before the 6-month time point after the end of treatment; 4 of the 7 cases were identified during scheduled follow-up. In 6 cases (7.5%), recurrent disease was found after the 6-month time point. Recurrence was systemic in 5 cases and local/inguinal in 1 case. In 3 of the 6 cases (50%), recurrence was identified during scheduled follow-up. In one asymptomatic patient, a single liver metastasis was detected during scheduled follow-up and the patient remains free of disease 19 months after surgery. Surveillance resulted in a high rate of false-positive findings (70 findings in 604 investigations), of which only 14 could be confirmed. Scheduled follow-up after treatment of ACa detected recurrent disease at systemic sites, enabling potentially curative treatment in a single case. Effectiveness of abdominal imaging during follow-up after ACa treatment should be tested in a prospective trial. (orig.) [German] Nach kurativ intendierter kombinierter Radiochemotherapie beim Analkarzinom (ACa) wird von den Guidelines eine Nachsorge empfohlen, die Datenlage hierzu ist jedoch mangelhaft. Ziel unserer Studie war es, die Wertigkeit der Nachsorge beim ACa in einem ''Real-life''-Setting zu evaluieren. Es erfolgte die retrospektive Aufarbeitung der Nachsorge inklusive Anamnese, klinischer Untersuchung und Nachsorgeuntersuchungen (untere Endosonographie, Endoskopie, Computertomographie Abdomen

  16. Metabolic tumour volume of anal carcinoma on (18)FDG PET/CT before combined radiochemotherapy is the only independant determinant of recurrence free survival.

    Science.gov (United States)

    Mohammadkhani Shali, Siamak; Schmitt, Vanessa; Behrendt, Florian F; Winz, Oliver H; Heinzel, Alexander; Mottaghy, Felix M; Eble, Michael J; Verburg, Frederik A

    2016-08-01

    to determine whether [(18)F]2-fluoro-2-deoxyglucose (FDG) positron emission tomography and X-ray computed tomography (PET/CT) findings and metabolic parameters before combined chemo- and radiotherapy (CRT) have a prognostic value in patients with anal carcinoma. 45 patients with anal cancer who underwent pre-treatment FDG-PET/CT were included. Metabolic parameters, recurrence and anal carcinoma specific survival were analyzed. SUV max and metabolic volume of the primary tumour were significantly higher in patients with lymph node or distant metastases than in those with locally confined disease (p=0.020 and p=0.015, respectively). The extent of disease (local tumour only, lymph node or distant metastases) was highly predictive of both for recurrence free and disease specific survival (p=0.010 and p45ml. Multivariate analysis revealed that a metabolic volume >45ml was the only significant independent determinant (p=0.19) for recurrence free survival whereas for anal carcinoma specific survival the extent of disease was identified as the only significant independent determinant (p=0.002). the extent of disease on FDG PET/CT before combined radio-chemotherapy is strongly predictive of prognosis in anal cancer. Furthermore, patients with a large metabolic volume of the primary tumour (>45ml) are at significantly higher risk of recurrence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Ciclooxygenase inhibitor and metronomic chemotherapy association for the treatment of metastatic anal sac carcinoma in dog: case report

    Directory of Open Access Journals (Sweden)

    N.C.T. Teixeira

    2016-08-01

    Full Text Available ABSTRACT Metronomic chemotherapy consists of an anticancer modality treatment. It is applicable in patients at an advanced stage, with the objective of increasing overall survival. The aim of this study was to report an anal sac apocrine carcinoma case in a dog with lymph node metastasis treated with metronomic chemotherapy sequential to surgery and conventional chemotherapy using gemcitabine and carboplatin. Metronomic chemotherapy was associated with cyclooxygenase-2 (COX-2 inhibitors, due to strong tumor COX-2 immunohistochemistry expression. Metronomic chemotherapy was initiated with cyclophosphamide, but it was replaced by lomustine, also in metronomic dosage, due to adverse effects. Treatment showed effectiveness, since the patient's overall survival exceeded 1095 days (36 months, considerably higher than the mean overall survival expected for this pathology.

  18. Esophageal carcinoma extending into the spinal canal - case report and review of the literature; Carcinoma do esofago com invasao do canal medular - relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Urban, Linei A.B.D.; Rogacheski, Enio; Ledesma, Jorge A. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Radiologia]. E-mail: radiohc@terra.com.br; Zaparolli, Mauricio; Duarte, Maria Cecilia B. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas; Sakamoto, Danielle G. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Anatomia Patologica

    2002-06-01

    The authors report the case of a 62-year-old male with a 4 month history of weight loss and a 2 day complaint of weakness and paraesthesia on the lower limbs. A computed tomography myelogram revealed a mass in the posterior mediastinum associated with destruction of the vertebral body, spinal canal extension and irregular esophageal wall thickening. The patient was later submitted to a barium esophagogram that showed an irregular filling defect. A biopsy confirmed the presence of a squamous cell carcinoma. This is the first report in the Latin-American literature (Lilacs) of a patient with an esophageal carcinoma with spinal canal extension and spinal cord compression syndrome at initial presentation. (author)

  19. Prospective Evaluation of Acute Toxicity and Quality of Life After IMRT and Concurrent Chemotherapy for Anal Canal and Perianal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kathy; Cummings, Bernard J.; Lindsay, Patricia; Skliarenko, Julia; Craig, Tim [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Le, Lisa W. [Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Brierley, James; Wong, Rebecca; Dinniwell, Robert; Bayley, Andrew J.; Dawson, Laura A.; Ringash, Jolie [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Krzyzanowska, Monika K.; Moore, Malcolm J.; Chen, Eric X. [Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Easson, Alexandra M. [Department of Surgical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario (Canada); Kassam, Zahra; Cho, Charles [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Kim, John, E-mail: John.Kim@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada)

    2014-11-01

    Purpose: A prospective cohort study was conducted to evaluate toxicity, quality of life (QOL), and clinical outcomes in patients treated with intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for anal and perianal cancer. Methods and Materials: From June 2008 to November 2010, patients with anal or perianal cancer treated with IMRT were eligible. Radiation dose was 27 Gy in 15 fractions to 36 Gy in 20 fractions for elective targets and 45 Gy in 25 fractions to 63 Gy in 35 fractions for gross targets using standardized, institutional guidelines, with no planned treatment breaks. The chemotherapy regimen was 5-fluorouracil and mitomycin C. Toxicity was graded with the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR29 questionnaires. Correlations between dosimetric parameters and both physician-graded toxicities and patient-reported outcomes were evaluated by polyserial correlation. Results: Fifty-eight patients were enrolled. The median follow-up time was 34 months; the median age was 56 years; 52% of patients were female; and 19% were human immunodeficiency virus—positive. Stage I, II, III, and IV disease was found in 9%, 57%, 26%, and 9% of patients, respectively. Twenty-six patients (45%) required a treatment break because of acute toxicity, mainly dermatitis (23/26). Acute grade 3 + toxicities included skin 46%, hematologic 38%, gastrointestinal 9%, and genitourinary 0. The 2-year overall survival (OS), disease-free survival (DFS), colostomy-free survival (CFS), and cumulative locoregional failure (LRF) rates were 90%, 77%, 84%, and 16%, respectively. The global QOL/health status, skin, defecation, and pain scores were significantly worse at the end of treatment than at baseline, but they returned to baseline 3 months after treatment. Social functioning and appetite scores were

  20. Radio(chemo)therapy of the anal carcinoma. A retrospective study

    International Nuclear Information System (INIS)

    Sauer, Thomas Albert

    2013-01-01

    In a retrospective study the data of a consecutive cohort of 138 patients with a locally advanced squamous cell anal cancer were analysed, who were treated with a radio(chemo)therapy in the period from 1988 to 2011. The 5-year overall survival rate was 82%±4%. T category, UICC clinical stage, histopathologic grading and the ECOG performance status were significantly associated with overall survival. Acute toxicity grade 3/4 and chronic side effects grade 3 were found in 58% and 37% of the patients, respectively.

  1. The midterm results of concurrent superselective arterial chemoradiotherapy for carcinoma of the external auditory canal and middle ear

    International Nuclear Information System (INIS)

    Fujiwara, Masayuki; Yamamoto, Satoshi; Doi, Hiroshi

    2010-01-01

    This study retrospectively reports the midterm results of concurrent superselective arterial chemoradiotherapy for carcinoma of the external auditory canal and middle ear. Fifteen patients (7 males and 8 females) who were treated for carcinoma of the external auditory canal and middle ear between March 2003 and July 2009 were enrolled in this study. The median follow-up period was 14 months (4-44 months). All patients were staged according to the Pittsburgh staging system by Moody as follows: T1 (n=1), T2 (n=1), T3 (n=1), T4 (n=12). Thirteen patients had squamous cell carcinoma, one had adenocarcinoma, and one had undifferentiated carcinoma. All catheterizations were performed via a transfemoral approach by the Seldinger method. After identifying the feeding arteries of the primary tumor, cisplatin (50 mg/body) was injected. Simultaneously a cisplatin antagonist, sodium thiosulfate, was administered intravenously. Four or five courses of arterial infusion were given weekly. The catheter was removed after each session. External beam irradiation was performed five times a week at 2 Gy per fraction. Total dose ranged from 40 to 60 Gy (median: 60 Gy). The toxicity was evaluated by Common Terminology Criteria for Adverse Events (CTC-AE) ver. 3.0. The 2-year overall survival (OS) rate was 73.4%, and progression free survival (PFS) rate was 53.3% for all patients. Concerning acute toxicity, one patient had Grade 3 dermatitis, and one had Grade 3 leucopenia. No catheter-related complications and no treatment-related deaths were observed. No severe late complications were observed, but one patient had a mild inflammation on the subcutaneous tissue. These results are comparable with those of other reports, suggesting that this method for carcinoma of the external auditory canal and middle ear is acceptable, but the OS rate and PFS rate need improvement. Further investigations are required with larger series to evaluate the long-term survival rate with this treatment. (author)

  2. Retrospective study about 71 patients with anal carcinoma, treated with a uniform radiochemotherapy; Retrospektive Studie an 71 Patienten mit Analkarzinom, behandelt mit einheitlicher Radiochemotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmeth, Alfred J.

    2013-07-17

    The aim of this retrospectively prospective study was to examine the outcome (over all survival, tumorspecific survival, local control, colostomy free survival as well as sideeffects of the tumorspecific treatment) on a roughly homogenous and compared to other studies appropriate large group of 71 patients with diagnosed anal carcinoma. All patients underwent primary radiochemotherapy during the period of 1991 to 2010 in a municipal hospital. The median follow-up consisted of 38 month.

  3. Squamous Cell Carcinoma of the Anal Transitional Zone after Ileal Pouch Surgery for Ulcerative Colitis: Systematic Review and Treatment Perspectives

    Directory of Open Access Journals (Sweden)

    Gianluca Pellino

    2017-01-01

    Full Text Available Background: Few cases of pouch-related cancers have been reported in ulcerative colitis (UC, and squamous cell carcinoma (SCC is very rare. Method: A systematic review of the literature was performed to identify all unequivocal cases of pouch-related SCC in UC patients. Results: Eight cases of SCC developing after ileal pouch-anal anastomosis (IPAA have been observed since 1978. Two arose from the pouch mucosa and 6 from below. The pooled cumulative incidence of SCC is below 0.06% after IPAA. Many patients had neoplasia on the preoperative specimen, but squamous metaplasia of the pouch or anorectal mucosa may have an important role in SCC. These patients are rarely offered chemoradiation therapy and the outcome is poor. Selected patients with SCC located close to the pouch outlet can be treated with chemoradiation prior to consideration of surgery and salvage their pouch. A chemoradiation regimen is suggested to avoid pouch excision in these patients. Conclusions: SCC is rare after pouch surgery but associated with extremely poor survival. Very low SCC can be managed with chemoradiation treatment, preserving the pouch and avoiding surgery, even in older patients. The role of pouch metaplasia, surveillance frequency, and treatment modalities after IPAA need further studying.

  4. The prognostic value of HPV combined p16 status in patients with anal squamous cell carcinoma: a meta-analysis.

    Science.gov (United States)

    Sun, Guorui; Dong, Xiaoyuan; Tang, Xiaolong; Qu, Hui; Zhang, Hao; Zhao, Ensheng

    2018-01-30

    Human papillomavirus (HPV) DNA and p16 expression have been identified to be related to the progression of anal squamous cell carcinoma (ASCC). However, the prognostic relevance of combined detection, particularly HPV-/p16+ and HPV+/p16- signatures, is unknown. A meta-analysis of epidemiologic studies was therefore conducted to address this issue. Data were collected from studies comparing overall survival (OS) and disease-free survival (DFS) / disease-specific survival (DSS) / relapse-free survival (RFS) / progression-free survival (PFS) in ASCC patients with HPV and p16 status. The electronic databases of MEDLINE and EMBASE were searched from their inception till 31 May 2017. Study-specific risk estimates were pooled using a fixed-effects model for OS and DFS/DSS/RFS/PFS. Four studies involving a total of 398 ASCC cases were included in this meta-analysis. The pooled results showed that HPV+/p16+ cancers were significantly associated with improved OS (HR = 0.30, 95% CI: 0.17-0.51) and DFS/DSS/RFS/PFS (HR = 0.23, 95% CI: 0.14-0.36). However, patients with HPV-/p16+ or HPV+/p16- do not have a comparably good prognosis compared with HPV+/p16+ patients. The meta-analysis indicated that concomitant detection of HPV-DNA and p16 expression may be of prognostic or therapeutic utility in the evaluation of factors contributing to ASCC. Testing tumor specimens for HPV-DNA and p16 expression might indirectly affect treatment decisions.

  5. Technical considerations in brachytherapy boost for a case of squamous cell carcinoma of the external auditory canal based on our case

    Directory of Open Access Journals (Sweden)

    Bhargavi Ilangovan

    2015-01-01

    Full Text Available Squamous cell carcinoma of the external auditory canal is a rare entity. The patients present with ear discharge and otalgia. They are treated with radiotherapy and surgery. Surgery with oncological priorities is quite complex with substantial consequences. We are reporting a patient with squamous cell carcinoma of the external auditory canal, who was treated with limited surgery followed by radiotherapy. Radiotherapy was a combination of external beam radiotherapy and brachytherapy. High dose rate brachytherapy was given using an ear speculum fixed with wax and a suction catheter. This article is to highlight the technique and dosimetry of the brachytherapy procedure.

  6. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  7. Anal verrucous carcinoma is not related to infection with human papillomaviruses and should be distinguished from giant condyloma (Buschke-Löwenstein tumour).

    Science.gov (United States)

    Zidar, Nina; Langner, Cord; Odar, Katarina; Hošnjak, Lea; Kamarádová, Kateřina; Daum, Ondrej; Pollheimer, Marion J; Košorok, Pavle; Poljak, Mario

    2017-05-01

    Verrucous carcinoma (VC) is a variant of well-differentiated squamous cell carcinoma and in the anal region is regarded as synonymous with giant condyloma (Buschke-Löwenstein tumour) (BLT). Aetiology, diagnostic criteria and clinical behaviour of both lesions are controversial. Recent studies suggest that VC at other sites is not associated with human papillomaviruses (HPV). We hypothesized that anal VC is also not related to HPV, while BLT is a HPV-induced lesion. Ten cases of VC and four cases of BLT were included. Several techniques were used for HPV detection: in-situ hybridization for HPV6, 11, 16 and 18, six different polymerase chain reaction (PCR) protocols for detection of at least 89 HPV types from alpha-, beta-, gamma- and mu-PV genera and in-situ hybridization for high-risk HPV E6/E7 mRNA; p16 immunohistochemistry and morphometric analysis were also performed. Alpha-, gamma- and mu-PVs were not found in any case of VC, while HPV6 was detected in all cases of BLT. p16 overexpression was not present in any of the lesions. Among microscopic features, only the absence of koilocytosis and enlarged spinous cells seem to be useful to distinguish VC from BLT. Our results suggest that anal VC, similarly to VC at other sites, is not associated with HPV infection, and must be distinguished from BLT, which is associated with low-risk HPV. Only with well-set diagnostic criteria will it be possible to ascertain clinical behaviour and optimal treatment for both lesions. © 2016 John Wiley & Sons Ltd.

  8. Epidermal Growth Factor Receptor and K-RAS status in two cohorts of squamous cell carcinomas

    International Nuclear Information System (INIS)

    Van Damme, Nancy; Pauwels, Patrick; Peeters, Marc; Deron, Philippe; Van Roy, Nadine; Demetter, Pieter; Bols, Alain; Dorpe, Jo Van; Baert, Filip; Van Laethem, Jean-Luc; Speleman, Franki

    2010-01-01

    With the availability of effective anti-EGFR therapies for various solid malignancies, such as non-cell small lung cancer, colorectal cancer and squamous cell carcinoma of the head and neck, the knowledge of EGFR and K-RAS status becomes clinically important. The aim of this study was to analyse EGFR expression, EGFR gene copy number and EGFR and K-RAS mutations in two cohorts of squamous cell carcinomas, specifically anal canal and tonsil carcinomas. Formalin fixed, paraffin-embedded tissues from anal and tonsil carcinoma were used. EGFR protein expression and EGFR gene copy number were analysed by means of immunohistochemistry and fluorescence in situ hybridisation. The somatic status of the EGFR gene was investigated by PCR using primers specific for exons 18 through 21. For the K-RAS gene, PCR was performed using exon 2 specific primers. EGFR immunoreactivity was present in 36/43 (83.7%) of anal canal and in 20/24 (83.3%) of tonsil squamous cell carcinomas. EGFR amplification was absent in anal canal tumours (0/23), but could be identified in 4 of 24 tonsil tumours. From 38 anal canal specimens, 26 specimens were successfully analysed for exon 18, 30 for exon 19, 34 for exon 20 and 30 for exon 21. No EGFR mutations were found in the investigated samples. Thirty samples were sequenced for K-RAS exon 2 and no mutation was identified. From 24 tonsil specimens, 22 were successfully analysed for exon 18 and all 24 specimens for exon 19, 20 and 21. No EGFR mutations were found. Twenty-two samples were sequenced for K-RAS exon 2 and one mutation c.53C > A was identified. EGFR mutations were absent from squamous cell carcinoma of the anus and tonsils, but EGFR protein expression was detected in the majority of the cases. EGFR amplification was seen in tonsil but not in anal canal carcinomas. In our investigated panel, only one mutation in the K-RAS gene of a tonsil squamous cell carcinoma was identified. This indicates that EGFR and K-RAS mutation analysis is not

  9. Anal cancer

    Science.gov (United States)

    ... body through the anus when you have a bowel movement. Anal cancer is fairly rare. It spreads slowly and is ... pain Itching Discharge from the anus Change in bowel habits Swollen lymph nodes in the groin or anal region

  10. Comparação das contagens das células de Langerhans de tecidos contendo carcinoma anal em doentes com e sem infecção pelo HIV Comparison of Langerhans cells counts from tissues containing anal carcinoma of patients with and without HIV infection

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2006-09-01

    Full Text Available INTRODUÇÃO: As células de Langerhans (LC são derivadas da medula óssea e constituem-se nas principais apresentadoras de antígeno da pele.conferindo desta forma, a resposta imune cutânea. Seu número está reduzido nos imunodeprimidos, incluindo na infecção pelo HIV, e a presença do tumor inibe sua migração, impedindo que os linfócitos T promovam regressão das células neoplásicas. OBJETIVO: Conhecer as diferenças entre as contagens de LC no tecido tumoral de doentes de carcinomas anais com e sem AIDS. MÉTODO: Avaliamos 24 doentes, sendo 14 com HIV e 10 outros sem HIV . O tratamento para o carcinoma foi semelhante nos dois grupos. Cortes retirados de blocos parafinados submetidos ao teste imunoistoquímico com anticorpo anti-CD68. Contamos as LC com método da histometria e os comparamos aos números obtidos com amostras previamente conhecidas de doentes sem doença infecciosa anorretal ou infecção pelo HIV. Revisamos também a evolução e as contagens séricas de linfócitos T CD4+ de doentes HIV-positivos. RESULTADOS: Observamos que o carcinoma anal foi mais freqüente em mulheres HIV-negativas e em homens HIV-positivos e que esses ultimos eram mais jovens. As LC foram menos numerosas nos doentes HIV-positivos e as maiores contagens estavam associadas com pior evolução. Os doentes HIV-positivos com os níveis mais baixos de linfócitos T CD4+ também tiveram as piores evoluções. CONCLUSÃO: Concluímos que as LC estavam diminuídas nos doentes HIV-positivos, portadores de carcinoma anal, quando comparados aos soronegativos.Langerhans cells (LC are bone marrow derived dendritic cells that represent the major antigen-presenting cells (APC in the skin, thus representing an integral part of the cutaneous immune response. Immunossupression decreases their number, including HIV infection, and skin tumors products are sufficient to immobilize LC within the tumor, preventing their migration to lymph nodes. This reduces the

  11. The Impact of Intensity Modulated Radiation Therapy on Hospitalization Outcomes in the SEER-Medicare Population With Anal Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    Pollom, Erqi L.; Wang, Guanying; Harris, Jeremy P.; Koong, Albert C.; Bendavid, Eran; Bhattacharya, Jay; Chang, Daniel T.

    2017-01-01

    Purpose: We examined the impact of intensity modulated radiation therapy (IMRT) on hospitalization rates in the Surveillance, Epidemiology, and End Results (SEER)–Medicare population with anal squamous cell carcinoma (SCC). Methods and Materials: We performed a retrospective cohort study using the SEER-Medicare database. We identified patients with nonmetastatic anal SCC diagnosed between 2001 and 2011 and treated with chemoradiation therapy. We assessed the relation between IMRT and first hospitalization by use of a multivariate competing-risk model, as well as instrumental variable analysis, using provider IMRT affinity as our instrument. Results: Of the 1165 patients included in our study, 458 (39%) received IMRT. IMRT use increased over time and was associated more with regional and provider characteristics than with patient characteristics. The 3- and 6-month cumulative incidences of first hospitalization were 41.9% (95% confidence interval [CI], 37.3%-46.4%) and 47.6% (95% CI, 43.0%-52.2%), respectively, for the IMRT cohort and 46.7% (95% CI, 43.0%-50.4%) and 52.1% (95% CI, 48.4%-55.7%), respectively, for the non-IMRT cohort. IMRT was associated with a decreased hazard of first hospitalization compared with 3-dimensional radiation techniques (hazard ratio, 0.70; 95% CI, 0.58-0.84; P=.0002). Instrumental variable analysis suggested an even greater reduction in hospitalizations with IMRT after controlling for unmeasured confounders. There was a trend toward improved overall survival with IMRT, with an adjusted hazard ratio of 0.77 (95% CI, 0.59-1.00; P=.05). Conclusions: The use of IMRT is associated with reduced hospitalizations in elderly patients with anal SCC. Further work is warranted to understand the long-term health and cost impact of IMRT, particularly for patient subgroups most at risk of toxicity and hospitalization.

  12. The Impact of Intensity Modulated Radiation Therapy on Hospitalization Outcomes in the SEER-Medicare Population With Anal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pollom, Erqi L., E-mail: erqiliu@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Wang, Guanying [Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California (United States); Harris, Jeremy P.; Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Bendavid, Eran; Bhattacharya, Jay [Center for Health Policy–Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California (United States); Chang, Daniel T. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States)

    2017-05-01

    Purpose: We examined the impact of intensity modulated radiation therapy (IMRT) on hospitalization rates in the Surveillance, Epidemiology, and End Results (SEER)–Medicare population with anal squamous cell carcinoma (SCC). Methods and Materials: We performed a retrospective cohort study using the SEER-Medicare database. We identified patients with nonmetastatic anal SCC diagnosed between 2001 and 2011 and treated with chemoradiation therapy. We assessed the relation between IMRT and first hospitalization by use of a multivariate competing-risk model, as well as instrumental variable analysis, using provider IMRT affinity as our instrument. Results: Of the 1165 patients included in our study, 458 (39%) received IMRT. IMRT use increased over time and was associated more with regional and provider characteristics than with patient characteristics. The 3- and 6-month cumulative incidences of first hospitalization were 41.9% (95% confidence interval [CI], 37.3%-46.4%) and 47.6% (95% CI, 43.0%-52.2%), respectively, for the IMRT cohort and 46.7% (95% CI, 43.0%-50.4%) and 52.1% (95% CI, 48.4%-55.7%), respectively, for the non-IMRT cohort. IMRT was associated with a decreased hazard of first hospitalization compared with 3-dimensional radiation techniques (hazard ratio, 0.70; 95% CI, 0.58-0.84; P=.0002). Instrumental variable analysis suggested an even greater reduction in hospitalizations with IMRT after controlling for unmeasured confounders. There was a trend toward improved overall survival with IMRT, with an adjusted hazard ratio of 0.77 (95% CI, 0.59-1.00; P=.05). Conclusions: The use of IMRT is associated with reduced hospitalizations in elderly patients with anal SCC. Further work is warranted to understand the long-term health and cost impact of IMRT, particularly for patient subgroups most at risk of toxicity and hospitalization.

  13. Prosthetic rehabilitation of intentionally malpositioned implants in a patient with squamous cell carcinoma of the external auditory canal: a clinical report.

    Science.gov (United States)

    Bagherpour, Reza; Mirfazaelian, Ali; Mangoli, Amir A; Alikhasi, Marzieh

    2009-08-01

    This clinical report describes the rehabilitation of a patient with a compromised temporal bone anatomy caused by resection of bone due to squamous cell carcinoma of external auditory canal. Tumor resection was followed by placement of three implants. The implants were intentionally malpositioned in the anterior-posterior plane due to the lack of temporal bone. Prosthodontic treatment included customized implant bar-supported auricular prosthesis.

  14. Squamous cell carcinoma of external auditory canal lacking epidermal growth factor receptor protein overexpression, in an elderly Omani with oculocutaneous albinism treated with palliative radiotherapy

    OpenAIRE

    Furrukh, Muhammad; Mufti, Taha; Hamid, Rana Shoaib; Qureshi, Asim

    2014-01-01

    We report a case of squamous cell carcinoma of external auditory canal in an Omani man with oculocutaneous albinism. The disease mimicked inflammatory process revealing positive cultures for various microorganisms during the course of his illness. He was eventually biopsied to rule out atypical infective process or presence of malignancy. He was staged as T4N0M0 and treated with radical doses of palliative radiation therapy which was very well tolerated and resulted in a complete resolution o...

  15. Perineural Spread of Salivary Duct Carcinoma to the Internal Auditory Canal

    Directory of Open Access Journals (Sweden)

    Winfred Kitavi

    2014-01-01

    Full Text Available Salivary duct carcinomas (SDCs are high-grade malignant tumors exhibiting aggressive growth with early regional and distant metastasis. We report a case of SDC in a 63-year-old male with early recurrent disease in the cerebellopontine angle (CPA after total parotidectomy and adjuvant radiotherapy. The tendency of the tumor to recur or metastasize despite radical surgical measures and radiotherapy continues to pose a therapeutic challenge.

  16. Anal Cancer

    Science.gov (United States)

    ... to spread elsewhere in the body (metastasize). Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority ...

  17. Anal Fissures

    Science.gov (United States)

    ... with anal fissures Your doctor may prescribe stool softeners to make going to the bathroom easier and ... feel better. Fill the tub with enough lukewarm water to cover your hips and buttocks. Don’t ...

  18. [A Case of Carcinoma Associated with an Anal Fistula Repaired Using a Hatchet Flap after Neoadjuvant Chemoradiotherapy].

    Science.gov (United States)

    Kuroda, Masatoshi; Ikeda, Eiji; Yokoyama, Nobuji; Kenmotsu, Masaichi; Takagi, Shoji; Yamano, Toshihisa

    2016-11-01

    The patient was a 53-year-old man who complained of perianal pain. He had a 20-year history of an anal fistula. There was a 10 cm tumor with mucin-like discharge on the left side of the anus. His CEA level was high, at 7.3 ng/mL, and T2-weighted MRI revealed a multilocular cystic tumor with high signal intensity. The second biopsy result indicated mucinous adenocarcinoma. We performed neoadjuvant chemoradiotherapy. The chemotherapy regimen was TS-1 with radiation therapy, along with 4-port irradiation(50.4 Gy)of the primary tumor, located at the interior of the pelvis and inguinal lymph nodes. At the time of treatment completion, a partial response(PR)was observed, and a complete response(CR)was obtained after 6 months. We performed laparoscopic abdominoperineal resection. The large defect in the perianal skin and the pelvic cavity was repaired using a hatchet flap. The final diagnosis was confirmed as mucinous adenocarcinoma, pT4b, ly0, v0, N0, pPM0, pDM0, pRM0, pStage II . The patient was discharged 20 days after surgery. There is no indication of recurrence of the cancer after 1 year, and he continues to visit the outpatient clinic for regular follow-ups. Neoadjuvant chemoradiotherapy was effective in this case.

  19. Local tumor control and toxicity in HIV-associated anal carcinoma treated with radiotherapy in the era of antiretroviral therapy

    International Nuclear Information System (INIS)

    Oehler-Jänne, Christoph; Seifert, Burkhardt; Lütolf, Urs M; Ciernik, I Frank

    2006-01-01

    To investigate the outcome of HIV-seropositive patients under highly active antiretroviral treatment (HAART) with anal cancer treated with radiotherapy (RT) alone or in combination with standard chemotherapy (CT). Clinical outcome of 81 HIV-seronegative patients (1988 – 2003) and 10 consecutive HIV-seropositive patients under HAART (1997 – 2003) that were treated with 3-D conformal RT of 59.4 Gy and standard 5-fluorouracil and mitomycin-C were retrospectively analysed. 10 TNM-stage and age matched HIV-seronegative patients (1992 – 2003) were compared with the 10 HIV-seropositive patients. Pattern of care, local disease control (LC), overall survival (OS), cancer-specific survival (CSS), and toxicity were assessed. RT with or without CT resulted in complete response in 100 % of HIV-seropositive patients. LC was impaired compared to matched HIV-seronegative patients after a median follow-up of 44 months (p = 0.03). OS at 5 years was 70 % in HIV-seropositive patients receiving HAART and 69 % in the matched controls. Colostomy-free survival was 70 % (HIV+) and 100 % (matched HIV-) and 78 % (all HIV-). No HIV-seropositive patient received an interstitial brachytherapy boost compared to 42 % of all HIV-seronegative patients and adherence to chemotherapy seemed to be difficult in HIV-seropositive patients. Acute hematological toxicity reaching 50 % was high in HIV-seropositive patients receiving MMC compared with 0 % in matched HIV-seronegative patients (p = 0.05) or 12 % in all HIV-seronegative patients. The rate of long-term side effects was low in HIV-seropositive patients. Despite high response rates to organ preserving treatment with RT with or without CT, local tumor failure seems to be high in HIV-positive patients receiving HAART. HIV-seropositive patients are subject to treatment bias, being less likely treated with interstitial brachytherapy boost probably due to HIV-infection, and they are at risk to receive less chemotherapy

  20. Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy

    International Nuclear Information System (INIS)

    Fraunholz, Ingeborg; Weiss, Christian; Eberlein, Klaus; Haberl, Annette; Roedel, Claus

    2010-01-01

    Purpose: To report the clinical outcomes of chemoradiotherapy (CRT) for anal carcinoma in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy. Patients and Methods: Between 1997 and 2008, 21 HIV-positive patients who were receiving highly active antiretroviral therapy were treated with CRT (50.4 Gy at 1.8 Gy/fraction plus a 5.4-10.8-Gy external boost; 5-fluorouracil, 1,000 mg/m 2 , Days 1-4 and 29-32; and mitomycin C, 10 mg/m 2 , Days 1 and 29). A retrospective analysis was performed with respect to the tumor response, local control, cancer-specific and overall survival, and toxicity. The immunologic parameters, including pre- and post-treatment CD4 count, viral load, and acquired immunodeficiency syndrome-specific morbidity was recorded during follow-up (median, 53 months; range, 10-99). Results: CRT could be completed in all 21 patients with a reduction in the chemotherapy dose and/or interruption of radiotherapy in 5 and 5 cases, respectively. Acute Grade 3 toxicity occurred in 8 (38%) of the 21 patients. A complete response was achieved in 17 patients (81%), and tumor persistence or early progression was noted in 4 (19%). Six patients (29%) died, 5 of cancer progression and 1 of treatment-related toxicity. The 5-year local control, cancer-specific, and overall survival rate was 59%, 75%, and 67%, respectively. The median CD4 count significantly decreased from 347.5 cells/μL before CRT to 125 cells/μL 3-7 weeks after CRT completion (p <.001). In 6 (32%) of 19 patients, an increase of the HIV viral load was noted. Both parameters returned to the pretreatment values with additional follow-up. Conclusion: Our data have confirmed that in the highly active antiretroviral therapy era, HIV-related anal cancer can be treated with standard CRT without dose reductions. Close surveillance of the immunologic parameters is necessary.

  1. Biomarkers in anal cancer: from biological understanding to stratified treatment.

    Science.gov (United States)

    Jones, Christopher M; Goh, Vicky; Sebag-Montefiore, David; Gilbert, Duncan C

    2017-01-17

    Squamous cell carcinomas of the anus and anal canal represent a model of a cancer and perhaps the first where level 1 evidence supported primary chemoradiotherapy (CRT) in treating locoregional disease with curative intent. The majority of tumours are associated with infection with oncogenic subtypes of human papilloma virus and this plays a significant role in their sensitivity to treatment. However, not all tumours are cured with CRT and there remain opportunities to improve outcomes in terms of oncological control and also reducing late toxicities. Understanding the biology of ASCC promises to allow a more personalised approach to treatment, with the development and validation of a range of biomarkers and associated techniques that are the focus of this review.

  2. SFRO booklets - The radiotherapy of cancers: of anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder for a better understanding of radiotherapy, sarcoma radiotherapy - To better understand your treatment

    International Nuclear Information System (INIS)

    Leroy, Thomas; Mornex, Francoise; Peiffert, Didier; Thariat, Juliette; Faivre, Jean-Christophe; Huguet, Florence; Vendrely, Veronique; Barillot, Isabelle; Janoray, Guillaume; Bibault, Jean-Emmanuel; Antoni, Delphine; Crehange, Gilles; Meillan, Nicolas; Pichon, Baptiste; Biau, Julian; Pointreau, Yoann; Mirabel, Xavier; Leysalle, Axel; Claren, Audrey; Cartier, Lysian; Chand, Mari-Eve; Jacob, Julian; Renard-Oldrini, Sophie; Le Pechoux, Cecile; Ducassou, Anne; Moureau-Zabotto, Laurence; Lagrange, Jean Leon; Molina, Sarah

    2016-07-01

    This document gathers several booklets which, for different types of cancers, propose information regarding the anatomy and location of the cancer, its diagnosis, possible treatments, secondary effects during treatment, some practical advices, issues related to the post-treatment period, associations and other resources which can be useful for patient information, and a glossary of the main terms used for this cancer and its treatment. Cancer types are anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder cancers

  3. Câncer ano-reto-cólico: aspectos atuais v - câncer de reto: tratamento cirúrgico Anal canal and colorectal cancer: current features: v - rectal cancer - surgical management

    Directory of Open Access Journals (Sweden)

    Júlio César M. Santos Jr

    2009-03-01

    , the TME (total mesorectal excision was "the standout technique" introduced in the past 100 years able to modify local recurrence, to increase life expectancy of patients with rectal cancer, and to preserve the continence with ultra-low anastomosis through sphincter-sparing procedures. Most all of patients with rectal cancer must be operated with TME technique and only those with malignant neoplasm invading the anal canal should be submitted an abdominoperineal resection.

  4. Anal sphincter complex: endoanal MR imaging of normal anatomy

    NARCIS (Netherlands)

    Hussain, S. M.; Stoker, J.; Laméris, J. S.

    1995-01-01

    To determine the normal anatomy of the anal sphincter complex on magnetic resonance (MR) images. Ten healthy volunteers (four men, six women; age range, 21-26 years) underwent MR imaging with an endoanal coil. The lower part of the anal canal contained the internal sphincter, the longitudinal muscle

  5. Programmed death-ligand 1 expression correlates with diminished CD8+ T cell infiltration and predicts poor prognosis in anal squamous cell carcinoma patients

    Directory of Open Access Journals (Sweden)

    Zhao Y

    2017-12-01

    Full Text Available Yu-Jie Zhao,1 Wei-Peng Sun,2 Jian-Hong Peng,1 Yu-Xiang Deng,1 Yu-Jing Fang,1 Jun Huang,2 Hui-Zhong Zhang,3 De-Sen Wan,1 Jun-Zhong Lin,1,* Zhi-Zhong Pan,1,* 1Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 2Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, 3Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China *These authors contributed equally to this work Objective: Increased expression of programmed death-ligand 1 (PD-L1 on tumor cells can be found in various malignancies; however, very limited information is known about its role in anal squamous cell carcinoma (ASCC. This study explored PD-L1 expression in ASCC patients and its association with patients’ clinicopathological features, CD8+ T cell infiltration, and prognosis.Methods: Formalin-fixed paraffin-embedded tumor samples from 26 patients with ASCC were retrieved. The levels of PD-L1 expression on the membrane of both tumor cells and tumor-infiltrating mononuclear cells (TIMCs were evaluated by immunohistochemistry. CD8+ T cell densities, both within tumors and at the tumor–stromal interface, were also analyzed. Baseline clinicopathological characteristics, human papilloma virus (HPV status, and outcome data correlated with PD-L1-positive staining.Results: PD-L1 expression on tumor cells and TIMCs was observed in 46% and 50% of patients, respectively. Nineteen patients (73% were HPV positive, with 7 showing PD-L1-positive staining on tumor cells and 9 showing PD-L1-positive staining on TIMCs. Increasing CD8+ density within tumors, but not immune stroma, was significantly associated with decreased PD-L1 expression by both tumor cells and TIMCs (P=0.0043 and P=0.0007. Patients with negative PD-L1 expression had significantly better progression-free survival (P=0.038 and P

  6. Adenoid cystic carcinoma of the external auditory canal with metastases to lymph nodes and lungs--problematic diagnosis and treatment based on a case report.

    Science.gov (United States)

    Buda-Nowak, Anna; Swiąder, Małgorzata; Püsküllüoğlu, Mirosława; Dyduch, Grzegorz; Krupiński, Maciej; Krzemieniecki, Krzysztof

    2015-01-01

    Adenoid cystic carcinoma (ACC) of the external auditory canal (EAC) is an exceedingly rare tumor. Despite the slow growth it is characterized by a high malignancy and infiltration of surrounding tissue. Differential diagnosis may be especially difficult if the tumor appears in an atypical localization as it can present with non-specific features. The optimal treatment of this malignancy has not been fully established. We present a case report of a 55-year-old man with ACC of EAC metastasizing to the lymph nodes, lungs and vertebrae, with intracranial involvement. The patient was initially diagnosed with basal cell carcinoma (BCC) of EAC based on MR imaging examinations and excisional biopsy from EAC. Current information about nomenclature, epidemiology, characteristic features and treatment possibilities of ACC are presented and difficulties in making diagnosis are discussed. ACC should be considered among the malignant tumors of EAC. Its natural behavior is probably more unpredictable than commonly thought. Similar cases are rare and our knowledge about the tumor's specificity and prognosis is limited.

  7. Squamous cell carcinoma of external auditory canal lacking epidermal growth factor receptor protein overexpression, in an elderly Omani with oculocutaneous albinism treated with palliative radiotherapy.

    Science.gov (United States)

    Furrukh, Muhammad; Mufti, Taha; Hamid, Rana Shoaib; Qureshi, Asim

    2014-06-06

    We report a case of squamous cell carcinoma of external auditory canal in an Omani man with oculocutaneous albinism. The disease mimicked inflammatory process revealing positive cultures for various microorganisms during the course of his illness. He was eventually biopsied to rule out atypical infective process or presence of malignancy. He was staged as T4N0M0 and treated with radical doses of palliative radiation therapy which was very well tolerated and resulted in a complete resolution of disease clinically and a major soft tissue response on radiological imaging. Another unique finding was the absence of epidermal growth factor receptor (EGFR) protein overexpression in the tumour specimen. More than 90% of mucosal squamous cell carcinoma (SCC) involving the head and neck region overexpress the EGFR protein in normal skin patients. SCC is the predominant cutaneous malignancy in albinos, and the presence of EGFR protein overexpression in cutaneous SCC is believed to be 56-58% in normal skin patients. The scientific literature is scarce on reporting incidence of EGFR overexpression in either cutaneous or mucosal SCC in albinos, and it remains to be defined whether being albino is the cause for its absence. 2014 BMJ Publishing Group Ltd.

  8. Functional Morphology of Anal Sphincter Complex Unveiled by High Definition Manometery & 3-Dimensional Ultrasound Imaging

    Science.gov (United States)

    Raizada, Varuna; Bhargava, Valmik; Karsten, Anna; Mittal, Ravinder K.

    2011-01-01

    Objective Anal sphincter complex consists of anatomically overlapping internal anal sphincter (IAS), external anal sphincter (EAS) & puborectalis muscle (PRM). We determined the functional morphology of anal sphincter muscles using high definition manometery (HDAM), 3D-ultrasound (US) and Magnetic resonance (MR) imaging. Patients We studied 15 nulliparous women. Interventions HDAM probe equipped with 256 pressure transducers was used to measure the anal canal pressures at rest and squeeze. Lengths of IAS, PRM and EAS were determined from the 3D-US images and superimposed on the HDAM plots. Movements of anorectal angle with squeeze were determined from the dynamic MR images. Results HDAM plots reveal that anal canal pressures are highly asymmetric in the axial and circumferential direction. Anal canal length determined by the 3D-US images is slightly smaller than measured by HDAM. The EAS (1.9 ± 0.5 cm long) and PRM (1.7 ± 0.4 cm long) surround distal and proximal parts of the anal canal respectively. With voluntary contraction, anal canal pressures increase in the proximal (PRM) and distal (EAS zone) parts of anal canal. Posterior peak pressure in the anal canal moves cranially in relationship to the anterior peak pressure, with squeeze. Similar to the movement of peak posterior pressure, MR images show cranial movement of anorectal angle with squeeze. Conclusion Our study proves that the PRM is responsible for the closure of the cranial part of anal canal. HDAM, in addition to measuring constrictor function can also record the elevator function of levator ani/pelvic floor muscles. PMID:21951657

  9. Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

    International Nuclear Information System (INIS)

    Glynne-Jones, Robert; Nilsson, Per J.; Aschele, Carlo; Goh, Vicky; Peiffert, Didier; Cervantes, Andrés; Arnold, Dirk

    2014-01-01

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30–40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5–8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16–18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80–90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer

  10. Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal. Case report of a child

    International Nuclear Information System (INIS)

    Snietura, Miroslaw; Pakulo, Slawomir; Kopec, Agnieszka; Piglowski, Wojciech; Stanek-Widera, Agata; Chelmecka-Wiktorczyk, Liliana; Drabik, Grazyna; Kosowski, Bogdan; Wyrobek, Lukasz; Balwierz, Walentyna

    2017-01-01

    There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2-year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary. A 2-year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival. This is the first case of advanced, HPV-related HNSCC in a 2-year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor. (orig.) [de

  11. Surgery With or Without Postoperative Radiation Therapy for Early-stage External Auditory Canal Squamous Cell Carcinoma: A Meta-analysis.

