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Sample records for chronic anal fissures

  1. Anal fissure - series (image)

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    Anal fissures are tears in the skin overlying the anal sphincter, usually due to increased tone of the anal sphincter muscles, and a failure of these muscle to relax. Anal fissures cause pain during defecation and bleeding from the anus.

  2. Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging.

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    Erden, Ayşe; Peker, Elif; Gençtürk, Zeynep Bıyıklı

    2017-02-01

    OBJECTıVE: To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system. Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann-Whitney U test, and Spearman correlation. The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal. CONCLUSıON: 3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

  3. Recent Advances in the Pharmacotherapy of Chronic Anal Fissure: An Update

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    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.

  4. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

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    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

  5. Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa

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    Cassandra Chaptini, MBBS

    2015-12-01

    Full Text Available We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

  6. A COMPARATIVE STUDY OF LATERAL SPHINCTEROTOMY AND LOCAL APPLICATION OF 2% DILTIAZEM GEL IN TREATMENT OF CHRONIC ANAL FISSURE

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    Rajashekar

    2015-11-01

    Full Text Available BACKGROUND AND OBJECTIVES Anal fissures are commonly encountered in routine colorectal practice. Chronic fissures have traditionally been treated surgically. Developments in the pharmacological understanding of the internal anal sphincter have resulted in more conservative approaches towards treatment. In this study, we compare topical 2% Diltiazem gel and lateral internal sphincterotomy with respect to symptomatic relief, healing and side effects in the treatment of chronic fissure in ano. METHODS 60 patients with chronic fissure in ano were randomly divided into Diltiazem gel and internal sphincterotomy groups. Patients were followed up at weekly intervals for minimum of eight weeks. Data was recorded accordingly. RESULTS Fissure completely healed in 28(93.33% out of 30 patients treated with 2% Diltiazem gel between 4-8 weeks. Healing was 100% with internal sphincterotomy. The mean duration required for healing of fissure was 4.86 weeks in Diltiazem gel group and 3.66 weeks in internal sphincterotomy group. 61.5% patients were free from pain after treatment with Diltiazem gel whereas in internal sphicterotomy group 66.66% patients had pain relief at the end of 4 weeks. INTERPRETATION AND CONCLUSION Comparison between Diltiazem gel application and internal sphincterotomy did not show any significant difference in fissure healing and pain relief. No side effects were seen in Diltiazem gel therapy. Topical Diltiazem should be the initial treatment in chronic fissure in ano. It is better to reserve internal sphincterotomy for patients with relapse or therapeutic failure to prior pharmacological treatment.

  7. Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy.

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    Pascual, Marta; Pera, Miguel; Courtier, Ricard; Gil, Mariá José; Parés, David; Puig, Sonia; Andreu, Montserrat; Grande, Luis

    2007-08-01

    Anorectal pressure studies have demonstrated internal anal sphincter (IAS) hypertonia in patients with chronic anal fissure. It is unknown however, if these changes in IAS function are associated with any abnormality in sphincter morphology. The first aim was to investigate the clinical characteristics and the manometric and endosonographic findings of the IAS in a cohort of patients with chronic anal fissure. The second aim was to investigate the association between these findings and the outcome with topical Glyceryl trinitrate (GTN) therapy. All patients who presented with chronic anal fissure from November 1999 to May 2004 were included after failure of conservative therapy. Anorectal manometry and anal endosonography were performed before treatment with 0.2% GTN ointment twice daily was initiated. Patients were evaluated after 8 weeks. One hundred and twenty-four patients (66 women, mean age, 45.2 +/- 14.8 years) were included. Hypertonia of the IAS was found in 84 (68%) patients. The mean maximum IAS thickness was 3.6 +/- 0.76 mm (1.6-5.5). An abnormally thick IAS, adjusted by age, was observed in 113 (91.1%) patients. We found no correlation between resting pressure and IAS thickness (r = 0.074; p = 0.41). At 8 weeks, 52 patients (42%) had healed with complete symptoms resolution. No statistically significant differences were observed when clinical features and manometric and endosonographic findings were compared between healing and no-healing fissures. The majority of patients with chronic anal fissure present an abnormally thick IAS. Clinical, manometric and endosonographic features had no association with outcome after GTN treatment.

  8. Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomized study

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    Vivek Gupta

    2014-10-01

    Conclusion: Closed lateral internal sphincterotomy is the treatment of choice for chronic fissures as it is effective, safe, less expensive, and associated with a lower rate of complications than the open sphincterotomy technique.

  9. Stress and psychopathology and its impact on quality of life in chronic anal fissure (CAF) patients.

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    Arısoy, Özden; Şengül, Neriman; Çakir, Affan

    2017-06-01

    Chronic anal fissure (CAF) onset, exacerbation, and impact on quality of life are influenced by a host of psychological, physiological, and social factors. We aimed to investigate the difference in psychopathology and stress between normal and CAF groups. Thirty CAF patients and 20 age-sex matched healthy controls were evaluated for Axis I psychopathology, depression, anxiety, and stress with Hamilton and Hospital Depression-Anxiety Scales, Perceived Stress Scale, and SF-36. With a mean age of 39.47, 83.3% of CAF patients were female. Anxiety-depression and stress scores were all significantly higher and functionality was lower in the CAF group compared to controls (p psychopathology while 50% had a previous psychopathology. Pain (96.7% had pain (VAS = 6.55)) and bleeding (83.3% had bleeding (VAS = 4.14)) severity showed a negative impact on bodily pain and role limitations emotional subscales of SF36. There is a high comorbidity of psychopathology in the CAF patients and depression and anxiety severities show a negative impact on the quality of life. Stress acts as both a triggering and an exacerbating factor in CAF.