    Science.gov (United States)

    Oya, Ryohei; Takenaka, Yukinori; Takemura, Kazuya; Ashida, Naoki; Shimizu, Kotaro; Kitamura, Takahiro; Yamamoto, Yoshifumi; Uno, Atsuhiko

    2017-10-01

    External auditory canal squamous cell carcinoma (EACSCC) is a rare disease with no standard treatment supported by high-level evidence. The aim of this study was to investigate EACSCC prognoses according to treatment modality and thus determine the optimal intervention for early-stage disease. PubMed, Scopus, and Ichushi-Web searches of the English and Japanese-language literature published between January 1, 2006 and December 31, 2016 were performed using the key words "external auditory canal cancer" and "temporal bone cancer." Articles related to EACSCC that include the 5-year overall survival rate or individual patient data for histological types, follow-up periods, and final outcomes were enrolled. Sex, age, Moody's modified Pittsburgh stage, type of treatment modality, type of operation, follow-up period, and 5-year survival rates were extracted. Twenty articles were used for the aggregate meta-analysis using a random-effects model, and 18 articles that reported 99 patients with early-stage EACSCC were used for the individual patient data meta-analysis. The 5-year overall survival rate of early-stage EACSCC was 77%. Postoperative radiation therapy (PORT) was performed in 45% of stage I patients and 68% of stage II patients. Survival analysis of all patients showed no differences between the surgery-only and PORT groups; however, PORT exhibited a better prognosis than surgery alone among patients with stage I disease (p = 0.003, log-rank test). This result indicated that PORT can be the standard therapy for stages I and II EACSCC.

  12. How the anal gland orifice could be found in anal abscess operations

    Directory of Open Access Journals (Sweden)

    Shahram Paydar

    2015-01-01

    Full Text Available Background: On an average 30-50% of patients who undergo incision and drainage (I and D of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time. Materials and Methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2% and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening. Results: The internal orifice was identified in 44 out of 49 patients (90% who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess. Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation.

  13. Risk factors for anal high-grade squamous intraepithelial lesions in HIV-positive MSM: is targeted screening possible?

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, Matthijs L.; Marra, Elske; de Vries, Henry J. C.; Schim van der Loeff, Maarten F.; Prins, Jan M.

    2017-01-01

    HIV-positive MSM are at increased risk for developing anal squamous cell carcinoma. Detection of precursor lesions of anal cancer [anal high-grade squamous intraepithelial lesions (HSIL)] is cumbersome and expensive. Our objective was to identify potential risk factors for anal HSIL in HIV-positive

  14. Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal. Case report of a child

    Energy Technology Data Exchange (ETDEWEB)

    Snietura, Miroslaw; Pakulo, Slawomir; Kopec, Agnieszka; Piglowski, Wojciech; Stanek-Widera, Agata [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Tumor Pathology Department, Gliwice (Poland); Chelmecka-Wiktorczyk, Liliana [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Drabik, Grazyna [University Children' s Hospital of Cracow, Pathology Department, Cracow (Poland); Kosowski, Bogdan [NZOZ Prosmed, Cracow (Poland); Wyrobek, Lukasz [University Children' s Hospital of Cracow, Department of Radiology, Cracow (Poland); Balwierz, Walentyna [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Jagiellonian University in Cracow, Clinic of Oncology and Hematology, Polish-American Pediatric Institute, Cracow (Poland)

    2017-02-15

    There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2-year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary. A 2-year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival. This is the first case of advanced, HPV-related HNSCC in a 2-year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor. (orig.) [German] Es gibt reichlich Belege dafuer, dass das menschliche Papillomavirus vom Hochrisikotyp (HR-HPV) in einigen Faellen von Plattenepithelkarzinomen des Kopf- und Halsbereichs (HNSCC) eine Schluesselrolle spielt. HPV-positive Tumoren verhalten sich anders, auch bezueglich des Ansprechens auf die Behandlung. Deswegen stellen sie eine separate biologische Gruppe dar. Sowohl HPV-positive als auch HPV

  15. Concurrent chemoradiotherapy with 5-fluorouracil and mitomycin C for anal carcinoma: Are there differences between HIV-positive and HIV-negative patients in the era of highly active antiretroviral therapy?

    International Nuclear Information System (INIS)

    Fraunholz, Ingeborg; Rabeneck, Daniela; Gerstein, Johanna; Jaeck, Katharina; Haberl, Annette; Weiss, Christian; Roedel, Claus

    2011-01-01

    Purpose: To report treatment compliance, toxicity and clinical outcome of chemoradiotherapy (CRT) for anal carcinoma in HIV-negative vs. HIV-positive patients treated with highly active antiretroviral therapy. Material and methods: Between 1997 and 2008, 25 HIV-positive and 45 HIV-negative patients received CRT (50.4 Gy at 1.8 Gy/fraction plus 5.4-10.8 Gy boost; 5-fluorouracil, 1000 mg/m 2 , Days 1-4 and 29-32, mitomycin C, 10 mg/m 2 , Days 1 and 29). Median follow-up was 51 (range, 3-235) months. Results: HIV-positive patients were significantly younger (mean age, 47 vs. 57 years, p < 0.001) and predominantly male (92% vs. 29%, p < 0.001). CRT could be completed in all patients with a reduction of chemotherapy and/or RT-interruption in 28% and 8%, respectively, in HIV-positive patients, and in 9% and 11%, respectively, in HIV-negative patients. Acute Grade 3/4-toxicity occurred in 44% vs. 49% (p = 0.79). Initial complete response (84% vs. 93%, p = 0.41), 5-year rates of local control (65% vs. 78%, p = 0.44), cancer-specific (78% vs. 90%, p = 0.17) and overall survival (71% vs. 77%, p = 0.76) were not significantly different. Conclusion: HIV-positive patients with anal cancer can be treated with standard CRT, with the same tolerability and toxicity as HIV-negative patients. Long-term local control and survival rates are not significantly different between these groups.

  16. Dose-Painted Intensity-Modulated Radiation Therapy for Anal Cancer: A Multi-Institutional Report of Acute Toxicity and Response to Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kachnic, Lisa A., E-mail: lisa.kachnic@bmc.org [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Tsai, Henry K. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, MA (United States); Coen, John J. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Blaszkowsky, Lawrence S. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hartshorn, Kevan [Department of Medicine, Boston Medical Center, Boston, MA (United States); Kwak, Eunice L. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Willins, John D. [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ryan, David P. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hong, Theodore S. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2012-01-01

    Purpose: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). Patients and Methods: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 Gy/fx to elective nodal PTV, and 54 Gy, 1.8 Gy/fx to the anal tumor and metastatic nodal PTV >3 cm with 50.4 Gy, 1.68 Gy/fx to nodal PTVs {<=}3 cm in size. Acute and late toxicity was reported by the treating physician. Actuarial analysis was performed using the Kaplan-Meier method. Results: Median age was 58 years; 67% female; 16% Stage I, 37% II; 42% III; 5% IV. Fourteen patients were immunocompromised: 21% HIV-positive and 12% on chronic immunosuppression. Median follow-up was 24 months (range, 0.6-43.5 months). Sixty percent completed chemoradiation without treatment interruption; median duration of treatment interruption was 2 days (range, 2-24 days). Acute Grade 3+ toxicity included: hematologic 51%, dermatologic 10%, gastrointestinal 7%, and genitourinary 7%. Two-year local control, overall survival, colostomy-free survival, and metastasis-free survival were 95%, 94%, 90%, and 92%, respectively. Conclusions: Dose-painted IMRT appears effective and well-tolerated as part of a chemoradiation therapy regimen for the treatment of anal canal cancer.

  17. Correlation between anal sphincter incompetence and anal sex practice in male homosexual

    OpenAIRE

    Ferreira, Maíra Costa; Braz, Tatiana Pereira; Machado, Ana Maria Oliveira; Ribeiro, Gabriel; Andrade, Rosana Cristina Pererira de

    2010-01-01

    INTRODUÇÃO: a incontinência anal (IA) é uma disfunção de origem multifatorial com impacto significativo na qualidade de vida do indivíduo. Dentre as diversas etiologias para IA encontra-se a traumática, provocada pela penetração de objetos no canal anal. A inclusão do ânus na atividade sexual, já vem sendo descrita, principalmente entre homossexuais do sexo masculino. A partir desta premissa, questionou-se nesta pesquisa a possibilidade da penetração do pênis no ânus se enquadrar como etiolog...

  18. Reproducibility and genital sparing with a vaginal dilator used for female anal cancer patients.

    Science.gov (United States)

    Briere, Tina Marie; Crane, Christopher H; Beddar, Sam; Bhosale, Priya; Mok, Henry; Delclos, Marc E; Krishnan, Sunil; Das, Prajnan

    2012-08-01

    Acute vulvitis, acute urethritis, and permanent sexual dysfunction are common among patients treated with chemoradiation for squamous cell carcinoma of the anal canal. Avoidance of the genitalia may reduce sexual dysfunction. A vaginal dilator may help delineate and displace the vulva and lower vagina away from the primary tumor. The goal of this study was to evaluate the positional reproducibility and vaginal sparing with the use of a vaginal dilator. Ten female patients treated with IMRT for anal cancer were included in this study. A silicone vaginal dilator measuring 29 mm in diameter and 114 mm in length was inserted into the vagina before simulation and each treatment. The reproducibility of dilator placement was investigated with antero-posterior and lateral images acquired daily. Weekly cone beam CT (CBCT) imaging was used to confirm coverage of the GTV, which was typically posterior and inferior to the dilator apex. Finally, a planning study was performed to compare the vaginal doses for these 10 patients to a comparable group of 10 female patients who were treated for anal cancer with IMRT without vaginal dilators. The absolute values of the location of the dilator apex were 7.0 ± 7.8mm in the supero-inferior direction, 7.5 ± 5.5 mm in the antero-posterior, and 3.8 ± 3.1mm in the lateral direction. Coverage of the GTV and CTV was confirmed from CBCT images. The mean dose to the vagina was lower by 5.5 Gy, on average, for the vaginal dilator patients, compared to patients treated without vaginal dilators. The vaginal dilator tended to be inserted more inferiorly during treatment than during simulation. For these ten patients, this did not compromise tumor coverage. Combined with IMRT treatment planning, use of a vaginal dilator could allow for maximum sparing of female genitalia for patients undergoing radiation therapy for anal cancer. Published by Elsevier Ireland Ltd.

  19. Impact of hypothyroidism on primary anal malignant melanoma: a rare entity.

    Science.gov (United States)

    Singh, Siddharth; Verma, Satyajeet; Kala, Sanjay

    2014-01-01

    Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  20. Impact of hypothyroidism on primary anal malignant melanoma: A rare entity

    Directory of Open Access Journals (Sweden)

    Siddharth Singh

    2014-01-01

    Full Text Available Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  1. Should the treatment of anal carcinoma be adapted in the elderly? A retrospective analysis of acute toxicities in a French centre and a review of the literature

    International Nuclear Information System (INIS)

    De Bari, B.; Lestrade, L.; Chekrine, T.; Shakir Shakir, I.; Ardiet, J.M.; Chapet, O.; Mornex, F.

    2012-01-01

    Purpose. - To study the tolerance to radiotherapy, with or without chemotherapy, followed by brachytherapy, in elderly patients (75 years or older) suffering from anal cancer. Patients and methods. - We treated 12 elderly patients with a curative intent. Median age was 78 years (range: 75-90). Ten patients had a stage II or IIIA (UICC 2009) tumour and six out of 12 were N+. Taking into account the age, the Eastern Cooperative Oncology Group (ECOG) performance status and co-morbidities, five patients received exclusive radiotherapy ('RT group') and seven a concomitant radio-chemotherapy ('RT-CT group'). All patients received a boost by interstitial brachytherapy. One patient of the 'RT-CT group' presented rectorragies during brachytherapy. The irradiation was completed by external beam radiotherapy focalized on the tumour volume. Results. - Grade 3 acute reactions (Radiation Therapy Oncology Group [RTOG]) were reported in three out of 12 patients. One grade 2-3 leucopenia was observed in one out of 7 patients ('RT-CT group'). After brachytherapy, one grade 3 rectal toxicity (rectorrhagia) (in 'RT group') and one grade 4 (in 'RT-CT group') were observed. One patient ('RT-CT group') presented a late grade 3 rectal toxicity (evaluated only for patients with at least 12 months of follow-up). Conclusions. - Concomitant radio-chemotherapy followed by brachytherapy showed an acceptable toxicity profile, and seems to be adapted in selected elderly patients. It could be recommended as reference treatment in elderly patients with a good physiological status. (authors)

  2. Cancer of the external auditory canal

    DEFF Research Database (Denmark)

    Nyrop, Mette; Grøntved, Aksel

    2002-01-01

    OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000...

  3. canal24

    Data.gov (United States)

    California Natural Resource Agency — Canal system center lines in the Central Valley of California and adjacent areas captured from 1:24,000-scale USGS topographic maps. Updates and modifications made...

  4.  Surgical excision of extensive anal condylomata is a safe operation without risk of anal stenosis

    Directory of Open Access Journals (Sweden)

    Konrad Wroński

    2012-03-01

    Full Text Available  Introduction:Anal condylomata acuminata was a well-known disease in ancient times but in recent years there has been a rapidly increasing number of people who suffer from this disease. The main cause of this disease is infection of human papilloma virus (HPV which occurs through sexual contact.Currently there are three different ways to treat anal condylomata. Small changes of anal condylomata can be treated with local therapeutic agents, but the best results of treatment of extensive changes are obtained by surgical techniques.Material/Methods:The study group consisted of 30 patients with diagnosed extensive anal condylomata who underwent surgery in Mikolaj Pirogow High Specialized Hospital in Lodz. The survey was conducted from 2007 to 2011. Patients had been directed to the surgical ward by general surgeons and practitioners, proctologists and urologists. The diagnosis was made after proctological assessment in the knee-chest position.Results:All patients underwent surgery and had complete macroscopic electroexcision of anal condylomata. In the research group there was no mortality. Postoperative complications occurred in 4 (13.3�20patients – postoperative bleeding. Strong pain was present in 14 (46.7�20patients but only in the postoperative period. During postoperative follow-up there was no observed infection in the anal region or recurrence of disease. In the operated group there were no observed cosmetic deformations of the anus and/or the anal canal, narrow anal canal or functional fecal incontinence symptoms.Conclusions:Surgical treatment of anal condylomata is an effective and safe method for the patient. In our research there were no serious postoperative complications or recurrence of the disease during the follow-up period.

  5. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  6. Evaluation of expression and function of vascular endothelial growth factor receptor 2, platelet derived growth factor receptors-alpha and -beta, KIT, and RET in canine apocrine gland anal sac adenocarcinoma and thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Urie Bridget K

    2012-05-01

    Full Text Available Abstract Background Toceranib phosphate (Palladia has a reported objective response rate of 25% in both canine apocrine gland anal sac adenocarcinoma (AGASACA and thyroid carcinoma (TC, with stable disease occurring in an additional 50-60% of dogs. The basis for the observed responses to toceranib is not known. The purpose of this study was to evaluate AGASACA and TC samples for the expression and activation of VEGFR2, PDGFRα, PDGFRβ, KIT and RET to assess whether dysregulation of these receptor tyrosine kinases (RTKs may contribute to the biologic activity of toceranib. Results mRNA for VEGFR2, PDGFRα/β, KIT and RET was detected in all AGASACA samples. mRNA for VEGFR2, PDGFRα/β, and KIT was detected in all TC samples, while mRNA for RET was amplified in 10/15 samples. No phosphorylation of VEGFR2, PDGFRα/β, or KIT was observed on the arrays. However, phosphorylation of RET was detected in 54% of the primary AGASACA and 20% of TC. VEGFR2 was expressed in 19/24 primary and 6/10 metastatic AGASACA and 6/15 TC samples. KIT was present in 8/24 primary and 3/10 metastatic AGASACA and 9/15 TC samples. PDGFRα expression was noted in all tumor samples. In contrast PDGFRβ expression was found in only a few tumor samples but was evident in the stroma of all tumor specimens. Conclusions Known targets of toceranib are expressed in both AGASAC and TC. Given the observed expression of VEGFR and PDGFRα/β and phosphorylation of RET, these RTKs merit investigation as to their roles in the biology of AGSACA and TC and their contribution to toceranib’s activity.

  7. Anal Disorders - Multiple Languages

    Science.gov (United States)

    ... Health Information Translations Spanish (español) Expand Section Anal Disorders: MedlinePlus Health Topic - English ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  8. Anal Cancer Treatment

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat anal cancer. Chemotherapy Chemotherapy ...

  9. Stages of Anal Cancer

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat anal cancer. Chemotherapy Chemotherapy ...

  10. Câncer ano-reto-cólico: aspectos atuais III - câncer de reto - terapêutica neoadjuvante Anal canal and colorectal cancer: current features III - rectal cancer - neodajuvant chemoradiation

    Directory of Open Access Journals (Sweden)

    Júlio César M Santos Jr

    2008-03-01

    Full Text Available O tratamento cirúrgico do câncer de reto era feito por meio de operação via abdominal se o tumor estivesse no terço superior ou abdominoperineal, se o tumor estivesse no terço médio ou inferior, era associado à radioterapia e/ou a quimioterapia. A preservação do esfíncter anal, pelos princípios cirúrgicos vigentes, era limitada e destinava-se aos tumores que estavam acima do alcance do toque digital. As anastomoses baixas, ensaiadas em doenças benignas, foram introduzidas para o câncer, mas somente ganharam destaques com grampeadores mecânicos. Avanços posteriores incorporaram novas concepções sobre a anatomia cirúrgica do reto e seus aspectos oncológicos, provocando alterações operatórias cujos resultados promoveram revisão de conceitos e emancipação da terapêutica. O arsenal farmacológico foi tão ampliado e enriquecido, que o embaraço atual está em escolher e testar as drogas oncológicas disponíveis. Paralelamente aos aceleradores lineares, os avanços na área de computação e produção de imagens radiológicas possibilitaram o planejamento tridimensional do segmento anatômico a ser atingido, com ganhos valorosos para a radioterapia. O maior desafio no tratamento do câncer de reto, superado os aspectos físicos e cirúrgico-anatômicos, continua sendo o controle da recidiva local, ainda que bem inferiores aos observados no passado. Esse progresso ocorreu graças ao avanço tecnológico das imagens ultra-sonográficas e da ressonância magnética que, no campo propedêutico, vêm aprimorando o estadiamento do tumor; à maior definição do uso da terapêutica neo-adjuvante, à técnica cirúrgica de excisão total do mesorreto e ao apuro manual dos cirurgiões.The management of locally advanced rectal cancer was done by surgery followed by radiotherapy and/or 5-fluorouracil chemotherapy. Anterior resection with sphincter-sparing was devised for removal malignant disease on the upper third of rectum and

  11. Do changes in anal sphincter anatomy correlate with anal function in women with a history of vaginal delivery?

    Science.gov (United States)

    Murad-Regadas, Sthela Maria; Dealcanfreitas, Iris Daiana; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Pereira, Jacyara de Jesus Rosa

    2014-01-01

    To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Female with fecal incontinence and vaginal delivery were assessed with Wexner's score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Fecal incontinence symptoms did not correlate with anal pressures and anal sphincter anatomy changes, but women with sphincter defects have shorter anterior EAS and IAS and a longer gap.

  12. To analyze the impact of intracavitary brachytherapy as boost radiation after external beam radiotherapy in carcinoma of the external auditory canal and middle ear: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Dinesh K Badakh

    2014-01-01

    Conclusion: ICBT as a boost after EBRT has got a positive impact on the OS. In conclusion, our results demonstrate that radical radiation therapy (EBRT and ICBT is the treatment of choice for stage T2, carcinoma of EACMA.

  13. A novel four quadrant laser sphincterotomy for idiopathic severe anal stenosis

    Directory of Open Access Journals (Sweden)

    Ashwin Porwal

    2018-01-01

    Full Text Available Anal stricture or stenosis, though uncommon, is disabling condition. It affects the quality of life due to pain, bleeding and difficulty in defecation, incontinence or increased frequency. It occurs when the normally pliable anoderm is replaced with fibrotic connective tissue, leading to an abnormally tight and inelastic anal canal. Mostly it occurs secondary to trauma, iatrogeny, inflammatory diseases, radiation or neoplasia. The treatment of anal stricture is generally considered to be difficult and various methods of treatment have been suggested. It is often unresponsive to conservative medical management. The surgical procedures such as dilatations and anoplasty are associated with significant complications which make it a difficult treatment challenge. Several good treatment options are available currently. Through this case, we report and explore a new medical treatment for anal strictures with four quadrant laser sphincterotomy. Resumo: A estritura ou estenose anal, embora incomum, é problema incapacitante. Essa condição afeta a qualidade de vida por causa da dor, do sangramento e da dificuldade de defecação, de incontinência ou aumento da frequência. A estenose anal ocorre quando o anoderma, normalmente flexível, foi substituído por tecido conjuntivo fibrótico, e o resultado é um canal anal anormalmente estenosado e inelástico. Na maioria dos casos, a estenose anal ocorre secundariamente a trauma, por causa iatrogênica, por doença inflamatória, radiação ou neoplasia. Em geral, se considera que o tratamento dessa condição é tarefa difícil, tendo sido sugeridos diversos métodos de tratamento. Com frequência a estenose anal não responde ao tratamento clínico conservador. Procedimentos cirúrgicos como as dilatações ou a anoplastia estão associados a complicações significativas, implicando difícil desafio terapêutico. Atualmente, o cirurgião conta com várias opções terapêuticas satisfatórias. No

  14. NMR imaging of the vertebral column and the spinal canal. 2. rev. and enl. ed.; MRT der Wirbelsaeule und des Spinalkanals

    Energy Technology Data Exchange (ETDEWEB)

    Forsting, Michael [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Uhlenbrock, Detlev [St.-Josefs-Hospital, Dortmund (Germany). MVZ Radiologie, Nuklearmedizin und Strahlentherapie; Wanke, Isabel [Privatklinikengruppe Hirslanden, Zurich (Switzerland); Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie

    2009-07-01

    The book on the MRT (magnetic resonance tomography) of the vertebral cord and spinal canal covers the following topics: physics fundamentals and application; malformation of the spinal canal; degenerative vertebral column diseases; vertebral column and spinal canal carcinomas; inflammatory diseases of the vertebral column and the spinal canal; applicability of MRT in case of acute spinal cord traumata; vascular diseases of the spinal canal.

  15. Defects on endoanal ultrasound and anal incontinence after primary repair of fourth-degree anal sphincter rupture: a study of the anal sphincter complex and puborectal muscle

    DEFF Research Database (Denmark)

    Sakse, A; Secher, N J; Ottesen, M

    2009-01-01

    as the length of the anal canal, and then correlate these measures with AI; and to assess the interobserver measurement agreement between an inexperienced and an experienced sonologist. METHODS: EAUS was offered to 84 consecutive women, who were asked to answer a validated questionnaire after fourth-degree ASR......OBJECTIVES: To perform three-dimensional endoanal ultrasound (EAUS) after primary repair of fourth-degree anal sphincter rupture (ASR) and correlate the sonographic defects with anal incontinence (AI); to measure the axial and sagittal thickness and angle of the puborectal muscle (PRM) as well...... with Starck score. No clear association between the measurements of the PRM and AI was shown. The experienced observer detected more of the small defects than did the inexperienced observer. CONCLUSION: In a 1-9-year follow-up period after primary suture of fourth-degree ASR, the frequency of AI was high...

  16. Anal screening cytology

    Directory of Open Access Journals (Sweden)

    Leiman Gladwyn

    2005-02-01

    Full Text Available Abstract This issue of CytoJournal contains an article on screening for anal intraepithelial neoplasia in high-risk male patients. This accompanying Editorial focuses on current understanding of this relatively new disease entity, with insights as to the potential role of screening cytopathology in the epidemiology, pathophysiology and clinical management of this HIV and HPV related anal lesion, which predominates in male patients living long-term with AIDS. Mention is made of techniques of obtaining samples, methods of preparation, and morphologic classification. Issues of anoscopic confirmation, as well as topical and surgical management are emphasized. The similarity of initial experiences in anal screening to problems encountered early in cervical cancer screening programs several decades ago, are highlighted.

  17. Obstetric anal sphincter injuries

    Directory of Open Access Journals (Sweden)

    Remon Keriakos

    2015-10-01

    Full Text Available Obstetric anal sphincter injuries can be associated with significant short and long term consequences causing devastating impacts on the quality of lives of young, otherwise healthy women. The major consequence is anal incontinence which may be short or long term and vary in severity. The other consequences include pain, infection, dyspareunia and sexual dysfunction. This may in turn result in considerable economic burden to health care providers and patients. It also has an implication on future deliveries. Although it can never be eliminated, it can be reduced by improving practice, training and provision of high quality multidisciplinary care in order to reduce long-term morbidity. Obstetric anal sphincter injuries are also a source of litigation which can be distressing to both patients and clinicians. The aim of this review article is to explore the available evidence on epidemiology, strategies for preventions, prognosis and also how to deal with governance issues.

  18. Long-term anal incontinence after obstetric anal sphincter injury

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2018-01-01

    BACKGROUND: Anal incontinence is a major concern following delivery with obstetric anal sphincter injury and has been related to the degree of sphincter tear. OBJECTIVES: To 1) evaluate whether women with a fourth degree obstetric anal sphincter injury in the first delivery have an increased risk...... of long-term anal- and fecal incontinence after a second delivery and 2) assess the impact of mode of second delivery on anal incontinence and related symptoms in these patients. STUDY DESIGN: We performed secondary analyses of a national questionnaire study in all Danish women with an obstetric anal...... performed uni- and multivariable logistic regression analyses to evaluate the outcomes. RESULTS: In total, 2,008 patients had an obstetric anal sphincter injury of which 12.2% (n=245) had a fourth degree tear in the first delivery. The median follow-up time since the first delivery with OASIS was 11.6 years...

  19. Familial Peters Plus syndrome with absent anal canal, sacral ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2013-07-23

    Jul 23, 2013 ... Hydrocephalus, agenesis of the corpus callosum, · and cleft lip/palate represent frequent associations in fetuses with · Peters' plus syndrome and B3GALTL mutations. Fetal PPS · phenotypes, expanded by Dandy Walker cyst and encephalocele. Prenat Diagn 2013;33:75–80. 428. R.M. Shawky et al.

  20. The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

    Directory of Open Access Journals (Sweden)

    A. M. Vieira

    2010-05-01

    Full Text Available Objective: endoanal ultrasonography can detect organic causes of anal pain without pathology on physical examination. The aim of this study is to evaluate the importance of endoanal ultrasonography in the diagnosis and therapeutic management of idiopathic and functional anal pain. Material and methods: retrospective study, between 15 March 2005 and 15 June 2008, of all patients with proctalgia and normal examination or with alterations not responsible for anal pain at proctologic exam that have undergone an endoanal ultrasonography. Results: a total of 90 patients were analyzed, with a mean age of 50.5 years, 58% were female. Twenty-three patients had functional anal pain clinic criteria. Endoanal ultrasonography revealed alterations in 49% of patients. The primary findings were changes in sphincters in 14 patients, followed by anal sepsis in 12 patients, anal fissure in 10 patients, perirectal lesions in 6 patients and ulcer of the anal canal in 2 patients. Of the patients with sphincter defects, 5 patients had criteria of chronic anal pain. In this group of patients, no differences were found in manometric and defecographic results between the different ultrasound abnormalities. Conclusions: the endoanal ultrasonography detected occult organic lesions to proctologic examination, in half the patients with anal pain. Ultrasound abnormalities were found in 22% of patients with functional anal pain. However, there was no correlation between ultrasound findings and physiological studies, and therefore could not find etiological or pathogenic factors of functional anal pain.Objetivo: la ecografía endoanal puede detectar causas orgánicas en el dolor anal sin patología en la exploración física. El objetivo de este estudio es evaluar la importancia de la ecografía endoanal en el diagnóstico y en el abordaje terapéutico del dolor anal idiopática y funcional. Material y métodos: estudio retrospectivo realizado entre el 15 de marzo de 2005 y el

  1. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

    Science.gov (United States)

    Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

    2015-01-01

    In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, pSingapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

  2. Management of giant anal condyloma by wide local excision and anoplasty.

    Science.gov (United States)

    Uribe, N; Rueda, C; López, M; Balciscueta, Z; Martín, M C; Terrádez, J J; Flores, J

    2012-11-01

    Treatment of giant condyloma acuminatum, is controversial, especially in human immunodeficiency virus (HIV)-positive patients, owing to concern over wound healing, complications, risk of progression to carcinoma and a high recurrence rate. The aim of this study was to evaluate the outcome after extensive local excision with V-Y anoplasty. Nine patients were identified from a prospective database, six of whom were HIV positive. All patients had a giant perianal condyloma acuminatum extending into the anal canal and perianal region, which required wide excision with V-Y reconstruction. Postoperative complications, recurrence and continence were all determined. Nine patients were included (eight men, median age 40 years), six seropositive for HIV infection. A bilateral V-Y anoplasty was performed in six patients, and unilateral in two. There were no postoperative infections, graft failures or flap necrosis. The mean follow-up was 92 (2-137) months. One patient developed local recurrence treated with excision under local anaesthesia. Extensive local surgery of giant perianal condyloma with anoplastic reconstruction gives good results even in HIV-positive patients. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  3. Testing for and the role of anal and rectal sensation.

    Science.gov (United States)

    Rogers, J

    1992-03-01

    The rectum is insensitive to stimuli capable of causing pain and other sensations when applied to a somatic cutaneous surface. It is, however, sensitive to distension by an experimental balloon introduced through the anus, though it is not known whether it is the stretching or reflex contraction of the gut wall, or the distortion of the mesentery and adjacent structures which induces the sensation. No specific sensory receptors are seen on careful histological examination of the rectum in humans. However, myelinated and non-myelinated nerve fibres are seen adjacent to the rectal mucosa, but no intraepithelial fibres arise from these. The sensation of rectal distension travels with the parasympathetic system to S2, S3 and S4. The two main methods for quantifying rectal sensation are rectal balloon distension and mucosal electrosensitivity. The balloon is progressively distended until particular sensations are perceived by the patient. The volumes at which these sensations are perceived are recorded. Three sensory thresholds are usually defined: constant sensation of fullness, urge to defecate, and maximum tolerated volume. The modalities of anal sensation can be precisely defined. Touch, pain and temperature sensation exist in normal subjects. There is profuse innervation of the anal canal with a variety of specialized sensory nerve endings: Meissner's corpuscles which record touch sensation, Krause end-bulbs which respond to thermal stimuli, Golgi-Mazzoni bodies and pacinian corpuscles which respond to changes in tension and pressure, and genital corpuscles which respond to friction. In addition, there are large diameter free nerve endings within the epithelium. The nerve pathway for anal canal sensation is via the inferior haemorrhoidal branches of the pudendal nerve to the sacral roots of S2, S3 and S4. Anal sensation may be quantitatively measured in response to electrical stimulation. The technique involves the use of a specialized constant current generator

  4. Economic burden of anal cancer management in France.

    Science.gov (United States)

    Abramowitz, L; Rémy, V; Vainchtock, A

    2010-10-01

    The incidence of anal cancer has increased over the last 25 years. No organized screening exists for the precursors of anal cancer (anal intraepithelial neoplasia and carcinoma in situ) and diagnosis is often delayed. Treatment for precursor lesions is of limited success, while cancer management is traumatic for the patient. Like cancers of the cervix, most cases of anal cancer are associated with infection with human papillomavirus (HPV). With increases in the incidence of anal cancer, and in light of the availability of prevention strategies such as screening and HPV vaccination, it is important, from a public health perspective, to assess the economic burden of anal cancer in France. We performed a retrospective analysis based on data extracted from a French hospital database - the Programme de médicalisation des systèmes d'information (PMSI) - to assess the number and management of patients hospitalized for anal cancer in 2006. Data on radiotherapy sessions performed in private hospitals were obtained from the Statistiques annuelles des établissements de santé (SAE) database. Costs of hospitalization, from the healthcare-payer perspective, were obtained from official diagnosis-related group tariffs for public and private hospitals. Ambulatory and indirect costs were estimated using information obtained from the literature. In 2006, 3,711 patients with anal cancer were treated in hospitals in France. Of these, the majority were women (69%). The annual cost of hospital treatment for anal cancer was estimated at € 20,326,868. The overall estimated cost (including hospitalization, outpatient and daily allowances costs) to the healthcare payer was € 38,249,981. This study, the first to investigate the economic burden of anal cancer in France, shows that the management costs of anal cancer are high and comparable to cervical cancer management costs (€ 44 million). Further research is required to determine the cost of management of precursor lesions, which

  5. A study of the effect of renal pelvic and ureteric distention on the anorectal function with identification of the "reno-anal reflex".

    Science.gov (United States)

    Shafik, A

    1998-05-01

    Renal or ureteral diseases are often associated with gastrointestinal symptoms. In this communication, we studied the effect of renal pelvic or ureteric distension on the anorectal function in 12 healthy volunteers. A 3F balloon-tipped catheter was introduced into the renal pelvis. The balloon was filled with saline in increments of 2 ml up to 12 ml and the pressure response of the rectum and anal canal was recorded. Balloon filling was performed twice: rapidly (1 ml/sec) and slowly (1 ml/min). The test was repeated in the ureter with balloon fillings in increments of 0.25 ml up to 1 ml. The electromyographic (EMG) response of the external anal sphincter to distension of the renal pelvis or ureter was evaluated. The pressure response of the rectum, anal canal and external anal sphincter to distension of the anesthetised renal pelvis or ureter was then determined. The test was repeated after external anal sphincter anaesthetisation. Rapid renal pelvic or ureteric distension increased the anal canal pressure (p 0.05). With 10 and 12 ml rapid renal pelvis distension and with 0.75 and 1 ml rapid ureteric distension, the EMG activity of the external anal sphincter increased and was accompanied with loin and anal pain. Slow renal pelvic or ureteric distension caused no significant change in the anal or rectal pressures (p > 0.05) or in the EMG activity of the external anal sphincter and no anal pain was perceived. Distension of the anesthetised renal pelvis or ureter effected no changes in anal or rectal pressures (p > 0.05). The anesthetised external anal sphincter as well as the anal or rectal pressure did not respond to renal pelvis or ureteric distension. In conclusion, rapid renal pelvic or ureteric distension stimulates the mechanoreceptors in the renal pelvis or ureteric wall leading to reflex external anal sphincter contraction. This leads to elevation of the anal canal pressure. The findings suggest the possible involvement of a "reno-anal reflex" which is

  6. Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

    Directory of Open Access Journals (Sweden)

    Marina Tayla Mesquita Aguiar

    2014-04-01

    Full Text Available Anal cancer is relatively rare; however, its incidence has increased in recent years. Several risk factors are associated with the development of anal cancer, including age older than 50 years, low-fiber diet, chronic anal fistulas, smoking, multiple partners, anal intercourse practice, Human Immunodeficiency Virus infection and immunosuppression. However, the presence of human papillomavirus represents the main risk factor for the development of anal cancer. The aim of this study was to evaluate the clinicopathological aspects of a series of patients with anal carcinomas diagnosed in Hospital Araújo Jorge, Goiânia-Goiás, as well as the prevalence of human papillomavirus genome in these tumors. Clinical, pathological and socio-demographic data were collected from the respective medical files and paraffin blocks containing anal carcinomas specimens were used for DNA extraction and detection of human papillomavirus, by means of polymerase chain reaction, using short PCR fragment primers. Forty-three cases were selected and had the data analyzed, while 38 cases were tested for human papillomavirus genome detection. Among the evaluated patients, 62.8% were women; 53.4% of tumors were squamous cell carcinoma and 46.5% of the patients were aged between 60 and 75 years. Risk factors, such as smoking (39.5% and alcoholism (20.9% were recorded in the studied group. Lymph node metastases were detected in 30.2% of cases and 7.0% had distant metastasis. The detection of human papillomavirus DNA was positive in 76% of cases assessed and this was significantly associated with squamous cell carcinomas. Aggressive behavior and advanced stage of anal cancer described in this study highlight the need for preventive measures that contemplate these tumors, including vaccination against human papillomavirus. Resumo: O câncer anal é relativamente raro, entretanto, sua incidência aumentou nos últimos anos. Vários fatores de risco são associados ao

  7. Cancer of the external auditory canal

    DEFF Research Database (Denmark)

    Nyrop, Mette; Grøntved, Aksel

    2002-01-01

    MEASURE: Recurrence rate. RESULTS: Half of the patients had squamous cell carcinoma. Thirteen of the patients had stage I tumor (65%), 2 had stage II (10%), 2 had stage III (10%), and 3 had stage IV tumor (15%). Twelve patients were cured. All patients with stage I or II cancers were cured except 1...... with adenoid cystic carcinoma. No patients with stage III or IV cancer were cured. All recurrences developed in patients with incompletely resected tumors. CONCLUSIONS: The outcome was related to the stage of disease, suggesting that the Pittsburgh staging system is useful also in patients with non......OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000...

  8. ANAL INCONTINENCE AFTER UNRECOGNISED ANAL SPHINCTER TEAR AT VAGINAL DELIVERY

    Directory of Open Access Journals (Sweden)

    Mija Blaganje

    2018-02-01

    Full Text Available Background: Anal sphincter tears during vaginal delivery may result in serious sequel. Anal sphincter tears occur in approximately 2–19 % of all vaginal deliveries and are the most common precursor for faecal incontinence,1 however »occult« anal sphincter injury has been defined in 33 % of primiparous women following vaginal delivery.2 Methods: 31-year old primiparous woman received transfusion due to atony after delivery. Episiotomy, second degree perineal tear and vaginal tear were surgically corrected immediately after delivery. In the following days inability to control passing of liquid stools and flatulence together with stress urinary incontinence appeared. The complaint persisted. Ultrasound and EMG examination confirmed rupture of the external anal sphincter, which had been missed at delivery. Over a year after delivery the patient had a posterior colporraphy with surgical correction of external anal sphincter, which did not result in any clinical improve- ment. On follow-up ultrasound examination a hypoechoegenic area between the external sphincter and vaginal wall was detected. The patient was referred to The University Hos- pital in Graz, where the tear will be treated with autologous myoblast transplantation in a clinical trial. Conclusions: Treatment of a missed anal sphincter tear is complicated, expensive and unpleasant for the patient. Early detection with immediate appropriate surgical correction after delivery is most efficient, but it takes experience.

  9. Treatment Option Overview (Anal Cancer)

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat anal cancer. Chemotherapy Chemotherapy ...

  10. Comparative study of anal acoustic reflectometry and anal manometry in the assessment of faecal incontinence

    DEFF Research Database (Denmark)

    Hornung, B R; Mitchell, P J; Carlson, G L

    2012-01-01

    Anal acoustic reflectometry (AAR) is a reproducible technique providing a novel physiological assessment of anal sphincter function. It may have advantages over conventional anal manometry. The aims of this study were to determine the ability of AAR and anal manometry to identify changes in anal ...... sphincter function in patients with faecal incontinence (FI) and to relate these changes to the severity of FI....

  11. Topographic Anatomy of the Anal Sphincter Complex and Levator Ani Muscle as It Relates to Intersphincteric Resection for Very Low Rectal Disease.

    Science.gov (United States)

    Tsukada, Yuichiro; Ito, Masaaki; Watanabe, Kentaro; Yamaguchi, Kumiko; Kojima, Motohiro; Hayashi, Ryuichi; Akita, Keiichi; Saito, Norio

    2016-05-01

    Intersphincteric resection has become a widely used treatment for patients with rectal cancer. However, the detailed anatomy of the anal canal related to this procedure has remained unclear. The purpose of this study was to clarify the detailed anatomy of the anal canal. This is a descriptive study. Histologic evaluations of paraffin-embedded tissue specimens were conducted at a tertiary referral hospital. Tissue specimens were obtained from cadavers of 5 adults and from 13 patients who underwent abdominoperineal resection for rectal cancer. Sagittal sections from 9 circumferential portions of the cadaveric anal canal (histologic staining) and 3 circumferential portions from patients were studied (immunohistochemistry for smooth and skeletal muscle fibers). Longitudinal fibers between the internal and external anal sphincters consisted primarily of smooth muscle fibers that continued from the longitudinal muscle of the rectum. The levator ani muscle attached directly to the lateral surface of the longitudinal smooth muscle of the rectum. The length of the attachment was longer in the anterolateral portion and shorter in the posterior portion of the anal canal. In the lateral and posterior portions, the levator ani muscle partially overlapped the external anal sphincter; however, there was less overlap in the anterolateral portion. In the posterior portion, thick smooth muscle was present on the surface of the levator ani muscle and it continued to the longitudinal muscle of the rectum. We observed only limited portions in some surgical specimens because of obstruction by tumors. The levator ani muscle attaches directly to the longitudinal muscle of the rectum. The spatial relationship between the smooth and skeletal muscles differed in different portions of the anal canal. For intersphincteric resection, dissection must be performed between the longitudinal muscle of the rectum and the levator ani muscle/external anal sphincter, and the appropriate surgical lines

  12. The Evaluation of Digital Rectal Examination for Assessment of Anal Tone in Suspected Cauda Equina Syndrome.

    Science.gov (United States)

    Sherlock, Katrina Eve; Turner, William; Elsayed, Sherief; Bagouri, M; Baha, L; Boszczyk, Bronek M; McNally, Donal

    2015-08-01

    Seventy-five doctors completed a questionnaire documenting their grade, specialty, and experience in performing digital rectal examination (DRE). A model anus, using a pressure transducer surrounding an artificial canal, was assembled and calibrated. Participants performed 4 DREs on the model (with a break between attempts) and predicted tone as "reduced" or "normal" (35 and 60 mm Hg, respectively), followed by a "squeeze" test. Thirty health care assistants partook as a control group with no training in DRE. Our main objective was to investigate the validity of digital rectal examination (DRE) for assessment of anal tone. Cauda equina syndrome represents the constellation of symptoms and signs resulting from compression of lumbrosacral nerve routes. Combined with subjective neurological findings, a reduction in anal tone is an important sign, deeming further imaging necessary. DRE is an invasive procedure used to assess anal tone despite debated accuracy. A total of 75 doctors from various specialties were asked to fill in a questionnaire detailing their grade, age, and area of expertise. In addition, information was gathered with regard to prior training in performing DRE to assess anal tone and the importance placed on any findings. Thirty hospital health care assistants (HCAs) were used as a control group. HCAs were selected as a control group because they receive no training on the technique and would never be required to perform it in their clinical practice. A model anus was assembled using a modified pediatric sphygmomanometer cuff to act as a sphincter. The cuff could be inflated to simulate a full range of anal tone. The cuff was incorporated into an artificial anal canal, which was, in turn, placed into a model buttock created from plaster of Paris. The apparatus was calibrated across a range of pressures. In each attempt, 60%, 61%, 63%, and 67% of doctors correctly identified the anal tone, respectively (average accuracy: 64%). HCAs had an identical

  13. The impact of naloxegol on anal sphincter function - Using a human experimental model of opioid-induced bowel dysfunction

    DEFF Research Database (Denmark)

    Grønlund, Debbie; Poulsen, Jakob L; Krogh, Klaus

    2018-01-01

    of the anal canal. Gastrointestinal symptoms were assessed with the Patient Assessment of Constipation Symptom (PAC-SYM) questionnaire and the Bristol Stool Form Scale. RESULTS: During oxycodone treatment, naloxegol improved RAIR-induced sphincter relaxation by 15% (-45.9 vs -38.8 mm Hg; P 

  14. Early effect of external beam radiation therapy on the anal sphincter: A study using anal manometry and transrectal ultrasound

    International Nuclear Information System (INIS)

    Birnbaum, E.H.; Dreznik, Z.; Myerson, R.J.; Lacey, D.L.; Fry, R.D.; Kodner, I.J.; Fleshman, J.W.

    1992-01-01

    The early of pelvic irradiation on the anal sphincter has not been previously investigated. This study prospectively evaluated the acute effect of preoperative radiation on anal function. Twenty patients with rectal carcinoma received 4,500 cGy of preoperative external beam radiation. The field of radiation included the sphincter in 10 patients and was delivered above the anorectal ring in 10 patients. Anal manometry and transrectal ultrasound were performed before and four weeks after radiotherapy. No significant difference in mean maximal squeeze or resting pressure was found after radiation therapy. An increase in mean minimal sensory threshold was significant. Histologic examination revealed minimal radiation changes at the distal margin in 8 of 10 patients who underwent low anterior resection and in 1 of 3 patients who underwent abdominoperineal resection. The authors conclude that preoperative radiation therapy has minimal immediate effect on the anal sphincter and is not a major contributing factor to postoperative incontinence in patients after sphincter-saving operations for rectal cancer

  15. Root canal irrigation

    NARCIS (Netherlands)

    van der Sluis, L.; Boutsioukis, C.; Jiang, L.M.; Macedo, R.; Verhaagen, B.; Versluis, M.; Chávez de Paz, L.E.; Sedgley, C.M.; Kishen, A.

    2015-01-01

    The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm), and their products from the root canal wall, their removal out of the root

  16. The Root Canal Biofilm

    NARCIS (Netherlands)

    van der Sluis, L.W.M.; Boutsioukis, C.; Jiang, L.M.; Macedo, R.; Verhaagen, B.; Versluis, Michel; Chávez de Paz, E.; Sedgley, C.M.; Kishen, A.

    2015-01-01

    The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm), and their products from the root canal wall, their removal out of the root

  17. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain? ¿Se debe incluir la ecografía rectoanal como prueba diagnóstica del dolor anal crónico?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    2010-01-01

    Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.Objetivo: evaluar el rendimiento de la ecografía rectoanal (ERA en el estudio del dolor anal crónico idiopático (DACI. Material y método: se trata de un estudio prospectivo y descriptivo en el que se han incluido 40 pacientes, 18 hombres y 22 mujeres, con edad media de 47 años, con clínica de dolor anal crónico de al menos 3 meses de evolución. A todos los pacientes se les había realizado una colonoscopia completa, en la que no se encontró anomalía que justificara la clínica. Se

  18. Significance of the thickness of the anal sphincters with age and its relevance in faecal incontinence.

    Science.gov (United States)

    Papachrysostomou, M; Pye, S D; Wild, S R; Smith, A N

    1994-08-01

    Ultrasonographic studies in healthy volunteers showed that the external anal sphincter (EAS) and internal anal sphincter (IAS) thicknesses were inversely related at rest. The functional importance of the two sphincters in continence control was demonstrated in the relationship between the sum of the thicknesses of the two sphincters and the anal canal resting pressure. The aims of the present study were to assess the morphometric appearance of the anal sphincters by endosonography in faecally incontinent patients and to contrast this with that of older healthy subjects. Twenty-eight female patients with neurogenic faecal incontinence (FI) were studied. An older group of 7 healthy women, aged 41-75 years, and a young group of 11 nulliparous healthy women, aged 20-23 years, served as control groups. Anal endosonography was performed with a radial rotating endoprobe, with the subject in the left lateral position. Conventional anal manometry was performed in all subjects. The EAS in the FI group was thicker than the EAS in the old (p IAS thickness in the FI group did not differ from that in the older group. In both these groups the IAS was thicker than in the young women (p IAS in the FI group does not seem to compensate for function and results in a failure of the sphincter mechanism to maintain continence, whereas in healthy elderly subjects the increased IAS thickness appears to be compensatory and important for continence control.

  19. Prevalence of Human Papillomavirus in Anal and Oral Sites Among Patients with Genital Warts

    DEFF Research Database (Denmark)

    Kofoed, Kristian; Sand, Carsten; Forslund, Ola

    2014-01-01

    genital, anal and oral infection is unclear. A total of 201 men and women with genital wart-like lesions were recruited. Swab samples were obtained from the genital warts and the anal canal and an oral rinse was collected. Anal HPV was found in 46.2% and oral HPV in 10.4% of the participants. Concordance...... between anal and genital wart HPV types was 78.1%, while concordance between oral and genital wart types was 60.9%. A lower concordance of 21.7% was observed between anal and oral HPV types. Significantly more women than men had multiple HPV types and anal HPV. In conclusion, extra genital HPV is common......Genital warts are caused by human papillomavirus (HPV). HPV is a leading cause of anogenital malignancies and a role of HPV in the aetiology of oro-pharyngeal cancers has been demonstrated. The frequency of oral HPV infection in patients with genital warts and the association between concomitant...

  20. Similar mechanisms of traumatic rectal injuries in patients who had anal sex with animals to those who were butt-fisted by human sexual partner.

    Science.gov (United States)

    Sendler, Damian Jacob

    2017-10-01

    Sexual pleasure comes in various forms of physical play, for many it involves stimulation of the vagina, while the anus for others; some enjoy both. A recent report by Cappelletti et al. 1 shows a meta-analysis of cases describing anal trauma due to sexual fisting in human partners. This clinical article reports four cases of males diagnosed with zoophilia, and who received anal sex from animals, resulting in injuries. Surgical and psychiatric evaluations are summarized. Unusual etiology of sexual activity with animals caused peri-anal trauma in men who engaged in anal sex with dogs and farm animals. Injuries to patients who receive anal sex from animals are mechanistically similar to fisting-induced rectal damage. Among zoophiles, the mode of harm occurs through blood-engorged, interlocked penis that causes tissue lacerations upon retraction from an anus. In people experimenting with fisting, repetitive stretching within anal canal and of external sphincter causes the internal injuries. The mode of physical stimulation explains the extent of injuries in fisters vs. zoophiles: in fisting, the pressure applied by hand is controllable proximally around and within anal sphincter, while penetration by the animal penis is unpredictable and occurs within the proximal anal canal. Forensically, the findings presented in this article describe a significant mechanism of injury in fisters versus passive zoophiles. These descriptions may aid in clinically differentiating pleasurable and pathological rectal stimulation. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. MULTIPLE SPINAL CANAL MENINGIOMAS

    Directory of Open Access Journals (Sweden)

    Nandigama Pratap Kumar

    2016-10-01

    Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare. We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date. The search was conducted through http://pubmed.com, a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple

  2. Metástase cutânea rara de provável carcinoma basaloide de cólon simulando granuloma piogênico Rare cutaneous metastasis from a probable basaloid carcinoma of the colon mimicking pyogenic granuloma

    Directory of Open Access Journals (Sweden)

    Gustavo Costa Verardino

    2011-06-01

    Full Text Available As acrometástases, principalmente para as mãos, são incomuns e representam cerca de 0,0070,2% de todas as lesões metastáticas. O pulmão é o sítio de origem mais comum, colaborando com 4050% dos casos relatados na literatura. Os rins e mamas são outras localizações também relacionadas a neoplasias que metastatizam para as mãos, além de, mais raramente, trato gastrointestinal, outros tumores sistêmicos e sarcomas. Seu diagnóstico precoce é difícil, pois pode ser assintomático, se assemelhar a tenossinovite, artrite, paroníquia, granuloma piogênico ou infecção local. No presente relato, os autores apresentam paciente com diagnóstico de acrometástase, em ambos os quartos quirodáctilos, oriunda de carcinoma basaloide de canal anal, com pobre resposta à radioterapiaAcrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2% of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50% of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor

  3. Design of canals

    CERN Document Server

    Swamee, P K

    2015-01-01

    The book presents firsthand material from the authors on design of hydraulic canals. The book discusses elements of design based on principles of hydraulic flow through canals. It covers optimization of design based on usage requirements and economic constraints. The book includes explicit design equations and design procedures along with design examples for varied cases. With its comprehensive coverage of the principles of hydraulic canal design, this book will prove useful to students, researchers, and practicing engineers. End-of-chapter pedagogical elements make it ideal for use in graduate courses on hydraulic structures offered by most civil engineering departments across the world.

  4. Nasolacrimal relapse of nasopharyngeal carcinoma.

    Science.gov (United States)

    Sia, K J; Tang, I P; Kong, C K L; Tan, T Y

    2012-08-01

    To describe three rare cases of nasolacrimal relapse of nasopharyngeal carcinoma, and to discuss the route of tumour spread from nasopharynx to lacrimal system as well as the relevant computed tomography findings. We report three cases of nasolacrimal relapse in patients with previously treated nasopharyngeal carcinoma. The common initial presentations in these cases were epiphora and medial canthal swelling. The tumour spread from the nasopharynx to the lacrimal sac along the lateral nasal wall and nasolacrimal canal. Computed tomography demonstrated nasolacrimal canal invasion and osteomeatal complex obliteration by the tumour. Distant metastasis was detected in two cases. More targeted radiotherapy should be delivered to prevent under-treatment of nasopharyngeal carcinoma. Nasolacrimal relapse of nasopharyngeal carcinoma is an advanced disease with a poor prognosis.

  5. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    : Women with recurrent ASR between January 2000 and June 2011 were identified at two delivery wards in Copenhagen. The women answered a questionnaire with a validated scoring system for AI (St. Mark`s score), and the results were compared with those obtained in two control groups: women with subsequent......UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...... uncomplicated vaginal delivery or caesarean section. RESULTS: There were 93 437 vaginal deliveries. ASR occurred in 5.5% (n = 2851) of the nulliparous and 1.5% (n = 608) of the multiparous women. Recurrent ASR occurred in 8% (n = 49) of whom 50% reported symptoms of AI. We found no difference in the occurrence...

  6. Revestimiento de canales

    Directory of Open Access Journals (Sweden)

    A. Woll

    2017-05-01

    Full Text Available La maquinaria moderna alemana empleada para el revestimiento de canales de gran sección, presenta grandes ventajas de economía, rendimiento, regularidad e impermeabilidad de la construcción. Para la aplicación de esta maquinaria —inicialmente se ha procedido a la excavación del canal mediante el empleo de maquinaria ordinaria de desmonte y la maquinaria especial— comienza su trabajo con el enrase de las cotas previstas.

  7. COMPARATIVE STUDY OF LATERAL SPHINCTEROTOMY AND LATERAL SPHINCTEROTOMY WITH V-Y ADVANCEMENT FLAP IN TREATMENT OF CHRONIC ANAL FISSURE

    Directory of Open Access Journals (Sweden)

    S. Meenaa Saravanaperumaal

    2016-12-01

    Full Text Available BACKGROUND Anal fissure is an elongated ulcer in the long axis of lower anal canal. The most frequent site for anal fissure is midline posteriorly and followed by midline anteriorly. It causes severe pain during defecation and rectal bleeding that stain the tissue or streaks the stools. Chronic anal fissure has traditionally been treated by surgery, an effective and standard procedure that results in healing in 90-95% of cases. Lateral sphincterotomy heals chronic anal fissure in 90% of cases that is associated with incontinence to flatus and faeces. Anal advancement flaps was used to cover the chronic anal fissure. Using anal flaps to resurface chronic or recurrent anal fissure to promote wound healing and to assess the added advantage over lateral sphincterotomy in tissues of complete epithelialisation; time of relief of pain; persistent symptoms; patient satisfaction and quality of life. The aim of the study is to- 1. Compare the efficacy of lateral sphincterotomy against lateral sphincterotomy with V-Y advancement flap in treatment of chronic anal fissures. 2. Assess the added advantages of V-Y advancement flap in treatment of chronic anal fissure in terms of wound healing, time of relief of pain, persistent symptoms and patients’ satisfaction. 3. Compare the complications associated with procedures. MATERIALS AND METHODS A study of 50 patients was done. It included 26 females and 24 males. In that, lateral sphincterotomy alone was done in 25 patients and lateral sphincterotomy along with anal advancement flap was done in 25 patients. RESULTS In group A patients only lateral sphincterotomy done. In group B lateral sphincterotomy with anal advancement flap done. Anal advancement flap done by ‘v’ shaped flap formed of skin and subcutaneous tissue was elevated incontinuity with excised tissue to allow to cover the tissue defect. Flap should be broad based with adequate blood supply and avoid tension while suturing with 3-0 vicryl. A study

  8. Metástasis cervical contralateral en el carcinoma epidermoide de la cavidad oral: Estudio clínico analítico retrospectivo en 315 pacientes primariamente tratados con cirugía Contralateral neck metastasis in squamous cell carcinoma of the oral cavity: An analytical retrospective clinical study of 315 patients primarily treated with surgery

    Directory of Open Access Journals (Sweden)

    R. González-García

    2008-06-01

    Full Text Available Objetivos. Existen en la literatura numerosos estudios en relación con los factores pronósticos implicados en la aparición de metástasis cervicales ipsilaterales en el carcinoma epidermoide de cavidad oral. Sin embargo, no existen estudios clínicos amplios acerca de la asociación de factores clínico-patológicos y la aparición de metástasis cervicales contralaterales tras la resección quirúrgica del tumor primario. El propósito de este estudio es el análisis de los factores implicados en la aparición de metástasis cervical contralateral en pacientes con carcinoma epidermoide de cavidad oral primariamente tratados con cirugía. Pacientes y métodos. Se analizó una serie de 315 pacientes consecutivos con carcinoma epidermoide de la cavidad oral no tratados previamente. Se realizó un estudio complementario del subgrupo de 203 pacientes con carcinoma epidermoide del borde lateral de la lengua libre, por tratarse de un grupo muy prevalente en la serie analizada. Todos los pacientes recibieron tratamiento quirúrgico con o sin tratamiento radioterápico adyuvante. Varias fueron las variables clínicas e histopatológicas analizadas, como son: las características clínicas del tumor, el estadio tumoral, el grado de diferenciación histológica, el tipo de disección cervical, la supervivencia enfermedad- específica, los márgenes quirúrgicos en la pieza resecada, la extensión ganglionar extracapsular, la diseminación perineural y la afectación ósea. Resultados. La duración media del seguimiento de los pacientes que sobrevivieron fue de 70,9 ± 49,6 meses. Ochenta y tres pacientes murieron a causa de la enfermedad a lo largo del seguimiento. Cuarenta y siete de estos pertenecían al subgrupo de pacientes con carcinoma epidermoide de lengua. Un total de 147 pacientes permanecía vivo sin evidencias de recurrencia de la enfermedad al final del periodo de seguimiento, 116 de los cuales correspondían al subgrupo de pacientes con

  9. Correlação entre a incompetência esfincteriana anal e a prática de sexo anal em homossexuais do sexo masculino

    OpenAIRE

    Ferreira, Maíra Costa; Braz, Tatiana Pereira; Machado, Ana Maria Oliveira; Ribeiro, Gabriel; Andrade, Rosana Cristina Pererira de

    2010-01-01

    p. 55-60,jan./mar. INTRODUÇÃO: a incontinência anal (IA) é uma disfunção de origem multifatorial com impacto significativo na qualidade de vida do indivíduo. Dentre as diversas etiologias para IA encontra-se a traumática, provocada pela penetração de objetos no canal anal. A inclusão do ânus na atividade sexual, já vem sendo descrita, principalmente entre homossexuais do sexo masculino. A partir desta premissa, questionou-se nesta pesquisa a possibilidade da penetração do pênis no ânus se ...

  10. Anal, penile, and oral high-risk HPV infections and HPV seropositivity in HIV-positive and HIV-negative men who have sex with men

    NARCIS (Netherlands)

    van Rijn, Vera M.; Mooij, Sofie H.; Mollers, Madelief; Snijders, Peter J. F.; Speksnijder, Arjen G. C. L.; King, Audrey J.; de Vries, Henry J. C.; van Eeden, Arne; van der Klis, Fiona R. M.; de Melker, Hester E.; van der Sande, Marianne A. B.; van der Loeff, Maarten F. Schim

    2014-01-01

    The effects of single or multiple concordant HPV infections at various anatomical sites on type-specific HPV seropositivity are currently unknown. In this cross-sectional study we assessed whether high-risk HPV infections at various anatomical sites (i.e., anal canal, penile shaft, and oral cavity),

  11. Early discharge after external anal sphincter repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Kehlet, H

    1999-01-01

    PURPOSE: The aim of this study was to describe an accelerated-stay program for repair of the external anal sphincter. METHODS: Twenty consecutive patients undergoing overlapping repair of the external anal sphincter were included in the study. Effect parameters were length of hospitalization....... CONCLUSION: We have described a safe accelerated-stay program (24 to 48 hours) for overlapping repair of external anal sphincter....

  12. Prevalence and predictors of unsatisfactory anal cytology tests in a cohort of gay and bisexual men in Sydney, Australia: baseline findings from the Study of the Prevention of Anal Cancer (SPANC).

    Science.gov (United States)

    Templeton, David J; Roberts, Jennifer M; Poynten, I Mary; Law, Carmella; Hillman, Richard J; Farnsworth, Annabelle; Fairley, Christopher K; Tabrizi, Sepehr N; Garland, Suzanne M; Grulich, Andrew E; Jin, Fengyi

    2017-05-01

    Anal cytology has been suggested as a screening test for the anal cancer precursor high-grade squamous intraepithelial lesion (HSIL). We aimed to assess the prevalence and predictors of initial unsatisfactory anal cytology tests ('unsats'). The Study of the Prevention of Anal Cancer is a natural history study of anal human papillomavirus (HPV) and precancerous lesions among gay and bisexual men (GBM) of at least 35 years in Sydney, Australia. At each study visit, an anal swab is collected for cytological testing. Unsats are defined as slides with fewer than 2000 nucleated squamous cells and no abnormal cells. Among 617 GBM enrolled, the median age was 49 (range: 35-79) years and 220 (35.7%) were HIV positive. Initial unsats occurred in 61 (9.9%, 95% confidence interval: 7.6-12.5%), and 29 (4.7%, 95% confidence interval: 3.2-6.7%) remained unsatisfactory on repeat cytology. Initial unsats were associated with fewer lifetime anal-receptive partners with a condom (P=0.007); fewer recent anal-receptive sexual partners without a condom (P=0.005); never having had anal chlamydia (P=0.023) or gonorrhea (P=0.003); HIV-negative status (P=0.002); fewer total (P=0.002), low-risk (P=0.005), and high-risk (P=0.015) HPV types detected; lack of anal HPV18 detection (P=0.001); never having anally douched (P<0.001); and douching with soapy water (P=0.009) among those who douched. Unsats were less common among those with histologic HSIL (P=0.008) and nonsignificantly less common among those with fewer anal canal octants affected by HSIL (P=0.080), but were more common among those who felt more nervous (P=0.020) during the examination. Our findings suggest that unsats are more common among GBM with less receptive anal sexual experience. Avoiding douching with soapy water and strategies to aid patient relaxation during sampling may reduce the unsat rate.

  13. Nutrient canal of the fibula

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo-Hyuk; Ehara, Shigeru; Tamakawa, Yoshiharu [Departments of Radiology, Iwate Medical University School of Medicine, Morioka (Japan); Horiguchi, Masahura [Department of Anatomy I, Iwate Medical University School of Medicine, Morioka (Japan)

    2000-01-01

    Objective. To investigate the radiological features of the nutrient canal in the fibula.Design and patients. One hundred and seventy-nine dried fibulae were studied regarding the type, number, location, and direction of the nutrient canal. They were classified into a usual type (type I: a radiolucent line confined to the cortex) and an atypical type (type II: a radiolucent line extending beyond the cortex).Results. Among the total of 230 nutrient canals seen on radiography, 197 (86%) were type I and 33 (14%) were type II. On CT scans, the ossified rim of the canal extended into the medullary cavity in type II canals. The most common site was the posteromedial aspect in both type I and type II canals. Type II canals were significantly more common in fibulae with two or three nutrient canals. The frequency of the upward direction was more common in type II canals.Conclusion. Nutrient canals with extension of the ossified rim into the medullary canal are the cause of linear lucency that may simulate a fracture. Their features are slightly different from those of usual canals. (orig.)

  14. High-resolution magnetic resonance imaging of the anal sphincter using a dedicated endoanal receiver coil

    Energy Technology Data Exchange (ETDEWEB)

    DeSouza, N.M.; Williams, A.D.; Gilderdale, D.J. [Dept. of Radiology, Imperial College School of Medicine, London (United Kingdom)

    1999-04-01

    The use of a surface coil in MR imaging improves signal-to-noise ratio of adjacent tissues of interest. We therefore devised an endoanal receiver coil for imaging the anal sphincter. The probe is solid and re-usable: it comprises a saddle geometry receiver with integral tuning, matching and decoupling. It is placed in the anal canal and immobilised externally. Both in vitro and in vivo normal anatomy is identified. The mucosa is high signal intensity, the submucosa low signal intensity, the internal sphincter uniformly high signal intensity and the external sphincter low signal intensity on T1- and T2-weighted images. In females, the transverse perineal muscle bridges the inferior part of the external sphincter anteriorly. In perianal sepsis, collections and the site of the endoanal opening are identified. In early-onset fecal incontinence following obstetric trauma/surgery, focal sphincter defects are demonstrated; in late-onset fecal incontinence external sphincter atrophy is seen. In fecally incontinent patients with scleroderma, forward deviation of the anterior sphincter musculature with descent of rectal air and feces into the anal canal is noted. The extent of sphincter invasion is assessed in low rectal tumours. In children with congenital anorectal anomalies, abnormalities of the muscle components are defined using smaller-diameter coils. Such information is invaluable in the assessment and surgical planning of patients with a variety of anorectal pathologies. (orig.) With 15 figs., 26 refs.

  15. Lumbar Spinal Canal Stenosis

    Science.gov (United States)

    ... If you have lumbar spinal canal stenosis, your treatment will depend on how bad your symptoms are. If your pain is mild and you haven’t had it long, you can try an exercise program or a physical therapy program. This can strengthen your back muscles and ...

  16. Bilateral bifid mandibular canal

    OpenAIRE

    Sheikhi, Mahnaz; Badrian, Hamid; Ghorbanizadeh, Sajad

    2012-01-01

    One of the normal interesting variations that we may encounter in the mandible is bifid mandibular canal. This condition can lead to difficulties when performing mandibular anesthesia or during extraction of lower third molar, placement of implants, and surgery in the mandible. Therefore diagnosis of this variation is sometimes very important and necessary.

  17. Bilateral bifid mandibular canal

    Directory of Open Access Journals (Sweden)

    Mahnaz Sheikhi

    2012-01-01

    Full Text Available One of the normal interesting variations that we may encounter in the mandible is bifid mandibular canal. This condition can lead to difficulties when performing mandibular anesthesia or during extraction of lower third molar, placement of implants, and surgery in the mandible. Therefore diagnosis of this variation is sometimes very important and necessary.

  18. Time-dose considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; Kaufman, Donald S.; DeLaney, Thomas F.

    1997-01-01

    Purpose: To analyze the impact of patient and treatment parameters in concurrent chemoradiation treatment for anal carcinoma. Methods and Materials: Retrospective review of 50 MO anal cancer patients treated from 1984-1994. Most patients received concurrent 5-FU, mitomycin, and radiation. Local control and disease-free/overall survival were determined and analyzed according to patient and treatment parameters. Results: With 43 month median follow-up, projected overall survival is 66% at 5 and 8 years. Disease-free survival is 67% at 5 years and 59% at 8 years. Local control is 70% at 5 and 8 years. Doses of ≥54 Gy are associated with improved 5-year survival (84 vs. 47%, p = 0.02), disease-free survival (74 v. 56%, p = 0.09), and local control (77 vs. 61%, p = 0.04). Although local control, disease-free survival, and overall survival were improved in patients whose overall treatment time was <40 days, this was not statistically significant. Outcome in the four patients with pretreatment hemoglobin (Hgb) <10 appeared worse with 3-year overall survival 50 vs. 68% (p = 0.07), disease-free survival 0 vs. 67% (p = 0.11), and local control 0 vs. 74% (p = 0.05). Projected 5-year overall survival, relapse-free survival, and local control in 4 HIV (+) patients is 0, 75, and 75%. Multivariate analysis reveals that dose (p 0.02) and Hgb (p = 0.05) independently affect local control, dose (p = 0.02) affects disease-free survival, and dose (p = 0.01), Hgb (p = 0.03), T-stage (p = 0.03), and HIV-status (0.07) independently influence overall survival. Conclusion: Radiation doses of ≥54 Gy are associated with significantly improved survival and local control in anal cancer patients treated with chemoradiation. Overall treatment times of less than 40 days are associated with a trend towards improved outcome, but this is not significant. Pretreatment hemoglobin <10 is associated with worse treatment outcome. Survival of HIV (+) patient is poor, but the majority of such patients

  19. Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

    International Nuclear Information System (INIS)

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

    2008-01-01

    Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer

  20. Recurrent obstetric anal sphincter injury and the risk of long term anal incontinence

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2017-01-01

    BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal...... incontinence at long term follow up. OBJECTIVE: To evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal- and fecal incontinence more than 5 years after the second vaginal delivery. STUDY DESIGN: We performed a secondary analysis of data from a postal questionnaire study...... in women with obstetric anal sphincter injury in the first delivery and one subsequent vaginal delivery. The questionnaire was sent to all Danish women who fulfilled inclusion criteria and had two vaginal deliveries 1997 -2005. We performed uni- and multivariable analyses to assess how recurrent obstetric...

  1. Increased anal basal pressure in chronic anal fissures may be caused by overreaction of the anal-external sphincter continence reflex

    NARCIS (Netherlands)

    van Meegdenburg, Maxime M.; Trzpis, Monika; Heineman, Erik; Broens, Paul M. A.

    Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and

  2. Continuous Adductor Canal Blocks

    DEFF Research Database (Denmark)

    Monahan, Amanda M; Sztain, Jacklynn F; Khatibi, Bahareh

    2016-01-01

    BACKGROUND: It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for adductor canal perineural catheters. Therefore, we tested the hypothesis that scheduled bolus administration is superior or noninferior to a continuous infusion...... on cutaneous knee sensation in volunteers. METHODS: Bilateral adductor canal catheters were inserted in 24 volunteers followed by ropivacaine 0.2% administration for 8 hours. One limb of each subject was assigned randomly to a continuous infusion (8 mL/h) or automated hourly boluses (8 m...... tolerance of electrical current and quadriceps femoris maximum voluntary isometric contraction strength at baseline, hourly for 14 hours, and again after 22 hours. RESULTS: The 2 administration techniques provided equivalent cutaneous analgesia at 8 hours because noninferiority was found in both directions...

  3. Managing curved canals

    Directory of Open Access Journals (Sweden)

    Iram Ansari

    2012-01-01

    Full Text Available Dilaceration is the result of a developmental anomaly in which there has been an abrupt change in the axial inclination between the crown and the root of a tooth. Dilaceration can be seen in both the permanent and deciduous dentitions, and is more commonly found in posterior teeth and in maxilla. Periapical radiographs are the most appropriate way to diagnose the presence of root dilacerations. The controlled regularly tapered preparation of the curved canals is the ultimate challenge in endodontics. Careful and meticulous technique will yield a safe and sufficient enlargement of the curved canals. This article gives a review of the literature and three interesting case reports of root dilacerations.

  4. Canal plane dynamic visual acuity in superior canal dehiscence.

    Science.gov (United States)

    Janky, Kristen L; Zuniga, M Geraldine; Ward, Bryan; Carey, John P; Schubert, Michael C

    2014-06-01

    1) To characterize normal, horizontal active dynamic visual acuity (DVA) and passive canal plane head thrust DVA (htDVA) across ages to establish appropriate control data and 2) to determine whether horizontal active DVA and passive canal plane htDVA are significantly different in individuals with superior canal dehiscence syndrome (SCDS) before and after surgical repair in the acute (within 10 d) and nonacute stage (>6 wk). Prospective study. Tertiary referral center Patients diagnosed with SCDS (n = 32) and healthy control subjects (n = 51). Surgical canal plugging on a subset of patients. Static visual acuity (SVA), active horizontal DVA, and canal plane htDVA. Visual acuity (SVA, active DVA, and htDVA) declines with age. In SCDS, SVA and active DVA are not significantly affected in individuals after surgical canal plugging; however, htDVA in the plane of the affected canal is significantly worse after canal plugging. Age-based normative data are necessary for DVA testing. In SCDS, htDVA in the plane of the affected canal is normal before surgery but permanently reduced afterward.

  5. Wnt-β Catenin Signaling Pathway: A Major Player in the Injury Induced Fibrosis and Dysfunction of the External Anal Sphincter.

    Science.gov (United States)

    Rajasekaran, M Raj; Kanoo, Sadhana; Fu, Johnny; Bhargava, Valmik; Mittal, Ravinder K

    2017-04-19

    Wnt-β catenin is an important signaling pathway in the genesis of fibrosis in many organ systems. Our goal was to examine the role of Wnt pathway in the external anal sphincter (EAS) injury-related fibrosis and muscle dysfunction. New Zealand White female rabbits were subjected to surgical EAS myotomy and administered local injections of either a Wnt antagonist (sFRP-2; daily for 7 days) or saline. Anal canal pressure and EAS length-tension (L-T) were measured for 15 weeks after which the animals were sacrificed. Anal canal was harvested and processed for histochemical studies (Masson trichrome stain), molecular markers of fibrosis (collagen and transforming growth factor-β) and immunostaining for β catenin. Surgical myotomy of the EAS resulted in significant impairment in anal canal pressure and EAS muscle L-T function. Following myotomy, the EAS muscle was replaced with fibrous tissue. Immunostaining revealed β catenin activation and molecular studies revealed 1.5-2 fold increase in the levels of markers of fibrosis. Local injection of sFRP-2 attenuated the β catenin activation and fibrosis. EAS muscle content and function was significantly improved following sFRP-2 treatment. Our studies suggest that upregulation of Wnt signaling is an important molecular mechanism of injury related EAS muscle fibrosis and sphincter dysfunction.

  6. Anal microbiota profiles in HIV-positive and HIV-negative MSM.

    Science.gov (United States)

    Yu, Guoqin; Fadrosh, Doug; Ma, Bing; Ravel, Jacques; Goedert, James J

    2014-03-13

    Because differences in anal microbial populations (microbiota) could affect acquisition of HIV or other conditions, especially among MSM, we profiled the microbiota of the anal canal, assessed its stability, and investigated associations with diversity and composition. Microbiota profiles in anal swabs collected from 76 MSM (52 in 1989, swab-1; 66 1-5 years later, swab-2) were compared by HIV status (25 HIV-positive), T-cell subsets, and questionnaire data. Bacterial 16S rRNA genes were amplified, sequenced (Illumina MiSeq), and clustered into species-level operational taxonomic units (QIIME and Greengenes). Regression models and Wilcoxon tests were used for associations with alpha diversity (unique operational taxonomic units, Shannon's index). Composition was compared by Adonis (QIIME). Most anal bacteria were Firmicutes (mean 60.6%, range 21.1-91.1%) or Bacteroidetes (29.4%, 4.1-70.8%). Alpha diversity did not change between the two swabs (N = 42 pairs). In swab-2, HIV-positives had lower alpha diversity (P ≤ 0.04) and altered composition, with fewer Firmicutes and more Fusobacteria taxa (P ≤ 0.03), not completely attributable to very low CD4(+) cell count (median 232 cells/μl), prior AIDS clinical diagnosis (N = 17), or trimethoprim-sulfamethoxazole use (N = 6). Similar but weaker differences were observed in swab-1 (HIV-positive median 580 CD4(+) cells/μl; no trimethoprim-sulfamethoxazole). Associations with T-cell subsets, smoking, and sexual practices were null or inconsistent. The anal microbiota of MSM was relatively stable over 1-5 years. However, with uncontrolled, advanced HIV infection, the microbiota had altered composition and reduced diversity partially attributable to antibiotics. Investigations of microbial community associations with other immune perturbations and clinical abnormalities are needed.

  7. Dose-time considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; De Laney, Thomas F.

    1996-01-01

    Purpose: Concurrent chemoradiation has become the standard initial treatment of primary anal carcinomas. The objective of this study was to analyze the impact on treatment outcome of a variety of patient and treatment variables including radiation dose and overall treatment time in patients treated with concurrent chemoradiation for anal carcinomas. Materials and Methods: Retrospective chart review on 50 patients with MO anal cancer treated with concurrent chemoradiation during the years 1984-1993. Patients were identified from the hospital tumor registries. The majority of patients received treatment with 5-FU 1000 mg/m 2 days 1-4, 29-33 and Mitomycin 10-15 mg/m 2 days 1 ± 29. Radiation was given at 180-200 cGy daily starting at day 1 to total doses of 23.6-67.2 Gy (median 54 Gy) usually by shrinking field technique. Local control, disease-free survival, and overall survival of the group was determined and then analyzed with respect to a variety of patient characteristics including T and N stage, histology, radiation dose, overall treatment time, hemoglobin at the start of treatment, age, HIV status, and sex. Local control, disease-free and overall survival were calculated using the Kaplan-Meier method. Tests for significance were done using the log-rank method. Results: Patient characteristics were: (1) histology-squamous 78 %, cloacogenic/basaloid 20%, and adenosquamous 2%; (2) age- range 30-82 years (median 58.5), (3) sex- female 58%, male 42%; (4) T stage- T1 16%, T2 46%, T3 24%, T4 8%, TX 6%; (5) N stage- NO 69%, N+ 23 %, NX 8%; (6) HIV (+) 8%, HIV(-/?) 92%. Follow-up ranged from 2-132 months (median 43 months). Overall survival was 66% and 44% at 5 and 10 years. Disease-free survival was 67% at 5 years and 59% at 10 years. Local control was 70% at 5 and 10 years. Five year local control by T stage: T stage- T1 87.5 %, T2 63%, T3 83%, T4 67%, TX 50%. Doses of ≥ 54 Gy are associated with improved 5-year survival (84 % vs. 47%, p=0.02), disease-free survival

  8. Spinal canal stenosis; Spinalkanalstenose

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Boutchakova, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2014-11-15

    Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) [German] Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung. (orig.)

  9. Manejo dos portadores das neoplasias intraepiteliais anais Managment of anal intra-epithelial neoplasia patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2008-12-01

    Full Text Available Acredita-se que a neoplasia intraepitelial anal (NIA, provocada pelo HPV, seja a lesão precursora do carcinoma anal. Segundo a literatura, são encontradas entre 11% e 52% dos homens infectados pelo HIV, entre 6% a 20% dos homens e 1% a 2,8% das mulheres sem essa infecção. Entre 8,5% e 13% das NIA de alto grau evoluirão para carcinoma invasivo, indicando a necessidade do rastreamento e do seguimento desses doentes para prevenção. Não há tratamento satisfatório com baixos índices de morbidez e a recidiva é comum. Em geral, as formas de tratamento podem de ser divididas em tópicas, entre elas, ácido tricloroacético, podofilina, podofilotoxina, imiquimod, terapia fotodinâmica, e ablativas, ou seja, excisão cirúrgica, ablação pelo LASER, coagulação pelo infravermelho e eletrofulguração. Há, ainda, os que consideram aceitável a conduta expectante. O tratamento tópico se justifica pelo caráter multifocal da lesão e os ablativos têm taxas de complicação e recidiva muito semelhantes. De qualquer forma, doentes com qualquer anormalidade histológica necessitam de seguimento adequado, principalmente com colposcopia e citologia anal.Anal intra-epithelial neoplasia (AIN, provoked by HPV, is considered as an anal cancer precursor. Some articles noticed that it occurred among 11% and 52% of men who have sex with men (MSM infected with HIV and, among seronegatives, from 6% to 20% of men and from 1% to 2.8% of women. From 8.5% to 13% of high grade AIN will evolve to invasive carcinoma, needing follow-up and screening for prevention. There is no satisfactory treatment with low morbidity and recurrence is frequent. There are two main forms of treatment: topics (trichloroacetic acid, podophylin, podophylotoxin, imiquimod, photodynamic therapy and ablatives (chirurgical excision, LASER, infrared, eletrocautery. Others consider acceptable an expectant management. Topical therapy is justified because of multifocal presentation of HPV

  10. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012.

    Directory of Open Access Journals (Sweden)

    Jennifer O Lam

    Full Text Available In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV. Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968-2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC, 183 anal squamous cell carcinoma (ASCC and 8,019 invasive cervical cancer (ICC cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC cases were included as comparators. Age-standardized incidence rates (ASR were determined by gender and ethnicity (Chinese, Malay and Indian. Joinpoint regression was used to evaluate annual percentage change (APC in incidence. OPSCC incidence increased in both genders (men 1993-2012, APC = 1.9%, p<0.001; women 1968-2012, APC = 2.0%, p = 0.01 and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968-2012 among men (APC = -1.6%, p<0.001 and women (APC = -0.4%, p = 0.06. ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001. ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years but declined significantly between 1968-2012 (APC = -2.4%. Incidence of each cancer varied across ethnicities. Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence.

  11. ANAL SPHINCTER INJURIES (OASIS AT DELIVERY

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    Full Text Available Background: Anal incontinence severely impairs quality of life. It affects 4 to 19 % of women and is statistically related to number of vaginal deliveries. It is grossly underreported and most patients that do seek help are referred to gastroenterologists or colorectal surgeons. Incidence of recognized sphincter injuries at time of delivery is 1 to 2 %. However studies with anal ultrasound showed incidence of anal sphincter injuries at 28 to 41 %. Depending on the degree of injury symptoms range from partial to complete inability to control passing of winds, liquid or solid stools. About three thirds of patients are asymp- tomatic in puerperium, however half of them are at risk of developing anal incontinence in later life. Hypoestrogenisem, additional perineal trauma during consequent deliveries and sphincter atrophy can unmask anal sphincter damage years later. Timely recognition and treatment are vital for good long term results and quality of life, if possible immediately after delivery. Good knowledge of perineal anatomy, recognition of risk factors, intense search and appropriate treatment and follow-up are essential to management of anal sphincter injuries. All secondary sphincter repair is less effective. Content: Updated overview of current opinion and guidelines on anal sphincter injuries are pre- sented. Anal sphincter is composed of external anal sphincter (EAS and internal anal sphincter (IAS. Striated EAS is divided into three parts – subcutaneous, superficial, deep, and con- nected to puborectalis muscle posteriorly. Smooth-muscled IAS is a continuation of a cir- cular smooth-muscle layer of rectum. In between there is a thin longitudinal muscle layer. IAS constitutes 70 % of resting tone and is under constant contraction. EAS contributes to 30 % of resting tone and almost all pressure during active contraction. EAS injury leads to insufficient contraction after rectal sampling and filling which causes urgency – patient can

  12. HPV in genital cancers (at the exception of cervical cancer) and anal cancers.

    Science.gov (United States)

    de Sanjosé, Silvia; Bruni, Laia; Alemany, Laia

    2014-12-01

    Human papillomavirus (HPV) infection has been firmly established as a central and necessary cause of invasive cervical cancer and it has been etiologically linked to other anogenital (vulva, vagina, anus and penis) and head and neck cancers, particularly oropharyngeal. Although being rare, the incidence of some of these cancers in some countries has increased in the last decades. HPV-related anogenital tumors share many risk factors with cervical cancer. The HPV aetiological contribution differs in each anatomical location reflecting differences in the natural history and viral tissue tropism. The highest prevalence of HPV DNA in cancers other than cervix has been described for anal, followed by vagina, penile and vulvar cancers. HPV16 has been described as the most common type detected in all cancer sites with different contributions being the highest in anal carcinoma (around 80% of HPV DNA positive anal cancers) and the lowest in vaginal cancers with a contribution similar to that found in cervical cancers (around 60%). Current HPV vaccines have already demonstrated their efficacy in preventing anogenital pre-neoplastic lesions caused by vaccine HPV types. HPV-based prevention tools like HPV vaccination and to a lesser extend screening (e.g. for anal cancer) can be useful measures for reducing the burden of these anogenital cancers. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Large prostate motion produced by anal contraction

    International Nuclear Information System (INIS)

    Onishi, Hiroshi; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Araya, Masayuki; Saito, Ryo; Aoki, Shinichi; Maehata, Yoshiyasu; Tominaga, Licht; Sano, Naoki; Oguri, Mitsuhiko; Onohara, Kojiro; Watanabe, Iori; Koshiishi, Tsuyota; Ogawa, Kazuhiko; Araki, Tsutomu

    2012-01-01

    Background and purpose: The aim of this study was to define the effects of voluntary anal contraction on prostate motion in an experimental setting. Materials and methods: Thirty-eight patients (median age, 76 years) with prostate cancer underwent thin-slice computed tomography (CT) in the vicinity of the prostate before and after active anal contraction. Three-dimensional displacement of the pelvis and prostate was measured. Results: Mean (±standard deviation, SD) overall displacement of the prostate due to anal contraction was 0.3 ± 1.4 mm to the right, 9.3 ± 7.8 mm to the anterior, and 5 ± 4 mm to the cranial direction. Mean displacement of the pelvis was 0.5 ± 1.8 mm to the right, 4.1 ± 7.1 mm to the anterior, and 1 ± 3 mm to the cranial direction. Mean displacement of the prostate relative to the pelvis was 0.1 ± 1.1 mm to the left, 5.2 ± 3.3 mm to the anterior, and 4 ± 4 mm to the cranial direction. Conclusions: Voluntary anal contraction within an experimental setting induces large prostate and bone motion, mainly in the anterior and cranial directions. The frequency and magnitude of actual anal contractions during radiotherapy for prostate cancer need to be determined.