  10. Optimal Dosing of Botulinum Toxin for Treatment of Chronic Anal Fissure: A Systematic Review and Meta-Analysis.

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    Lin, Jin Xin; Krishna, Sanjeev; Su'a, Bruce; Hill, Andrew G

    2016-09-01

    Chronic anal fissures are associated with significant morbidity and reduced quality of life. Studies have investigated the efficacy of botulinum toxin with variable results; thus, there is currently no consensus on botulinum toxin dose or injection sites. This study aimed to systematically analyze trials studying the efficacy of botulinum toxin for treatment of chronic anal fissure to identify an optimum dosage and injection regimen. A comprehensive review of the literature was conducted according to PRISMA guidelines. PubMed/Medline, Embase, Scopus, and the Cochrane Library were searched from inception to June 2015. All clinical trials that investigated the efficacy of botulinum toxin for chronic anal fissure were selected according to specific criteria. The interventions used were various doses of botulinum toxin. Clinical outcomes, dosage, and injection site data were evaluated with weighted pooled results for each dosage and 95% confidence intervals. There were 1158 patients, with 661 in botulinum toxin treatment arms, from 18 clinical trials included in this review. The outcomes of interest were 3-month healing, incontinence, and recurrence rates. Meta-regression analysis demonstrated a small decrease in healing rate (0.34%; 95% CI, 0-0.68; p = 0.048) with each increase in dosage, a small increase in incontinence rate (1.02 times; 95% CI, 1.0002-1.049; p = 0.048) with each increase in dosage and a small increase in recurrence rate (1.037 times; 95% CI, 1.018-1.057; p = 0.0002) with each increase in dosage. The optimum injection site could not be determined. This study was limited by weaknesses in the underlying evidence, such as variable quality, short follow-up, and a limited range of doses represented. Fissure healing with lower doses of botulinum toxin is as effective as with high doses. Lower doses also reduce the risk of incontinence and recurrence in the long term.

  11. Isosorbide dinitrate ointment vs botulinum toxin A (Dysport®) as the primary treatment for chronic anal fissure: a randomized multicentre study

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    Berkel, A.E.M.; Rosman, C.; Koop, R.; van Duijvendijk, P.; van der Palen, Jacobus Adrianus Maria; Klaase, J.M.

    2014-01-01

    Aim Nitric oxide donors, such as isosorbide dinitrate ointment (ISDN), are considered as first-choice agents in the treatment of chronic anal fissure. Injection with botulinum toxin A in the internal anal sphincter is often used as a second-line therapy, although it may give better results and fewer

  12. Long-term outcomes of Botulinum toxin in the treatment of chronic anal fissure: 5 years of follow-up.

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    Barbeiro, Sandra; Atalaia-Martins, Catarina; Marcos, Pedro; Gonçalves, Cláudia; Canhoto, Manuela; Arroja, Bruno; Silva, Filipe; Cotrim, Isabel; Eliseu, Liliana; Santos, Antonieta; Vasconcelos, Helena

    2017-03-01

    Chronic anal fissure is a frequent and disabling disease, often affecting young adults. Botulinum toxin and lateral internal sphincterotomy are the main therapeutic options for refractory cases. Botulinum toxin is minimally invasive and safer compared with surgery, which carries a difficult post-operative recovery and fecal incontinence risk. The long-term efficacy of Botulinum toxin is not well known. The aim of this study was to evaluate the long-term efficacy and safety of Botulinum toxin in the treatment of chronic anal fissure. This was a retrospective study at a single center, including patients treated with Botulinum toxin from 2005 to 2010, followed over at least a period of 5 years. All patients were treated with injection of 25U of Botulinum toxin in the intersphincteric groove. The response was registered as complete, partial, refractory and relapse. Botulinum toxin was administered to 126 patients, 69.8% ( n  = 88) were followed over a period of 5 years. After 3 months, 46.6% ( n  = 41) had complete response, 23.9% ( n  = 21) had partial response and 29.5% ( n  = 26) were refractory. Relapse was observed in 1.2% ( n  = 1) at 6 months, 11.4% ( n  = 10) at 1 year, 2.3% ( n  = 2) at 3 years; no relapse at 5 years. The overall success rate was 64.8% at 5 years of follow-up. Botulinum toxin was well tolerated by all patients and there were no complications. The use of Botulinum toxin to treat patients with chronic anal fissure was safe and effective in long-term follow-up.

  13. Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy

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    Silvana Marques e Silva

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS. METHODS: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. RESULTS: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. CONCLUSION: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.OBJETIVO: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. MÉTODOS: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame físico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. RESULTADOS: Todas as pacientes

  14. Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial.

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    Renzi, Adolfo; Izzo, Domenico; Di Sarno, Giandomenico; Talento, Pasquale; Torelli, Francesco; Izzo, Giuseppe; Di Martino, Natale

    2008-01-01

    This prospective, randomized, controlled trial was designed to compare the clinical, functional, and morphologic results of pneumatic balloon dilatation with lateral internal sphincterotomy for the treatment of chronic anal fissure. All patients with symptomatic chronic anal fissure were randomly assigned to pneumatic balloon dilatation or lateral internal sphincterotomy and invited to complete a standardized questionnaire inquiring about their symptoms. Anal ultrasonography and anal manometry were performed before and six months after surgery. A proctologic examination was performed between the fifth and sixth postoperative weeks. Anal continence, scored by using a validated continence grading scale, was evaluated preoperatively at 1 and 6 weeks and at 12 and 24 months. Fifty-three patients, who satisfied selection criteria, were enrolled in the trial. Four patients (7.5 percent) were lost to follow-up. Twenty-four patients (11 males; mean age, 42 +/- 8.2 years) underwent pneumatic balloon dilatation and 25 patients (10 males; mean age, 44 +/- 7.3 years) underwent lateral internal sphincterotomy. Fissure-healing rates were 83.3 percent in the pneumatic balloon dilatation and 92 percent in the lateral internal sphincterotomy group. Recurrent anal fissure was observed in one patient (4 percent) after lateral internal sphincterotomy. At anal manometry, mean resting pressure decrements obtained after pneumatic balloon dilatation and lateral internal sphincterotomy were 30.5 and 34.3 percent, respectively. After pneumatic balloon dilatation, anal ultrasonography did not show any significant sphincter damage. At 24-month follow-up, the incidence of incontinence, irrespective of severity, was 0 percent in the pneumatic balloon dilatation group and 16 percent in the lateral internal sphincterotomy group (P < 0.0001). As lateral internal sphincterotomy, pneumatic balloon dilatation grants a high anal fissure-healing rate but with a statistically significant reduction in

  15. Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study

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    Abdulwahid M. Salih

    2017-03-01

    Conclusion: lateral sphincterotomy for internal anal sphincter, along, is the procedure of choice for management of CAF because it is effective and it can cure the disease in nearly all patients with good patient satisfaction.