  14. Hood Canal Steelhead - Hood Canal Steelhead Supplementation Experiment

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Hood Canal Steelhead Project is a 17-year before-after-control-impact experiment that tests the effects of supplementation on natural steelhead populations in...

  15. Method for Constructing Standardized Simulated Root Canals.

    Science.gov (United States)

    Schulz-Bongert, Udo; Weine, Franklin S.

    1990-01-01

    The construction of visual and manipulative aids, clear resin blocks with root-canal-like spaces, for simulation of root canals is explained. Time, materials, and techniques are discussed. The method allows for comparison of canals, creation of any configuration of canals, and easy presentation during instruction. (MSE)

  16. Malignant transformation from benign papillomatosis of the external auditory canal.

    Science.gov (United States)

    Miah, Mohammed S; Crawford, Mairi; White, Sharon J; Hussain, Syed Shah Musheer

    2012-06-01

    Report a case of malignant transformation of benign ear canal papillomatosis to malignant squamous cell carcinoma (SCC) of the temporal bone. A 73-year-old with papillomata involving the posterior and inferior walls of the right external auditory canal (EAC), which subsequently transformed into SCC. Radical mastoidectomy and excision of the tumor and then radical radiotherapy. Loco-regional disease control. Recovery of facial nerve function. Approximately 20 months post-treatment, the patient remains disease free. No recovery of facial nerve function. Malignant transformation of a benign EAC papilloma to SCC of the temporal bone has not been reported previously. The association of human papillomavirus with temporal bone SCC has been reported in small number of studies with human papillomavirus subtypes 16 and 18 isolated in a high proportion of cases. With the increased availability in genotyping, the question over whether there should be further genetic analysis of benign lesions to assess their susceptibility to malignant transformation has merit.

  17. OCCULT ANAL SPHINCTER INJURIES (OASIS IN DEPARTMENT OF PERINATOLOGY IN LJUBLJANA – INCIDENCE AND RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    solid stools, before and six weeks after delivery. Faecal urgency was defined as inability to hold passing of stools for more than 5 minutes, anal incontinence as partial or complete inability to control passing of winds, liquid or formed stools. Patients were examined with 7 MHz 360-degrees rotating probe on the second or third day after delivery. With the probe we identified the U-shaped puborectalis muscle, then slowly extracted the probe through the anal canal towards the anus. We examined ultrasound im- age of puborectalis muscle, internal anal sphincter, longitudinal muscle and external anal sphincter. Internal anal sphincter (IAS appears as a uniform hypoechoic circle, which is surrounded by heterogenous hyperechoic circle of external anal sphincter (EAS. External anal sphincter defect was defined as hypoechoic gap of various size in hyperechoic circle, that enlarges with voluntary contraction. Internal anal sphincter defect was defined as a gap in hypoechoic circle. All patients were contacted by telephone 6 weeks after delivery to complete the same ques- tionnaire again. Deliveries were managed by midwives according to standard active delivery management protocols the Ljubljana Maternity Hospital. All episiotomies were mediolateral. Information about pregnancy and delivery was obtained with patient’s consent from national delivery forms. We analysed use of analgesia at the delivery, induction and stimulation of labour, difference in body mass index (BMI before pregnancy and before the delivery, duration of labour, fetal weight and head circumference and maternal age. Results: We found signs of external anal sphincter injury in 12 (46 % out of 26 patients examined, all of them had only external sphincter injury. None of them had any de novo symptoms regarding defecation or problems restraining winds or stool 6 weeks after delivery (Table 1. There was no significant statistic difference for use of analgetics, stimulation of labour, vacuum extraction and

  18. Horizontal Canal Benign Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  19. Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens

    2017-01-01

    . Median follow-up time was 9.8 years after the first delivery and 6.4 years after the second. The prevalence of flatal incontinence, fecal incontinence and fecal urgency were 11.7, 4.1, and 12.3%, respectively. Overall, 20.1% had any degree of anal incontinence and/or fecal urgency. In 6.3% these symptoms...... affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. CONCLUSIONS: Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal...

  20. Morphologic changes of the anal sphincter musculature during and after temporary stool deviation.

    Science.gov (United States)

    Sailer, M; Fein, M; Fuchs, K H; Bussen, D; Grun, C; Thiede, A

    2001-04-01

    Temporary stool deviation, using a stoma, is a well-known surgical principle to protect low colorectal or coloanal anastomoses. The purpose of this study was to evaluate any morphologic changes with regard to the anal sphincter muscles during and after temporary ileostomy. Forty-four patients with rectal carcinomas were studied prospectively. All patients underwent low anterior resection. Reconstruction was performed using either a coloanal pouch or a straight end-to-end anastomosis. A protective stoma was fashioned in all 44 patients (ileostomy n=41; colostomy n=3). Stoma closure was carried out after a median of 85 days (41-330 days). Using a standard protocol, anal-sphincter thickness [m. puborectalis, external anal sphincter (EAS) and internal anal (IAS) sphincter] was assessed by means of endoanal ultrasonography preoperatively, at the time of stoma closure, and every 3 months thereafter for 1 year. The diameter of the puborectal muscle decreased from a median preoperative value of 6.3 mm to 5.7 mm at the time of stoma closure (P=0.03). After 3 months, 6.2 mm was measured. This value remained stable for the complete follow-up period. Similar results were recorded for the EAS. The IAS thickness remained stable throughout the study period, measuring between 2.1 mm and 2.4 mm. Temporary stool deviation does lead to morphologic changes of the anal sphincter. While the smooth muscle remains unchanged, the striated counterpart undergoes atrophic transformation. However, after passage reconstruction, i.e., stoma closure, a rapid regeneration of the voluntary muscles is observed.

  1. Primena swot analize na sistem integralnog transporta Vojske Srbije

    OpenAIRE

    Dragan Pamučar

    2008-01-01

    U radu je prikazana primena SWOT analize na sistem integralnog transporta Vojske Srbije. Kao rezultat analize predstavljeni su ciljevi daljeg usavršavanja integralnog transporta, kao i mogući problemi generisani strateškim upravljanjem.

  2. Management of rare, low anal anterior fistula exception to Goodsall′s rule with Kṣārasūtra

    Directory of Open Access Journals (Sweden)

    Pradeep S Shindhe

    2014-01-01

    Full Text Available Anal fistula (bhagandara is a chronic inflammatory condition, a tubular structure opening in the ano-rectal canal at one end and surface of perineum/peri-anal skin on the other end. Typically, fistula has two openings, one internal and other external associated with chronic on/off pus discharge on/off pain, pruritis and sometimes passing of stool from external opening. This affects predominantly male patients due to various etiologies viz., repeated peri-anal infections, Crohn′s disease, HIV infection, etc., Complex and atypical variety is encountered in very few patients, which require special treatment for cure. The condition poses difficulty for a surgeon in treating due to issues like patient hesitation, trouble in preparing kṣārasūtra, natural and routine infection with urine, stool etc., and dearth of surgical experts and technique. We would like to report a complex and atypical, single case of anterior, low anal fistula with tract reaching to median raphe of scrotum, which was managed successfully by limited application of kṣārasūtra.

  3. Midwestern Rural Adolescents' Anal Intercourse Experience

    Science.gov (United States)

    Dake, Joseph A.; Price, James H.; McKinney, Molly; Ward, Britney

    2011-01-01

    Purpose: The purpose of this study was to examine the prevalence of anal intercourse and its associated risk behaviors in a sample of Midwestern, predominantly white rural adolescents. Most of the research on this activity has been local or regional studies, with urban East and West Coast racial and ethnic minority adolescents. Methods: A…

  4. Study on Root Canal Preparation with Endo Motor Tecnika Vision and Sealing of Root Canal Filing

    OpenAIRE

    藤原, 治; 佐々木, 重夫; 天野, 義和; フジワラ, オサム; ササキ, シゲオ; アマノ, ヨシカズ; Osamu, FUJIWARA; Shigeo, SASAKI; Yoshikazu, AMANO

    2008-01-01

    Because root canal preparation in root canal treatment takes long time, various special contraangle handpiece are developed to promote efficiency of root canal preparation. Root canal are prepared with computerized micro motor handpiece. The purpose of this study is to examine the time of root canal preparation and the difference of sealing efficiency of root canal fillings between exclusive point and other point after preparation in the cases of files Endo and motor technika vision, and to f...

  5. Retreatment of a 6-Canalled Mandibular First Molar with Four Mesial Canals: A Case Report

    OpenAIRE

    Aminsobhani, Mohsen; Shokouhinejad, Noushin; Ghabraei, Sholeh; Bolhari, Behnam; Ghorbanzadeh, Abdollah

    2010-01-01

    Successful root canal treatment requires adequate knowledge regarding morphologic variations in root canal system of teeth. This report describes a six-canalled mandibular first molar with four mesial root canals requiring endodontic retreatment. The two additional canals in the mesial root were found during retreatment with the aid of illumination and magnification. In conclusion, the possibility of atypical morphology and additional canals should never be overlooked.

  6. Teaching Men's Anal Pleasure: Challenging Gender Norms with "Prostage" Education

    Science.gov (United States)

    Branfman, Jonathan; Ekberg Stiritz, Susan

    2012-01-01

    To help students critique sex/gender norms, sexuality educators should address men's anal pleasure. Men's anal receptivity blurs accepted binaries like male/female, masculine/feminine, and straight/queer. By suppressing men's receptivity, the taboo against men's anal pleasure helps legitimize hegemonic sex/gender beliefs--and the sexism,…

  7. Coinfection of Epstein-Barr virus, cytomegalovirus, herpes simplex virus, human papillomavirus and anal intraepithelial neoplasia in HIV patients in Amazon, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Gonçalves Daumas Pinheiro Guimarães

    2012-03-01

    Full Text Available OBJECTIVE: The prevention of anal cancer is a goal of worldwide Aids support centers. Despite the efforts that have been made and progress in the antiretroviral therapy, effective disease control remains elusive. Difficulty in preventing anal cancer may result from the ineffectiveness of highly active antiretroviral therapy on the human papillomavirus (HPV since the coinfection with HIV and HPV appears to increase the risk of HPV-infected cells, becoming cancerous. METHODS: We evaluated 69 HIV-positive and 30 HIV-negative male patients who underwent cytological evaluation by RT-PCR for the presence of HPV, Epstein-Barr virus, cytomegalovirus and herpes virus types (HSV 1 and 2, and histopathology analysis of the anal canal. RESULTS: The prevalence of anal intraepithelial neoplasia was 35% and it was restricted to HIV-positive patients. Patients infected with high-risk HPV and with fewer than 50 TCD4 cells/µL showed an anal intraepithelial neoplasia rate of 85.7% compared to those with TCD4 cells >200 cells/µL (pOBJETIVO: A prevenção do câncer anal tem sido aplicada pelos centros de apoio a pacientes com Aids em todo o mundo. Apesar dos esforços empregados, o eficaz controle da doença permanece distante. A dificuldade na prevenção do câncer anal pode resultar, em parte, da ineficácia da ação da terapia antirretroviral sobre o papilomavírus humano (HPV, pois a coinfecção com HIV e HPV parece aumentar o risco das células infectadas pelo HPV em tornarem-se cancerosas. MÉTODOS: Foram avaliados 69 HIV-positivos e 30 pacientes HIV-negativos do sexo masculino, que foram submetidos à avaliação citológica anal por real time-PCR para a presença de HPV, vírus Epstein-Barr, citomegalovírus e herpes vírus tipos (HSV 1 e 2 além da análise histopatológica de fragmento de mucosa do canal anal. RESULTADOS: A prevalência de neoplasia intraepitelial anal foi de 35% e foi restrita a pacientes HIV-positivos. Os pacientes infectados com o

  8. Thymic carcinoma

    Directory of Open Access Journals (Sweden)

    Vitória Homem Machado

    2016-10-01

    Full Text Available Thymic carcinomas are a heterogeneous group of aggressive, invasive epithelial malignancies. Their incidence is rare, occurring predominantly in middle-aged men. Here we present the typical imaging findings of a thymic carcinoma. The combination of imaging characteristics with tumor location and patient age provides a roadmap for approaching the differential diagnosis. Keywords: Thymus Gland; carcinoma; mediastinal neoplasms

  9. Corinth Canal, Greece

    Science.gov (United States)

    2006-01-01

    The Isthmus of Corinth has played a very important role in the history of Greece. It is the only land bridge between the country's north (Attica) and south (Peloponnese). It is a 6 km wide tongue of land separating the Gulf of Corinth from the Saronic Sea. Populations, armies and commodities have got to move through it. In the 6th century BCE, the Greeks built the Diolkos, a 10 meter-wide stone roadway to pull ships across the Isthmus on wooden cylinders and wheeled vehicles. In 1882, a canal was started and completed 11 years later. It is 6343 meters long, 25 meters wide, and 8 meters deep. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance. The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate. Size: 25.3 by 37.7 kilometers (15.7 by 23.4 miles) Location: 37.9 degrees North latitude, 23 degrees East longitude Orientation: North at top Image

  10. Ship canals and aquatic ecosystems

    Science.gov (United States)

    Aron, William I.; Smith, Stanford H.

    1971-01-01

    Through a combination of ecosystem homeostasis and the perversity of man and nature, oftentimes the significant biological changes effected by environmental modifications are not detected until long after the initial change has taken place. The immediate impact, which may range from the spectacular to the undetectable, is a deceptive measure of the long-term and often more important changes in the ecosystem. Two major engineering achievements illustrate this premise: (i) construction of the Erie Canal, which provided access from the Atlantic Ocean to the Great Lakes, and the Welland Canal, which bypasses the block between Lakes Ontario and Erie created by Niagara Falls (Fig. 1), and (ii) construction of the Suez Canal between the Red Sea and the Mediterranean Sea.

  11. Retention of Root Canal Posts

    DEFF Research Database (Denmark)

    Sahafi, A; Benetti, Ana Raquel; Flury, S

    2015-01-01

    The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc......] and a self-etch adhesive resin cement [Panavia F2.0]) were used. After removal of the crowns of 360 extracted premolars, canines, or incisors, the root canals were prepared with a parallel-sided drill system to three different final diameters. Half the posts did not receive any pretreatment. The other half...... received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement...

  12. Chronic anal fissure from suspected adult sexual abuse in a traumatic anal sex practice patient.

    Science.gov (United States)

    Nzimbala, M J; Bruyninx, L

    2007-01-01

    The aetiopathogenesis of chronic anal fissure (CAF) is unclear and is probably multifactorial. CAF represents 10-15% of proctological consultations. This case report identifies adulthood sexual abuse as a significant risk and a potential aetiopathogenic factor of CAF This case history was discovered while carrying out administrated interviews during authors' clinical retrospective study on CAF. The clinical presentation of this 49-year-old woman is predominated by chronic anal lesions (anal tears in the anoderm, anal sphincter hypertrophy), associated medical history as a high consumer of healthcare with very poor mental health, chronic traumatic anal sex practice history, and especially persistent recurrences of gastro-intestinal symptoms after surgery. Surgical history is summarized as: 7x spontaneous abortion; 5x fistulectomy and 3x anal abscess; 4x Bartholin's gland; 4x hypertrophy papilla ablation; 2x anal manometry, 2x fissurectomy and 1x sphincterotomy; 2x haemorrhoid; and 1x hysterectomy. These symptoms initially started and the operations in particular took place after she was married. After 26 years of sexual abuse within her marriage, the clinical diagnosis was made and was consented by this patient. A referral to a psychiatrist was evident and a long course of multidisciplinary therapy (medical, surgical, physiological and psychological approaches) seemed to be of benefit, in terms of improving the clinical symptoms. Authors suggest that physicians should suspect sexual abuse in any patient with a medical history as a high consumer of healthcare and especially when there is persistent recurrence after the lateral subcutaneous internal sphincterotomy. We recognise that the link or causality is difficult to prove and further study is probably needed to shed light on the link between sexual abuse and CAF: although in the United Kingdom, over 20.83% of the population are subject to sexual abuse. 83%.

  13. High prevalence and incidence of HPV-related anal cancer precursor lesions in HIV-positive women in the late HAART era.

    Science.gov (United States)

    Hidalgo-Tenorio, Carmen; de Jesus, Samantha E; Esquivias, Javier; Pasquau, Juan

    2017-12-02

    Anal cancer is one of the most common non-AIDS defining malignancies, especially in men who have sex with men and women living with HIV (WLHIV). To evaluate the prevalence and incidence of precursor lesions (high-grade squamous intraepithelial lesions [HSIL]) and anal cancer in our cohort of women and to compare them to cervical lesions; to calculate the percentage of patients that acquire and clear oncogenic genotypes (HR-HPV) in the anal canal; and to determine predictive factors for anal HPV infection. Prospective-longitudinal study (May 2012-December 2016). At baseline (V1) and follow up visits, anal mucosa samples were taken in liquid medium for cytology and HPV PCR. In cases of abnormal anal cytology and/or positive HR-HPV PCR results, a high resolution anoscopy was performed. Patients were also referred to the gynaecologist. Ninety five women with an average age of 43.7years were included. At baseline, 11.6% had cervical abnormalities (4.1% CIN1, 2.2% CIN2/3, 1.1% cervical cancer), 64.3% anal abnormalities (50% LSIL/AIN1, 9.5% HSIL/AIN2/3 and 2.4% anal cancer) and 49.4% had HR-HPV genotypes. During 36months of follow up, the incidence of anal HSIL was 16×1,000 person-years; 14.8% acquired HR-HPV genotypes and 51.2% cleared them, P=.007. No patients presented CIN1/2/3/ or cervical cancer. In the multivariate analysis we found the following predictive factors for HR-HPV infection: smoking (RR: 1.55, 95%CI: 0.99-2.42), number of sexual partners >3 (RR: 1.69; 95%CI: 1.09-2.62), cervical and anal dysplasia (RR: 1.83; 95%CI: 1.26-2.67) and (RR: 1.55; 95%CI: 1.021-2.35), respectively. Despite clearance rates of anal oncogenic genotypes being higher than acquisition rates, prevalence and incidence of HSIL were still high and greater than cervical HSIL. Therefore, screening for these lesions should perhaps be offered to all WLHIV. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights

  14. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... rupture (ASR). Design  Population-based retrospective cohort study. Setting  Data were taken from the National Medical Birth Registry, Denmark. Population  Patients with a first and a second vaginal delivery in the time period 1997-2010. Methods  Univariate analysis and multivariate logistic regression...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...

  15. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review.

    Science.gov (United States)

    Stier, Elizabeth A; Sebring, Meagan C; Mendez, Audrey E; Ba, Fatimata S; Trimble, Debra D; Chiao, Elizabeth Y

    2015-09-01

    The aim of this study was to systematically review the findings of publications addressing the epidemiology of anal human papillomavirus (HPV) infection, anal intraepithelial neoplasia, and anal cancer in women. We conducted a systematic review among publications published from Jan. 1, 1997, to Sept. 30, 2013, to limit to publications from the combined antiretroviral therapy era. Three searches were performed of the National Library of Medicine PubMed database using the following search terms: women and anal HPV, women anal intraepithelial neoplasia, and women and anal cancer. Publications were included in the review if they addressed any of the following outcomes: (1) prevalence, incidence, or clearance of anal HPV infection, (2) prevalence of anal cytological or histological neoplastic abnormalities, or (3) incidence or risk of anal cancer. Thirty-seven publications addressing anal HPV infection and anal cytology remained after applying selection criteria, and 23 anal cancer publications met the selection criteria. Among HIV-positive women, the prevalence of high-risk (HR)-HPV in the anus was 16-85%. Among HIV-negative women, the prevalence of anal HR-HPV infection ranged from 4% to 86%. The prevalence of anal HR-HPV in HIV-negative women with HPV-related pathology of the vulva, vagina, and cervix compared with women with no known HPV-related pathology, varied from 23% to 86% and from 5% to 22%, respectively. Histological anal high-grade squamous intraepithelial lesions (anal intraepithelial neoplasia 2 or greater) was found in 3-26% of the women living with HIV, 0-9% among women with lower genital tract pathology, and 0-3% for women who are HIV negative without known lower genital tract pathology. The incidence of anal cancer among HIV-infected women ranged from 3.9 to 30 per 100,000. Among women with a history of cervical cancer or cervical intraepithelial neoplasia 3, the incidence rates of anal cancer ranged from 0.8 to 63.8 per 100,000 person-years, and in

  16. Unpredictable Root Canal Morphology: Expect the Unexpected

    Directory of Open Access Journals (Sweden)

    Sohez J Makani

    2015-01-01

    Full Text Available Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root. Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

  17. Invasive ductal carcinoma vs. invasive lobular carcinoma; mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Chun; Do, Young Soo; Oh, Hoon Il; Han, Yoon Hee; Kim, Ki Soo; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1996-01-01

    The purpose of this study is to evaluate mammographic findings of invasive ductal carcinoma (IDC) and invasive lobular carcinoma(ILC) and to find differential points between the two. 239 patients, who underwent mammography prior to surgery and were proved to have IDC(patients) or ILC(15 patients) pathologically, were analized retrospectively. On mammogram, presence of mass and microcalcification were analized. When there was a mass on mammogram, lesion opacity was classified into high, equal, or low opacity and border of the mass was classified into spiculated, poorly marginated, and well-marginated. When there was no definite mass, mammographic findings were classifie into asymmetric opacity and no mass. Masses were observed in 168 patients(75%) of IDC and 12 patients(80%) of ILC. Border of the masses were spiculated(n=50, 22.3%), poorly marginated(n=112, 50%), or well-marginated(n=6, 2.7%) in patients with IDC. Spiculated and poorly marginated borders were observed in 8 patients(53.3%) and 4 patients(26.7%) respectively, in patients with ILC. Microcalcifications were seen in 88 patients(17.3%) of IDC and patients(33.3%) of ILC. Although equal or low opacities were observed more frequently in ILC and microcalcifications were noted more frequently in IDC, it was difficult to differentiate the two diseases based on mammographic findings.

  18. Invasive ductal carcinoma vs. invasive lobular carcinoma; mammographic findings

    International Nuclear Information System (INIS)

    Lee, Eun Chun; Do, Young Soo; Oh, Hoon Il; Han, Yoon Hee; Kim, Ki Soo; Chin, Soo Yil

    1996-01-01

    The purpose of this study is to evaluate mammographic findings of invasive ductal carcinoma (IDC) and invasive lobular carcinoma(ILC) and to find differential points between the two. 239 patients, who underwent mammography prior to surgery and were proved to have IDC(patients) or ILC(15 patients) pathologically, were analized retrospectively. On mammogram, presence of mass and microcalcification were analized. When there was a mass on mammogram, lesion opacity was classified into high, equal, or low opacity and border of the mass was classified into spiculated, poorly marginated, and well-marginated. When there was no definite mass, mammographic findings were classifie into asymmetric opacity and no mass. Masses were observed in 168 patients(75%) of IDC and 12 patients(80%) of ILC. Border of the masses were spiculated(n=50, 22.3%), poorly marginated(n=112, 50%), or well-marginated(n=6, 2.7%) in patients with IDC. Spiculated and poorly marginated borders were observed in 8 patients(53.3%) and 4 patients(26.7%) respectively, in patients with ILC. Microcalcifications were seen in 88 patients(17.3%) of IDC and patients(33.3%) of ILC. Although equal or low opacities were observed more frequently in ILC and microcalcifications were noted more frequently in IDC, it was difficult to differentiate the two diseases based on mammographic findings

  19. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    Moreira, E.S.

    1984-01-01

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author) [pt

  20. Erie Canal Technology: Stump Pullers

    Science.gov (United States)

    Greenslade, Thomas B., Jr.

    2013-01-01

    Many years ago I saw a picture of a huge set of wheels that was used to remove tree stumps during the construction of the Erie Canal (1817-1825) and was intrigued by its use of leverage, mechanical advantage, and torque. Figure 1 is a scale model of the device based on my memory of the (lost) picture and published accounts.

  1. The Dehiscent Facial Nerve Canal

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  2. An Analysis of Widely Viewed YouTube Videos on Anal Cancer.

    Science.gov (United States)

    Basch, Corey H; Kecojevic, Aleksandar; Berdnik, Alyssa; Cadorett, Valerie; Basch, Charles E

    2017-01-01

    Rates of anal squamous cell carcinoma have increased over recent decades. The aim of this study was to describe characteristics of widely viewed YouTube videos about anal cancer. A total of 57 videos were identified and reviewed. Videos were assessed and coded with respect to date uploaded, upload source, gender of presenter, number of views, length in minutes, number of likes and dislikes, and selected aspects of content. Each video was assessed to determine if the sole purpose of the video was to provide information regarding anal cancer or existed to serve another purpose. Content related to anal cancer was categorized. The mean number of views was 23,548 (range 1014-440,078), and the average length of videos was 8:14 min. The upload source of 57 videos was 19 (33.3%) by consumers, 12 (21.1%) by professional, and 26 (45.6%) by news-based sources. More than half ( n = 30; 52.6%) had the sole purpose of providing information. The most frequently mentioned topics were treatment ( n = 25, 43.9%), symptoms ( n = 15, 26.3%), encouraging screening, human papillomavirus, and pain, respectively ( n = 14, 26.4% for each); only 6 of the 57 videos (10.5%) specifically mentioned prevention. None of 57 most widely viewed videos were uploaded by any agency of the U.S. Public Health Service or by any other U.S. governmental agency. It is important for health practitioners to be aware of the type of information available for their patients on the YouTube platform.

  3. Anterior canal BPPV and apogeotropic posterior canal BPPV: two rare forms of vertical canalolithiasis

    OpenAIRE

    CALIFANO, L.; SALAFIA, F.; MAZZONE, S.; MELILLO, M.G.; CALIFANO, M.

    2014-01-01

    SUMMARY Posterior canal benign paroxysmal positional vertigo (BPPV) is the most frequent form of BPPV. It is characterized by a paroxysmal positioning nystagmus evoked through Dix-Hallpike and Semont positioning tests. Anterior canal BPPV (AC) is more rare than posterior canal BPPV; it presents a prevalent down beating positioning nystagmus, with a torsional component clockwise for the left canal, counterclockwise for the right canal. Due to the possible lack of the torsional component, it is...

  4. Mandibular Second Premolar with Four Canals

    Directory of Open Access Journals (Sweden)

    Javad Ghiasi

    2015-09-01

    Full Text Available A mandibular second premolar with four canals is an interesting example of anatomic variations. This report describes a case of a mandibular second premolar with three roots and four canals (one mesiobuccal, two distobuccal and one lingual. The canals were prepared using K-files and irrigated with NaOCl (5.25% and normal saline as the final irrigant. The canals were filled laterally with gutta percha and AH26 sealer (De Trey, Dentsply, Switzerland. This case shows a rare anatomic configuration and points out the importance of looking for additional canals.

  5. Squamous Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Squamous cell carcinoma Overview Squamous cell carcinoma: This man's skin ... a squamous cell carcinoma on his face. Squamous cell carcinoma: Overview Squamous cell carcinoma (SCC) is a ...

  6. De mundejarismo de los Anales Toledanos Segundos

    Directory of Open Access Journals (Sweden)

    Felipe MAÍLLO SALGADO

    2009-12-01

    Full Text Available Como es sabido los Anales Toledanos (Primeros, Segundos y Terceros, compuestos en su mayor parte durante el siglo XIII en distintos momentos y por diferentes manos, son piezas importantes de la historiografía medieval hispánica, tanto por recoger gran cantidad de noticias —por más que éstas sean escuetas— cuanto por estar todas ellas rigurosamente fechadas; de ahí que sean de gran utilidad para el historiador.De estos tres anales, los Segundos (A.T.II tienen unas peculiaridades que los distinguen fuertemente de los otros; sin embargo, en una primera hojeada el lector poco avisado vería que, por su aspecto formal, nada difieren de otros escritos del mismo género, un género éste cuya condición esencial radica en la consignación del evento fechado, esto es, se presenta en párrafos que comienzan o terminan —como es aquí el caso— con una fecha determinada. Nuestro imaginario lector, por otra parte, se encontraría con las peladas noticias típicas del género analístico, a saber: una serie de referencias que dan cuenta de fenómenos naturales (como son las sequías prolongadas o las excesivas lluvias, las heladas intempestivas, los terremotos, los eclipses..., que informan de las épocas de hambre o carestía, de los precios de los artículos, de prodigios, de acontecimientos locales, etc.; el todo amalgamado con noticias de carácter político-militar.

  7. Transitional Cell Carcinoma within a Portion of Inguinally Herniated Bladder

    Directory of Open Access Journals (Sweden)

    Matthew A. Uhlman

    2013-01-01

    Full Text Available Bladder herniation within the inguinal canal is a relatively uncommon finding. We report an even less-common occurrence of transitional cell carcinoma located within a portion of inguinally herniated bladder. Fewer than 20 reports exist in the literature describing this scenario.

  8. Comentarios sobre dibujo analítico

    OpenAIRE

    Mata Botella, Elena

    2004-01-01

    Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

  9. Anal sphincter responses after perianal electrical stimulation

    DEFF Research Database (Denmark)

    Pedersen, Ejnar; Klemar, B; Schrøder, H D

    1982-01-01

    not fatigued by repeated stimulation, were most dependent on placement of stimulating and recording electrodes, and always had a higher threshold than the third response. The third response was constantly present in normal subjects. It had the longest EMG response and the latency decreased with increasing......By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were...

  10. Scalloping at the lumbosacral canal

    International Nuclear Information System (INIS)

    Reinhardt, R.

    1987-01-01

    Scalloping is an indentation of the dorsal side of the vertebral body (anterior wall of the lumbosacral or sacral canal) which typically involves several adjacent lumbal vertebral body segments and the anterior wall of the canalis sacralis. Occurrence without underlying disease is rare; it occurs most frequently with chondrodystrophy, neurofibromatosis, Morquio's syndrome, Hurler's syndrome, acromegaly, Ehlers-Danlos syndrome, Marfan's syndrome, cysts, tumors and in peridural lipomas. (orig.) [de

  11. Scalloping at the lumbosacral canal

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, R.

    1987-07-01

    Scalloping is an indentation of the dorsal side of the vertebral body (anterior wall of the lumbosacral or sacral canal) which typically involves several adjacent lumbal vertebral body segments and the anterior wall of the canalis sacralis. Occurrence without underlying disease is rare; it occurs most frequently with chondrodystrophy, neurofibromatosis, Morquio's syndrome, Hurler's syndrome, acromegaly, Ehlers-Danlos syndrome, Marfan's syndrome, cysts, tumors and in peridural lipomas.

  12. Parotid carcinoma

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; de Stricker, Karin

    2006-01-01

    OBJECTIVES: Our aim is to investigate the expression of kit protein (KIT) and epidermal growth factor receptor (EGFR) in parotid carcinomas in order to correlate the expression to histology and prognosis. Further we want to perform mutation analysis of KIT-positive adenoid cystic carcinomas. PATI...

  13. Basisquamous Carcinoma

    Directory of Open Access Journals (Sweden)

    Yesudian Devakar P

    1997-01-01

    Full Text Available A 50 year old woman presented with an ulceroproliferative mass in the value of 4 month duration. Biopsy of the lesion showed features of a basisquamous cell carcinoma. This is a rare tumour showing histopathological features of both basal cell and squamous cell carcinomas. The clinical, histopathological and histogenetic status of this tumour are discussed.

  14. Protocolo diagnóstico y seguimiento de la prevalencia e incidencia del virus del papiloma humano (vph) y las anormalidades citológicas de la mucosa anal de hombres que tienen sexo con hombres (hsh) e infección por el virus de la inmunodeficiencia humana (vih).

    OpenAIRE

    Rivero Rodríguez, Maria del Mar

    2012-01-01

    La citologia anal és un mètode sensible en el despistatge de la neoplàsia de canal anal i similar a la biòpsia dirigida mitjançant rectoscopi i tinció amb àcid acètic al 5%, sobretot en lesions d'alt grau de malignitat; a més de ser una prova adequada en el seguiment d'aquestes lesions. Els pacients VIH homes que tenen sexe amb altres homes tenen major incidència i prevalència de virus papiloma humà i major nombre d'anormalitats en la mucosa del canal anal que els VIH negatius. La citologí...

  15. Squamous cell carcinoma of temporal bone: four case reports

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Ha; Sung, Ki Joon; Sim, Young; Shim, Sue Yoen; Yoon, Byoung Moon [Wonju College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    2000-04-01

    We report the CT findings of four cases of squamous cell carcinoma, paying special attention to the epicenter of the lesion and the pattern of bony destruction. All four patients had a past history of chronic otitis media. Squamous cell carcinoma affected mainly the hypotympanum and inferior wall of the external auditory canal. and in all cases revealed an irregular pattern of bony destruction. Irregular destruction of the tegmen tympani occurred in two cases. In cases of squamous cell carcinoma, CT findings suggesting involvement of the promontory are usually noted. (author)

  16. 75 FR 39632 - Regulated Navigation Area; Gulf Intracoastal Waterway, Inner Harbor Navigation Canal, Harvey...

    Science.gov (United States)

    2010-07-12

    ..., Algiers Canal, New Orleans, LA; Correction ACTION: Interim rule; Correction. SUMMARY: In the Federal... Area; Gulf Intracoastal Waterway, Inner Harbor Navigation Canal, Harvey Canal, Algiers Canal, New...

  17. Mode of delivery after obstetric anal sphincter injury.

    Science.gov (United States)

    Karmarkar, Roopali; Bhide, Alka; Digesu, Alex; Khullar, Vik; Fernando, Ruwan

    2015-11-01

    To assess the effect of vaginal delivery and caesarean section on faecal symptoms and structure and function of anal sphincter in women who sustained obstetric anal sphincter injuries (OASIS) in their previous pregnancy and were advised about the mode of delivery based on faecal incontinence symptoms, anal manometry and endoanal ultrasound. It is a descriptive study on a cohort of women who had OASIS from 2006 to 2013. They were assessed after OASIS and during subsequent pregnancy with a questionnaire, endoanal ultrasound and anal manometry. Vaginal delivery was recommended to asymptomatic women with normal investigations. Elective caesarean section was recommended to women with faecal symptoms, anal sphincter defects of more than 30° or low resting or incremental anal pressures. All women were reassessed after subsequent delivery. Fifty women who had pregnancies after OASIS, were seen after OASIS, during subsequent pregnancy and after the second delivery. 15 women had faecal symptoms after OASIS. The external, internal and combined anal sphincter defects were seen in 13, 11 and 9 women respectively. Low resting and incremental pressure were seen in 15 and 11 women respectively. Caesarean section was done in 22 women and 28 women delivered vaginally. Worsening of faecal symptoms and reduction in anal pressures were not observed in planned vaginal delivery or elective caesarean section groups. Faecal symptoms were worse with reduced anal pressures in three women from the planned caesarean section group. One of the women had a vaginal delivery and two women had emergency caesarean section at 7cm and 10cm dilatation. There were no new sphincter defects or recurrent OASIS in any of the women in the study group. Decision about the mode of delivery of pregnancy after OASIS based on symptoms, anal manometry and endoanal ultrasound helps in preserving the anal sphincter function and avoiding unnecessary caesarean sections. Further follow-up of these patients is essential

  18. Core outcome research measures in anal cancer (CORMAC): protocol for systematic review, qualitative interviews and Delphi survey to develop a core outcome set in anal cancer.

    Science.gov (United States)

    Fish, Rebecca; Sanders, Caroline; Williamson, Paula R; Renehan, Andrew G

    2017-11-22

    The incidence of anal squamous cell carcinoma (ASCC) has increased threefold in the last 30 years. Initial treatment is chemoradiotherapy, associated with short-term and long-term side effects. Future therapy innovations aim to reduce morbidity in treatment of early tumours while maintaining treatment efficacy, and to escalate treatment intensity in locally advanced tumours with acceptable quality of life (QoL). However, all phase III randomised controlled trials to-date have utilised different primary outcomes, which hinders evidence synthesis and presents challenges to the selection of optimal outcomes in future trials. No trial comprehensively assessed long-term side effects and QoL, suggesting outcomes reflecting issues important to patients are under-represented. This project aims to determine the priority outcomes for all stakeholders and reach agreement on a standardised core set of outcomes to be measured and reported on in all future ASCC trials. A systematic review will identify all outcomes reported in trials and observational studies of chemoradiotherapy as primary treatment for ASCC. Outcomes of importance to patients will be identified through patient interviews. The long list of outcomes generated from the systematic review and interviews will be used to create a two-round Delphi process, including key stakeholders (patients and healthcare professionals). The results of the Delphi will be discussed at a face-to-face consensus meeting. Discussion will focus on outcomes that did not achieve consensus through the Delphi process and conclude with anonymous voting to ratify the final core outcome set (COS). The final COS will feed directly into the PersonaLising Anal cancer radioTherapy dOse (PLATO) national anal cancer trials and the Association of coloproctologists of Great Britain and Ireland (ACPGBI) supported national anal cancer database. Utilisation of the COS will increase the relevance of research output to all stakeholders and increase the

  19. Stability of guest molecules in urea canal complexes by canal polymerization

    International Nuclear Information System (INIS)

    Yoshii, Fumio; Makuuchi, Keizo

    1995-01-01

    It was found that various organic materials are attracted into urea canal by hexanediol diacrylate (HDDA) and long chain compounds. This means that materials which does not form complex by itself are induced in canal by HDDA and long chain compounds. To include with stability perfumes, insecticides, attractants and repellents in urea canal, leaf alcohol was used as a model compound for guest molecules in the canal. The leaf alcohol from the canal released gradually over many days and the release was inhibited for 15 days by long chain compounds and for 30 days by polymerized HDDA after irradiation. After releasing, the leaf alcohol in the canal remained 25 % stable for long chain compounds and 40 % for polymerized HDDA. The dose required for stabilization of leaf alcohol in the urea canal by canal polymerization of HDDA was 30 kGy. (author)

  20. Syndemic synergy of HPV and other sexually transmitted pathogens in the development of high-grade anal squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Jenny C. McCloskey

    2017-12-01

    Full Text Available Background: Anal intraepithelial neoplasia is associated with high-risk human papillomavirus (hrHPV as a precursor to anal cancer. However, factors other than hrHPV are likely to be involved and further study of cofactors is required because of the possibility of syndemic interactions. Methods: Three hundred and fourteen patients underwent 457 operations. Histopathology and hrHPV testing using the Digene Hybrid Capture 2 (HC 2 method were performed. Demographic factors and sexually transmissible infections (STIs were recorded. Results: Results showed that hrHPV alone was associated with HSIL (OR = 4.65, p < 0.001. None of the other STIs were alone associated with HSIL but amplification of risk was found when hrHPV infection occurred with HIV (OR = 11.1; syphilis (OR = 5.58; HSV 2 (OR = 7.85; gonorrhoea (OR = 6.45 and some other infections. Conclusions: These results suggest that hrHPV is a sufficient cause of anal HSIL. Seropositivity for HIV, HSV 2, T. pallidum, HBV and HCV and a history of gonorrhoea or chlamydia exert a powerful amplifying factor increasing the risk of HSIL above the risk with hrHPV alone. Other co-factors which are associated with an increased risk of HSIL are increased age, male gender, MSM behaviour and self-reported history of more than 50 sexual partners. This pattern of disease in patients with warts is characteristic of a syndemic with potential serious increased risk of anal carcinoma. Keywords: HSIL, Anal warts, Sexually transmissible infections, High-risk HPV, HIV, Syndemic

  1. Giant Anal Condyloma Acuminatum in Childhood: A Case Report ...

    African Journals Online (AJOL)

    Giant Anal Condyloma Acuminatum in Childhood: A Case Report. K. Attipou, K. Yawovi, N. James, G. A. Napo-Koura, A. Tchangaï-Walla, K James. Abstract. The authors report a case of anal giant condyloma acuminatum present for 10 years in a 14 year old. The giant tumor was responsible for difficulty in the sitting and ...

  2. Fiber types in the striated urethral and anal sphincters

    DEFF Research Database (Denmark)

    Schrøder, H D; Reske-Nielsen, E

    1983-01-01

    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...

  3. Tuberculous anal fistulas – prevalence and clinical features in an ...

    African Journals Online (AJOL)

    Tuberculous anal fistulas – prevalence and clinical features in an endemic area. D Stupart, P Goldberg, A Levy, D Govender. Abstract. Introduction. The aim of this study was to determine the prevalence of tuberculosis (TB) in anal fistulas at a referral hospital in Cape Town, and to document the clinical features and course of ...

  4. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  5. Effect of endorectal pullthrough on external anal sphincter integrity ...

    African Journals Online (AJOL)

    tissue during dissection. Anal sphincter electromyography. (EMG) is an indispensable parameter for the diagnosis of patients with any anorectal dysfunction. The aim of our study was to assess the integrity of the anorectal sphincter after transanal endorectal pullthrough using anal EMG. Methods This prospective study was ...

  6. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

    Heyckendorff-Diebold, Tina; Maeda, Yasuko; Buntzen, Steen

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional...

  7. Female hydrocele of canal of nuck.

    Science.gov (United States)

    Patil, Sowmya Naveen; Bielamowicz, Kevin

    2010-08-01

    Hydrocele of the canal of Nuck is a very rare condition in females. The processus vaginalis within the inguinal canal forms "the canal of Nuck" in females, homologous to the processus vaginalis in males. Failure of obliteration of the processus vaginalis results in either a direct or an indirect inguinal hernia or if a sac of serous fluid is retained, it forms a hydrocele. Very little has been reported on this condition in the literature. We present a case of hydrocele of canal of Nuck in an 8-year-old female.

  8. Anal metastasis originating from colorectal cancer: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Min; Lim, Joon Seok; Choi, Jin Young; Park, Mi Suk; Kim, Myeong Jin [Dept. of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Taek; Kim, Ho Guen [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    Anal metastasis from colorectal cancer rarely occurs, but it severely impairs the patient's quality of life, often requiring wide resection including the anal sphincter with permanent colostomy. This lesion can be misdiagnosed as a perianal fistula or an abscess, and it can be overlooked at the time of surgery because it is not included in the routine surgical extent of low anterior resection. We report two rare cases of anal metastasis from colorectal cancer. In both cases, perianal nodules with an internal solid portion were detected on preoperative rectal magnetic resonance imaging and additional local excisions of the anal lesions were performed during the process of treatment. Anal metastasis was pathologically confirmed by histology and immunohistochemical staining.

  9. Narrow, duplicated internal auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, T. [Servico de Neurorradiologia, Hospital Garcia de Orta, Avenida Torrado da Silva, 2801-951, Almada (Portugal); Shayestehfar, B. [Department of Radiology, UCLA Oliveview School of Medicine, Los Angeles, California (United States); Lufkin, R. [Department of Radiology, UCLA School of Medicine, Los Angeles, California (United States)

    2003-05-01

    A narrow internal auditory canal (IAC) constitutes a relative contraindication to cochlear implantation because it is associated with aplasia or hypoplasia of the vestibulocochlear nerve or its cochlear branch. We report an unusual case of a narrow, duplicated IAC, divided by a bony septum into a superior relatively large portion and an inferior stenotic portion, in which we could identify only the facial nerve. This case adds support to the association between a narrow IAC and aplasia or hypoplasia of the vestibulocochlear nerve. The normal facial nerve argues against the hypothesis that the narrow IAC is the result of a primary bony defect which inhibits the growth of the vestibulocochlear nerve. (orig.)

  10. Anaplastic carcinoma

    International Nuclear Information System (INIS)

    Parikh, D.M.; Agarwal, S.; Rao, R.S.

    1999-01-01

    Thyroid carcinoma (TC) is a slow growing tumor with an indolent course and has an excellent prognosis. However, a sharp contrast exists in the biological behavior of TC, which in its well-differentiated form is associated with long-term survival, but in its undifferentiated form is one of the most lethal neoplasms known. The anaplastic carcinoma (ANC) form has a fulminanat course with poor prognosis and almost invariably, a fatal outcome

  11. Basal Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Basal cell carcinoma Overview Basal cell carcinoma: This skin cancer ... that has received years of sun exposure. Basal cell carcinoma: Overview Basal cell carcinoma (BCC) is the ...

  12. Some History and Hydrology of the Panama Canal

    National Research Council Canada - National Science Library

    Pabst, Arthur

    2000-01-01

    At the request of the Panama Canal Commission (now Panama Canal Authority), the Hydrologic Engineering Center participated in the development of a model to simulate the existing operation of the Panama Canal System...

  13. Anorectal function following colo-anal sleeve anastomosis for chronic radiation injury to the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Varma, J.S.; Smith, A.N.

    1986-04-01

    This paper reports the results of anorectal manometry and electrophysiological studies of the pelvic floor in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. The group comprised six women and two men (age range 61-84 years, mean 71 years). Six bladder carcinoma patients had received small field (10 x 10 cm) external beam radiotherapy (5500 cGy in 20 treatments over 4 weeks); two cervical cancer patients had been given whole pelvis, external beam radiotherapy supplemented by a single caesium implant (cumulative dosage of 9500 cGy to the vaginal vault, equivalent to 7500 cG to point A).

  14. Anorectal function following colo-anal sleeve anastomosis for chronic radiation injury to the rectum

    International Nuclear Information System (INIS)

    Varma, J.S.; Smith, A.N.

    1986-01-01

    This paper reports the results of anorectal manometry and electrophysiological studies of the pelvic floor in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. The group comprised six women and two men (age range 61-84 years, mean 71 years). Six bladder carcinoma patients had received small field (10 x 10 cm) external beam radiotherapy (5500 cGy in 20 treatments over 4 weeks); two cervical cancer patients had been given whole pelvis, external beam radiotherapy supplemented by a single caesium implant (cumulative dosage of 9500 cGy to the vaginal vault, equivalent to 7500 cG to point A). (UK)

  15. Root canal morphology of upper and lower molars

    OpenAIRE

    Dimova, Cena; Zlatanovska, Katerina; Popovska, Lidija

    2015-01-01

    Introduction: Diagnosis, treatment planning and knowledge of root canal morphology and its’ frequent variations is a basic requirement for endodontic success. The success of root canal therapy is dependent on the clinician’s knowledge of root canal morphology with goal to precisely locate all canals, properly clean, shape and obturate the canal space. Aim: The aim in our study was to to determine the root canal morphology in maxillary and mandibular molars. Material and method: A total...

  16. Root canal morphology of maxillar and mandibular molars

    OpenAIRE

    Dimova, Cena; Panova, Gordana; Zlatanovska, Katerina; Popovska, Lidija

    2015-01-01

    Introduction: Diagnosis, treatment planning and knowledge of root canal morphology and its’ frequent variations is a basic requirement for endodontic success. The success of root canal therapy is dependent on the clinician’s knowledge of root canal morphology with goal to precisely locate all canals, properly clean, shape and obturate the canal space. Aim: The aim in our study was to to determine the root canal morphology in maxillary and mandibular molars. Material and method: A total...

  17. Anal endosonography and manometry: comparison in patients with defecation problems.

    Science.gov (United States)

    Schäfer, R; Heyer, T; Gantke, B; Schäfer, A; Frieling, T; Häussinger, D; Enck, P

    1997-03-01

    Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

  18. Endoanal ultrasound in benign anal disorders: findings and usefulness

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Tae Haeng; Shin, Hyun Joon; Cho, Young Kwon; Park, Dong Rib; Jeon, Hae Jeong; Park, Jeong Hee; Choi, Yong Chil; Park, Ung Chae; Choi, Jin Yong [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    To evaluate the usefulness of endoanal ultrasonography and to determine the imaging features of patients with fecal incontinence, anal abscess or anal fistula. Twenty five patients underwent endoanal ultrasonography between October 1995 and July 1996. Ten of these were fecal incontinence cases, eight had an anal abscess, and seven, an anal fistula. The incontinence grading scale (IGS) was used for clinical grading of fecal incontinence and pudendal nerve terminal motor latency (PNTML) for pudendal nerve injury. Endoanal ultrasonographic features and operative findings were retrospectively reviewed. Endoanal ultrasonography revealed defective sphincteric muscles in all three patients with myogenic fecal incontinence, but in six of seven cases with neurogenic fecal incontinence, these muscles were not difective. Myogenic and neurogenic incontience showed different findings (p=3D0.033). In comparison with surgical findings, endoanal ultrasonography was 88% accurate in anal abscess cases and 86% accurate in those of anal fistula. Endoanal ultrasonography in conjunction with PNTML was very useful for the detection of the site and severity of sphincteric muscle defect and diagnosis of the etiology of fecal incontinence. Through analysis of the site and type of lesion, the procedure can also serve as a guide to the surgical treatment of patients with anal abscess or fistula.=20.

  19. Bilateral duplication of the internal auditory canal

    International Nuclear Information System (INIS)

    Weon, Young Cheol; Kim, Jae Hyoung; Choi, Sung Kyu; Koo, Ja-Won

    2007-01-01

    Duplication of the internal auditory canal is an extremely rare temporal bone anomaly that is believed to result from aplasia or hypoplasia of the vestibulocochlear nerve. We report bilateral duplication of the internal auditory canal in a 28-month-old boy with developmental delay and sensorineural hearing loss. (orig.)

  20. The enigma of the lateral canal.

    Science.gov (United States)

    Weine, F S

    1984-10-01

    It is difficult to summarize an article of this type, in which the author is certain that his case has been presented fairly, but is aware that other views that are contrary could be stated and endorsed by pertinent clinical cases. Bearing this fact in mind, I wish to reiterate the following: Lateral canals are demonstrated in endodontic cases with much less frequency than they exist. This variance rarely, if ever, causes an endodontic failure. Some demonstrated lateral canals may really be other conditions. Preoperative evaluation should include examination of radiographs for lateral, as well as periapical, lesions. Lateral canals may be demonstrated by a variety of filling techniques. Careful canal preparation may enhance the frequency of such demonstration. Cases with necrotic pulps probably yield more frequent demonstration than do cases with vital pulps. Lateral canals harboring inflamed and/or infected material may cause pain during endodontic treatment. They may simulate periodontal disease and may cause problems with treatment if present when a tooth is left open for drainage. Periodontal disease may cause pulp exposure via lateral canals located coronally. Improper use of post room may lead to lateral failure from breakdown of tissue in a lateral canal. The enigma of the lateral canal has been the object of description and discussion in many articles, but no one is truly certain of their exact significance in endodontic therapy for the long haul.

  1. [Upper lateral incisor with 2 canals].

    Science.gov (United States)

    Fabra Campos, H

    1991-01-01

    Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

  2. Type III apical transportation of root canal

    Directory of Open Access Journals (Sweden)

    Shiv P Mantri

    2012-01-01

    Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

  3. Colgajo anal cutáneo por deslizamiento :

    OpenAIRE

    Rodriguez, Carlos E

    2009-01-01

    Tesis (Doctor)--Universidad Nacional de Córdoba. Facultad de Ciencias Médicas, 2009 Desde Julio del año 2004 a Septiembre del año 2008, se trataron 34 pacientes que presentaban patología ano-orificial beningna, mediante la realización del colgajo anal cutáneo por deslizamiento. La edad promedio fue de 59 años y el sexo predominante el masculino. Las patologías que presentaban fueron, enfermedad hemorroidal el 64%; estenosis anal 18% y fisura anal 18% del total de enfermos operados el 22% t...

  4. Sensibilidade e especificidade da citologia anal com escova no diagnóstico das lesões clínicas provocadas pelo papilomavírus humano, comparando uma com duas coletas Sensibility and specifity of anal cytology with cytobrush in the HPV induced clinical lesions diagnosis, comparing one to two smears

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-09-01

    Full Text Available OBJETIVO: comparar os resultados da coleta única com duas amostras para avaliar se haverá melhora da sensibilidade e especificidade do exame. MÉTODO: Foram 112 doentes masculinos HIV-positivo com doença anal pregressa ou atual pelo Papilomavírus humano (HPV. As lesões HPV induzidas foram observadas em 58 deles. Colhemos material do canal anal utilizando duas escovas (cytobrush Comparamos estatisticamente os resultados da primeira amostra com a soma das duas coletas. RESULTADOS: dos 58 doentes com lesões clínicas, a primeira amostra confirmou a doença em 40 (69% e a soma das duas coletas revelou lesões em 51 (88%. Os resultados mostraram sensibilidade de 69% com a primeira coleta e 88% quando somadas as duas amostras. Essa diferença foi confirmada estatisticamente. A especificidade foi menor para as duas amostras, porém sem diferença estatística. CONCLUSÃO: Concluímos que a sensibilidade foi maior e a especificidade foi semelhante quando os resultados foram obtidos com a somação das duas amostras da citologia anal.OBJECTIVE: The aim of this study was to know if two smears may have better sensibility and specificity than a unique smear for anal cytology. METHOD: There were 112 patients, males, HIV-positive, with current or previous anal HPV-induced lesions. Proctological examination revealed clinical disease in the anal canal of 58 of them. Smears were collect with cytobrushes. We compared results of the first smear to a sum of this with a second one. RESULTS: First smear was positive in 40 patients (69%, and with both smears this incidence reached 88%. Results showed sensibility of 69% to the unique smear, and 88% when both were summed. Statistics revealed significant difference. Specificity was higher when both smears were summed, but statistics showed no difference. CONCLUSION: We concluded sensibility of anal cytology was better and specificity was similar when results were obtained with a sum of two smears.

  5. Også gravide skal rektaleksploreres ved anale symptomer

    DEFF Research Database (Denmark)

    Højgaard, Helle Manfeld; Rahr, Hans

    2012-01-01

    assessment. Following caesarian section, diagnostic workup showed multiple liver metastases. Rectal cancer in pregnancy is rare, while haemorrhoids are common. We recommend keeping the differential diagnoses in mind and performing a digital rectal examination if pregnant women have anal symptoms....

  6. Micro-computerized tomographic analysis of radicular and canal morphology of premolars with long oval canals.

    Science.gov (United States)

    Grande, Nicola M; Plotino, Gianluca; Pecci, Raffaella; Bedini, Rossella; Pameijer, Cornelis H; Somma, Francesco

    2008-09-01

    The aims of this in vitro study were to measure root and canal diameters, root and canal diameter ratios, mean taper of the root canal and of each root canal section, and radicular wall thickness at different levels in premolars with long oval root canals. Thirty human premolars, with single long oval canals were selected for this study. The specimens were analyzed with micro-computerized tomography. The cross-sections corresponding to 1, 2, 3, 4, 5, 7, 9, 11, and 13 mm from the radiologic apex were analyzed to measure the mesiodistal (MD) and buccolingual (BL) diameters of the canals and the thickness of the root and the walls. The BL/MD ratios of the canal (DeltaC) and the root (DeltaR) diameters were calculated, as was as the mean taper in both a BL and an MD dimension. Multiple logistic regression analyses were performed with a level of significance of P = .05. At all levels of analysis, the BL diameter was greater than the MD diameter for both the canal and the root. Generally, DeltaC and DeltaR increased coronally. Buccal and lingual wall thicknesses were greater than mesial and distal at all levels. Canal diameters at 1 mm from the apex were >0.30 mm in the shorter-oval diameter and >0.40 mm in the longer-oval diameter. In all root segments the BL taper was greater than the MD taper. An oval canal anatomy was frequently present even in the most apical sections of the root canals. A high correlation was established between the shape of the root canal and the corresponding root.

  7. Early pelvic floor muscle training after obstetrical anal sphincter injuries for the reduction of anal incontinence.

    Science.gov (United States)

    Mathé, Mélodie; Valancogne, Guy; Atallah, Anthony; Sciard, Clémentine; Doret, Muriel; Gaucherand, Pascal; Beaufils, Etienne

    2016-04-01

    Between 0.5 and 5% of vaginal deliveries involve obstetrical anal sphincter injuries (OASIS). Thirty to forty percent of patients with OASIS will suffer from anal incontinence in the subacute postpartum period. The aim of the present study was to assess the effectiveness of early pelvic floor muscle training (PFMT) combined with standard rehabilitation on anal incontinence after vaginal deliveries complicated by OASIS. The present work was a retrospective quantitative study performed in a tertiary-level maternity hospital. Women with 3rd or 4th degree obstetric tears were included. Women who gave birth between January 1st, 2011 and December 31st, 2012 underwent standard pelvic-perineal rehabilitation within 6-8 weeks postpartum. Women who gave birth between January 1st, 2013 and July 1st, 2014 had early rehabilitation (within 30 days after delivery) followed by the same standard rehabilitation received by the other group. Rehabilitation was performed by physiotherapists specialized in perineology. No electrostimulation was done in early rehabilitation. An in-house-validated modification of the Jorge and Wexner questionnaire was sent by mail to the patients to assess symptoms. The main judgment criterion was anal incontinence to gas, loose stools and/or solid stool. Two hundred and thirty patients were diagnosed with OASIS. Nineteen women (8.3%) were lost to follow-up. The intention-to-treat analysis included 211 patients, 109 of whom underwent standard rehabilitation and 102 early rehabilitation plus standard rehabilitation. The two groups were comparable in terms of parity, birth weight, assisted delivery, epidural anesthesia and rates of mediolateral episiotomy. Multivariate analyses adjusted for type of perineal lesion were performed. Early rehabilitation significantly reduced gas leakage: OR 0.51 [0.29-0.90] (p=0.02), liquid stool leakage: OR 0.22 [0.08-0.58] (p=0.02) and urinary stress incontinence: OR 0.43 [0.24-0.77] (p=0.004). We recommend early (during the

  8. Follicular carcinoma

    International Nuclear Information System (INIS)

    Shah, D.H.; Samuel, A.M.

    1999-01-01

    Follicular thyroid carcinoma (FTC) is considered as a disease of the elderly with a higher incidence in females as compared to papillary thyroid carcinoma (PTC). Some studies have reported its occurrence at an early age, which may be attributed to early diagnosis because of the availability of advanced techniques. The prognosis of the disease is considered poor as compared to that of PTC. The conclusions drawn in this review are based on 663 cases in whom adequate data was available for meaningful analysis followed for a mean period of 9.2 years, median, 7.8 years; range, 1-32 years

  9. Ameloblastic carcinoma

    Directory of Open Access Journals (Sweden)

    Praveen B Kumar

    2009-01-01

    Full Text Available Ameloblastoma of jaws are common and locally destructive tumors originating from odontogenic apparatus. They constitute approximately 1% of all jaw tumors with 80% occurring in the mandible. Ameloblastoma exhibiting a frank malignancy is a rare entity and occurs in less than 1% of all ameloblastomas. Among the two jaws, ameloblastic carcinoma involving maxilla is extremely rare with only few cases reported so far in the literature. Here we report two cases of ameloblastic carcinoma one involving the maxilla and the other involving mandible, with an aggressive clinical course leading to extensive local destruction of the affected jaws.

  10. Panama Canal Watershed Experiment- Agua Salud Project

    Science.gov (United States)

    Stallard, Robert F.; Ogden, Fred L.; Elsenbeer, Helmut; Hall, Jefferson S.

    2010-01-01

    The Agua Salud Project utilizes the Panama Canal’s (Canal) central role in world commerce to focus global attention on the ecosystem services provided by tropical forests. The Canal was one of the great engineering projects in the world. Completed in 1914, after almost a decade of concerted effort, its 80 km length greatly shortened the voyage between the Atlantic and Pacific Oceans. An entire class of ships, the Panamax, has been constructed to maximize the amount of cargo that can be carried in a Canal passage. In today’s parlance, the Canal is a “green” operation, powered largely by water (Table 1). The locks, three pairs on each end with a net lift of 27 meters, are gravity fed. For each ton of cargo that is transferred from ocean to ocean, about 13 tons of water (m3) are used. Lake Gatún forms much of the waterway in the Canal transect. Hydroelectricity is generated at the Gatún dam, whenever there is surplus water, and at Madden Dam (completed in 1936) when water is transferred from Lake Alhajuela to Lake Gatún. The Canal watershed is the source of drinking water for Panama City and Colon City, at either end of the Canal, and numerous towns in between.

  11. Wave Mechanics of the Vestibular Semicircular Canals.

    Science.gov (United States)

    Iversen, Marta M; Rabbitt, Richard D

    2017-09-05

    The semicircular canals are biomechanical sensors responsible for detecting and encoding angular motion of the head in 3D space. Canal afferent neurons provide essential inputs to neural circuits responsible for representation of self-position/orientation in space, and to compensatory circuits including the vestibulo-ocular and vestibulo-collic reflex arcs. In this work we derive, to our knowledge, a new 1D mathematical model quantifying canal biomechanics based on the morphology, dynamics of the inner ear fluids, and membranous labyrinth deformability. The model takes the form of a dispersive wave equation and predicts canal responses to angular motion, sound, and mechanical stimulation. Numerical simulations were carried out for the morphology of the human lateral canal using known physical properties of the endolymph and perilymph in three diverse conditions: surgical plugging, rotation, and mechanical indentation. The model reproduces frequency-dependent attenuation and phase shift in cases of canal plugging. During rotation, duct deformability extends the frequency bandwidth and enhances the high frequency gain. Mechanical indentation of the membranous duct at high frequencies evokes traveling waves that move away from the location of indentation and at low frequencies compels endolymph displacement along the canal. These results demonstrate the importance of the conformal perilymph-filled bony labyrinth to pressure changes and to high frequency sound and vibration. Published by Elsevier Inc.

  12. How to bond to root canal dentin

    Science.gov (United States)

    Nica, Luminita; Todea, Carmen; Furtos, Gabriel; Baldea, Bogdan

    2014-01-01

    Bonding to root canal dentin may be difficult due to various factors: the structural characteristic of the root canal dentin, which is different from that of the coronal dentin; the presence of the organic tissue of the dental pulp inside the root canal, which has to be removed during the cleaning-shaping of the root canal system; the smear-layer resulted after mechanical instrumentation, which may interfere with the adhesion of the filling materials; the type of the irrigants used in the cleaning protocol; the type of the sealer and core material used in the obturation of the endodontic space; the type of the materials used for the restoration of the endodontically treated teeth. The influence of the cleaning protocol, of the root canal filling material, of the type of the adhesive system used in the restoration of the treated teeth and of the region of the root canal, on the adhesion of several filling and restorative materials to root canal dentin was evaluated in the push-out bond strength test on 1-mm thick slices of endodontically treated human teeth. The results showed that all these factors have a statistically significant influence on the push-out bond strength. Formation of resin tags between radicular dentin and the investigated materials was observed in some of the samples at SEM analysis.

  13. Acceleration induced water removal from ear canals.

    Science.gov (United States)

    Kang, Hosung; Averett, Katelee; Jung, Sunghwan

    2017-11-01

    Children and adults commonly experience having water trapped in the ear canals after swimming. To remove the water, individuals will shake their head sideways. Since a child's ear canal has a smaller diameter, it requires more acceleration of the head to remove the trapped water. In this study, we theoretically and experimentally investigated the acceleration required to break the surface meniscus of the water in artificial ear canals and hydrophobic-coated glass tubes. In experiments, ear canal models were 3D-printed from a CT-scanned human head. Also, glass tubes were coated with silane to match the hydrophobicity in ear canals. Then, using a linear stage, we measured the acceleration values required to forcefully eject the water from the artificial ear canals and glass tubes. A theoretical model was developed to predict the critical acceleration at a given tube diameter and water volume by using a modified Rayleigh-Taylor instability. Furthermore, this research can shed light on the potential of long-term brain injury and damage by shaking the head to push the water out of the ear canal. This research was supported by National Science Foundation Grant CBET-1604424.

  14. Anal sphincter EMG in the diagnosis of parkinsonian syndromes

    DEFF Research Database (Denmark)

    Winge, K; Jennum, Poul Jørgen; Løkkegaard, Annemette

    2010-01-01

    The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective.......The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective....

  15. Changes in the proportions of types I and III collagen in hemorrhoids: the sliding anal lining theory

    Directory of Open Access Journals (Sweden)

    Carlos Sardiñas

    2016-07-01

    Full Text Available Objective: This study aims to determine changes in the proportions of types I and III collagen in hemorrhoids and to verify the sliding anal canal lining theory. Patients and method: The study is focused on a sample of 17 patients, 9 females and 8 males (age range: 30–70 years, with grade III and grade IV hemorrhoids. Tissue from 4 fetuses (age: 16 weeks of gestation was used as control sample. All the participants gave their informed consent. Samples were gathered in 2014. All patients underwent open hemorrhoidectomy by using the technique described by Milligan and Morgan, published in Lancet journal in 1937. The hemorrhoid samples were stained with hematoxylin–eosin for the histologic study to confirm the hemorrhoidal tissue diagnosis. The picrosirius red staining protocol was used after the histologic analysis. The method used for image processing is described in the text. Images were imported to the Image Tool for Windows software. The same process was used on the embryonic tissue. Data resulting from the analysis of images were processed using STATISTICA, a software for statistical analysis. Results: When compared, it was found that the two tissues presented very different values, with hemorrhoids containing the highest type III collagen values. Conclusion: Our results seem to imply that hemorrhoids have a larger proportion of type III collagen than fetal tissue. They also suggest a possible age-related deterioration of the tissue. Resumo: Objetivo: Esse estudo tem por objetivo determinar mudanças nos percentuais do colágeno dos tipos I e III em hemorroidas e verificar a teoria do revestimento de canal anal deslizante. Pacientes e método: O estudo está focado em uma amostra de 17 pacientes (9 mulheres e 8 homes; faixa etária: 30-70 anos, com hemorroidas de graus III e IV. Utilizamos tecido de quatro fetos (idade: 16 semanas de gestação como amostra de controle. Todos os participantes deram consentimento informado. As amostras

  16. Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia.

    Science.gov (United States)

    Hehir, Mark P; Rubeo, Zachary; Flood, Karen; Mardy, Anne H; O'Herlihy, Colm; Boylan, Peter C; D'Alton, Mary E

    2018-03-01

    Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland. Details of maternal demographics, intrapartum characteristics, and delivery outcomes in cases of shoulder dystocia were analyzed. Univariate and multivariate analyses were used to describe the association between shoulder dystocia and anal sphincter injury. There were 685 cases of shoulder dystocia, and the rate of shoulder dystocia was similar at both institutions. The incidence of anal sphincter injury was 8.8% (60 out of 685). The rate was 14% (45 out of 324) in nulliparas and 4.2% (15 out of 361) in multiparas. Women with sphincter injury were more likely to be nulliparous (75% [45 out of 60] vs 45% [279 out of 625]; p shoulder dystocia, the risk of anal sphincter injury is 9%. Risk factors include nulliparity, operative vaginal delivery, and use of internal maneuvers, whereas episiotomy was found to have a protective effect against anal sphincter injury during cases of shoulder dystocia.

  17. Hernia of canal of nuck: Some considerations

    Directory of Open Access Journals (Sweden)

    Mirat Dholakia

    2015-01-01

    Full Text Available Hernia of canal of Nuck is an extension of peritoneal fold through the inguinal canal up to the labia majora. Defective obliteration of this peritoneal fold leads to herniation of abdominal content into the inguinal canal. Incidence of ovary and fallopian tube as contents of henia is rare overall and very rare in middle age women. This hernia would require surgical intervention once diagnosed, but type of intervention may vary. Although mesh repair is acceptable worldwide with low recurrence rate, nonmesh repair still has a place specifically in developing countries wherein cost consideration without significantly affecting outcome will be an important factor. Two cases treated with nonmesh repair are reported.

  18. Bifid mandibular canal: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Ajay Parihar

    2015-01-01

    Full Text Available Bifid mandibular canal could be an interesting variation in the mandible. This condition can pose complications during surgical procedures in the mandible, such as extraction of lower molars, placement of implants, and surgery. Therefore, identification of this variation is sometimes very crucial and can assist in minimizing postoperative complications. Hereby, we report the presence of bifid mandibular canal in the first molar region, an unusual presentation. The patient was evaluated for implant prosthesis using cone beam computed tomography (CBCT that confirmed the bifid canal which was seen as an unusual radiolucency on intraoral periapical radiograph.

  19. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all...... in women. Between 1978-1982 and 2003-2008, the age-standardized incidence rate of anal cancer increased from 0.68 to 1.48 per 100 000 person-years in women and from 0.45 to 0.80 per 100 000 person-years in men. Although there is no systematic screening for AIN in Denmark, we nevertheless identified 608...

  20. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    Energy Technology Data Exchange (ETDEWEB)

    Zilli, Thomas, E-mail: Thomas.Zilli@hcuge.ch [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Betz, Michael [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Radiation Oncology Institute, Hirslanden Lausanne, Lausanne (Switzerland); Bieri, Sabine [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Ris, Frederic; Roche, Bruno [Department of Surgery, Geneva University Hospital, Geneva (Switzerland); Roth, Arnaud D. [Oncosurgery Unit, Geneva University Hospital, Geneva (Switzerland); Allal, Abdelkarim S. [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Department of Radiation Oncology,Hôpital Fribourgeois, Fribourg (Switzerland)

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC, cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ≥3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.

  1. 21 CFR 872.3810 - Root canal post.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal post. 872.3810 Section 872.3810 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal... of the platinum group intended to be cemented into the root canal of a tooth to stabilize and support...

  2. Assessment of periapical health, quality of root canal filling, and ...

    African Journals Online (AJOL)

    Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was ...

  3. Clinical analysis of ear carcinoma treated in the Department of Otolaryngology, Niigata University Hospital. Focus on correlation between treatment method and prognosis

    International Nuclear Information System (INIS)

    Sato, Katsuro; Tomita, Masahiko; Takahashi, Sugata; Watanabe, Jun; Matsuyama, Hiroshi

    2008-01-01

    Thirty-six patients of ear carcinoma treated in our department were clinically analyzed. Those ear carcinoma patients accounted for 3.5% of all head and neck carcinoma patients. The most common primary site was the external auditory canal (67%), followed by the middle ear (19%) and the auricle (14%). The mean age of the patients was 66 years old, and the male to female ratio was 3:2. The most common chief complaint of the external auditory canal and middle ear carcinoma was otorrhea followed by ear itching and ear ache. Of patients with external auditory canal carcinoma and middle ear carcinoma, 26% had a history of ear surgery, and 35% had a habit of ear-picking. Histopathologically, 94% of the patients were squamous cell carcinoma, and 6% were malignant melanoma. Sixty-two % of squamous cell carcinoma patients underwent surgery, and the remaining 38% had radiotherapy without surgery. Postoperative radiotherapy was added for 67% of the surgery group. Five-year survival rates of the patients with squamous cell carcinoma were 74% for external auditory canal carcinoma, 67% for auricular carcinoma, and 34% for middle ear carcinoma, respectively. The five-year survival rate of the surgery group was 82%, and that of the non-surgery group was 29%. There was a statistical significance between the two groups. No statistical significance was seen between with and without postoperative radiotherapy. In the treatment of squamous cell carcinoma in the ear, radical en bloc surgery followed by postoperative radiotherapy was considered to be an appropriate treatment strategy. (author)

  4. Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

    DEFF Research Database (Denmark)

    Hornung, Benjamin R; Telford, Karen J; Carlson, Gordon L

    2017-01-01

    BACKGROUND: Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function with gre...... is a sensitive test of anal sphincter function and, unlike anal manometry, can discriminate male leakers from continent subjects. An identifiable abnormality has been detected using anal acoustic reflectometry, which may further our understanding of the pathogenesis in this group....

  5. [Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

    2016-01-01

    The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Parathyroid carcinoma

    DEFF Research Database (Denmark)

    Qvist, N; Krøll, L; Ladefoged, C

    1986-01-01

    Parathyroid carcinoma is a slow growing tumor, and the patients most often die from complications to the hypercalcemia. Therefore, any attempt should be made to remove local recurrence and metastasis surgically, as medical treatment is disappointing. A case treated with extensive vascular surgery...

  7. Nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Brennan Bernadette

    2006-06-01

    Full Text Available Abstract Nasopharyngeal carcinoma (NPC is a tumor arising from the epithelial cells that cover the surface and line the nasopharynx. The annual incidence of NPC in the UK is 0.3 per million at age 0–14 years, and 1 to 2 per million at age 15–19 years. Incidence is higher in the Chinese and Tunisian populations. Although rare, NPC accounts for about one third of childhood nasopharyngeal neoplasms. Three subtypes of NPC are recognized in the World Health Organization (WHO classification: 1 squamous cell carcinoma, typically found in the older adult population; 2 non-keratinizing carcinoma; 3 undifferentiated carcinoma. The tumor can extend within or out of the nasopharynx to the other lateral wall and/or posterosuperiorly to the base of the skull or the palate, nasal cavity or oropharynx. It then typically metastases to cervical lymph nodes. Cervical lymphadenopathy is the initial presentation in many patients, and the diagnosis of NPC is often made by lymph node biopsy. Symptoms related to the primary tumor include trismus, pain, otitis media, nasal regurgitation due to paresis of the soft palate, hearing loss and cranial nerve palsies. Larger growths may produce nasal obstruction or bleeding and a "nasal twang". Etiological factors include Epstein-Barr virus (EBV, genetic susceptibility and consumption of food with possible carcinogens – volatile nitrosamines. The recommended treatment schedule consists of three courses of neoadjuvant chemotherapy, irradiation, and adjuvant interferon (IFN-beta therapy.

  8. Carcinoma vulvar

    Directory of Open Access Journals (Sweden)

    Yamit Peñas Zayas

    2015-11-01

    Full Text Available El carcinoma de la vulva tiene una incidencia de aproximadamente un 3-5% dentro de todas las enfermedades ginecológicas malignas. El 90% de los tumores malignos de la vulva está constituido por carcinoma epidermoide, el resto son adenocarcinomas, carcinomas de células basales y melanomas. Se realiza la presentación de un caso de una paciente femenina de 25 años de edad con antecedentes  de Diabetes Mellitus tipo II y trombopatia, que ingresa en el servicio de ginecología con un cuadro cutáneo polimorfo, localizado en labios mayores y menores, dado por lesiones eritematoerosivas y vegetante, sospechándose clínicamente el diagnóstico  de un carcinoma epidermoide, corroborándose el mismo histológicamente al realizarse biopsia de piel. Se indicó tratamiento con quimioterapia. Por la edad de la paciente y ser menos frecuente en mucosa que en la piel,  motivo la presentación del caso.

  9. Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files

    Directory of Open Access Journals (Sweden)

    Živković Slavoljub

    2010-01-01

    Full Text Available Introduction. Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. Objective. The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. Methods. The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. Results. The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GT and ProTaper files has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups shaped with different instruments. Conclusion. Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.

  10. MRI of radiation-induced tumors of the head and neck in post-radiation nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Abrigo, Jill M.; King, Ann D.; Wong, Jeffrey K.T.; Ahuja, Anil T. [The Chinese University of Hong Kong, Prince of Wales Hospital, Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Hong Kong S.A.R. (China); Leung, Sing Fai [The Chinese University of Hong Kong, Prince of Wales Hospital, Department of Clinical Oncology, Faculty of Medicine, Hong Kong S.A.R. (China); Vlantis, Alexander C.; Tong, Michael C.F. [The Chinese University of Hong Kong, Prince of Wales Hospital, Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Hong Kong S.A.R. (China); Tse, Gary M.K. [The Chinese University of Hong Kong, Prince of Wales Hospital, Department of Anatomical and Cellular Pathology, Faculty of Medicine, Hong Kong S.A.R. (China)

    2009-05-15

    The aim of this study was to document the sites and MRI features of radiation-induced tumors (RITs) in the head and neck following treatment for nasopharyngeal carcinoma (NPC). The MRI examinations and clinical records of 20 patients with 21 RITs were reviewed retrospectively. RITs developed 3-30 years after radiotherapy and included eleven squamous cell carcinomas, six sarcomas, two neuroendocrine carcinomas, one mucoepidermoid carcinoma and one meningioma. RITs arose in the maxillary region (9), oro/hypopharynx and oral cavity (5), external auditory canal (4), nasopharynx and sphenoid sinus (2) and brain (1). Radiation-induced carcinoma and sarcoma had MRI features that were useful to distinguish them from recurrent NPC. To improve early detection of RITs, the check areas on an MRI of a patient with previous NPC treated by radiation should always include the maxillary region, tongue, and external auditory canal/temporal bone. (orig.)

  11. Adapting fiber-reinforced composite root canal posts for use in noncircular-shaped canals.

    Science.gov (United States)

    Grande, Nicola Maria; Butti, Andrea; Plotino, Gianluca; Somma, Francesco

    2006-10-01

    Post placement in oval-shaped root canals implies the sacrifice of sound dental tissue to adapt the canal shape to fit the post, which can result in one of several significant complications. A semidirect, single-visit, chairside procedure is proposed, which permits the use of an almost anatomically shaped post, starting from a preformed fiber-reinforced composite root canal post of the largest size commercially available. The utilization of this post capitalizes on the advantages of both the fiber post and the anatomical post in oval- and ribbon-shaped canals to provide restoration of endodontically treated teeth.

  12. [Endodontic treatment of the fourth canal].

    Science.gov (United States)

    Aiello, G; D'Andria, L

    1989-11-01

    This article points out that autonomous apical outlets of the fourth canal of upper molars are much more frequent than commonly thought. This is all the more reason for maximum commitment on the dentists part to research and instrumentation.

  13. Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS).

    Science.gov (United States)

    Eisenberg, Vered H; Valsky, Dan V; Yagel, Simcha

    2018-03-24

    Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women 1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39% 2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult. Having sustained an OASI may impact significantly on women's physical and emotional health. Missed OASI, inadequate repair or lack of follow up are potential sources of litigation 4 . The reported incidence of OASI may be as high as 4-6.6% 4 , averaging 2.9% in the UK 3 . The incidence is higher in primiparae (6.1%) than in multiparae (1.7%) 3 . Recent years are seeing an increased awareness and structured training programs, which appear to have resulted in an increase in the detection rate of OASI 3 . The following risk factors have been identified with varying risk rates reported 3 : Asian ethnicity (OR 2.27, 95% CI 2.14-2.41), nulliparity (relative risk [RR] 6.97, 95% CI 5.40-8.99), birth weight greater than 4 kg (OR 2.27, 95% CI 2.18-2.36), shoulder dystocia (OR 1.90, 95% CI 1.72-2.08), occipito-posterior position (RR 2.44, 95% CI 2.07-2.89), prolonged second stage of labor (up to RR 2.02, 95% CI 1.62-2.51 after four hours duration). Instrumental deliveries and episiotomy use have been extensively studied resulting in the following evidence: Vacuum delivery without episiotomy (OR 1.89, 95% CI 1.74-2.05); vacuum delivery with episiotomy is protective (OR 0.57, 95% CI 0.51-0.63); forceps delivery without episiotomy carries the highest potential risk (OR 6.53, 95% CI 5.57-7.64); and forceps delivery with episiotomy (OR 1.34, 95% CI 1.21-1.49). Other potential risk factors have been suggested with varying evidence such as advanced maternal age at

  14. Papillary carcinoma

    International Nuclear Information System (INIS)

    Shah, D.H.; Samuel, A.M.

    1999-01-01

    Papillary carcinoma of the thyroid (PTC) constitutes a major proportion of all thyroid cancers and is generally believed to be a slow growing tumor with an indolent course. The diagnosis of PTC often makes the physician overly optimistic and complacent and yet this tumor can be aggressive in a subset of patients leading to death in a few months. The fundamental but subtle differences underlying the extremes in biologic behaviour of this complex and fascinating tumor remain poorly understood. Although there is a general agreement among the investigators regarding prognostic factors, controversy exists about the management of the disease. There is divided opinion with respect to the type and extent of surgery and the need for radioiodine (1 31 I) treatment in case of PTC. The experiences at Radiation Medicine Centre (RMC) of 1904 cases of differentiated thyroid carcinoma (DTC) registered during the period 1963-1990 are reviewed

  15. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Lambertini, Roberto; Dalurzo, Liliana; Jaen, Ana del V.

    2008-01-01

    In this document the case of a 66-year old woman is presented, with record of multi nodular goiter of 5 year of evolution, which is derived to scan ultrasound office to make a puncture-aspiration with thin needle because of the growth of nodular thyroid injuries. The ultrasound scan examination made before the puncture determine multiple dominant nodules of hyperplasia aspect between 15 and 25 mm of diameter and a small nodule of 6 mm suspected proliferate process. Despite its size, it was decided to include small nodule in injuries to a biopsy. The cytological study reveals nodular hyperplasia with carcinoma in the small nodule of 6 mm. A thyroidectomy is practiced on the patient. The deferred histological study of the thyroid gland confirms the finding of multi-nodular goiter with a small focus of papillar carcinoma. The ganglions examined were negative in the deferred examination [es

  16. The fluid mechanics of root canal irrigation

    International Nuclear Information System (INIS)

    Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

    2010-01-01

    Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

  17. The fluid mechanics of root canal irrigation.

    Science.gov (United States)

    Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

    2010-12-01

    Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

  18. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

    International Nuclear Information System (INIS)

    Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W.; DiMartino, E.; Prescher, A.; Kinzel, S.

    2003-01-01

    Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

  19. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); DiMartino, E. [Department of Otorhinolaryngology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Kinzel, S. [Department of Experimental Veterinarian Medicine, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany)

    2003-06-01

    Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

  20. Root Canal Transportation in Canals Joining together: Assessed by Cone-Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Neda Naghavi

    2018-06-01

    Full Text Available Introduction: Statement of the Problem: Cleaning and shaping are regarded as the most important aspects of root canal therapy and prerequisite for the success of endodontic treatment. Apical transportations can jeopardize the outcome of treatment due to the significant decrease in the sealing ability of root filling material. The purpose of this study was to evaluate transportation in type II canals with two preparation techniques. Materials and Method: Twenty lower first molars were selected and divided into 2 groups of 10. In the first group, the lingual canal of the mesial root was selected as the main canal and prepared up to the WL. The other canal (buccal was prepared up to the juncture point. In the second group, both canals in the mesial root were prepared up to the working length. The amount and direction of canal transportation in each group were determined in five sections from 2 mm above the juncture point of the canals to 2 mm below the juncture point in 1-mm increments. Results: There were no significant differences between the two techniques in causing transportation in both buccolingual and mesiodistal directions in each increments (P>0.05. Conclusion: Both preparation techniques caused transportation in both mesiodistal and buccolingual directions.

  1. [ADRENOCORTICAL CARCINOMA].

    Science.gov (United States)

    Kranjčević, K

    2016-12-01

    Adrenocortical carcinoma is a rare entity. However, it is the most common type of cancerous adrenal gland tumor with poor prognosis. Approximately 4 to 12 per 1 million people develop this type of tumor, which begins in the adrenal cortex. Adrenocortical carcinoma can occur at any age. Women tend to be diagnosed slightly more often than men. In most cases, the cause of cancerous adrenal gland tumor remains unknown. However, people with certain hereditary conditions have a higher risk. Adrenocortical carcinoma can be a functional or nonfunctional tumor. If the tumor is functional, it may produce hormones causing symptoms such as high blood pressure, low potassium level, heart palpitations, nervousness, feelings of anxiety or panic attacks, excessive perspiration, diabetes, Cushing syndrome, unexplained weight gain or weight loss, weakness, abdominal stretch marks, excessive hair growth, changes in genitalia, change in libido, etc. If the tumor is nonfunctional, symptoms occur because the tumor has grown so large that it exerts pressure on the nearby organs, causing abdominal pain or a feeling of fullness. To diagnose adrenocortical carcinoma, in addition to thorough physical examination, the following tests are used: blood and urine tests to help determine whether the tumor is functional or nonfunctional, and imaging tests (computed tomography scan or magnetic resonance imaging). The treatment depends on cancer stage. Two major staging systems are used: the American Joint Committee on Cancer (AJCC) TNM staging system and the ENSAT (European Network for the Study of Adrenal Tumors) staging system. Both are based on the same TNM categories. The main types of treatment for adrenal cancer are surgery (the main treatment), chemotherapy and targeted therapy. Radiation therapy is not used often as the main initial treatment for adrenal cancer because the cancer cells are not easy to kill with x-rays. Radiation may be used as adjuvant therapy. By definition, adrenal

  2. Local high voltage radiotherapy with curative intent for prostatic carcinoma

    International Nuclear Information System (INIS)

    Jacobi, G.H.; Kurth, K.H.; Hohenfellner, R.