  16. Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

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    Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

    2002-04-01

    Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

  17. Retalhos de avanço no tratamento da fissura anal crônica: experiência inicial Advancement flap in the treatment of chronic anal fissure: inicial experience

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    Maria Auxiliadora Prolungatti Cesar

    2009-12-01

    Full Text Available A fissura anal é uma laceração do canal anal relacionada ao trauma, hipertonia esfincteriana e isquemia. A maioria cicatriza espontaneamente ou com tratamento conservador, e poucas requerem tratamento cirúrgico. O objetivo deste trabalho é verificar os resultados clínicos e alterações manométricas de pacientes submetidos ao tratamento cirúrgico da fissura anal com avançamento de retalhos em v-y. Métodos: Estudo prospectivo, realizado nos anos de 2007, 2008 e 2009, que abrangeu nove pacientes portadores de fissura anal crônica submetidos ao avançamento de retalho anal. Foram avaliadas as pressões do canal anal ao repouso, contração e esforço evacuatório; no pré e pós-operatório. Resultados: Na amostra, todos os pacientes apresentaram hipertonia esfincteriana prévia. seis (66,6% obtiveram resolução total dos sintomas e das lesões. Um (11,11% sofreu deiscência parcial do retalho, sem sintomas clínicos; e outros dois (22,22%, infecção com perda dos mesmos e persistência da fissura. A análise manométrica das pressões de repouso, contração e evacuação nos grupos não mostrou alteração estatisticamente significativa (p>0,05, o que comprova que a cirurgia não incluiu manipulação dos esfíncteres. Conclusão: Os retalhos anais mostraram-se efetivos no tratamento da fissura anal, com cicatrização da lesão, sem que ocorram alterações nas pressões anais desses pacientes.The anal fissure is a laceration of the anal canal related to trauma, hypertonic sphincter and ischemia. The majority heals spontaneously or with conservative treatment and only a few requires surgical treatment. The objective of this study is to verify the clinical results and manometric alterations of patients submitted to the surgical treatment of the anal fissure with advance of v-y skin flaps. Methods: Prospective study, accomplished in 2007,2008 and 2009, in witch nine patients with chronic anal fissure were submitted to v-y advance. The

  18. Cutting Whole Length or Partial Length of Internal Anal Sphincter in Managementof Fissure in Ano

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    Furat Shani Aoda

    2017-12-01

    Full Text Available A chronic anal fissure is a common painful perianal condition.The main operative procedure to treat this painful condition is a lateral internal sphincteretomy (LIS.The aim of study is to compare the outcome and complications of closed LIS up to the dentate line (whole length of internal sphincter or up to the fissure apex (partial length of internal sphincter in the treatment of anal fissure.It is a prospective comparativestudy including 100 patients with chronic fissure in ano. All patients assigned to undergo closed LIS. Those patients were randomly divided into two groups: 50 patients underwent LIS to the level of dentate line (whole length and other 50 patients underwent LIS to the level of fissure apex (partial length. Patients were followed up weekly in the 1st month, twice monthly in the second month then monthly   for next 2 months and finally after 1 year. There was satisfactory relief of pain in all patients in both groups & complete healing of the fissure occurred. Regarding post operative incontinence no major degree of incontinence occur in both group but minor degree of incontinence persists In 7 patients after whole length LIS after one year. In conclusion, both whole length & partial length LIS associated with improvement of pain, good chance of healing but whole length LIS associated with more chance of long term  flatus incontinence. Hence,we recommend partial length LIS as treatment forchronic anal fissure.

  19. Avaliação do tratamento de fissura anal crônica com isossorbida tópica a 1% Evaluation of the treatment of chronic anal fissure with topical isosorbide 1%

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    Ana Carolina Lisboa Prudente

    2010-12-01

    Full Text Available INTRODUÇÃO: Fissuras anais crônicas são úlceras benignas, dolorosas, profundas. Ocorrem devido a trauma das fezes, hipertonia esfincteriana e pobre vascularização. Cirurgia é mais efetiva, porém com efeitos adversos (incontinência anal. Terapia conservadora consegue decréscimo transitório da pressão de repouso, cicatrizando muitas lesões, sem dano muscular. MÉTODOS: Objetivando avaliar tratamento de fissuras crônicas com isossorbida (ISO a 1% tópica, foi realizado um ensaio clínico, duplo-cego em pacientes do Serviço de Coloproctologia da Universidade Federal de Sergipe (UFS - Aracaju, Sergipe, durante um ano. Foram estudados 24 pacientes: 14 no Grupo 1 - creme com ISO, e 10 no Grupo 2 - placebo. Avaliaram-se comportamento da pressão de repouso, melhora da dor e grau de cicatrização das feridas com e sem ISO. RESULTADOS: Resultados mostraram que a fissura acometeu mais mulheres, a constipação foi observada em 58,3%. Quanto à dor, obteve-se menor intensidade no Grupo 2, mas sem significância. A cicatrização ao fim de 60 dias foi igual nos dois grupos (50%. Quanto às médias de pressão de repouso com 30 e 60 dias, houve queda no padrão em ambos os grupos, porém sem significância. Observou-se que pacientes curados foram os de maior redução de pressão de repouso. CONCLUSÃO: Concluiu-se que a ISO não modificou o padrão de resposta manométrica; todavia, houve melhora clínica importante nos dois grupos, cuja taxa de cicatrização foi equivalente.INTRODUCTION: Chronic anal fissures are deep, benign and painful ulcers. The involved factors are local trauma, sphinter hypertonia and poor blood flow. Surgery is gold standard treatment, but it causes fecal incontinence. Medical non-surgical therapy gets transitory resting pressure reduction and cure of lesions, without muscular damage. METHODS: In order to evaluate the treatment of chronic anal fissures using topical isossorbide (ISO 1%, a randomizated and double

  20. Hemorrhoids and anal fissures in inflammatory bowel disease.

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    D'Ugo, S; Stasi, E; Gaspari, A L; Sileri, P

    2015-12-01

    Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.