    1979-01-01

    In a 10-year interval 179 patients with prostatic carcinoma were treated by cobalt-60 teletherapy (7600 R). A selected group of 47 patients with localized disease and irradiated with curative intent had serial prostatic biopsies and were analized after a minimum follow-up of 1 year. Biopsies of half of the patients rendered definitively negative, on an average 14 months after radiotherapy. 8 patients with initial negative biopsy changed to positive secondarily. In one third of the patients histological conversion was missed, considered as radiation persister. Persistent carcinoma were of predominant low grade. 5 patients developed distant metastases 30 months after irradiation on an average. These patients had persistent positive tissue studies. Over all cumulative 5-years survival was 89%. In patients with prostatic carcinoma and local high voltage radiotherapy with curative intent (stage A through C) serial prostatic biopsies to document therapy effect seen mandatory. (orig.) 891 AJ/orig. 892 BRE [de

  3. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have been...... among health care personnel, followed by an expert panel discussion. Ten women were interviewed about their understanding and attitude toward answering the questionnaire and it was pre-tested on 52 women with ASR. The questionnaire was revised five times during the validation process. The final version...... offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

  4. MR staging of endometrial carcinoma

    International Nuclear Information System (INIS)

    Innocenti, P.; Agostini, S.; Erroi, C.; Ambrogetti, D.; Cellerini, A.; Nori, J.

    1991-01-01

    Biopsy is the technique of choice for the definitive diagnosis of endometrial carcinoma. Since lymphatic tumor spread has been demonstrated to depend on the degree of myometrial involvement, the definition of the latter with imaging techniques may significantly affect both pfognosis and therapy. We investigated, by means of MR imaging at 0.5 T, 14 patients with endometrial carcinoma, to assess both tumor stage and myometrial involvement. FIGO staging system was employed, and M parameter evaluated (M0= no myometrial involvement; M1involvement confined to the inner third; M2= Involvement confined to the middle third; M3= involvement of the whole myometrium). Another parameter was the characteristic high signal of the tumor on PD and T2W images. The patients were then operated and MR information was correlated with surgical findings. Overall diagnostic accuracy of MR imaging was 85.7% in tumor staging, and 92.2% in defining M parameter. Tumor spread into adnexa and into cervical canal was poorly demonstrated by MR imaging

  5. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tomaszewski, Jonathan M., E-mail: jonathan.tomaszewski@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Heriot, Alexander [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Vazquez, Melisa [Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Lynch, Craig A. [Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mackay, John [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Michael, Michael [University of Melbourne, Parkville, Victoria (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Tran, Phillip [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Ngan, Samuel Y. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-06-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78-88), 92% (95% CI, 89-96), 73% (95% CI, 68-79), and 82% (95% CI, 77-87), respectively. Higher T stage and male sex predicted for locoregional failure, and higher N stage predicted for distant metastases. Locoregional failure occurred most commonly at the primary site. Omission of elective inguinal irradiation resulted in inguinal failure rates of 1.9% and 12.5% in T1N0 and T2N0 patients, respectively. Pelvic nodal failures were very uncommon. Late vaginal and bone toxicity was observed in addition to gastrointestinal toxicity. Conclusions: CRT is a highly effective approach in anal cancer. However, subgroups of patients fare relatively poorly, and novel approaches are needed. Elective inguinal irradiation can be safely omitted only in patients with Stage I disease. Vaginal toxicity and insufficiency fractures of the hip and pelvis are important late effects that require prospective evaluation.

  6. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    International Nuclear Information System (INIS)

    Tomaszewski, Jonathan M.; Link, Emma; Leong, Trevor; Heriot, Alexander; Vazquez, Melisa; Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T.; Lynch, Craig A.; Mackay, John; Michael, Michael; Tran, Phillip; Ngan, Samuel Y.

    2012-01-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78–88), 92% (95% CI, 89–96), 73% (95% CI, 68–79), and 82% (95% CI, 77–87), respectively. Higher T stage and male sex predicted for locoregional failure, and higher N stage predicted for distant metastases. Locoregional failure occurred most commonly at the primary site. Omission of elective inguinal irradiation resulted in inguinal failure rates of 1.9% and 12.5% in T1N0 and T2N0 patients, respectively. Pelvic nodal failures were very uncommon. Late vaginal and bone toxicity was observed in addition to gastrointestinal toxicity. Conclusions: CRT is a highly effective approach in anal cancer. However, subgroups of patients fare relatively poorly, and novel approaches are needed. Elective inguinal irradiation can be safely omitted only in patients with Stage I disease. Vaginal toxicity and insufficiency fractures of the hip and pelvis are important late effects that require prospective evaluation.

  7. Pro-inflammatory cytokines in cryptoglandular anal fistulas.

    Science.gov (United States)

    van Onkelen, R S; Gosselink, M P; van Meurs, M; Melief, M J; Schouten, W R; Laman, J D

    2016-09-01

    Sphincter-preserving procedures for the treatment of transsphincteric fistulas fail in at least one out of every three patients. It has been suggested that failure is due to ongoing disease in the remaining fistula tract. Cytokines play an important role in inflammation. At present, biologicals targeting cytokines are available. Therefore, detection and identification of cytokines in anal fistulas might have implications for future treatment modalities. The objective of the present study was to assess local production of a selected panel of cytokines in anal fistulas, including pro-inflammatory interleukin (IL)-1β and tumor necrosis factor α (TNF-α). Fistula tract tissue was obtained from 27 patients with a transsphincteric fistula of cryptoglandular origin who underwent flap repair, ligation of the intersphincteric fistula tract or a combination of both procedures. Patients with a rectovaginal fistula or a fistula due to Crohn's disease were excluded. Frozen tissue samples were sectioned and stained using advanced immuno-enzyme staining methods for detection of selected cytokines, IL-1β, IL-8, IL-10, IL-12p40, IL-17A, IL-18, IL-36 and TNF-α. The presence and frequencies of cytokine-producing cells in samples were quantitated. The key finding was abundant expression of IL-1β in 93 % of the anal fistulas. Frequencies of IL-1β-producing cells were highest (>50 positive stained cells) in 7 % of the anal fistulas. Also, cytokines IL-8, IL-12p40 and TNF-α were present in respectively 70, 33 and 30 % of the anal fistulas. IL-1β is expressed in the large majority of cryptoglandular anal fistulas, as well as several other pro-inflammatory cytokines.

  8. Optimizacija procesa razvoja izdelkov z uporabo metode analize koristnosti

    OpenAIRE

    Majhen, Nejc

    2016-01-01

    Diplomsko delo obravnava razvoj novega izdelka od same ideje pa vse do končnega razvoja novega izdelka. Problemi v podjetjih se kažejo v premalem sodelovanju tehnične, kot tudi ekonomske stroke v podjetju pri razvijanju novih izdelkov. V ta namen sem v diplomi teoretično prikazal možnost sodelovanja področij analize koristnosti in projektnega managementa pri sami ocenitvi in izboru najboljše ideje s pomočjo Combinex metode in primerjavo izvedbe analize koristnosti po domači literaturi in meto...

  9. Steinert's syndrome presenting as anal incontinence: a case report

    Directory of Open Access Journals (Sweden)

    Uzum Ayse

    2011-08-01

    Full Text Available Abstract Introduction Myotonic dystrophy (MD or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.

  10. Management of C-shaped canals: Two case reports

    Directory of Open Access Journals (Sweden)

    Nilesh Suryakant Kadam

    2013-01-01

    Full Text Available A C-shaped canal with varying configuration is commonly observed in single-rooted mandibular second molars. Cooke and Cox (1979 first documented the C-shaped canal in endodontic literature. The presence of high incidence of transverse anastomoses, lateral canals, and apical deltas makes it difficult to clean and seal the root canal system in these teeth. The main reason for failure in endodontic treatment of mandibular second molars is the inability to detect the presence of C-shaped canals prior to an endodontic therapy. This case report presents successful management of two rare cases of C-shaped canal configurations.

  11. Root canal treatment and special needs patients.

    Science.gov (United States)

    Yap, E; Parashos, P; Borromeo, G L

    2015-04-01

    To identify current trends of root canal treatment for patients with special needs. A postal questionnaire was sent to General Dentists in Victoria, Australia and Endodontists and Special Needs Dentists across Australia to determine the extent of root canal treatment performed on special needs patients. Over a four-month period, 1120 questionnaires were distributed with an overall response rate of 63.9% (n = 716). Response rates were 63.2% (n = 655), 68.5% (n = 50) and 100.0% (n = 11) amongst General Dentists, Endodontists and Special Needs Dentists, respectively. Endodontists (95.7%) and Special Needs Dentists (100.0%) performed significantly more root canal treatment on adult patients with special needs compared with 51.2% of General Dentists, (P special needs patients compared with only 29.7% of General Dentists (P special needs patients was more likely to be carried out by specialist dental practitioners who were more likely to utilize a pharmacological approach for behaviour guidance and to perform single-visit root canal treatment compared with General Dentists. A multidisciplinary approach for special needs patients who require root canal treatment provides an opportunity for these patients to retain their dentition. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  12. The Kra Canal and Southeast Asian Relations

    Directory of Open Access Journals (Sweden)

    Rini Suryati Sulong

    2012-01-01

    Full Text Available This paper is a conceptual study that attempts to analyse the possible effects of the development of the Kra Isthmus Canal on ASEAN relations. The Kra Canal would constitute a mega-project, a passageway that would connect the Andaman Sea and the Gulf of Thailand at the Isthmus of Kra, Thailand. Although the proposed Kra Canal is projected to provide many economic and trade benefits to Thailand, and to the region as a whole, steps toward its development have yet to be taken. There has been much debate over the costs for trade, the costs for the environment, national and regional security concerns, as well as major concerns related to political and economic relations in the region. Therefore, one of the main purposes of this study is to contribute to the debate on the possible impact of the devel-opment of the Kra Canal on ASEAN’s regional relations. In particular, it proposes that the development of the Kra Canal could threaten regional solidarity as it would physically divide maritime Southeast Asia from main-land Southeast Asia, which would ultimately result in an economic, cultural and political divide of ASEAN itself.

  13. Comparison of anal sac cytological findings and behaviour in clinically normal dogs and those affected with anal sac disease.

    Science.gov (United States)

    James, Danielle J; Griffin, Craig E; Polissar, Nayak L; Neradilek, Moni B

    2011-02-01

    No previous study has explored the relationship between cytology and the frequency of behaviours associated with anal sac disease (ASD). The goals of the study were: (i) to compare the cytological findings between anal sac secretions from normal dogs with no history of ASD to those with non-neoplastic ASD; (ii) to determine whether anal sac cytological findings can be used to differentiate between normal dogs and dogs with ASD; (iii) to explore the correlation of anal sac cytology and behaviour between normal dogs and dogs with ASD; and (iv) to describe behaviours typical of ASD as reported by owners. Thirty dogs were selected for this study, based on their behavioural history as detailed in a questionnaire completed by their owners. Of the thirty dogs, ten were considered normal insofar as they had no history of ASD clinical signs. The remaining 20 dogs were characterized as having ASD, with a chronic history of perianal pruritus, but no other pruritus. All dogs had their anal sacs manually expressed, and the discharge was examined microscopically in a blinded manner. A total of 171 oil immersion fields (OIFs) were examined from normal dogs and 333 OIFs from dogs with ASD. The behavioural results for dogs with ASD revealed that scooting recurred with a median frequency of 3 weeks post-anal sac expression. There were no clinically statistically significant cytological differences between normal dogs and those with ASD, thereby leading to the conclusion that cytology is an ineffective tool for diagnosing ASD. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

  14. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Friedman, M.; Skolnik, E.M.; Baim, H.M.; Becker, S.P.; Katz, A.H.; Mantravadi, R.V.

    1980-01-01

    Differentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Prognosis was found to be dependent on age of presentation more than any other factor. Patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15-year cure. Treatment for distant metastatic disease by surgery, radioactive iodine and external radiation all resulted in long-term survival in certain cases

  15. Carcinoma Basocelular

    OpenAIRE

    Inês Alencar de Castro; Lucio Bakos; Roberto Lopes Gervini

    2008-01-01

    Vemos na região frontal de um paciente masculino, fototipo II de Fitzpatrick, lesão ulcerada com bordas papulosas róseas e peroladas, correspondendo a Carcinoma Basocelular. É lesão maligna originária das células não- queratinizadas da camada basal da epiderme, sendo a forma mais comum de câncer em humanos. Estima-se em torno de 100.000 casos/ano no Brasil. Ocorre predominantemente em pele exposta de indivíduos com pouca capacidade de se bronzear. Pode se tornar invasivo, mas raramente metast...

  16. Anal, penile, and oral high-risk HPV infections and HPV seropositivity in HIV-positive and HIV-negative men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Vera M van Rijn

    Full Text Available The effects of single or multiple concordant HPV infections at various anatomical sites on type-specific HPV seropositivity are currently unknown. In this cross-sectional study we assessed whether high-risk HPV infections at various anatomical sites (i.e., anal canal, penile shaft, and oral cavity, as well as concordant infections at multiple anatomical sites, were associated with type-specific seropositivity in HIV-positive and HIV-negative MSM. MSM aged ≥ 18 years were recruited in Amsterdam, the Netherlands (2010-2011. Baseline anal, penile, and oral samples were analyzed for HPV DNA and genotyped using a highly sensitive PCR and reverse line blot assay. Virus-like particle (VLP based multiplex immunoassay was used to asses HPV-specific serum antibodies against L1 VLPs. The associations between HPV infections and type-specific seropositivity of seven high-risk HPV types (7-hrHPV: types 16, 18, 31, 33, 45, 52, 58 were estimated using logistic regression analyses with generalized estimating equations. We found that 86% of 306 HIV-positive MSM and 62% of 441 HIV-negative MSM were seropositive for at least one 7-hrHPV type. 69% of HIV-positive and 41% of HIV-negative MSM were infected with at least one 7-hrHPV type at the anus, penis, or oral cavity. In multivariable analyses, 7-hrHPV seropositivity was associated with type-specific anal (and not penile 7-hrHPV infection, and did not significantly increase with a higher number of infected anatomical sites. Oral 7-hrHPV infection showed a positive, albeit non-significant, association with seropositivity. In conclusion, seropositivity among MSM appears to be largely associated with anal HPV infection, irrespective of additionally infected anatomical sites.

  17. Otolith and canal reflexes in human standing

    Science.gov (United States)

    Cathers, Ian; Day, Brian L; Fitzpatrick, Richard C

    2005-01-01

    We used galvanic vestibular stimulation (GVS) to identify human balance reflexes of the semicircular canals and otolith organs. The experiment used a model of vestibular signals arising from GVS modulation of the net signal from vestibular afferents. With the head upright, the model predicts that the GVS-evoked canal signal indicates lateral head rotation while the otolith signal indicates lateral tilt or acceleration. Both signify body sway transverse to the head. With the head bent forward, the model predicts that the canal signal indicates body spin about a vertical axis but the otolith signal still signifies lateral body motion. Thus, we compared electromyograms (EMG) in the leg muscles and body sway evoked by GVS when subjects stood with the head upright or bent forward. With the head upright, GVS evoked a large sway in the direction of the anodal electrode. This response was abolished with the head bent forward leaving only small, oppositely directed, transient responses at the start and end of the stimulus. With the head upright, GVS evoked short-latency (60–70 ms), followed by medium-latency (120 ms) EMG responses, of opposite polarity. Bending the head forward abolished the medium-latency but preserved the short-latency response. This is compatible with GVS evoking separate otolithic and canal reflexes, indicating that balance is controlled by independent canal and otolith reflexes, probably through different pathways. We propose that the short-latency reflex and small transient sway are driven by the otolith organs and the medium-latency response and the large sway are driven by the semicircular canals. PMID:15618274

  18. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  19. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  20. Modifiable risk factors of obstetric anal sphincter injury in primiparous women

    DEFF Research Database (Denmark)

    Jango, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2014-01-01

    To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women.......To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women....

  1. Periampullary carcinomas.

    Science.gov (United States)

    Filiz, Gulaydan; Yerci, Omer; Adim, Saduman Balaban; Gurel, Selim; Dolar, Enver; Memik, Faruk

    2007-06-01

    The purpose of this study was to determine predictors of survival after resection for periampullary neoplasms. In this study, we reevaluated our 17 cases of this type tumor which we had reported as periampullar site tumors, in advanced stages with undetermined localization, in our pathology department of the Uludag University faculty of medicine. Six of our cases were female, and 11 were male with a mean age of 60.6 years (range 31-77). Their main complaints were loss of weight, anorexia, jaundice and fatigue. Physical and endoscopic examination of these patients revealed periampullary mass and Whipple operations were performed on all of them. Histopathologic examinations of these tumors revealed adenocarcinoma in 15, small cell (neuroendocrin) carcinoma in two. All were in the advanced stages. Eight of them were alive and free of disease after 1.5- to 20-month follow-ups, while ten died because of disease. Periampullary carcinoma is a problem with increasing clinical significance. Tumor size, tumor type and differentiation, lymph node status appears to be prognostic markers.

  2. Rectocele and anal sphincter defect – surgical anatomy and ...

    African Journals Online (AJOL)

    carefully directed translabial ultrasound scan of the rectum and anal sphincters. The ultrasound examination was performed by a radi- ologist with specific understanding of the pathology. Conventional two-dimensional ultrasound imaging was performed using a 4 - 8. MHz curved array probe. The patient was in the left ...

  3. Anovestibular fistula with normal anal opening: Is it always congenital?

    Directory of Open Access Journals (Sweden)

    Jain Prashant

    2008-01-01

    Full Text Available Aim: To review 12 cases of anovestibular fistula with normal anal opening. Methods: Retrospective analysis of 12 children with anovestibular fistula and normal anal opening were treated between the years 2000 and 2007. Of these, 11 patients were diagnosed as having acquired anovestibular fistula with normal anal opening and were managed by conservative management. Results: Most of them presented with diarrhea and labial redness. One patient was considered to have fistula of congenital origin and was managed surgically. Eleven patients presented between the ages of 1.5-11 months and were considered as cases of acquired anovestibular fistula and only two of them required surgical management in the form of colostomy and fistula excision. Others were successfully managed by conservative treatment; the fistulous output and labial redness decreased gradually within a period of 5-19 (average 11.5 days. Conclusions: Not all presentations of anovestibular fistula with normal anal opening can be considered as congenital. Presence of inflammation, paramedian fistula, and a favourable response to conservative management/colostomy suggest acquired etiology. Trial of conservative management should be given in the acquired variety.

  4. Gastrointestinal stromal tumor of the anal wall in a Nigerian ...

    African Journals Online (AJOL)

    Documented reports of gastrointestinal stromal tumors (GIST) are relatively few in the sub-Saharan continent. The body of evidence points towards anal wall involvement being a rarity indeed. In this article we document a 61 year old Nigerian man who presented with bleeding per rectum and in whom the histological ...

  5. OEIS Complex (omphalocele-exstrophy of the bladder-anal ...

    African Journals Online (AJOL)

    We describe a Congolese case of OEIS complex: Omphalocele-Exstrophy of the Bladder-anal imperforation-spina bifida, rare congenital malformation complex. Its genetic and environmental factors are not well known. In our case, the fetus has been exposed to alcohol throughout the all pregnancy and the mother ...

  6. Anal incontinence - what the gynaecologist should know | Brouard ...

    African Journals Online (AJOL)

    ... for patients with AI will be performed by other members of the multidisciplinary healthcare team (e.g. colorectal surgeons, dieticians, occupational therapists, physiotherapists) we have an important role to play in identifying these patients and referring them appropriately. Keywords: Anal incontinence; Faecal incontinence; ...

  7. Radiographic versus electronic root canal working length determination

    Directory of Open Access Journals (Sweden)

    Lumnije Kqiku

    2011-01-01

    Conclusions: The present ex vivo study showed that electronic root canal working length determination is not superior to radiographic methods. Both methods provided a good performance in determining the root canal working length.

  8. Report from the Panama Canal Stakeholder Working Group.

    Science.gov (United States)

    2013-03-01

    This project assists the Texas Department of Transportation (TxDOT) in assessing the potential impacts of the Panama Canal expansion on Texas ports and the landside transportation system. TxDOT formed a Panama Canal Stakeholder Working Group (PCSWG) ...

  9. Cochlear implant outcomes in patients with superior canal dehiscence

    NARCIS (Netherlands)

    Puram, Sidharth V.; Roberts, Daniel S.; Niesten, Marlien E F; Dilger, Amanda E.; Lee, Daniel J.

    2015-01-01

    Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.

  10. The anal verge: localization with multi-slice spiral CT

    International Nuclear Information System (INIS)

    Wang Wei; Tang Guangjian

    2010-01-01

    Objective: To determine and evaluate the method of localization of anal verge by multislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the Sth sacral vertebra (Lb), the inferior aperture of minor pelvis (Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the mid- sagittal images obtained by MPR. The averages, the standard deviations (s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ±1.96 s or ±1.28 s 0.05) between two different sex groups [male group, (10.0±1.2) mm], female group, (9.6±1.2) mm and between two age groups [young group, (9.6±1.2) mm, elderly group, (9.9±1.3) mm]. Conclusions: The lower margin of the basement of external anal sphincter was a useful anatomic landmark for localizing the anal verge, and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge. (authors)

  11. Focal lesions in external auditory canal: computed tomography images

    International Nuclear Information System (INIS)

    Asensio, J.; Lopez Rios, J.

    1999-01-01

    To analyze and review the most common focal lesions of the external auditory canal (EAC), describing the computed tomography (CT) findings. The CT images of EAC were reviewed in a series of 167 patients. Abnormal findings were recorded in 13 cases. The CT images were correlated with otoscopic and/or intraoperative findings. There were four cases of osteoma (one located outside the EAC); all of which were treated surgically, as was the one case of exostosis. Six patients presented debris in EAC, coinciding with clinical evidence of external otitis. There were two cholesteatomas derived from EAC, one of them secondary to survery to treat osteoma. On patient was diagnosed as having a basal cell carcinoma of the ear, extending to EAC, but refused to undergo surgery. Five patients presented small triangular laminae of dense bone arising from the upper wall of the EAC which were defined as abnormal variants of the fusion of the temporal squamous epithelium to the promontory. CT is the technique of choice for assessing bone erosion in EAC, enabling the determination of the extension and grade of the lesion, as well as the definitive diagnosis of exostoses and osteomas. It also provides excellent information on the projection of the EAC walls, knowledge that is decisive in the selection of the endaural or retroauricular surgical approach. (Author) 23 refs

  12. Vestibular Neuritis With Minimal Canal Paresis: Characteristics and Clinical Implication.

    Science.gov (United States)

    Kim, Hyun Ji; Kim, Dae-Young; Hwang, Jun Ha; Kim, Kyu-Sung

    2017-06-01

    To analyze the clinical characteristics of vestibular neuritis patients with minimal canal paresis (canal paresis vestibular neuritis and treated at our institute (n=201) underwent otoneurological examination and vestibular function tests. Patients were categorized in terms of the results of caloric testing (canal paresisvestibular neuritis patients, but have faster recovery of symptoms and a higher incidence of recovery nystagmus. This finding support that the minimal canal paresis could be considered as a milder type of vestibular neuritis.

  13. Relation between anal electrosensitivity and rectal filling sensation and the influence of age

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal

  14. A Rare Case of Sarcomatoid Carcinoma of the Lung with Spine Metastasis, Including a Literature Review.

    Science.gov (United States)

    Arshad, Hafiza Sobia; Dudekula, Rizwan Ahmed; Niazi, Masooma; Malik, Sandeep; Khaja, Misbahuddin

    2017-07-07

    BACKGROUND Sarcomatoid carcinoma is a rare, aggressive, malignant cancer composed of sarcoma and sarcoma-like components, and can occur in different organs such as the thyroid gland, bone, skin, breast, pancreas, liver, urinary tract, and lung. Pulmonary sarcomatoid carcinoma accounts for only a small percentage of lung cancers and has histological variants that include pleomorphic carcinoma, giant cell carcinoma, spindle cell carcinoma, carcinosarcoma, and pulmonary blastoma. CASE REPORT Here, we present a case of sarcomatoid carcinoma in a 63-year-old HIV-positive Hispanic male who presented with back pain, dry cough, and weight loss. A CT scan of his chest showed an ovoid mass in the lower lobe of the left lung, and an MRI of the spine showed a left lateral paraspinal soft tissue mass causing central canal stenosis and mild cord compression. The patient underwent laminectomy and resection of the spinal mass. A transthoracic needle biopsy of the lung and spinal masses had similar histopathology, and were indicative of sarcomatoid carcinoma. CONCLUSIONS We report a rare case of sarcomatoid carcinoma involving both the lung and spinal cord in the same patient. Sarcomatoid carcinomas of the lung have poor prognosis and are aggressive cancers. Moreover, our case also had the co-occurrence of HIV and sarcomatoid carcinoma.

  15. Coordinated model predictive reach control for irrigation canals

    NARCIS (Netherlands)

    Negenborn, R.R.; Van Overloop, P.J.; De Schutter, B.

    2009-01-01

    Irrigation canals are large-scale systems, covering vast geographical areas, and consisting of many interconnected canal reaches that interact with control structures such as pumps and gates. The control of such irrigation canals is usually done in a manual way, in which a human operator travels

  16. Water-level difference controller for main canals

    Science.gov (United States)

    The operation of main irrigation canals is complicated in situations where the operator does not have full control over the canal inflow, or where there are very long transmission distances from the point of supply, or both. Experienced operators are able to control the canal, but often supply error...

  17. The clinical relevance of bifid and trifid mandibular canals.

    NARCIS (Netherlands)

    Mizbah, K.; Gerlach, N.L.; Maal, T.J.J.; Berge, S.J.; Meijer, G.J.

    2012-01-01

    BACKGROUND: Bifid mandibular canals (BMC) and trifid mandibular canals (TMC) are variations on the normal anatomy with incidences ranging from 0.08% to 65.0%. Such aberrations have an important clinical impact. For example, an extra mandibular canal may explain inadequate anesthesia, especially when

  18. 21 CFR 872.3820 - Root canal filling resin.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal filling resin. 872.3820 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended...

  19. Vulvar carcinoma

    International Nuclear Information System (INIS)

    Anderson, John M.; Cassady, J. Robert; Shimm, David S.; Stea, Baldassarre

    1995-01-01

    Purpose: Controversies exist regarding the use of radiation therapy in the treatment of vulvar carcinoma. A retrospective review was performed to evaluate our institution's experience with surgery and radiation for this disease. Methods and Materials: The medical records of 47 patients treated for squamous cell carcinoma of the vulva at our institution (1974-1992) were reviewed for TNM stage (AJCC criteria), treatment modality, and associated 5-year local control and survival based on Kaplan-Meier analysis. Results: Twenty-eight patients (60%) presented with Stage I and II disease and their 5-year survival was 69%. Stage III patients accounted for 12 (25%) of the patients and their 5-year survival was 73%. Seven patients presented with Stage IV disease and five died within 13 months of diagnosis after predominantly palliative therapy. The 40 patients with Stages I, II, and III disease were treated aggressively and were further evaluated for treatment-modality-associated survival and local control. Radiation therapy was used as primary treatment in nine patients, of whom seven were treated with radiation alone and two were treated postoperatively after wide excision. Surgery alone was performed in 31 patients consisting of either radical vulvectomy (20 patients) or wide excision (11 patients). When comparing outcomes of radical vulvectomy vs. radiation therapy, we noted that the 5-year actuarial survivals were comparable (74% for either modality), despite the presence of more favorable prognostic factors in the group treated with radical vulvectomy. Patients treated with wide excision alone had a trend for a poorer 5-year actuarial survival (51%) and local control (50%). Conclusions: Radical vulvectomy offers good locoregional control and survival. This retrospective review further supports the use of radiation therapy with conservative surgery as an alternative treatment option for patients with vulvar carcinoma treated with curative intent. In contrast, the use of

  20. adénocarcinome anal sur fistule anale: à propos de 3 cas en Côte d ...

    African Journals Online (AJOL)

    Diagnosis was confirmed by histologic examination of swab and / or biopsy specimens that revealed colloid adenocarcinoma that leads us to evocate that the lesion originates from anal gland. None patient underwent radiation therapy; one of them refused any treatment, the other two underwent abdominoperineal resection ...

  1. Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

    International Nuclear Information System (INIS)

    Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul

    2001-01-01

    To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

  2. Periapical repair after root canal filling with different root canal sealers.

    Science.gov (United States)

    Tanomaru-Filho, Mário; Tanomaru, Juliane Maria Guerreiro; Leonardo, Mario Roberto; da Silva, Lea Assed Bezerra

    2009-01-01

    The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.

  3. Infrared tympanic temperature and ear canal morphology

    NARCIS (Netherlands)

    Daanen, H.A.M.

    2006-01-01

    Several publications indicate that the infrared tympanic temperature (IRTT) underestimates the core temperature of the body when the ear canal is long, curvy and narrow. In order to quantify these observations, a study was performed in 10 subjects. The IRTT was determined and compared to the

  4. The crazy project – Canal Istanbul

    Directory of Open Access Journals (Sweden)

    Seda Kundak

    2011-10-01

    Full Text Available It was late April 2011 when “the Crazy Project - Canal Istanbul” was proposed by the Prime Minister of Turkey, during his election campaign.  Although the idea of an artificial canal is not new, since it is initiated without any consensus between the people and institutions in Istanbul, the project immediately set a large number of debates. These vary from the legitimacy of decentralization of governance, to potential impacts of the canal on international politics, economy, environment and urban life.  Regarding past infrastructure projects in Istanbul, such large scale investments have caused extensive acceleration in construction sector in one hand and social and economic shifts on the other.  In this paper, the Canal Istanbul Project is evaluated according to basic motivations and claims of the PM, multi-perspective view through challenges and limitation that the project is likely to face with and speculations on implementation approach. The final discussion on the project is based on benefits/losses of Istanbul once the project will be implemented.

  5. Magnetic resonance imaging of semicircular canals.

    Science.gov (United States)

    Sbarbati, A; Leclercq, F; Zancanaro, C; Antonakis, K

    1992-01-01

    The present paper reports the results of the first investigation of the semicircular canals in a living, small animal by means of high spatial resolution magnetic resonance imaging. This procedure is noninvasive and allows identification of the endolymphatic and perilymphatic spaces yielding a morphology quite consistent with direct anatomical examination. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:1506290

  6. Parotid carcinoma

    DEFF Research Database (Denmark)

    Godballe, Christian; Schultz, Joyce H; Krogdahl, Annelise

    2003-01-01

    Hospital (Odense, Denmark) from 1975 to 1994. METHODS: Patient records were retrospectively reviewed and tabulated for relevant clinical parameters. A complete revision of histological examination was performed by the same pathologist and the tumors were classified according to the 1991 international...... guidelines from the World Health Organization. Five tumors (6%) did not fulfill the criteria of malignancy and were reclassified as benign. In another five cases the assumed primary parotid carcinomas were found to be metastatic disease from cancers of the breast, prostate, skin, and lungs. Ten patients (12......-year recurrence-free survival of the entire study group was 63%, disease-specific survival was 69%, and crude survival was 52%. In univariate analysis, tumor size, histological appearance, T status, stage, the presence of lymph node metastases, distant metastases, pain, and facial nerve dysfunction had...

  7. Assessment of the wetting behavior of three different root canal sealers on root canal dentin

    OpenAIRE

    Muralidhar Tummala; Veeramachaneni Chandrasekhar; A Shashi Rashmi; M Kundabala; Vasudev Ballal

    2012-01-01

    Aim: The objective of the present study was to evaluate and compare the wetting behavior of three different root canal sealers on the root canal dentin surface treated with irrigants and their combination. Materials and Methods: Decoronation and apical third resections of 27 extracted single-rooted human mandibular premolars were done. The roots were then split longitudinally into two halves, and randomly assigned into three treatment groups (n=18). The root dentin surfaces in Group1, Gro...

  8. Giant basal cell carcinoma Carcinoma basocelular gigante

    Directory of Open Access Journals (Sweden)

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  9. Cervical spinal canal narrowing in idiopathic syringomyelia

    Energy Technology Data Exchange (ETDEWEB)

    Struck, Aaron F. [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States); Carr, Carrie M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shah, Vinil [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Hesselink, John R. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Haughton, Victor M. [University of Wisconsin, Department of Radiology, Madison, WI (United States)

    2016-08-15

    The cervical spine in Chiari I patient with syringomyelia has significantly different anteroposterior diameters than it does in Chiari I patients without syringomyelia. We tested the hypothesis that patients with idiopathic syringomyelia (IS) also have abnormal cervical spinal canal diameters. The finding in both groups may relate to the pathogenesis of syringomyelia. Local institutional review boards approved this retrospective study. Patients with IS were compared to age-matched controls with normal sagittal spine MR. All subjects had T1-weighted spin-echo (500/20) and T2-weighted fast spin-echo (2000/90) sagittal cervical spine images at 1.5 T. Readers blinded to demographic data and study hypothesis measured anteroposterior diameters at each cervical level. The spinal canal diameters were compared with a Mann-Whitney U test. The overall difference was assessed with a Friedman test. Seventeen subjects were read by two reviewers to assess inter-rater reliability. Fifty IS patients with 50 age-matched controls were studied. IS subjects had one or more syrinxes varying from 1 to 19 spinal segments. Spinal canal diameters narrowed from C1 to C3 and then enlarged from C5 to C7 in both groups. Diameters from C2 to C4 were narrower in the IS group (p < 0.005) than in controls. The ratio of the C3 to the C7 diameters was also smaller (p = 0.004) in IS than controls. Collectively, the spinal canal diameters in the IS were significantly different from controls (Friedman test p < 0.0001). Patients with IS have abnormally narrow upper and mid cervical spinal canal diameters and greater positive tapering between C3 and C7. (orig.)

  10. MR determination of neonatal spinal canal depth

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen, E-mail: owenarthurs@uk2.net [Centre for Cardiovascular MR, Great Ormond Street Hospital for Children, London WC1N 3JH (United Kingdom); Thayyil, Sudhin, E-mail: s.thayyil@ucl.ac.uk [Academic Neonatology, Institute for Women' s Health, London WC1E 6AU (United Kingdom); Wade, Angie, E-mail: a.wade@ucl.ac.uk [Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London (United Kingdom); Chong, W.K., E-mail: Kling.Chong@gosh.nhs.uk [Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London (United Kingdom); Sebire, Neil J., E-mail: Neil.Sebire@gosh.nhs.uk [Histopathology, Great Ormond Street Hospital for Children, London WC1E 6AU (United Kingdom); Taylor, Andrew M., E-mail: a.taylor76@ucl.ac.uk [Centre for Cardiovascular MR, Cardiorespiratory Unit, Great Ormond Street Hospital for Children and UCL Institute of Cardiovascular Science, London WC1E 6AU (United Kingdom)

    2012-08-15

    Objectives: Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI). Patients and methods: Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04 kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age. Results: ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r > 0.8). A simple linear model MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. Conclusion: There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 could result in fewer traumatic LPs in this population.

  11. Anomalous facial nerve canal with cochlear malformations.

    Science.gov (United States)

    Romo, L V; Curtin, H D

    2001-05-01

    Anteromedial "migration" of the first segment of the facial nerve canal has been previously identified in a patient with a non-Mondini-type cochlear malformation. In this study, several patients with the same facial nerve canal anomaly were reviewed to assess for the association and type of cochlear malformation. CT scans of the temporal bone of 15 patients with anteromedial migration of the first segment of the facial nerve canal were collected from routine departmental examinations. In seven patients, the anomalous course was bilateral, for a total of 22 cases. The migration was graded relative to normal as either mild/moderate or pronounced. The cochlea in each of these cases was examined for the presence and size of the basilar, second, and apical turns. The turns were either absent, small, normal, or enlarged. The CT scans of five patients with eight Mondini malformations were examined for comparison. The degree of the facial nerve migration was pronounced in nine cases and mild/moderate in 13. All 22 of these cases had associated cochlear abnormalities of the non-Mondini variety. These included common cavity anomalies with lack of definition between the cochlea and vestibule (five cases), cochleae with enlarged basilar turns and absent second or third turns (five cases), and cochleae with small or normal basilar turns with small or absent second or third turns (12 cases). None of the patients with Mondini-type cochlear malformations had anteromedial migration of the facial nerve canal. Anteromedial migration of the facial nerve canal occurs in association with some cochlear malformations. It did not occur in association with the Mondini malformations. A cochlea with a Mondini malformation, being similar in size to a normal cochlea, may physically prohibit such a deviation in course.

  12. Resultados do exame anátomo-patológico e "Polymerase Chain Reaction (PCR" na forma clinica e subclinica da infecção anal pelo Papilomavirus Humano (HPV: estudo em quatro grupos de pacientes Histopathological and PCR results for clinical and subclinical forms of HPV anal infection: study of four groups of patients

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2006-12-01

    Full Text Available O Papilomavírus Humano tem alta incidência na população. O objetivo deste trabalho é o estudo dos resultados encontrados no exame anatomo-patológico e no PCR das formas clínica e subclínica da infecção anal por HPV em quatro grupos de pacientes. MÉTODO: Foram estudados 10 pacientes com prurido anal idiopático, seis com infecção genital pelo HPV, tratada, seis com condiloma anal tratado e oito com condiloma anal. As verrugas foram biopsiadas nos oito pacientes com condiloma e feito exame de anuscopia de alta resolução com biópsia dirigida nos outros 22 pacientes. O material foi encaminhado para exame anátomo-patológico e depois, a partir do mesmo bloco de parafina, foi feito o exame de PCR. Resultados: O anátomo-patológico foi positivo para HPV em todos os pacientes, sendo que nos oito com condiloma confirmou-se a forma clínica e em 22 diagnosticou-se a subclínica com 13 casos de neoplasia intraepitelial associada. O PCR foi positivo em 91,9% dos 22 pacientes da forma subclínica ao anátomo-patológico e em 87,5% dos oito pacientes da forma clínica. O tipo predominante nos casos de HPV anal subclínico foi o 16 e o predominante nas verrugas foi o 11. CONCLUSÕES: O exame anátomo-patológico foi positivo para HPV em todos os pacientes, propiciando também o diagnóstico de 13 casos de neoplasia intraepitelial, sendo dois de carcinoma "in situ". O PCR foi positivo em 91,9% dos pacientes da forma subclínica ao anátomo-patológico e em 87,5% da forma clínica ao anátomo-patológico. O tipo predominante da forma subclinica foi o 16 e das verrugas foi o 11.The purpose of this study is to analyze the results found in the pathological examination and PCR test for clinical and subclinical HPV anal infections in four groups of patients. Methods: The four groups studied were: ten patients with idiopathic anal pruritus, six with treated HPV genital infection, six with treated anal condyloma, and eight with anal condyloma. Eight

  13. Anal cancer with large metastases into the perirectal fat: differential diagnosis and treatment policy

    Directory of Open Access Journals (Sweden)

    A. O. Rasulov

    2015-01-01

    Full Text Available Selected squamous-cell anal carcinoma (SCAC patients are initially presented with large pararectal lymph node metastases.The aim of this study was to investigate safety, efficacy and long-term outcome of chemoradiotherapy in this patient group.Materials and methods. SCAC patients, initially referred with gastrointestinal stromal tumors, rectal cancer diagnosis or patients with regional metastatic lymph nodes more than twice the size of the primary tumour were included in this retrospective analysis. Previous treatment, diagnostic and clinical mistakes of primary care specialists, short- and long-term outcome of chemoradiotherapy were analyzed.Results. 6 patients were included. Primary tumour size varied between 0.5 and 6.5 cm (median – 1.7 cm, metastatic lymph node size varied between 4.2 and 7.4 cm (median – 6.4 cm. All patients received radical doses of chemoradiation. All patients developed grade 3 toxicities, 2 patients developed grade 4 toxicities. Median followup was 15.5 months. 5 out of 6 patients had persistent complete clinical response. 1 patient died of disease progression (incomplete response and metachronous distant metastases.Conclusion. SCAC patients with large regional lymph node metastases have equal prognosis with the rest of the patient group of adequate treatment was carried out.

  14. Laparoscopic excision of cyst of canal of Nuck

    Directory of Open Access Journals (Sweden)

    Nafees Javed Qureshi

    2014-01-01

    Full Text Available Hydrocele of the canal of Nuck is a rare condition in females. It results from the failure of obliteration of the distal portion of evaginated parietal peritoneum within the inguinal canal which forms a sac containing fluid. Patients generally present with inguinal swelling. We present a case of left sided cyst of canal of Nuck with left inguinal hernia in a 28-year-old female, which was diagnosed on ultrasonography. Patient underwent laparoscopic excision of cyst of canal of nuck with hernioplasty. Histopathology confirmed the diagnosis. To our knowledge, this is the first reported case of laparoscopic excision of a cyst (encysted hydrocele of the canal of Nuck.

  15. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have been...... among health care personnel, followed by an expert panel discussion. Ten women were interviewed about their understanding and attitude toward answering the questionnaire and it was pre-tested on 52 women with ASR. The questionnaire was revised five times during the validation process. The final version...... was test-retested among 20 women with ASR. Results. The questionnaire revealed typical problems after ASR. The length, use of language, and the way the questionnaire was constructed, was deemed appropriate. The reliability test showed good to very good correlation (Kappa values from 0.733 to 0.923) in all...