  1. Anorectal pain and irritation: anal fissure, levator syndrome, proctalgia fugax, and pruritus ani.

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    Vincent, C

    1999-03-01

    Anal fissures, proctalgia fugax, levator ani syndrome, and pruritus ani are common causes of anorectal pain and irritation. The clinician who obtains a thorough history and performs a complete examination can accurately diagnose these disorders. Ancillary tests seldom are helpful and rarely are necessary. Most patients suffering from these conditions readily respond to conservative therapy provided in the primary care practitioner's office.

  2. Anal Fissure

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  3. Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

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    Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok

    2009-03-01

    Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.

  4. Treatment of fissure in ano-revisited | Gupta | African Health Sciences

    African Journals Online (AJOL)

    Methods: This paper outlines a brief account of the present scenario of different techniques available for the treatment of chronic anal fissure. Conclusion: Medical manipulation of the internal sphincter should be a first-line treatment in anal fissure. When this fails or fissures recur, lateral subcutaneous internal sphincterotomy ...

  5. Water Stream in Bidet Toilet Commode as a Cause of Anterior Anal Fissure: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Pankaj Garg

    2017-03-01

    Full Text Available Background Water used as a single sharp stream in toilet commode for post defecation cleansing is a common practice in several countries across the globe including India. Repeated hitting of the anus by water stream could potentially cause injury to the anal canal epithelium and lead to development of fissure-in-ano. As the water stream is emanating from the backside of the toilet commode, the possible injury, if any, would be on the anterior anal canal. Objectives The present study aimed at determining whether water stream usage in toilet commodes increased the incidence of anterior fissure-in-ano; this was determined by the incidence of anterior fissure-in-ano the study and control groups. Methods All consecutive fissure-in-ano patients referring to a colorectal clinic from February 2012 to 2015 were included in the study. The patients were classified as a study group (who were using water stream for cleansing purposes in toilet commodes and a control group (patients who were not using water stream. The characteristics and location (position of the fissure-in-ano was noted. Results In this study, 165 patients were prospectively enrolled. Male/female ratio was 96/69, and the mean age was 36.3 ± 11.2 years. The anterior fissure-in-ano in the study group was 55.9% (47/84, while it was 17.3 % (14/81 in the control group (P < 0.0001, odds ratio: 6.08, 95% CI: 2.96 - 12.47]. Conclusions Water used as a single sharp stream to cleanse after defecation in toilet commodes is hazardous and should be avoided.

  6. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    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.

  7. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Science.gov (United States)

    García-Montes, M J; Argüelles-Arias, Federico; Jiménez-Contreras, S; Sánchez-Gey, S; Pellicer-Bautista, F; Herrerías-Gutiérrez, J M

    2010-01-01

    To assess the efficiency of endorectal ultrasound (ERUS) in the study of chronic idiopathic anal pain (CIAP). 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. 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). 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.

  8. [Acute anal pain].

    Science.gov (United States)

    Pittet, Olivier; Demartines, Nicolas; Hahnloser, Dieter

    2013-07-01

    Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically.

  9. The Safety and Efficacy of a Mixture of Honey, Olive Oil, and Beeswax for the Management of Hemorrhoids and Anal Fissure: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Noori S. Al-Waili

    2006-01-01

    Full Text Available We have found that a mixture of honey, olive oil, and beeswax was effective for treatment of diaper dermatitis, psoriasis, eczema, and skin fungal infection. The mixture has antibacterial properties. A prospective pilot study was conducted to evaluate the therapeutic effect of topical application of the mixture on patients with anal fissure or hemorrhoids.Fifteen consecutive patients, 13 males and 2 females, median age 45 years (range: 28–70, who presented with anal fissure (5 patients or first- to third-degree hemorrhoids (4 with first degree, 4 with second degree, and 2 with third degree, were treated with a 12-h application of a natural mixture containing honey, olive oil, and beeswax in ratio of 1:1:1(v/v/v. Bleeding, itching, edema, and erythema were measured using a scoring method: 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. The pain score was checked using a visual analog scale (minimum = 0, maximum = 10. Efficacy of treatment was assessed by comparing the symptoms' score before and after treatment; at weekly intervals for a maximum of 4 weeks. The patients were observed for evidence of any adverse effect such as appearance of new signs and symptoms, or worsening of the existing symptoms. The honey mixture significantly reduced bleeding and relieved itching in patients with hemorrhoids. Patients with anal fissure showed significant reduction in pain, bleeding, and itching after the treatment. No side effect was reported with use of the mixture. We conclude that a mixture of honey, olive oil, and beeswax is safe and clinically effective in the treatment of hemorrhoids and anal fissure, which paves the way for further randomized double blind studies.

  10. 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

  11. Natural Treatments for Fissure in Ano Used by Traditional Persian Scholars, Razi (Rhazes) and Ibn Sina (Avicenna).

    Science.gov (United States)

    Derakhshan, Ali Reza

    2016-06-08

    Most cases of chronic fissure do not respond to medical treatment. Razi and Ibn Sina were 2 of the best-known scientists of ancient Persia. The purpose of this study was to find out new scientific evidence in modern medicine about their recommendations, in order to find certain clues to conduct useful researches in the future. First, treatments of anal fissure mentioned by Razi and Ibn Sina were reviewed. Then, literature search was made in electronic databases including PubMed, Scopus, and Google Scholar. Management of anal fissure according to Razi's and Ibn Sina's practices is done based on 3 interventions: lifestyle modifications, drug treatments, and manual procedures. Almost all remedies suggested by Razi and Ibn Sina have shown their effects on fissure in ano via several mechanisms of action in many in vitro and in vivo studies; Still there is lack of human studies on the subject. © The Author(s) 2016.

  12. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial Efeito da pimenta vermelha nos sintomas de pacientes com fissuras anais agudas

    Directory of Open Access Journals (Sweden)

    Pravin J. Gupta

    2008-06-01

    Full Text Available BACKGROUND: Red-hot chili pepper and other spices have been blamed for causing or exacerbating symptoms of anal pathologies like anal fissure and hemorrhoids. AIM: To determine if consumption of chilies increases symptoms of acute anal fissures. METHODS: Individual patients were randomized to receive capsules containing chili or placebo for one week in addition to analgesics and fiber supplement. Patients were asked to note score for symptoms like pain, anal burning, and pruritus during the study period. After 1 week, cross over treatment was administered to the same group of patients with the same methodology and results were noted at the end of 2 weeks. RESULTS: Fifty subjects were recruited for this study. Forty three of them completed the trial (22 in the chili group and 21 in the placebo group. The daily mean pain score was significantly lower in the placebo group in the study period. Score 2.05 in chili group and 0.97 in placebo group. There was a significant burning sensation experienced by the patients in the chili group (score 1.85 for the chili group vs 0.71 for the placebo group. Patient’s mean recorded improvement score was significantly higher after taking placebo. Eighty one point three percent patients preferred placebo while 13.9% preferred chilies. Two patients had no preference. CONCLUSION: Consumption of chili does increase the symptoms of acute anal fissure and reduces patient compliance.RACIONAL: A pimenta vermelha e outras especiarias têm sido responsabilizadas por agravar a sintomatologia das doenças anais, tais como fissuras e hemorróidas. OBJETIVO: Determinar se o consumo de pimentas vermelhas aumentaria os sintomas em fissuras anais agudas. MÉTODOS: Pacientes foram recrutados e randomizados para receber cápsulas contendo pimenta ou placebos por 1 semana, somadas a analgésicos e suplementos de fibras. Foi solicitado que anotassem um escore de sintomas, tais como dor, queimação anal, prurido durante o per

  13. Frequency of post-operative faecal incontinence in patients with closed and open internal anal sphincterotomy

    International Nuclear Information System (INIS)

    Ghayas, N.G.; Younus, S.M.; Mirani, A.J.; Ghayasuddin, M.

    2015-01-01

    Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Parks operation (open method) for chronic anal fissure. Methods: This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A and B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. Results: There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp±14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. Conclusion: CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity. (author)

  14. Chronic idiopathic anal pain. Results of a diagnostic-therapeutic protocol in a colorectal referral unit.

    Science.gov (United States)

    Armañanzas, Laura; Arroyo, Antonio; Ruiz-Tovar, Jaime; López, Alberto; Santos, Jair; Moya, Pedro; Gómez, María Amparo; Candela, Fernando; Calpena, Rafael

    2015-01-01

    Chronic idiopathic anal pain (CIAP) remains a diagnosis of exclusion. Its study and management still lack a standardized protocol. The aim of this study is to evaluate the results obtained with the diagnostic-therapeutic protocol established in our service. We performed a retrospective study of patients diagnosed with CIAP at the Colorectal Unit of the General University Hospital of Elche, between 2005 and 2011. We evaluated 57 patients with a diagnosis of chronic anal pain for functional anorectal disease (FAD). After the application of our diagnostic protocol, final diagnosis of chronic anal pain (CAP) was achieved in 43 cases (75%), including 22 cases of descending perineum syndrome, 12 of proctalgia fugax, 2 of pudendal neuritis and 7 of coccydynia. In 14 patients exclusion diagnosis of CIAP was established. Among the therapies used on patients with CIAP, biofeedback combined with conservative measures improved symptoms in 43% of the cases. Sacral nerve stimulation was assessed in patients who did not respond to other treatments. Through proper anamnesis, physical examination and complementary tests, a specific diagnosis of the cause of CAP by FAD can be achieved, reducing exclusion diagnosis of CIAP to 25% of cases. Conservative measures combined with biofeedback achieved an improvement in pain in more than 40% of the cases of CIAP in our study. Sacral nerve stimulation can be considered as a treatment option in refractory cases. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Anal Itching

    Science.gov (United States)

    ... has many possible causes, such as skin problems, hemorrhoids, and washing too much or not enough. If ... dermatitis. Other medical conditions. These include chronic diarrhea, hemorrhoids, anal tumors and diseases that affect the whole ...

  16. Fissure minerals, literature review

    International Nuclear Information System (INIS)

    Larsson, S.Aa.

    1980-01-01

    This paper is a review of methods used for direct and indirect dating of tectonic events. Isotope geochemistry including stable isotopes as well as fission track- dating, fluid inclusion and thermoluminescens techniques have been considered. It has been concluded that an investigation of tectonic (and thermal) events should start with a detailed study of the mineral phases grown in seald fissures as well as minerals from fissure walls. This study should include phase identification, textures as well as mineral chemistry. The information from this study is fundamental for the decision of further investigations. Mineral chemistry including isotopes and fluid inclusion studies will give an essential knowledge about crystallization conditions for fissure minerals concerned. Direct dating using fission tracks as well as radioactive isotopes could be useful for some minerals. Application of thermoluminescens dating on fissure minerals is doubtful. (Auth.)