  16. Analýza Stirlingova oběhu

    OpenAIRE

    Hazda, Jakub

    2015-01-01

    Tato práce se zabývá termodynamickým oběhem Strilingova motoru. Je zde uplatněna analýza ideálního cyklu, Schmidtova analýza a metoda druhého řádu se ztrátovou korekcí v rámci softwaru PROSA 2.4. Získané výsledky jsou porovnány s experimentálně získanými daty dvou modelů motorů. This paper deals with the thermodynamic cycle of Striling engine. Analysis of the ideal cycle, Schmidt analysis and second-order method with loss correction by PROSA 2.4 software is applied. The results are compare...

  17. Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia.

    Science.gov (United States)

    Mazeingia, Yohannes Teka; Olijjira, Lemessa; Dessie, Yadeta

    2017-01-01

    Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia. Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis. Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience. Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk

  18. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  19. Pulmonary squamous cell carcinoma associated with repaired congenital tracheoesophageal fistula and esophageal atresia.

    Science.gov (United States)

    Esquibies, Americo E; Zambrano, Eduardo; Ziai, James; Kesebir, Deniz; Touloukian, Robert J; Egan, Marie E; Reyes-Múgica, Miguel; Bazzy-Asaad, Alia

    2010-02-01

    We report a 19-year-old man with pulmonary squamous cell carcinoma (SCC) who had a history of vertebral, anal, cardiac, tracheal, esophageal, renal, and radial limb defects (VACTERL) association and tracheoesophageal fistula (TEF) + esophageal atresia (EA) repair as an infant. Children that undergo TEF + EA repair may have an increased risk for developing cancer as they reach adulthood. (c) 2010 Wiley-Liss, Inc.

  20. MRI in children following surgery for anal and rectal atresia

    International Nuclear Information System (INIS)

    Krahe, T.; Herold, A.; Doelken, W.; Hoecht, B.; Wuerzburg Univ.

    1989-01-01

    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.) [de

  1. The impact of anal sphincter injury on perceived body image.

    Science.gov (United States)

    Iles, David; Khan, Rabia; Naidoo, Kristina; Kearney, Rohna; Myers, Jenny; Reid, Fiona

    2017-05-01

    Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed. Multivariate regression analyses were performed to examine variables influencing self-reported change in body image. Questionnaires and operation notes were analysed from 422 women who attended at a median of four months after delivery. 222 (53%) reported a change in body image with 80 (19%) reporting lower self-esteem and 75 (18%) a change in their personality due to the change in body image. 248 (59%) perceived an anatomical change due to the delivery. Factors associated with increased likelihood of reporting a change in body image were reporting a perceived change in anatomy due to the delivery, adjusted OR 6.11 (3.56-10.49), anal incontinence, OR 1.97 (1.16-3.36), and delivery by forceps, OR 2.59 (1.23-5.43). This is the first study to quantify body image changes in women after anal sphincter injury sustained in childbirth. These were found to be very common, affecting up to 50% of women. The study has several limitations but it does highlight the significant psychosocial problems of negative self-esteem and personality changes associated with a perceived change in body image that has not previously been reported. It also outlines the further research questions that need to be addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Endosonographic appearance of the anal sphincters in patients following colostomy

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Szczepkowski, M.; Panorska, A.

    2002-01-01

    Background. The aim of the study was to visualize, by anal ultrasound (AUS), the suspected defects of the anal sphincters in the patients after colostomy and to analyze possible factors that could have led to such defects. Patients and methods. AUS, using a 7.0 MHz endorectal probe, was performed in a group of 25 patients with colostomy. The internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis muscle (PR) were visualized and the defects within them were qualified and quantified. For statistical analysis, the analysis of variance (ANOVA) was used. Results. The IAS was thin in all but three patients (22 patients; 88 %) with the mean thickness of 1.62 mm. A circular reduction of the thickness along the entire length of the IAS was seen in 20 patients (90.9 %). The echogenicity of the IAS was increased in 15 patients (60 %), and in 10 of them (66.6%), this defect embraced the whole length and circumference of the IAS. The margins of the IAS were not well-defined in 10 patients (40%). A significant correlation was found between the length of the patient's life with the stoma and the IAS echogenicity defect (p-value = 0.0001). No significant correlation was found between the dynamic examination, the IAS thickness and the IAS borders definition. Conclusion. The reduced thickness, increased echogenicity and borders definition defect of the IAS are seen in the patients after colostomy. The only significant correlation was confirmed between the length of the patient's life with the stoma and the IAS echogenicity defect. (author)

  3. Pelvic floor ultrasound and anal incontinence in primiparous women

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth

    2010-01-01

    Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

  4. The clinical characteristics of patients with chronic idiopathic anal pain

    Directory of Open Access Journals (Sweden)

    Mao Weiming

    2017-05-01

    Full Text Available The aim of this study was to investigate the clinical characteristics, treatment outcomes and psychological distress in patients with chronic idiopathic anal pain. The study was conducted on patients referred to Hangzhou Third Hospital for chronic anal pain from January, 2010 to December, 2014. Patient demographics, clinical history, anorectal physiology, and radiological imaging data were recorded for all patients. The treatment outcome was noted for patients treated and followed up for more than 6 month at the present unit. Ninety-six patients with mean age of 45.1 years (range, 17-82 were studied. Seventy-one patients (74.0% had functional anorectal pain(FARP. The main complaints were dull, sharp, stabbing, or spasm pain. Among all patients, 34.3% reported that their pain radiated into other locations. Fifty-one patients (53.1% had bowel dysfunction, while 28.1% patients had urinary dysfunction. The common factors associated with pain relief were day time, lying down and warm water baths; the factors that contributed to aggravated pain were night time, defecation or sitting. 92.7% (89/96 of patients reported symptoms of psychological disturbance. FARP patients exhibited increased depression than non-FARP patients(P<0.05. In addition, female patients were more likely to have depression than male patients (P<0.05. The overall pain treatment success rate was 55.2% (53/96. The pain treatment outcome was better in non-FARP patients than in FARP patients(χ2=3.85, P<0.05. Conclusively, chronic idiopathic anal pain is a complex clinical symptom, involving pelvic floor muscles, the nervous system, endocrine system, and the patients’ psychological conditions. Further research is needed to improve diagnosis and treatment for patients with chronic idiopathic anal pain.

  5. coloproctectomie avec anastomose colo-sus-anale pour tumeur ...

    African Journals Online (AJOL)

    Une coloproctectomie fut réalisée le 30/06/2014 avec anastomose colo-anale, colostomie de protection sous-couvert d'une transfusion sanguine. L'examen histologique du segment colorectal prélevé objectiva une rectocolite granulomateuse autour de nombreux oeufs de schistosomes. En effet, le patient a vécu à Pahou, ...

  6. Internal anal sphincter atrophy in patients with systemic sclerosis.

    Science.gov (United States)

    Thoua, Nora M; Schizas, Alexis; Forbes, Alastair; Denton, Christopher P; Emmanuel, Anton V

    2011-09-01

    SSc is a connective tissue, multisystem disorder of unknown aetiology. The gastrointestinal tract (GIT) is affected in up to 90% of patients. The exact pathophysiology of GIT involvement is not known, but it is related to both neurogenic and myogenic abnormalities as well as possible vascular and ischaemic changes. Thinning of the internal anal sphincter (IAS) has been demonstrated in SSc with faecal incontinence. We aimed to investigate anal sphincter structure in patients with SSc. Forty-four SSc patients [24 symptomatic (Sx) and 20 asymptomatic (ASx)] and 20 incontinent controls (ICs) were studied. Patients underwent anorectal manometry and endoanal US. In the ICs, external anal sphincter defects were more common, but the IAS was less atrophic, evident by both atrophy scores and IAS thickness. There was no significant difference in atrophy scores [Sx: 2 (1.5-3) vs ASx: 2 (1-2)] or IAS thickness [Sx: 1.85 (1.5-2.3) vs ASx: 1.8 (1.7-2.25)] between the Sx and ASx SSc patients. Patients with SSc (both Sx and ASx) have thin and atrophic IAS, suggesting that IAS atrophy develops even in ASx patients and this may be amenable to treatment with sacral neuromodulation.

  7. Thermal responses of shape memory alloy artificial anal sphincters

    Science.gov (United States)

    Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

    2003-08-01

    This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

  8. Anal sphincter electromyography in patients with Anorectal Dysfunctions

    International Nuclear Information System (INIS)

    Trinchet Soler, Rafael; Hidalgo Marrero, Yanet; Espichicoque Megret, Arianne; Manzano Suarez, Jianeya; Perez Gonzales, Ruth Maite

    2009-01-01

    The purpose of this work is to evaluate the electromyography value of anal sphincter in patients with anorectal dysfunctions. Anorectal dysfunctions are frequent reason of pediatric consultation in children, especially with anal incontinence. A study of series of cases in patient with anorectal dysfunctions was carried out from January 2002 to January of 2006. 65 patients were studied. Anorectal malformations (ARM) represented the predominant affection with 38 patients (58.5%), prevailing the male sex in 25 patients (65.8%). Encopresis and intestinal agagliosis dicrease was observed. Sphincter was found before surgical treatment through electromyography in patients with anorectal malformations and colostomy; in those with definitive operation and open colostomy, it avoided the operation in a patient that did not have muscular activity of the external sphincter. In children already operated and with closed colostomy several electromyography changes were observed in correspondence with different incontinence grades. In encopresis cases the study was useful to rule out sphincter functional alterations. Electromyography was pathological in all the operated patients of intestinal aganglionosis. This procedure was very useful for anal incontinence study that helped to determine and establish the prognosis. (author)

  9. Fractal dimension and image statistics of anal intraepithelial neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ahammer, H., E-mail: helmut.ahammer@medunigraz.a [Institute of Biophysics, Center of Physiological Medicine, Medical University of Graz, Harrachgasse 21, A-8010 Graz (Austria); Kroepfl, J.M. [Human Performance Research Graz (HPR Graz), Karl-Franzens and Medical University of Graz, Max-Mell Allee 11, A-8010 Graz (Austria); Hackl, Ch. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Sedivy, R. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria)

    2011-01-15

    Research Highlights: Human papillomaviruses cause anal intraepithelial neoplasia (AIN). Digital image processing was carried out to classify the grades of AIN quantitatively. The fractal dimension as well as grey value statistics was calculated. Higher grades of AIN yielded higher values of the fractal dimension. An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  10. Hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Sharieff, S.; Burney, I.; Salam, A.; Siddiqui, T.

    2002-01-01

    Objective: To describe the etiology, clinico pathological features and outcome of hepatocellular carcinoma (HCC). Design: A retrospective study. Place and Duration of Study: The study was conducted at the Aga Khan University Hospital, Karachi, on patients admitted between January 1994 and December 1998. Subjects and Methods: A total of 201 consecutive patients diagnosed to have primary HCC on liver biopsy were the subjects of this study. Data included clinical and physical examination, routine hematological and bio-chemical investigations along with alpha-fetoprotein (alpha-FP or AFP) and imaging studies. Results: The mean age at the time of diagnosis was 56 years (24 to 85 year). There was a male preponderance (74%). The mean alpha FP was 17, 027 plus minus 68,853 ng/ml. The viral hepatitis profile was: HbsAg positive = 36% anti-HCV positive = 41%; both positive =7%: both negative = 16%. HBV-related HCC patients were found to be younger than HCV-related HCC patients (49.7 v/s 56.3 years: p =ns). However there was no significant difference in the survival rates of either group of patients. The median survival time was 16 weeks. Conclusion: HBV and HCV account for 84.% of HCC in Pakistan. Majority of the patients had advanced stage of HCC. The median survival was 16 weeks. (author)

  11. Stages of Adrenocortical Carcinoma

    Science.gov (United States)

    ... and urine are used to detect (find) and diagnose adrenocortical carcinoma. Certain factors affect the prognosis (chance of recovery) and treatment options. Adrenocortical carcinoma is a rare disease in which malignant (cancer) cells form in the ...

  12. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or ...

  13. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... National Cancer Institute. PDQ thyroid cancer treatment. Bethesda, ... February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/ ...

  14. Nivolumab and Ipilimumab in Treating Patients With Rare Tumors

    Science.gov (United States)

    2018-04-23

    Acinar Cell Carcinoma; Adenoid Cystic Carcinoma; Adrenal Cortex Carcinoma; Adrenal Gland Pheochromocytoma; Anal Canal Neuroendocrine Carcinoma; Anal Canal Undifferentiated Carcinoma; Appendix Mucinous Adenocarcinoma; Bartholin Gland Transitional Cell Carcinoma; Bladder Adenocarcinoma; Cervical Adenocarcinoma; Cholangiocarcinoma; Chordoma; Colorectal Squamous Cell Carcinoma; Desmoid-Type Fibromatosis; Endometrial Transitional Cell Carcinoma; Endometrioid Adenocarcinoma; Esophageal Neuroendocrine Carcinoma; Esophageal Undifferentiated Carcinoma; Extrahepatic Bile Duct Carcinoma; Fallopian Tube Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Fibromyxoid Tumor; Gastric Neuroendocrine Carcinoma; Gastric Squamous Cell Carcinoma; Gastrointestinal Stromal Tumor; Giant Cell Carcinoma; Intestinal Neuroendocrine Carcinoma; Intrahepatic Cholangiocarcinoma; Lung Carcinoid Tumor; Lung Sarcomatoid Carcinoma; Major Salivary Gland Carcinoma; Malignant Odontogenic Neoplasm; Malignant Peripheral Nerve Sheath Tumor; Malignant Testicular Sex Cord-Stromal Tumor; Metaplastic Breast Carcinoma; Metastatic Malignant Neoplasm of Unknown Primary Origin; Minimally Invasive Lung Adenocarcinoma; Mixed Mesodermal (Mullerian) Tumor; Mucinous Adenocarcinoma; Mucinous Cystadenocarcinoma; Nasal Cavity Adenocarcinoma; Nasal Cavity Carcinoma; Nasopharyngeal Carcinoma; Nasopharyngeal Papillary Adenocarcinoma; Nasopharyngeal Undifferentiated Carcinoma; Oral Cavity Carcinoma; Oropharyngeal Undifferentiated Carcinoma; Ovarian Adenocarcinoma; Ovarian Germ Cell Tumor; Ovarian Mucinous Adenocarcinoma; Ovarian Squamous Cell Carcinoma; Ovarian Transitional Cell Carcinoma; Pancreatic Acinar Cell Carcinoma; Pancreatic Neuroendocrine Carcinoma; Paraganglioma; Paranasal Sinus Adenocarcinoma; Paranasal Sinus Carcinoma; Parathyroid Gland Carcinoma; Pituitary Gland Carcinoma; Placental Choriocarcinoma; Placental-Site Gestational Trophoblastic Tumor; Primary Peritoneal High Grade Serous Adenocarcinoma

  15. An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars

    Directory of Open Access Journals (Sweden)

    Hye-Rim Yun

    2012-05-01

    Full Text Available Objectives The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.

  16. Imaging diagnosis for bone invasion by gingival carcinoma of the mandible: The value and the limitation

    OpenAIRE

    Nakayama, Eiji

    2009-01-01

    The bone invasion in carcinoma of the mandibular gingiva (CaMG) is one of the important factors to determine the treatment planning and predict the prognosis. Japan Society for Oral Tumors proposed a new criterion of T4 classification of CaMG in 1997 as follows: the tumor is classified as T4 when the tumor spreads into the mandibular canal, and the tumor should not be classified as T4 when the tumor does not invade into the mandibular canal. Thus, the supero-inferior extent of bone invasion i...

  17. The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

    Directory of Open Access Journals (Sweden)

    Edmundo Zarzur

    1996-09-01

    Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

  18. Root canal filling using Resilon: a review.

    LENUS (Irish Health Repository)

    Shanahan, D J

    2011-07-01

    Root canal treatment is achieved by chemo-mechanical debridement of the root canal system followed by filling. The filling material \\'entombs\\' residual bacteria and acts as a barrier which prevents the entrance of oral microorganisms and reinfection of the root canal system through microleakage. However, filling with contemporary root filling materials such as gutta-percha offers limited long-term resistance to microorganisms; as a result other materials such as Resilon have been investigated as alternatives. The aim of this review was to analyse the literature to consider whether Resilon is a suitable root canal filling material. A MEDLINE and Cochrane library search including various keyword searches identified several papers which investigated or discussed Resilon or RealSeal\\/Epiphany. Analysis of the literature demonstrated that the bulk of the literature is in vitro in nature, based largely on leakage-type studies, and demonstrates a wide variety of methodologies with conflicting findings; as a result meaningful conclusions are difficult. Within the limit of these in vitro studies Resilon appears to perform adequately in comparison to gutta-percha, however, as a result of the questionable merit of such studies, it cannot presently be considered an evidence-based alternative to the current gold standard gutta-percha. It is imperative that before Resilon is considered as a replacement material, a better understanding of the physical properties of the resin sealer and the reality of the adhesive \\'monoblock\\' are elucidated. The literature also demonstrates a paucity of quality long-term clinical outcome studies which will need to be addressed before firm conclusions can be reached.

  19. Roentgenographic study of the mandibular canal

    International Nuclear Information System (INIS)

    Ahn, Hyung Kyu

    1980-01-01

    The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional relation between the mental foramen and the mandibular premolars in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group I consisted of 56 males and 44 females from 1 to 6 years of age, Group II consisted of 58 males and 45 females from 7 to 12 years of age, Group III consisted of 65 males and 33 females from 13 to 18 years of age, Group IV consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50 .deg. in Group II, 148.11 .deg. in Group III, 147.33 .deg. in Group IV. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group I (42%) and on the mandibular 2nd molar area in Group II (54%), Group III (59%), Group IV (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group I (58%), between the mandibular 1st premolar and the 2nd premolar in Group II (62%), Group III (47%), and below the mandibular 2nd premolar in Group IV (58%).

  20. Roentgenographic study of the mandibular canal

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Hyung Kyu [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1980-11-15

    The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional relation between the mental foramen and the mandibular premolars in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group I consisted of 56 males and 44 females from 1 to 6 years of age, Group II consisted of 58 males and 45 females from 7 to 12 years of age, Group III consisted of 65 males and 33 females from 13 to 18 years of age, Group IV consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50 .deg. in Group II, 148.11 .deg. in Group III, 147.33 .deg. in Group IV. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group I (42%) and on the mandibular 2nd molar area in Group II (54%), Group III (59%), Group IV (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group I (58%), between the mandibular 1st premolar and the 2nd premolar in Group II (62%), Group III (47%), and below the mandibular 2nd premolar in Group IV (58%).

  1. Microbial Ecology of the Dental Root Canal

    OpenAIRE

    Drucker, David B.; Natsiou, Ifigenia

    2011-01-01

    Understanding of microbial ecology of the pulp-dentine complex is important because it provides a rational basis for disease prevention and treatment. Endodontic microorganisms can be acquired via traumatic damage, failing pulpal restorations, the apical foramen and a multitude of dentinal tubules and accessory/lateral canals. Survival within the endodontium is determined by the microenvironment; for example, Eh, pH, absence of sugars, other microbes and host defences. Compared with other sit...

  2. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2012-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  3. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2009-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  4. Comparison of Bacterial Leakage between 3 Different Root Canal Obturation Techniques in Oval Shaped Canals

    Directory of Open Access Journals (Sweden)

    Eshagh-ali Saberi

    2014-06-01

    Full Text Available Introduction: The purpose of this study was to evaluate the sealing ability of 3 obturation techniques in oval-shaped canals by bacterial leakage assessment. Methods: Sixty mandibular incisors with oval canals were selected after providing buccolingual and mesiodistal radiographs. The teeth were sectioned at a 10 mm distance from the apex. After instrumentation, the teeth were divided into 3 groups and the canals in the three groups were obturated with lateral condensation (G1, warm vertical condensation (G2 and thermoplasticized injectable gutta percha (G3. The teeth were exposed to human saliva. Observing the turbidity of the BHI broth for a period of 63 days the number of days required for the complete contamination of root canals was recorded. The data were analyzed using descriptive statistical methods and Kruskal-Wallis test with SPSS statistical software. Results: Warm vertical condensation (G2 needed a significantly greater average time for leakage than the two other methods. No significant differences were found between lateral condensations and thermoplasticized injectable G.P techniques. Conclusion: warm vertical condensation provides a better seal against bacterial leakage than lateral condensation and obtura II method in obturating oval-canals.

  5. Diagnosis and root canal treatment in a mandibular premolar with three canals.

    Science.gov (United States)

    Soares, Lanuce Rosa; Arruda, Marcos; de Arruda, Marcos Pôrto; Rangel, Andréa Leão; Takano, Edson; de Carvalho Júnior, Jacy Ribeiro; Saquy, Paulo Cesar

    2009-01-01

    This paper presents a case report of a left mandibular second premolar with three canals and three different apical foramina. A 39-year-old male patient presented to our clinic with pain in the mandibular left second premolar. Initially, pain was caused by cold stimulus and later was spontaneously. The intraoral clinical examination revealed a fractured amalgam restoration with occlusal caries. Percussion and cold (Endo-Frost) tests were positive. The radiographic examination showed the presence of two roots. The probable diagnosis was an acute pulpitis. After access cavity, it was observed remaining roof of the pulp chamber and mild bleeding in the tooth lingual area, indicating the possible presence of a third canal. The endodontic treatment was completed in a single session using Root ZX apex locator and K3 NiTi rotary system with surgical diameter corresponding to a .02/45 file in the three canals and irrigation with 1% sodium hypochlorite. The canals were obtured with gutta-percha cones and Sealer 26 using the lateral condensation technique. After 1 year of follow-up, the tooth was asymptomatic and periapical repair was observed radiographically. Internal alterations should be considered during the endodontic treatment of mandibular second premolars. The correct diagnosis of these alterations by the analysis of preoperative radiographs can help the location of two or more canals, thereby avoiding root therapy failure.

  6. Undifferentiated salivary gland carcinomas

    DEFF Research Database (Denmark)

    Herbst, H.; Hamilton-Dutoit, S.; Jakel, K.T.

    2004-01-01

    Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases of...... at other primary sites, particularly when expressing the thyroid transcription factor-1 (TTF-1) Udgivelsesdato: 2004...

  7. Anterior canal lithiasis: diagnosis and treatment.

    Science.gov (United States)

    Casani, Augusto Pietro; Cerchiai, Niccolò; Dallan, Iacopo; Sellari-Franceschini, Stefano

    2011-03-01

    To describe the clinical and oculographic features in patients with anterior semicircular canal benign paroxysmal positional vertigo and to determine the efficacy of a canalith repositioning procedure for its management. Case series with chart review of patients presenting positional vertigo and positional downbeating nystagmus during a 2-year period. Outpatients' tertiary referral center for balance disorders. Eighteen patients suffering from positional vertigo and presenting positional downbeating nystagmus were treated with a maneuver based on a modification of the procedure proposed by Crevits. disappearance of positional downbeating nystagmus. Positional downbeating nystagmus was elicited unilaterally with the Dix-Hallpike maneuver in 6 cases. In 4 patients, it was triggered by both left and right Dix-Hallpike tests. In 8 patients, the positional nystagmus was elicited by a straight head-hanging maneuver. The positional nystagmus was purely downbeating in 12 patients. In the remaining, a torsional component was detected. After the treatment, only 1 patient showed positional nystagmus at 30 days. In anterior canal benign paroxysmal positional vertigo, the presence of a positional downbeating nystagmus in response to positional tests is key for diagnosis. In a significant number of patients, the affected side may not be detected because of the inconstant presence of a torsional component. Treatment with a simplified maneuver based on Crevits's technique can be considered an effective method for the treatment of anterior canal lithiasis, especially when the affected side cannot be detected clearly.

  8. Comparison of an anal fistula plug and mucosa advancement flap for complex anal fistulas: a meta-analysis.

    Science.gov (United States)

    Xu, Yansong; Tang, Weizhong

    2016-12-01

    The aim of this analysis was to compare the advantages of the anal fistula plug (AFP) with the mucosa advancement flap (MAF) for complex anal fistulas. Comparative studies of the efficacy of AFP and MAF were included. Two independent reviewers selected articles for inclusion. After information collection, a meta-analysis was performed using data on overall healing rates, complications, incontinences and recurrences. The quality of postoperative life and cost were also included with the clinical results. Ten studies included 778 patients who were divided into AFP and MAF groups in this meta-analysis. During the follow-up period, no significant difference in healing rates, complications and recurrences were found (P = 0.55, P = 0.78 and P = 0.23, respectively). The incontinence rate of AFP was lower than that of MAF (P = 0.04). The postoperative quality of life of AFP patients was superior to that of MAF patients. The AFP patients had less persistent pain of a shorter duration and shortened healing time and hospital stay. The treatment cost of AFP patient was lower than that of MAF. Compared to the MAF procedure, the AFP procedure has some advantages for complex anal fistulas, but more and large randomized clinical trials comparing the two procedures for fistula management need to be conducted. © 2016 Royal Australasian College of Surgeons.

  9. Anal metastasis of rectal cancer-adenocarcinoma of squamous cells: a case report and literature review.

    Science.gov (United States)

    Sasaki, Shun; Sugiyama, Masahiko; Nakaji, Yu; Nakanishi, Ryota; Nakashima, Yuichiro; Saeki, Hiroshi; Oki, Eiji; Oda, Yoshinao; Maehara, Yoshihiko

    2017-12-01

    Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy. Biopsy of both tumors revealed a similar histology of well- to moderately differentiated adenocarcinoma. There was no sign of metastases in lymph nodes or other organs. For the purpose of diagnosis and treatment, transperineal local resection of the anal tumor was performed, and it was histologically identified as adenocarcinoma of squamous cells with no invasion to muscles, lymph ducts, or microvessels. The pathological margin was free. Then, to achieve radical cure, laparoscopic low anterior resection (LAR) with D3 lymphadenectomy was performed. The histological diagnosis of the anal tumor was adenocarcinoma of squamous cells without invasion to muscles, lymph ducts, or vessels. The surgical margin was completely free. Immunohistochemical analysis of both tumors revealed similar staining patterns, and the final diagnosis was rectal cancer with metastasis to the anal skin. The patient received no postoperative therapy, and no recurrences have been observed 12 months after surgery. We expect that our sphincter-preserving surgical strategy provided a good prognosis for the synchronous rectal cancer and anal metastasis. This is a rare report of a case with an anal metastasis of colorectal cancer on perianal squamous cells without a history of anal disease that was resected while preserving anal function.

  10. Canal Centring Ability of ProTaper and Mtwo Rotary Systems in Curved Canals

    Directory of Open Access Journals (Sweden)

    Turkaydin Dilek Erbay

    2014-07-01

    Full Text Available The purpose of this investigation was to compare centring ratio of ProTaper and Mtwo rotary systems. 60 mandibular molar teeth which had 25, 30 and 35 degree curvature in mesio-buccal root canal were used. Group 1 had 25°, Group 2 had 30°, and Group 3 had 35° curvatures. The roots were sectioned horizontally at 2 mm away from the apex. The apical region was then observed under a stereo-microscope. In each group, teeth were instrumented using ProTaper and Mtwo systems. After canal preparation, digital images of apical part of canals were taken. These images were then superimposed by using Adobe Photoshop CS2 programme. The data were analyzed using ANOVA and Student’s t-test.

  11. Fratura toracolombar explosão: correlação entre o comprometimento do canal vertebral e os resultados do tratamento conservador Fractura toralumbar por explosión: correlación entre el comprometimiento del canal vertebral y resultados del tratamiento conservador Thoracolumbar burst fracture: correlation between the spinal canal compromise and the clinical results of conservative treatment

    Directory of Open Access Journals (Sweden)

    Osmar Avanzi

    2009-03-01

    Full Text Available INTRODUÇÃO: o tratamento das fraturas explosão toracolombares sem comprometimento neurológico é controverso. A porcentagem de estreitamento do canal vertebral tem sido utilizada como parâmetro de indicação cirúrgica, mas a sua significância em pacientes sem comprometimento neurológico permanece incerta. OBJETIVO: avaliar pacientes com fratura toracolombar explosão, correlacionando o estreitamento inicial do canal vertebral e os resultados clínicos do tratamento conservador. MÉTODOS: foram avaliados de forma retrospectiva os prontuários, radiografias e filmes de tomografia computadorizada (TC de pacientes adultos, portadores de fratura toracolombar explosão, incluindo os níveis de T11 a L2, do tipo A3 da classificação de Magerl, com menos de 10 dias de evolução, tratados conservadoramente com o uso de órtese tipo TLSO (Jewett ou gesso em hiperextensão. Foi ainda aplicado um questionário que incluía as escalas visual-analógico de dor ou EVA, escala de Dor e Trabalho de Denis, índice de Oswestry e questionário de qualidade de vida SF-36. RESULTADOS: não houve correlação entre o estreitamento canal vertebral e a EVA ou a Escala de Dor de Denis. Houve correlação negativa entre a porcentagem de estenose do canal vertebral e a Escala de Trabalho de Denis. Também houve correlação negativa entre o índice de Oswestry e a porcentagem de estenose do canal vertebral, indicando que os pacientes com maiores escores de incapacidade apresentaram menor porcentage de estenose. Na análise de correlação entre os índices obtidos nos domínios do SF-36 e a porcentagem de estenose do canal vertebral, houve correlação significativa apenas no domínio capacidade funcional, indicando que os pacientes com melhor capacidade funcional ou escores mais próximos a 100%, também apresentavam maior porcentagem de estenose. CONCLUSÃO: os resultados obtidos confirmam a inexistência de correlação entre maior estreitamento do canal

  12. The effect of QMix, an experimental antibacterial root canal irrigant, on removal of canal wall smear layer and debris.

    Science.gov (United States)

    Dai, Lin; Khechen, Khaled; Khan, Sara; Gillen, Brian; Loushine, Bethany A; Wimmer, Courtney E; Gutmann, James L; Pashley, David; Tay, Franklin R

    2011-01-01

    This study examined the ability of two versions of QMix, an experimental antimicrobial irrigant, on removal of canal wall smear layers and debris using an open canal design. Cleaned and shaped single-rooted human root canals were irrigated with NaOCl as the initial irrigant and one of the following as the final irrigant: (1) QMix I (pH = 8), (2) QMix II (pH = 7.5), (3) distilled water, (4) 17% EDTA, and (5) BioPure MTAD (Dentsply Tulsa Dental Specialties, Tulsa, OK). Smear and debris scores were evaluated in the coronal, middle, and apical thirds of longitudinally fractured canal spaces using scanning electron microscopy and analyzed using Cochran-Mantel-Haenszel statistic. Smear scores, when the overall canal was considered, differences were observed among groups except groups 1 versus 4 and groups 2 versus 4. After adjusting for canal levels, all groups differed significantly from each other (p < 0.005) with the exception of groups 2 versus 5. For the debris scores, no significant difference was observed among the treatment groups when the overall canal was considered and after adjusting for the effect of canal level. Within the limitations of an open-canal design, the two experimental QMix versions are as effective as 17% EDTA in removing canal wall smear layers after the use of 5.25% NaOCl as the initial rinse. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Simplification of total mesorectal excision with colonic J-pouch anal anastomosis for middle and lower rectal cancer. One surgeon's experience

    International Nuclear Information System (INIS)

    Kusunoki, Masato; Inoue, Yasuhiro; Yanagi, Hidenori

    2008-01-01

    The introduction of total mesorectal excision (TME) has dramatically improved local control of rectal cancer. Yet, despite its complexity, there is no clear technical explanation of this procedure in the text references. Thus, we attempted to simplify the TME procedure according to its original concept. Our procedure has three principles: posterolateral dissection, which is helpful for performing complete TME with autonomic nerve preservation; detachment of the hiatal ligament, which enables mobilization of the whole mesorectum and transection of the distal rectum just above the anal canal; and colonic J-pouch anal anastomosis to support fecal continence. We evaluated our modified TME, focusing on one surgeon's experience. Between 1993 and 2006, 164 patients underwent modified TME, performed by one surgeon (M.K.). Intraoperative blood loss and operating time were both significantly lower than for conventional resection (P<0.01), and the rate of anastomotic leakage was less than 1%. Modified TME combined with radiotherapy or chemotherapy, or both, also improved prognosis considerably. We have succeeded in simplifying the original TME procedure and improved its outcome even further, based on our familiarity with its anatomyoriented elements. (author)

  14. Canal of Nuck hernia: a multimodality imaging review

    Energy Technology Data Exchange (ETDEWEB)

    Rees, Mitchell A. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Squires, James E. [Children' s Hospital of Pittsburgh of UPMC, Department of Gastroenterology, Pittsburgh, PA (United States); Tadros, Sameh; Squires, Judy H. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States)

    2017-07-15

    Canal of Nuck abnormalities are a rare but important cause of morbidity in girls, most often those younger than 5 years of age. The canal of Nuck, which is the female equivalent of the male processus vaginalis, is a protrusion of parietal peritoneum that extends through the inguinal canal and terminates in the labia majora. The canal typically obliterates early in life, but in some cases the canal can partially or completely fail to close, potentially resulting in a hydrocele or hernia of pelvic contents. Recognition of this entity is especially important in cases of ovarian hernia due to the risk of incarceration and torsion. We aim to increase awareness of this condition by reviewing the embryology, anatomy and diagnosis of canal of Nuck disorders with imaging findings on US, CT and MRI using several cases from a single institution. (orig.)

  15. Environmental pollution and shipping feasibility of the Nicaragua Canal.

    Science.gov (United States)

    Chen, Jihong; Zeng, Xin; Deng, Yibing

    2016-12-15

    In recent years, the Nicaraguan government's renewed interest in constructing this interoceanic canal has once again aroused widespread concern, particularly in the global shipping industry. The project's immense ecological risks, coupled with the recent expansions of both the Panama Canal and the Suez Canal, have raised questions among scientists and experts about its viability. Whether the Nicaragua Canal is really feasible for international shipping, given its high marine pollution risks, requires the further study. This paper discusses and analyses the feasibility of the Nicaragua Canal in the context of its environmental impact and value as a shipping service. This paper aims to provide an important information reference to inform strategic decision-making among policymakers and stakeholders. Our research results indicate that the environmental complexity, economic costs and safety risks of building a new transoceanic canal are simply too high to justify the project. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Directory of Open Access Journals (Sweden)

    Newton Sérgio de Carvalho

    Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

  17. Evidence for the secondary sexual development of the anal fin in female kokanee salmon Oncorhynchus nerka.

    Science.gov (United States)

    Thorn, M W; Morbey, Y E

    2016-02-01

    This study examines whether the anal fin undergoes secondary sexual development similar to other reproductive traits in salmonids. This hypothesis was tested by comparing the anal-fin size of female kokanee salmon Oncorhynchus nerka that were in the early and late stages of sexual development. Females in an advanced stage of maturation had significantly larger anal fins relative to females in an early state of maturation (+4-7%), indicating that the anal fin undergoes secondary sexual development. The magnitude of this secondary growth was comparable with snout length (+9-10%), which is known to undergo secondary sexual development in female salmonids. When morphological trait dimensions were compared between the sexes, the anal fin was the only morphological trait found to have a female-biased sexual size dimorphism. This is the first study to show that the anal fin of female salmonids undergoes secondary sexual development. © 2015 The Fisheries Society of the British Isles.

  18. Recent Advances in the Pharmacotherapy of Chronic Anal Fissure: An Update

    Directory of Open Access Journals (Sweden)

    Bikash Medhi

    2008-07-01

    Full Text Available Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. Glyceryl trinitrate (GTN ointment (0.2% has an efficacy of up to 68% in healing chronic anal fissure, but it is associated with headache as the major and most common side effect. Though botulinum toxin injected into the anal sphincter healed over 80% of chronic anal fis-sures, it is more invasive and expensive than GTN therapy. Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.

  19. Geophysical investigation of a dutch levee and canal using various seismic and GPR techniques

    NARCIS (Netherlands)

    Noorlandt, R.P.; Kleine, M.P.E. de; Kruiver, P.P.; Bakker, M.A.J.; Mesdag, C.S.; Hoogendoorn, R.M.

    2011-01-01

    A geophysical survey has been carried out on the Juliana Canal and levee in the south of the Netherlands. For a stretch of about 35 km along this canal various construction works are planned, to deepen and widen the canal. The canal is in a geological setting such that leakage from the canal to the

  20. Magnetic resonance imaging of the internal auditory canal

    International Nuclear Information System (INIS)

    Daniels, D.L.; Herfkins, R.; Koehler, P.R.; Millen, S.J.; Shaffer, K.A.; Williams, A.L.; Haughton, V.M.

    1984-01-01

    Three patients with exclusively or predominantly intracanalicular neuromas and 5 with presumably normal internal auditory canals were examined with prototype 1.4- or 1.5-tesla magnetic resonance (MR) scanners. MR images showed the 7th and 8th cranial nerves in the internal auditory canal. The intracanalicular neuromas had larger diameter and slightly greater signal strength than the nerves. Early results suggest that minimal enlargement of the nerves can be detected even in the internal auditory canal

  1. CT of the external auditory canal: Correlation with clinical otoscopy

    International Nuclear Information System (INIS)

    Shankar, L.; Hawke, M.; Leekam, R.N.

    1987-01-01

    CT is the modality of choice in the assessment of external auditory canal abnormalities. Disorders of the complex structures within the ear that may be difficult to define clinically are well visualized on high-resolution CT. This exhibit illustrates various external auditory canal abnormalities and correlates these with color illustrations from clinical otoscopy. Congenital lesions of the external auditory canal - microtia, temporo-bandibular joint herniation, and fistulas - and various acquired lesions - traumatic, inflammatory, and neoplastic - are reviewed in this exhibit

  2. Basal cell carcinoma of the skin with areas of squamous cell carcinoma: a basosquamous cell carcinoma?

    OpenAIRE

    de Faria, J

    1985-01-01

    The diagnosis of basosquamous cell carcinoma is controversial. A review of cases of basal cell carcinoma showed 23 cases that had conspicuous areas of squamous cell carcinoma. This was distinguished from squamous differentiation and keratotic basal cell carcinoma by a comparative study of 40 cases of compact lobular and 40 cases of keratotic basal cell carcinoma. Areas of intermediate tumour differentiation between basal cell and squamous cell carcinoma were found. Basal cell carcinomas with ...

  3. Inverse solution of ear-canal area function from reflectance.

    Science.gov (United States)

    Rasetshwane, Daniel M; Neely, Stephen T

    2011-12-01

    A number of acoustical applications require the transformation of acoustical quantities, such as impedance and pressure that are measured at the entrance of the ear canal, to quantities at the eardrum. This transformation often requires knowledge of the shape of the ear canal. Previous attempts to measure ear-canal area functions were either invasive, non-reproducible, or could only measure the area function up to a point mid-way along the canal. A method to determine the area function of the ear canal from measurements of acoustic impedance at the entrance of the ear canal is described. The method is based on a solution to the inverse problem in which measurements of impedance are used to calculate reflectance, which is then used to determine the area function of the canal. The mean ear-canal area function determined using this method is similar to mean ear-canal area functions measured by other researchers using different techniques. The advantage of the proposed method over previous methods is that it is non- invasive, fast, and reproducible. © 2011 Acoustical Society of America

  4. Inverse solution of ear-canal area function from reflectance

    OpenAIRE

    Rasetshwane, Daniel M.; Neely, Stephen T.

    2011-01-01

    A number of acoustical applications require the transformation of acoustical quantities, such as impedance and pressure that are measured at the entrance of the ear canal, to quantities at the eardrum. This transformation often requires knowledge of the shape of the ear canal. Previous attempts to measure ear-canal area functions were either invasive, non-reproducible, or could only measure the area function up to a point mid-way along the canal. A method to determine the area function of the...

  5. Management of Acquired Atresia of the External Auditory Canal.

    Science.gov (United States)

    Bajin, Münir Demir; Yılmaz, Taner; Günaydın, Rıza Önder; Kuşçu, Oğuz; Sözen, Tevfik; Jafarov, Shamkal

    2015-08-01

    The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split- or full-thickness skin grafts, or pre- or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

  6. Recurrent anal fistulae: limited surgery supported by stem cells.

    Science.gov (United States)

    Garcia-Olmo, Damian; Guadalajara, Hector; Rubio-Perez, Ines; Herreros, Maria Dolores; de-la-Quintana, Paloma; Garcia-Arranz, Mariano

    2015-03-21

    To study the results of stem-cell therapy under a Compassionate-use Program for patients with recurrent anal fistulae. Under controlled circumstances, and approved by European and Spanish laws, a Compassionate-use Program allows the use of stem-cell therapy for patients with very complex anal fistulae. Candidates had previously undergone multiple surgical interventions that had failed to resolve the fistulae, and presented symptomatic recurrence. The intervention consisted of limited surgery (with closure of the internal opening), followed by local implant of stem cells in the fistula-tract wall. Autologous expanded adipose-derived stem cells were the main cell type selected for implant. The first evaluation was performed on the 8(th) postoperative week; outcome was classified as response or partial response. Evaluation one year after the intervention confirmed if complete healing of the fistula was achieved. Ten patients (8 male) with highly recurrent and complex fistulae were treated (mean age: 49 years, range: 28-76 years). Seven cases were non-Crohn's fistulae, and three were Crohn's-associated fistulae. Previous surgical attempts ranged from 3 to 12. Two patients presented with preoperative incontinence (Wexner scores of 12 and 13 points). After the intervention, six patients showed clinical response on the 8(th) postoperative week, with a complete cessation of suppuration from the fistula. Three patients presented a partial response, with an evident decrease in suppuration. A year later, six patients (60%) remained healed, with complete reepithelization of the external opening. Postoperative Wexner Scores were 0 in six cases. The two patients with previous incontinence improved their scores from 12 to 8 points and from 13 to 5 points. No adverse reactions or complications related to stem-cell therapy were reported during the study period. Stem cells are safe and useful for treating anal fistulae. Healing can be achieved in severe cases, sparing fecal

  7. Histopathologic observations of anorectal abnormalities in anal atresia.

    Science.gov (United States)

    Meier-Ruge, W A; Holschneider, A M

    2000-01-01

    Over the years from 1992 to 1997, 41 anorectal malformations (ARM) with histopathologic alterations were investigated to determine which morphologic abnormalities of the distal rectum accompany ARMs. Three other cases showed normal neuromuscular morphology; 9 further cases could not be evaluated owing to scanty biopsies. All resected specimens were caudocranially coiled and cryostat cut at -20 degrees C into serial sections, which were stained with a lactic dehydrogenase, succinic dehydrogenase, nitroxide synthase, and acetylcholinesterase reaction as well as hemalum and sirius red. Ten low, 15 intermediate, and 10 high forms of anal atresia (AA) were studied. In addition, six cloacal abnormalities were investigated. In 7 cases (17%) (5 intermediate, 2 low AAs), the characteristics of Hirschsprung's disease were observed. Oligoneuronal hypoganglionosis of the myenteric plexus proximal to the anal floor was diagnosed in 7 AAs (12%). In 10 children with high-type AA and resection of 1-5 cm distal rectum and in all cloacal anomalies (n = 6) defects of the muscularis propria were seen in the rectal-atresia sac. These defects were characterized by hypoplasia of the circular-muscle layer and/or the internal anal sphincter (IAS). Intestinal neuronal dysplasia of the submucous plexus was most frequently observed (12%) in high-type AA. A correlation between innervation anomalies or anomalies of the muscularis propria and the type of fistula could not be seen. In conclusion, all cases with high-type AA and cloacal anomalies were characterized by anomalies of the muscularis propria and/or IAS but this was not the case in intermediate and low-type AAs. Anomalies of the enteric nervous system were diagnosed in 60% of AAs.