  17. Fissure formation in coke. 1: The mechanism of fissuring

    Energy Technology Data Exchange (ETDEWEB)

    D.R. Jenkins; M.R. Mahoney; J.C. Keating [CSIRO Mathematical and Information Sciences, North Ryde, NSW (Australia)

    2010-07-15

    Pilot scale coke oven experiments, in which carbonisation has been arrested after 2 and 4 h, have been used to identify key aspects of the initial formation and propagation of fissuring in coke. The experiments show that the primary fissure network is formed within the first few hours of coking and the fissures propagate towards the centre of the oven as coking progresses. They also show that some of the initially formed fissures stop propagating, thus increasing the effective fissure spacing as coking continues. A model for the propagation of regular crack arrays has been used to identify the cause of the initial formation of the fissure network, evaluate the fissure spacing and explain the fissure coarsening effect. The coarsening is shown to be due to an instability, in the form of every second fissure stopping. The formation of lateral fissures is shown to be due to tensile stress formation near the tips of stopped fissures and also to increased shrinkage due to a maximum in the coke contraction coefficient at around 700{sup o}C. 45 refs., 11 figs., 1 tab.

  18. 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).

  19. 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)

  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. Flow in fissured porous media

    International Nuclear Information System (INIS)

    Stichel, Sabine

    2014-01-01

    The flow simulation in fissured porous media is of importance for hydro-geological applications like ground water contamination in the neighborhood of waste disposal sites, radioactive waste repositories, fossil fuel mining or underground CO2 storage facilities. The permeability within the fissures - that are preferred transport paths - could influence the flow profile. The anisotropic geometry and the excursive parameter changes produce enormous challenges to numerical methods. A low-dimensional approach is used to model then processes within the fissures, acceptable results were reached. Based on the properties of the fissure and flow parameters a criterion was defined that allows to judge whether the application of the low-dimensional approach is sufficient. A dimension-adapting approach is presented that allow the change tp a full-dimensional model according to the criterion.

  2. 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

  3. Migration of radionuclides in fissured rock

    International Nuclear Information System (INIS)

    Neretnieks, I.

    1982-01-01

    Some computed results of radionuclide migration in fissured rock are presented. The computations are based on a model which describes flow as occurring in a multitude of independent fissures (stratified flow). This gives rise to strong dispersion of channeling. The radionuclide migration in the individual fissures is modelled by the advection equation on a parallel walled channel with porous walls. The nuclides may diffuse into the pores and sorb reversibly on the pore surfaces. The effluent rates of 23 important nuclides are presented as functions of distance and time for various of important parameters such as rock permeability, diffusion coefficients, release rates, time of first release, fissure spacing and fissure width distribution. (Author)

  4. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  5. Radionuclide transport in a single fissure

    International Nuclear Information System (INIS)

    Eriksen, T.E.

    1983-01-01

    Radionuclide migration have been studied in natural fissures orieted parallel to the axis of granite drill cores. A short pulse of the radionuclides solution was injected at one end of the fissure and the temporal change in radionuclide concentration of the eluate measured. After several hundred fissure volumes water had been pumped through the fissure following the radionuclide pulse the activity distribution on the fissure surfaces was measured. From the retardation of 152 Eu, 235 Np and 237 Pu it is concluded that these radionuclides are transported in the oxidation states Eu(III), Pu(IV) and Np(V). The distribution coefficients K sub (d) calculated from flow and activity distribution data on the basis of geometric surface area/volume ratios are of the same order as published K sub (d) values obtained from batch equilibrium experiments. (Author)

  6. Fissure fillings from Finnsjoen and Studsvik Sweden

    International Nuclear Information System (INIS)

    Tullborg, E.-L.; Larsson, S.Aa.

    1982-12-01

    Samples were taken from cores and collected at different levels. The bedrock at Finnsjoen is a Svecokarelian granite-granodiorite, the most frequent mineral in the fissures being calcite. The water from boreholes have a mean S 18 O value of -12 per thousand and saturated by calcite. Isotopically three different groups of calcite have been distinguished. Ages of 29+-13x10 3 years to 79+-25x10 3 years were estimated. Two generations of quartz were recognized the minerals prehnite and lanmontite were found Most fissure filling materials have cation exchange capacities. The bedrock at Studsvik is a Svecokarelian gneiss of sedimentary type which is migmatized with calcite and chlorite as fissure filling minerals. Most fissure fillings are thin and simple Claby minerals of smectite type are also frequent. (G.B.)

  7. Radionuclide transport in a single fissure

    International Nuclear Information System (INIS)

    Eriksen, T.E.

    1984-01-01

    Radionuclide migration has been studied in natural fissures running parallel to the axes of granitic drill cores. A short pulse of radionuclide solution was injected at one end of the fissure and the temporal change in radionuclide concentration of the eluate measured. At the end of each experiment the fissure was opened and the radionuclide distribution on the fissure surfaces measured. The retardation of 241 Am(III) at pH 8.2 as well as the variation in 235 Np(V) retardation with pH are found to be in good agreement with K d-values obtained in batch experiments. The reduction of (TcO - 4 ) to Tc(IV) leads as expected to increasing retardation.(author)

  8. Seeded amplification of chronic wasting disease prions in nasal brushings and recto-anal mucosal associated lymphoid tissues from elk by real time quaking-induced conversion

    Science.gov (United States)

    Haley, Nicholas J.; Siepker, Chris; Hoon-Hanks , Laura L.; Mitchell, Gordon; Walter, W. David; Manca, Matteo; Monello, Ryan J.; Powers, Jenny G.; Wild, Margaret A.; Hoover, Edward A.; Caughey, Byron; Richt, Jürgen a.; Fenwick, B.W.

    2016-01-01

    Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since been detected across North America and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction or prevalence studies of large or protected herds, where depopulation may be contraindicated. This study evaluated the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay of recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brushings collected antemortem. These findings were compared to results of immunohistochemistry (IHC) analysis of ante- and postmortem samples. RAMALT samples were collected from populations of farmed and free-ranging Rocky Mountain elk (Cervus elaphus nelsoni; n = 323), and nasal brush samples were collected from a subpopulation of these animals (n = 205). We hypothesized that the sensitivity of RT-QuIC would be comparable to that of IHC analysis of RAMALT and would correspond to that of IHC analysis of postmortem tissues. We found RAMALT sensitivity (77.3%) to be highly correlative between RT-QuIC and IHC analysis. Sensitivity was lower when testing nasal brushings (34%), though both RAMALT and nasal brush test sensitivities were dependent on both the PRNP genotype and disease progression determined by the obex score. These data suggest that RT-QuIC, like IHC analysis, is a relatively sensitive assay for detection of CWD prions in RAMALT biopsy specimens and, with further investigation, has potential for large-scale and rapid automated testing of antemortem samples for CWD.

  9. Thirty-Day Hospital Readmission After Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis for Chronic Ulcerative Colitis at a High-Volume Center.

    Science.gov (United States)

    McKenna, Nicholas P; Mathis, Kellie L; Khasawneh, Mohammad; Shariq, Omair; Dozois, Eric J; Larson, David W; Lightner, Amy L

    2017-11-01

    Ileal pouch anal anastomosis (IPAA) is associated with a high 30-day hospital readmission rate. Risk factors and etiology of readmission remain poorly defined. We sought to determine the 30-day hospital readmission rate following IPAA at a high-volume center and identify any modifiable perioperative factors. A retrospective review of all patients undergoing two- or three-stage IPAA for chronic ulcerative colitis at our institution between 2002 and 2013 was performed. Analysis was performed on rate of readmission, readmission diagnosis, intervention performed upon readmission, and risk factors for readmission. Thirty-day primary and secondary readmission rates after IPAA were 20.3% (n = 185) and 2.1% (n = 19), respectively. The leading etiologies for readmission included partial small bowel obstruction/ileus (n = 52, 21.9%), pelvic sepsis (n = 43, 18.1%), dehydration (n = 42, 17.7%), and venous thromboembolism (n = 31, 13.1%). While the majority of readmissions were managed medically (n = 119, 65.4%), 19.2% (n = 35) required radiologic intervention and 15.3% (n = 28) required a return to the operating room. On univariate analysis, younger age (p = 0.03) and female sex (p = 0.04) had a significantly increased risk of readmission. On multivariable analysis, BMI ≥ 30 (OR 0.51; 95% CI, 0.25-0.97, p = 0.04) was protective of readmission. Thirty-day hospital readmission following IPAA remains a common problem. Preventable etiologies of readmission include dehydration and venous thromboembolism (VTE). Future quality improvement efforts should focus on education regarding stoma output and extended VTE prophylaxis to decrease hospital readmission rates following IPAA.

  10. Chronic adverse events and quality of life after radiochemotherapy in anal cancer patients. A single institution experience and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, K. [Universitaetsklinikum Bochum, Marienhospital Herne (Germany). Dept. of Radiation Oncology; Technische Univ. Muenchen, Klinikum Rechts der Isar (Germany). Dept. of Radiation Oncoalogy; Sauer, T.; Klemm, S.; Molls, M. [Technische Univ. Muenchen, Klinikum Rechts der Isar (Germany). Dept. of Radiation Oncoalogy; Dinkel, A. [Technische Univ. Muenchen, Klinikum Rechts der Isar (Germany). Dept. of Psychosomatic Medicine and Psychotherapy; Schuster, T. [Technische Univ. Muenchen, Klinikum Rechts der Isar (Germany). Inst. of Medical Statistics and Epidemiology; Geinitz, H. [Technische Univ. Muenchen, Klinikum Rechts der Isar (Germany). Dept. of Radiation Oncoalogy; Krankenhaus der Barmherzigen Schwestern, Linz (Austria). Dept. of Radiation Oncology

    2013-06-15

    Purpose: To report on chronic adverse events (CAE) and quality of life (QOL) after radiochemotherapy (RCT) in patients with anal cancer (AC). Patients and methods: Of 83 patients who had received RCT at our department between 1988 and 2011, 51 accepted the invitation to participate in this QOL study. CAE were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0 and QOL was assessed with the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire. Results: CAE could be evaluated in 49 patients. There was a tendency toward a higher rate of grade 3 CAE in female patients, i.e. 18 out of 37 (49 %) vs. 2 out of 12 (17 %) male patients (p = 0.089). The most common grade 3 CAE were dyspareunia and vaginal symptoms (itching, burning and dryness) in 35 and 22 % of female patients, respectively, followed by stool incontinence in 13 % of all patients (6 out of 49). Both FACT-C and CAE information were available for 42 patients, allowing evaluation of the impact of CAE on QOL. The median total FACT-C score was 110 (40-132) out of a possible maximum of 136. The absence of grade 3 CAE (115 vs. 94, p = 0.001); an interval of {>=} 67 months after the end of the treatment (111 vs. 107, p = 0.010), no stool incontinence vs. grade 3 stool incontinence (111 vs. 74, p = 0.009), higher education (114 vs. 107, p = 0.013) and no dyspareunia vs. grade 3 dyspareunia (116 vs. 93, p = 0.012) were significantly associated with a higher median FACT-C score. Conclusion: The majority of AC patients treated with RCT have acceptable overall QOL scores, which are comparable to those of the normal population. Patients with grade 3 CAE - particularly dyspareunia and fecal incontinence - have a poorer QOL compared to patients without CAE. In order to improve long-term QOL, future strategies might aim at a reduction in dose to the genitalia and more intensive patient support measures. (orig.)