  8. Mandibular second premolar with three canals: Re-treatment of a case with unusual root canal anatomy

    Directory of Open Access Journals (Sweden)

    Niranjan Desai

    2011-01-01

    Full Text Available A thorough knowledge of root canal anatomy along with the anatomical variations that may be present is essential for success of endodontic therapy. Unusual presentations in the number of the roots or the canals should be expected in every tooth. Mandibular second premolars are thought of as having a single root and canal. Studies have stated that the prevalence of three canals with three orifices in this tooth is 0.4%. The mandibular second premolar is particularly difficult to treat owing to the fact that a wide variation in the number, location and curvature of the roots and canals exist. Added to this is the fact that the access opening is restricted and location of the lingually placed orifices is difficult. This case report details the re-treatment of a mandibular second premolar with three canals and three separate orifices using the surgical microscope.

  9. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...... main questions but one. Two questions needed further explanation. Seven women made minor errors. Conclusion. The validated Danish questionnaire has a good construct, content and face validity. It is a well accepted, reliable, simple and clinically relevant screening tool. It reveals physical problems...

  10. Chronic anal fissure: common aetiopathogenesis, with special attention to sexual abuse.

    Science.gov (United States)

    Nzimbala, M J; Bruyninx, L; Pans, A; Martin, P; Herman, F

    2009-01-01

    Chronic anal fissures represent 15% of proctologic consultations, although their aetiopathogenesis is unclear and multifactorial. This study aims to identify the aetiopathogenesis, risk factor of recurrence after lateral subcutaneous internal anal sphincterotomy and existing correlation with sexual abuse, as sexual abuse accounts for over 21% of anal fissures. We retrospectively studied 80 cases of surgical (n = 54) and medical (n = 26) patients known with chronic anal fissure over eight months. We built an original questionnaire referring to the NorVold Abuse Questionnaire. Sixty cases were interviewed with only twenty filling the questionnaire themselves. Among the aetiological factors observed, as reported by these patients, we underlined chronic constipation 51 (64%), postoperative haemorrhoidectomy 15 (19%), sexual abuse 15 (19%), vaginal delivery and hysterectomy 10 (13%), traumatic anal sex 10 (13%), digital anal examination 4 (5%), anti-inflammatory non-steroid suppository 3 (4%), asthma with chronic cough 3 (4%). The recurrence rate reached 39% (31 cases, 13/26 (50%) in the medical group, against 18/54 (33%) in the surgical group. The 4/15 (27%) of sexual abuse happened in adulthood and 6/15 (40%) never disclosed this information. Sexual abuse is a significant aetiological factor of chronic anal fissures and it is to be suspected in cases of recurrence after anal sphincterotomy. For such cases, a multidisciplinary treatment is crucial to improve the prognosis of the disease. We recognise that the causality is difficult to prove and we cannot confirm that every sexually abused person could inevitably develop chronic anal fissure.

  11. Impact of canal water shortages on groundwater in the Lower Bari Doab Canal system in Pakistan

    International Nuclear Information System (INIS)

    Shakir, A.S.; Rehman, H.U.; Khan, N.M.; Qazi, A.U.

    2011-01-01

    This paper presents rigorous analysis of shortage of canal water supplies, crop water requirements, and groundwater use and its quality in the command of Lower Bari Doab Canal, Pakistan. The annual canal water supplies are 36% less than the crop water requirements. This shortage further increases to 56% if actual canal supplies (averaged over last ten years) are compared with the crop water requirement. The groundwater levels are depleting at the rate of 30 to 40 cm per year in most parts of the LBDC command and this tendency of lowering may increase in future due to further increase in crop water requirements. The analysis of data for the last seven years indicate that quality of groundwater in most parts of LBDC command is generally good (64% of the area) or marginally acceptable (28%) for irrigation use. However, declining trends in groundwater quality are visible and can create long term sustain ability problems if proper remedial actions are not taken well in time. (author)

  12. Revestimientos especiales para diques y canales

    Directory of Open Access Journals (Sweden)

    Zorzi, Silvano

    1964-11-01

    Full Text Available This paper summarizes the possibilities and advantages of adopting special facings for dykes and canals, and generally for all large hydraulic works, where waterproofing is of paramount importance. Technical advances in recent years have made it possible to prefabricate many facing units used in these types of works; large slabs, made in reinforced and prestressed concrete, are flexible, and watertight. Although there are many possibilities and types of facing treatments, the one described here is outstanding. It consists of narrow slabs, highly flexible, placed transversally with respect to the canal axis. They are attached with cement mortar, and the joints are finally sealed with a special mortar, called «Emboco». In this article a description is also given of a series of projects, where facing treatments have been used, which are now successfully in service. Finally some general and simple advise is given on the best procedure to apply these facing treatments in the most effective and economic manner.En este trabajo se resumen las posibilidades y ventajas que ofrecen los revestimientos especiales de diques y taludes de canales y, en general, en todas las grandes obras hidráulicas, en que la impermeabilización es de mayor importancia al tratar de conservar los caudales iniciales o la retención de aguas embalsadas, según los casos. Los progresos de las técnicas modernas, en particular la prefabricación, han permitido este tipo de revestimientos con losas de gran longitud, extremadamente flexibles e impermeables, de hormigón armado y pretensado. Aunque son muchas las posibilidades y tipos de revestimiento, destaca el que a continuación se expone: consiste en placas o losas estrechas, de gran flexibilidad, colocadas transversalmente al eje del canal sobre tongadas de mortero de cemento, y cuyas juntas se sellan, finalmente, con un mortero especial llamado «Emboco». Complementan la exposición teórica del método una serie de

  13. Three distal root canals in mandibular first molar with different canal configurations: Report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    Parul Bansal

    2015-01-01

    Full Text Available With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of three distal canals in distal roots of mandibular first molar is rare. This article reports endodontic management of two mandibular first molars presented with three distal canals present in a single distal root (Sert and Bayirli type XVIII and distal and distolingual root.

  14. [Root canal filling materials (electron scanning microscope comparison of root canal adaptation to 3 endodontic filling products)].

    Science.gov (United States)

    Tollens, H

    1979-01-01

    The main characteristics required of a good endodontic fillingsmaterial are its perfectly hermetic sealing of the root canal, the eventual secondary canals, and the dentine canals, against bacteria. 48 root canals, sealed respectively with A H 26, Endomethazone and N 2, have been checked by means of the Scanning Electron Microscope in order to discover to what extent these products conform to the qualifications mentioned. 842 photographs have been taken. The results of the investigation are discussed judging from some photographs chosen at random.

  15. Water Environment Evolution along the China Grand Canal

    Science.gov (United States)

    Mao, F.; Wu, Y. X.; Yang, B. F.; Li, X. J.

    2014-03-01

    The China Grand Canal is one of the earliest canals in the world, having lasted for nearly 3000 years. Even its section canals have a rich history, such as the North-South Grand Canal that was established during the Sui Dynasty, whereas the Beijing-Hangzhou Canal was excavated during the Yuan Dynasty and the east line of the South-to-North Water Diversion. As one of the longest in the world, the China Grand Canal's total length is over 3500 kilometers. This length includes the navigable, unnavigable, and underground sections. Making the best use of situations and according to local conditions, the Chinese people harmoniously constructed the Beijing-Hangzhou Canal with nature. Tens of millions of workers took nearly 3000 years to complete the great shipping system. Navigable sections still exist for up to 900 kilometers and the volume of freight traffic is approximately 300 million tons. The canal remains the main logistical channel of the North-to-South Coal Transportation, South-to-North Water Diversion, and resources circulation. To date, China is promoting the success of heritage application. Part of these efforts is the declaration of the China Grand Canal as a World Cultural Heritage by 2014. In addition, the east route of the South-to-North Water Transfer project is planned to be navigable by 2016. The ancient Beijing-Hangzhou Grand Canal will usher in the new ecological civilization and cultural revival along the canal. This paper presents technical methods of water environment evolution research on the river system, river, and water quality along the Beijing-Hangzhou Canal through the integration of historical literature and modern remote sensing image data. The study carried out water environment investigation and analysis along the Beijing-Hangzhou canal by using ETM, SPOT image data, and GPS measurement data. Spatial and temporal evolution characteristics and regulations of the Beijing-Hangzhou Grand Canal regional water environment in the span of 3000

  16. Root canal morphology of South asian Indian mandibular premolar teeth.

    Science.gov (United States)

    Singh, Shishir; Pawar, Mansing

    2014-09-01

    The purpose of this study was to study the root canal morphology of South Asian Indian mandibular premolars using a tooth clearing technique. Two hundred mandibular premolar teeth were collected from different dental schools and clinics in India. After pulp tissue removal and root canal staining with Indian ink, the specimens were decalcified with 5% nitric acid, dehydrated in ethyl alcohol, and subsequently cleared in methyl salicylate. Of the 200 mandibular premolars, 100 were first premolars and 100 were second premolars. Of the first premolars, 94% had a single root, whereas 6% were 2 rooted. Seventy-six percent had a single canal, 22% had 2 canals, and 2% had 3 canals. Eighty-two percent had a single apical foramen, 16% had 2 foramens, and 2% teeth had 3 apical foramens. Eighty percent of teeth had type I, 6% had type II, 10% had type IV, 2% had type V, and 2% teeth had type IX root canal anatomy. Of the 100 second premolars, 92% had a single root, whereas 8% teeth were 2 rooted and fused. Fifty-eight percent of teeth had a single canal, and 42% had two canals. Eighty-eight percent had a single apical foramen, and 12% had 2 foramens. Sixty-six percent had type I, 30% had type II, and 4% had type V root canal anatomy. A high prevalence of 2 canals was noted in the first and second premolars. Also, 20% of first premolars and 34% of second premolars had a root canal anatomy other than type I. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. Root canal filling evaluation using optical coherence tomography

    Science.gov (United States)

    Negrutiu, Meda L.; Sinescu, Cosmin; Topala, Florin; Nica, Luminita; Ionita, Ciprian; Marcauteanu, Corina; Goguta, Luciana; Bradu, Adrian; Dobre, George; Rominu, Mihai; Podoleanu, Adrian Gh.

    2010-04-01

    Endodontic therapy consists in cleaning and shaping the root canal system, removing organic debris and sealing the intra-canal space with permanent filling materials. The purpose of this study was to evaluate various root canal fillings in order to detect material defects, the marginal adaptation at the root canal walls and to assess the quality of the apical sealing. 21 extracted single-root canal human teeth were selected for this study. We instrumented all roots using NiTi rotary instruments. All canals were enlarged with a 6% taper size 30 GT instrument, 0,5 mm from the anatomical apex. The root canals were irrigated with 5% sodium hypochlorite, followed by 17% ethylenediaminetetraacetic acid (EDTA). After the instrumentation was completed, the root canals were obturated using a thermoplasticizable polymer of polyesters. In order to assess the defects inside the filling material and the marginal fit to the root canal walls, the conebeam micro-computed tomography (CBμCT) was used first. After the CBμCT investigation, time domain optical coherence tomography working in en face mode (TDefOCT) was employed to evaluate the previous samples. The TDefOCT system was working at 1300 nm and was doubled by a confocal channel at 970 nm. The results obtained by CBμCT revealed no visible defects inside the root-canal fillings and at the interfaces with the root-canal walls. TDefOCT investigations permit to visualize a more complex stratificated structure at the interface filling material/dental hard tissue and in the apical region.

  18. Root canal treatment of mandibular second premolar tooth with taurodontism

    Directory of Open Access Journals (Sweden)

    Vujašković Mirjana

    2008-01-01

    Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

  19. File list: Unc.CDV.50.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. Anal phyllodes tumor in a male patient: a unique case presentation and literature review.

    Science.gov (United States)

    Ho, Szu-pei; Tseng, Hui-hwa; King, T M; Chow, Philip-C

    2013-03-26

    Lesions of anogenital mammary-like glands are rare, and only 44 female cases have been reported. Herein, we describe a particularly rare case of phyllodes tumor of anogenital mammary-like glands in a 41-year-old male presenting anal bleeding. Papillectomy was performed. The excised tumor was circumscribed in shape, and after it was sliced into sections, it was noted that there were leaf-like slits on the surface of cut side. Under the microscope, the tumor was found to be biphasic, with a bland glandular epithelium and low-to-intermediate cellular stroma, which together created the leaf-like slits. Gynecomastoid hyperplasia was evident at the periphery. The epithelium showed immuno-activity for ER, PR(focal), AR, and GCDFP-15. The stromal cells showed positive staining for CD34 and vimentin. The morphology and immunophenotype were similar to benign phyllodes tumors of breast. To the best of our knowledge, this case report represents the first case of phyllodes tumor of anogenital mammary-like glands with gynecomastoid hyperplasia at the periphery in a male patient. To make a diagnosis, we had to differentiate this lesion from hidradenoma papilliferum of skin appendage, phyllodes tumor of ectopic prostatic tissue, and other tumors of anogenital mammary-like glands analogous to the breast tumor (e.g., fibroadenoma phyllodes, periductal stromal sarcoma, and spindle cell carcinoma). While gynecomastia of male breast is usually a result of hormone imbalance, our patient's tumor did not seem to be related to peripheral hormone status in the anogenital mammary-like glands. Nevertheless, because hormone imbalance has been strongly related to male breast cancer, hormone levels may need to be followed in male patients who have this rare malady. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1509145815899177.

  16. Long-standing Crohn's disease and its implication on anal squamous cell cancer management.

    Science.gov (United States)

    Lightner, Amy L; Moncrief, Sara B; Smyrk, Thomas C; Pemberton, John H; Haddock, Michael G; Larson, David W; Dozois, Eric J; Mathis, Kellie L

    2017-05-01

    Anal squamous cell carcinoma (ASCC) is rare, accounting for only 1% of gastrointestinal malignancies. We sought to better understand management strategies for ASCC in the setting of Crohn's disease (CD). A retrospective chart review from 2001 to 2016 was conducted using ICD-9/10 codes for CD (555.9/K50) and ASCC (154.3/C44.520). Adult patients with a diagnosis of CD at the time of ASCC diagnosis were included. Seven patients (five female) were included with a median age of 50 years. The majority presented with perianal pain (three) and bleeding (four). Mean duration of CD was 20 years. Five patients had active perianal fistulizing disease at the time of ASCC diagnosis. Clinical stage at diagnosis of ASCC was stage 0 (n = 1), stage I (n = 1), stage II (n = 1), stage III (n = 2), stage IV (n = 1), and unknown (n = 1). All patients were treated with radiation and chemotherapy. Three patients experienced complications during radiation therapy: fistulizing disease, stenotic disease, and flap necrosis. Two patients had persistent disease at 6 months; one patient underwent abdominoperineal resection (APR) and the other chemotherapy and radiation. Two patients developed locally residual and metastatic disease and died within 1 year of diagnosis. Five-year disease-free survival was 56%. While the standard Nigro protocol remains standard of care in patients with ASCC, in the setting of CD, patients may be best approached as a case-by-case basis and may even require an operation first due to complications from radiation and aggressive nature of disease. Due to poor treatment outcomes, surveillance guidelines for this patient population are necessary.

  17. Direct appositional (no flap) closure of deep anal fistula.

    Science.gov (United States)

    Thomson, W H F; Fowler, A L

    2004-01-01

    After sphincter-sparing core fistulectomy for deep anal fistula most surgeons advance a rectal mucosal flap to reinforce closure of the internal opening. Our own method having for many years been simple appositional closure the resulting series presented an opportunity for comparison. From November 1987 to January 2001, 44 patients underwent 46 core fistulectomies with flap-less direct appositional closure in our unit. Records were kept prospectively. Twenty-six fistulae (in 28 patients) appeared healed at two to five months follow-up and the patients had been discharged. A full review was mounted in May 2001, when 16 of the healed patients could be contacted and questionnaires completed. Two patients were excluded from the study. The procedure failed in 16 patients initially and was found to have done so in two more at long-term follow-up (41% overall). Three patients had died and five could not be traced. Simple appositional closure after core fistulectomy for deep anal fistula seems inferior to methods using flap reinforcement.

  18. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

    Directory of Open Access Journals (Sweden)

    Alice Capobiango

    2009-12-01

    Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

  19. Protruded superficial esophageal carcinoma

    International Nuclear Information System (INIS)

    Yamada, Akiyoshi; Satoh, Yuichi; Sugiyama, Akinori

    1986-01-01

    Until the end of 1985, 113 cases of superficial esophageal carcinoma had been operated on. Classified by histology, almost all cases are squamous cell carcinoma and some cases are pseudocarcinoma, adenocarcinoma, adenoid cystic carcinoma, basal cell carcinoma and so on. X-ray of the latter shows all cases except one are protruded type. Regarding the relation between X-ray findings and histology, semipeduncular tumorous type, generally speaking, belongs to pseudosarcoma. As to lymph node metastasis, there is no difference among superficial elevated, tumorous elevated and semi-peduncular tumorous types. Lymph node metastasis is less freqently seen in the cases with smooth surface. With regard to prognosis, there is no difference between early carcinoma without lymph node metastasis and superficial carcinoma with lymph node metastasis. Only two-year and more than 7-year survival rates of the one with smooth surface are superior to those of the one with irregular surface. (author)

  20. 55 HIV/AIDS, SURGICAL COMPLICATIONS AND CHALLENGES ...

    African Journals Online (AJOL)

    drclement

    HIV positive patient. The commonest anal neoplasms are squamous carcinoma of the anal canal, Kaposi sarcoma and non-Hodgkin's lymphoma. Fecal incontinence this is commonly encountered in those engaged in anoreceptive sex. ACUTE ABDOMEN. • Appendicitis – CMV, Kaposi sarcoma are common causes. Usually.

  1. Single-rooted maxillary first molar with a single canal: endodontic retreatment.

    Science.gov (United States)

    de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

    2008-12-01

    This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

  2. Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals

    OpenAIRE

    Shim, Dae Bo; Song, Chang Eun; Jung, Eun Jung; Ko, Kyung Min; Park, Jin Woo; Song, Mee Hyun

    2014-01-01

    Background and Objectives Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Materials and Methods Retrospective analysis was performed on 1054 co...

  3. New Technologies to Improve Root Canal Disinfection.

    Science.gov (United States)

    Plotino, Gianluca; Cortese, Teresa; Grande, Nicola M; Leonardi, Denise P; Di Giorgio, Gianni; Testarelli, Luca; Gambarini, Gianluca

    2016-01-01

    Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice.

  4. Birthing postures and birth canal lacerations.

    Science.gov (United States)

    Suzuki, Shunji

    2017-05-01

    This study was performed to assess the differences in the birth canal lacerations following the lateral and fours posture deliveries compared with those following the supine posture deliveries. We examined the birth canal lacerations of our "low risk" pregnant women under the midwife-led delivery care at Japanese Red Cross Katsushika Maternity Hospital between April 2006 and March 2015. There were 3826, 1754 and 719 women who delivered with supine, lateral and fours postures. The rate of no laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.630, 95% CI 0.56-0.71, p < 0.01); however, the incidence of perineal laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.856, 95% CI 0.76-0.90, p < 0.01). The incidence of perineal laceration of third- or fourth-degree in the women who delivered with fours posture was significant higher than that in the women who delivered with supine posture (OR 2.28, 95% CI 1.2-4.2, p < 0.01). The current results may be to help for self-determination of birthing postures in prenatal women.

  5. Visibility of the central canal on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Petit-Lacour, M.C.; Lasjaunias, P.; Iffenecker, C.; Benoudiba, F.; Hadj Rabia, M.; Doyon, D. [Service de Neuroradiologie, Faculte de Paris Sud (France); Hurth, M. [Department of Neurosurgery, Faculte Paris Sud, Kremlin-Bicetre (France)

    2000-10-01

    The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persiste partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral {sup 1}/{sub 3} and dorsal {sup 2}/{sub 3} of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up. (orig.)

  6. Visibility of the central canal on MRI

    International Nuclear Information System (INIS)

    Petit-Lacour, M.C.; Lasjaunias, P.; Iffenecker, C.; Benoudiba, F.; Hadj Rabia, M.; Doyon, D.; Hurth, M.

    2000-01-01

    The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persiste partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral 1 / 3 and dorsal 2 / 3 of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up. (orig.)

  7. 33 CFR 117.181 - Oakland Inner Harbor Tidal Canal.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Oakland Inner Harbor Tidal Canal. 117.181 Section 117.181 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Tidal Canal. The draws of the Alameda County highway drawbridges at Park Street, mile 5.2; Fruitvale...

  8. Scanning electron microscopic evaluation of root canal surfaces ...

    African Journals Online (AJOL)

    2014-07-15

    Jul 15, 2014 ... Hema, et al.: SEM Evaluation of root canal. 131. Nigerian Journal of Clinical Practice • Jan-Feb 2015 • Vol 18 • Issue 1 curvature during enlargement are the main objectives of root canal ... developed from nickel‑titanium (Ni‑Ti) alloys has brought ..... Glossen CR, Haller RH, Dove SB, del Rio CE.

  9. The Effect of Canal Contamination with Saliva on Apical Sealing

    Directory of Open Access Journals (Sweden)

    S Sabaghi

    2014-08-01

    Full Text Available Introduction: Root canal obturation aims at sealing the root canal system to prevent re-contamination of canal and periapical space. Presence of moisture in canal before obturation may posit a negative effect on the quality of canal sealing. Therefore, this study was conducted to investigate the effect of canal contamination with saliva on apical microleakage. Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

  10. Optimizing the chemical aspect of root canal irrigation

    NARCIS (Netherlands)

    de Macedo, R.G.

    2013-01-01

    Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that

  11. Reform in Indian canal irrigation: does technology matter?

    NARCIS (Netherlands)

    Narain, V.

    2008-01-01

    This paper examines the implications of technology - the design of canal irrigation for irrigation management reform. With reference to two different design systems in Indian irrigation - shejpali and warabandi - it shows that the potential for reform varies with the design of canal irrigation.

  12. 33 CFR 117.769 - Black Rock Canal.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Black Rock Canal. 117.769 Section 117.769 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.769 Black Rock Canal. The draws of the...

  13. Lumbar Vertebral Canal Diameters in Adult Ugandan Skeletons ...

    African Journals Online (AJOL)

    The midsagittal, transverse diameters of the lumbar vertebral canal and the anteroposterior diameter of the inferior vertebral notch were measured using an electronic digital caliper. Collected data was analyzed using SPSS 12.0 computer program. Results and discussion: In both sexes, the midsagittal diameter of the canal ...

  14. Molecular mechanisms of canalization: Hsp90 and beyond

    Indian Academy of Sciences (India)

    Madhu Sudhan

    2007-03-26

    Mar 26, 2007 ... Critics have argued that the novel fly phenotypes often affected the body plan unilaterally and were likely to decrease fitness severely. Moreover, concerns were raised that an. “evolvability” mechanism providing ..... canalization mechanism will certainly aid our search for other canalization mechanisms and ...

  15. Snail abundance in freshwater canals in the eastern province of ...

    African Journals Online (AJOL)

    The present study aimed to investigate the distribution of three species of freshwater snails, namely; Biomphalaria Arabica; Planorbidae, Lymnaea auricularia; Lymnaeidae and Melanoides tuberculatus; Thiaridae in two different parallel canals (the concrete irrigation and the earthen drainage canals) in the eastern province ...

  16. 76 FR 26182 - Drawbridge Operation Regulations; Hood Canal, WA

    Science.gov (United States)

    2011-05-06

    ... temporary deviation from the regulation governing the operation of the Hood Canal floating drawbridge near... Washington State Legislature have requested that the operating regulations of the Hood Canal Bridge be... south of the eastern end of the bridge can be long during and after openings of the drawspan. The...

  17. Improvement on the Performance of Canal Network and Method of ...

    African Journals Online (AJOL)

    This paper presents the required improvement on the performance of canal network and method of on-farm water application systems at Tunga-Kawo irrigation scheme, Wushishi, Niger state. The problems of poor delivery of water to the farmland were identified to include erosion of canal embarkment, lack of water ...

  18. GEOPOLITICS AND TRANSPORTATION. UNITED STATES AND PANAMA CANAL

    Directory of Open Access Journals (Sweden)

    Benea Ciprian Beniamin

    2009-05-01

    Full Text Available This article presents the great connection which exists between the realization of Panama Canal and the rising power on United States; and how this state, after the construction of this canal, could promote efficiently at global level its interests.

  19. Endodontic management of mandibular canine with two canals

    Directory of Open Access Journals (Sweden)

    Nidhi Shrivastava

    2013-01-01

    Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment procedures. Many investigators have reported the anatomical variations associated with mandibular canines. Mandibular canines are recognized as usually having one root and one root canal in most cases. This case report describes a clinical case of mandibular canine with two canals. Human mandibular canines do not present internal anatomy as simple as could be expected; there are such canines with a single root and two canals, two roots or fused roots. The existence of mandibular canines with more than one root canal is a fact that clinicians ought to keep in mind, in order to avoid failure during endodontic treatment. In spite of the low incidence of lower canines with one root and two canals, this possibility cannot be forgotten, inasmuch as the presence of a second canal in these teeth leads to difficulties in endodontic treatment. The precise knowledge of the dental endocanalicular system′s anatomy is essential in the success of the root canal therapy, because the failure to detect the accessories canals and the incomplete radicular obturation leads to the infection of the periapical space, which will ultimately result in the loss of the tooth.

  20. Evaluation of Various Filling Techniques in Distal Canals of ...

    African Journals Online (AJOL)

    2017-03-06

    Mar 6, 2017 ... treatment.[10] The percentage of GP-filled areas (PGFAs) has been used as a measure of the quality of the root filling.[7] Therefore, the aim of this study was to compare different filling techniques in the distal canals of lower molars, instrumented by different single-file systems, and the canal area in terms of ...

  1. Optimizing Indicator Choosing for Canal Control System and Simulation Study

    Science.gov (United States)

    One Key problem for canal system control is how to select appropriate performance indicators and how to tune the controller with these indicators. A canal system is a multi-input and multi-output (MIMO) system. The judging of control performance can be extremely complicated. In this paper, frequentl...

  2. Morphology of root canals in lower human premolars | Baroudi ...

    African Journals Online (AJOL)

    Background The knowledge of the root canal morphology and the possible anatomical variations of mandibular premolars are important for the successful endodontic treatment of such cases. The aim of this study was to investigate the presence of two or three root canals in extracted first and second mandibular premolars ...

  3. Cervical invasion of endometrial carcinoma - evaluation by parasagittal MR imaging

    International Nuclear Information System (INIS)

    Murakami, T.; Kurachi, H.; Nakamura, H.; Tsuda, K.; Miyake, A.; Tomoda, K.; Hori, S.; Kozuka, T.

    1995-01-01

    Twenty-seven consecutive patients were examined by T2-(1800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma. (orig.)

  4. Vulvar sweat gland carcinomas.

    Science.gov (United States)

    Wick, M R; Goellner, J R; Wolfe, J T; Su, W P

    1985-01-01

    Sweat gland carcinomas constitute less than 10% of all malignant tumors of the vulva, including those associated with extramammary Paget's disease (EPD). The histopathologic diagnosis of vulvar sweat gland carcinomas is difficult because of their rarity; their resemblance to metastatic carcinomas of the internal female genitalia, kidneys, and other sites; and their diversity of microscopic appearances. We report five examples of vulvar sweat gland carcinomas, two of which were associated with EPD. The other tumors included one example each of ductal eccrine adenocarcinoma, eccrine porocarcinoma, and clear cell hidradenocarcinoma. The clinical behavior of these neoplasms is correlated with their histologic types; we also discuss differential diagnosis and treatment recommendations.

  5. Carcinoma basocelular gigante

    OpenAIRE

    Nasser, Nilton; Nasser Filho, Nilton; Trauczynski Neto, Bruno; Silva, Lissandra Melati da

    2012-01-01

    The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no s...

  6. Primary cutaneous myoepithelial carcinoma

    DEFF Research Database (Denmark)

    Frost, Markus Winther; Steiniche, Torben; Damsgaard, Tine Engberg

    2014-01-01

    This study describes a case of primary myoepithelial carcinoma of the skin and reviews the available literature on this topic. Myoepitheliomas and carcinomas arise most frequently from myoepithelial cells within the salivary glands but are found in many anatomical locations. We documented a case...... literature search identified 23 papers that reported 58 cases of cutaneous myoepitheliomas and myoepithelial carcinomas. All cases are reviewed in the presented paper. This case report and literature review serves to increase awareness regarding myoepithelial carcinomas. These tumours exhibit high metastatic...

  7. Embryonic development of the alimentary canal of the scorpionfly Panorpa obtusa Cheng (Mecoptera: Panorpidae).

    Science.gov (United States)

    Yue, Chao; Hua, Baozhen

    2013-05-01

    The embryonic origin of the alimentary canal, especially the midgut, is a controversial problem in insects, and it has not been satisfactorily resolved to date. The organogenesis of the digestive system in the embryonic development was observed in the scorpionfly Panorpa obtusa Cheng using light, transmission, and scanning electron microscopy. The embryonic development lasts about 150-160 h at 24°C. The stomodaeum is formed from an invagination in the medioposterior portion of the protocephalon mid-ventrally posterior to the labral segment at 76 h after oviposition. The proctodaeum arises as an invagination from the caudal end of the abdomen at 78 h. Four anal forks are formed from within the opening of proctodaeum. Three pairs of proctodaeal evaginations are formed from the anterior part of the proctodaeum, and eventually developing into Malpighian tubules, thus are of ectodermal origin. The cardiac and pyloric valves develop from stomodaeum and proctodaeum, respectively, and also of ectodermal origin. The midgut epithelium originates from anterior and posterior midgut rudiments in blind ends of the stomodaeum and proctodaeum, and it is of endodermal origin. The two cell-bands (rudiments) cover the yolk ventrally and then dorsally, elongate to each other, and eventually fuse to form the midgut. The midgut formation pattern is briefly discussed in different insects. Copyright © 2013 Wiley Periodicals, Inc.

  8. High-Dose Split-Course Radiation Therapy for Anal Cancer: Outcome Analysis Regarding the Boost Strategy (CORS-03 Study)

    International Nuclear Information System (INIS)

    Hannoun-Levi, Jean-Michel; Ortholan, Cecile; Resbeut, Michel; Teissier, Eric; Ronchin, Philippe; Cowen, Didier; Zaccariotto, Audrey; Benezery, Karen; Francois, Eric; Salem, Naji; Ellis, Steve; Azria, David; Gerard, Jean-Pierre

    2011-01-01

    Purpose: To retrospectively assess the clinical outcome in anal cancer patients treated with split-course radiation therapy and boosted through external-beam radiation therapy (EBRT) or brachytherapy (BCT). Methods and Materials: From January 2000 to December 2004, a selected group (162 patients) with invasive nonmetastatic anal squamous cell carcinoma was studied. Tumor staging reported was T1 = 31 patients (19%), T2 = 77 patients (48%), T3 = 42 patients (26%), and T4= 12 patients (7%). Lymph node status was N0-1 (86%) and N2-3 (14%). Patients underwent a first course of EBRT: mean dose 45.1 Gy (range, 39.5-50) followed by a boost: mean dose 17.9 Gy (range, 8-25) using EBRT (76 patients, 47%) or BCT (86 patients, 53%). All characteristics of patients and tumors were well balanced between the BCT and EBRT groups. Results: The mean overall treatment time (OTT) was 82 days (range, 45-143) and 67 days (range, 37-128) for the EBRT and BCT groups, respectively (p < 0.001). The median follow-up was 62 months (range, 2-108). The 5-year cumulative rate of local recurrence (CRLR) was 21%. In the univariate analysis, the prognostic factors for CRLR were as follows: T stage (T1-2 = 15% vs. T3-4 = 36%, p = 0.03), boost technique (BCT = 12% vs. EBRT = 33%, p = 0.002) and OTT (OTT <80 days = 14%, OTT ≥80 days = 34%, p = 0.005). In the multivariate analysis, BCT boost was the unique prognostic factor (hazard ratio = 0.62 (0.41-0.92). In the subgroup of patients with OTT <80 days, the 5-year CRLR was significantly increased with the BCT boost (BC = 9% vs. EBRT = 28%, p = 0.03). In the case of OTT ≥80 days, the 5-year CRLR was not affected by the boost technique (BCT = 29% vs. EBRT = 38%, p = 0.21). Conclusion: In anal cancer, when OTT is <80 days, BCT boost is superior to EBRT boost for CRLR. These results suggest investigating the benefit of BCT boost in prospective trials.

  9. Two cases of female hydrocele of the canal of nuck

    Directory of Open Access Journals (Sweden)

    Yu Mi Choi

    2012-04-01

    Full Text Available The processus vaginalis within the inguinal canal forms the canal of Nuck, which is a homolog of the processus vaginalis in women. Incomplete obliteration of the processus vaginalis causes indirect inguinal hernia or hydrocele of the canal of Nuck, a very rare condition in women. Here, we report 2 cases of hydrocele of the canal of Nuck that were diagnosed with ultrasonography in both cases and magnetic resonance imaging in 1 case to confirm the sonographic diagnosis. High ligation and hydrocelectomy were conducted in both patients. In 1 patient, 14 months later, the occurrence of contralateral inguinal hernia was suspected, but did not require surgery. The other patient had a history of surgery for left inguinal hernia 11 months before the occurrence of right hydrocele of the canal of Nuck. In both cases, the occurrence of an inguinal hernia on the contralateral side was noted.

  10. Hydrology and environmental aspects of Erie Canal (1817-99)

    Science.gov (United States)

    Langbein, Walter Basil

    1976-01-01

    As the first major water project in the United States, the old Erie Canal provides an example of the hydrological and environmental consequences of water development. The available record shows that the project aroused environmental fears that the canal might be impaired by the adverse hydrologic effects of land development induced by the canal. Water requirements proved greater than anticipated, and problems of floods and hydraulic inefficiencies beset navigation throughout its history. The Erie Canal proved the practicality of major hydraulic works to the extent that operations and maintenance could cope with the burdens of deficiencies in design. The weight of prior experience that upland streams, such as the Potomac and Mohawk Rivers, had proved unsatisfactory for dependable navigation, led to a decision to build an independent canal which freed the location from the constraints of river channels and made possible a cross-country water route directly to Lake Erie. The decision on dimensioning the canal prism--chiefly width and depth-involved balance between a fear of building too small and thus not achieving the economic potentials, and a fear of building too expensively. The constraints proved effective, and for the first part of its history the revenues collected were sufficient to repay all costs. So great was the economic advantage of the canal that the rising trend in traffic soon induced an enlargement of the canal cross section, based upon a new but riskier objective-build as large as the projected trend in toll revenues would finance. The increased revenues did not materialize. Water supplies were a primary concern for both the planners and the operators of the canal. Water required for lockage, although the most obvious to the planners, proved to be a relatively minor item compared with the amounts of water that were required to compensate for leakage through the bed and banks of the canal. Leakage amounted to about 8 inches of depth per day. The total

  11. Contribuciones a la automatización de diseños analógicos

    OpenAIRE

    Chávez Orzaez, Jorge Jesús

    1996-01-01

    La automatización del diseño analógico ha experimentado en los últimos años, un notable avance. La popularidad alcanzada por los circuitos ASICs, y la constatación de que la mayor parte de ellos contiene una importante circuitería analógica, son las causa

  12. [Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

    2014-11-01

    The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. Iodamoeba butschlii in an anal pap test confirmed by iodine stain.

    Science.gov (United States)

    Schuetz, Audrey N; Pritt, Bobbi S; Schreiner, Andrew M

    2014-09-01

    We report the finding of Iodamoeba butschlii amebic cysts on a liquid-based anal Pap smear from an HIV-positive male. Iodine staining of the smear confirmed the diagnosis. It is important to distinguish I. butschlii from pathogenic ameobae and other organisms seen on anal Pap smears. Copyright © 2013 Wiley Periodicals, Inc.

  14. Resisting the "Condom Every Time for Anal Sex" Health Education Message

    Science.gov (United States)

    Adams, Jeffery; Neville, Stephen

    2012-01-01

    Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were…

  15. HIV-positive MSM's knowledge of HPV and anal cancer self-sampling: A scoping review.

    Science.gov (United States)

    Poon, M K L; Wong, J P H; Li, A T W; Manuba, M; Bisignano, A; Owino, M; Vahabi, M

    2018-02-01

    Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases. Available research has also shown high prevalence of anal hpv infection among men who have sex with men (msm). However, hpv vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of hpv and anal cancer among hiv-positive msm and (2) the acceptability of hpv and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates ( n= 40) and unmet criteria ( n= 754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that hiv-positive msm have limited knowledge regarding the risks of anal cancer associated with hiv and hpv coinfection. Furthermore, there is limited research on hpv and anal cancer self-sampling in this population. However, the review of available studies suggested that hiv-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach hiv-positive msm regarding anal cancer education and self-screening.

  16. Invited Commentary: Biological and Clinical Insights From Epidemiologic Research Into HIV, HPV, and Anal Cancer

    Science.gov (United States)

    Engels, Eric A.; Madeleine, Margaret M.

    2013-01-01

    Anal cancer is common among people infected with human immunodeficiency virus (HIV). This cancer is caused by human papillomavirus, and immunosuppression likely contributes to its development. In this issue of the Journal, Bertisch et al. (Am J Epidemiol. 2013;178(6):877–884) present the results of a case-control study of anal cancer among HIV-infected people in Switzerland. They demonstrate that anal cancer risk is increased in association with a low CD4+ cell count (a clinical measurement of immune status). In particular, HIV-induced immunosuppression was most severe among cases approximately 6–7 years prior to the diagnosis of anal cancer. A plausible biological interpretation is that immunosuppression is important at an early stage of the development of anal cancer, but that the neoplastic process becomes irreversible over time with persistent human papillomavirus infection and genetic damage. With current efforts to provide earlier combination antiretroviral therapy to HIV-infected people, anal cancer incidence may start to decline. Bertisch et al. also demonstrate a strong association between serum antibodies against the human papillomavirus type 16 protein E6 and anal cancer risk, highlighting the role of this viral oncoprotein in carcinogenesis. Additional biomarkers could help refine clinical approaches to anal cancer screening and prevention for the HIV-infected population. PMID:23900552

  17. HPV and anal cancer in HIV-infected individuals: a review

    NARCIS (Netherlands)

    Schim van der Loeff, Maarten F.; Mooij, Sofie H.; Richel, Oliver; de Vries, Henry J. C.; Prins, Jan M.

    2014-01-01

    HIV infection is one of the strongest risk factors for anal squamous cell cancer (ASCC). Most ASCC are caused by HPV, and most HPV-associated ASCC are caused by HPV-16. Anal HPV infections are very common in men who have sex with men (MSM), and nearly universal among HIV-infected MSM. High-grade

  18. Diagnostic imaging features of normal anal sacs in dogs and cats.

    Science.gov (United States)

    Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo; Lee, Kichang

    2016-09-30

    This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions.

  19. Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence

    NARCIS (Netherlands)

    Terra, Maaike P.; Deutekom, Marije; Beets-Tan, Regina G. H.; Engel, Alexander F.; Janssen, Lucas W. M.; Boeckxstaens, Guy E. E.; Dobben, Annette C.; Baeten, Cor G. M. I.; de Priester, Jacobus A.; Bossuyt, Patrick M. M.; Stoker, Jaap

    2006-01-01

    PURPOSE: External anal sphincter atrophy at endoanal magnetic resonance imaging has been associated with poor outcome of anal sphincter repair. We studied the relationship between external anal sphincter atrophy on endoanal magnetic resonance imaging and clinical, functional, and anatomic

  20. Relationship between lower third molar and mandibular canal

    International Nuclear Information System (INIS)

    Itou, Masaki; Miyagishima, Toshio; Onizuka, Hiroyuki; Takagi, Norio.

    1994-01-01

    The mandibular canal is often closely related to the lower third molars. During the surgical removal of the third molar, the inferior alveolar nerve in the canal is sometimes damaged leading to impaired sensation in the lower lip. This is one of the most unpleasant postoperative complications. The buccolingual relationship between the lower third molar and the mandibular canal cannot be diagnosed by ortho-pantomography although preoperative evaluation must be carried out radiologically. In present study, the relationship was determined by using CT scan. Forty-seven lower third molars of 35 patients were evaluated preoperatively by CT scan. The mandibular canal of all cases overlapped with the third molar on ortho-pantomography. CT scan was taken in two ways. The first was the Tragion-Menton plane which was nearly parallel to the canal at the apex of the third molar. The second was the plane of the axis of the third molar. Axial CT scan was taken when the third molar erupted horizontally, and coronal CT scan was done when the molar erupted vertically. CT scan examination exactly revealed the position of the mandibular canal in relation to the root of the third molar. The canal was located buccally to the roots in 55 percent of cases, apicobuccally in 6 percent, apically in 23 percent, apicolingually in 6 percent, lingually in 2 percent, and between roots in 6 percent. The results of the present study were consistent with previous reports. In 12 cases, the inferior alveolar neurovascular bundle was visible during operation. It was visible in only 2 of 22 cases when the canal was located buccally. It was visible, on the other hand, in all cases in which the canal was located apicolingually, lingually, and between roots. It also tended to be visible when the canal overlapped more strongly with the third molar on preoperative ortho-pantomography. (author)