  11. Chronic adverse events and quality of life after radiochemotherapy in anal cancer patients. A single institution experience and review of the literature

    International Nuclear Information System (INIS)

    Fakhrian, K.; Technische Univ. Muenchen, Klinikum Rechts der Isar; Sauer, T.; Klemm, S.; Molls, M.; Dinkel, A.; Schuster, T.; Geinitz, H.; Krankenhaus der Barmherzigen Schwestern, Linz

    2013-01-01

    Purpose: To report on chronic adverse events (CAE) and quality of life (QOL) after radiochemotherapy (RCT) in patients with anal cancer (AC). Patients and methods: Of 83 patients who had received RCT at our department between 1988 and 2011, 51 accepted the invitation to participate in this QOL study. CAE were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0 and QOL was assessed with the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire. Results: CAE could be evaluated in 49 patients. There was a tendency toward a higher rate of grade 3 CAE in female patients, i.e. 18 out of 37 (49 %) vs. 2 out of 12 (17 %) male patients (p = 0.089). The most common grade 3 CAE were dyspareunia and vaginal symptoms (itching, burning and dryness) in 35 and 22 % of female patients, respectively, followed by stool incontinence in 13 % of all patients (6 out of 49). Both FACT-C and CAE information were available for 42 patients, allowing evaluation of the impact of CAE on QOL. The median total FACT-C score was 110 (40-132) out of a possible maximum of 136. The absence of grade 3 CAE (115 vs. 94, p = 0.001); an interval of ≥ 67 months after the end of the treatment (111 vs. 107, p = 0.010), no stool incontinence vs. grade 3 stool incontinence (111 vs. 74, p = 0.009), higher education (114 vs. 107, p = 0.013) and no dyspareunia vs. grade 3 dyspareunia (116 vs. 93, p = 0.012) were significantly associated with a higher median FACT-C score. Conclusion: The majority of AC patients treated with RCT have acceptable overall QOL scores, which are comparable to those of the normal population. Patients with grade 3 CAE - particularly dyspareunia and fecal incontinence - have a poorer QOL compared to patients without CAE. In order to improve long-term QOL, future strategies might aim at a reduction in dose to the genitalia and more intensive patient support measures. (orig.)

  12. Intracranial lipoma in the sylvian fissure

    International Nuclear Information System (INIS)

    Ogasawara, Kuniaki; Kinjo, Toshihiko; Onuma, Takehide

    1988-01-01

    An experience with an operation on a case of intracranial lipoma in the sylvian fissure is reported. A 14-year-old man had complained of attacks of abnormal behavior for 2 years and was diagnosed by a psychiatrist as suffering from temporal epilepsy. A computed tomography (CT) scan indicated an abnormal shadow on the brain, and so he was admitted to our hospital. On admission, the results of physical and neurological examinations were normal. An electroencephalogram recorded irregular δ waves and sharp waves over the right frontotemporal region, however. A CT scan showed a round-shaped, extremely low-density area, with calcification of the wall and without contrast-enhancement, in the left sylvian fissure. No abnormal finding was seen in plain skull X-P or in left-carotid angiography. Left-frontotemporal craniotomy was performed to remove the tumor. A solid yellowish tumor was found in the sylvian fissure and totally removed. Histologically, it proved to be a lipoma. The postoperative course was uneventful, and the patient was discharged without any neurological deficit. We discussed the neuroradiological findings of sylvian lipomas. As far as we have learned in an extensive review of the literature, there have been nine reports on intracranial lipomas in the sylvian fissure; as for sylvian lipomas which were detected on a CT scan during life, there have been only six cases other than the present one. (author)

  13. Anal Cancer—Patient Version

    Science.gov (United States)

    Anal cancer cases have been increasing over several decades. Infection with human papillomavirus (HPV) is the major risk factor for anal cancer. Start here to find information on anal cancer treatment, causes and prevention, research, and statistics.

  14. Fissure fillings from Gideaa, central Sweden

    International Nuclear Information System (INIS)

    Tullborg, E.L.; Larsson, S.Aa.

    1983-08-01

    The most frequent fissure filling minerals at Gideaa are calcite, chlorite, pyrite, laumontite, stilbite, smectite, quartz and epidote. Potentially young minerals, i.e. minerals which can be formed during present conditions, are smectite, calcite and quartz, Equilibrium calculations show that these minerals can be stable in the water analysed from Gideaa. In borehole Gi 2, the water exhibits a greater equilibrium with existing minerals in the fissures than water from Gi 4. This is due to the recharge of the water in Gi 4 and discharge of the water in Gi 2. When carbonate saturated water penetrated through the bedrock, calcite precipitated within the more superficial portions of the rock. However, both calcite and zeolite fissures fillings are associated with certain zones in the drill holes. A large number of fractures can be concluded to be of post-Jotnian age. Stilbite, calcite and smectite are associated with these fractures. Laumontite can also be assumed to belong here. The dolerites in the area exhibit a high fracture frequency but a relatively low hydraulic conductivity. This is due to the fact that smectite is very prevalent in the dolerite fractures, Several generations of fracturefilling minerals (above all calcite) have been found in a single fracture. Stable isotope analyses of fissure filling calcites indicate that there are three different groups of calcite. Most of the calcites could not have been precipitated from water of present-day isotope composition at Gideaa, whereas recent calcite may be found in one of the groups. Another group of calcite was precipitated during hydro-thermal conditions.(author)

  15. Fissure fillings from the Klipperaas study site

    International Nuclear Information System (INIS)

    Tullborg, E.L.

    1986-07-01

    The Klipperaas study site is located within the Smaaland-Vaermland granitoid belt in southern Sweden. The area investigated can be subdivided into blocks with different hydraulic character and fracture frequency of the rocks. A fissure filling, study has been carried out within the area. This includes identification of the minerals, mineral frequency, textures within the fissures and isotope analyses of calcites. Four generation of fissure fillings, within the time space c. 1600 M.a. to present, has been distinguished. These are 1) quartz; 2) epidote + muscovite and adularia + hematite; 3) calcite + chlorite +/hematite; 4) calcite, clay minerals and Fe-oxyhydroxide. It is observed that the surface water affect the uppermost part of the bedrock resulting in calcite dissolution, break down of pyrite and precipitation of Fe-oxyhydroxide. It is also obvious from the fracture calcite frequency that calcite dissolution is more intensive close to and within the fracture zones. There, Fe-oxyhydroxide can be found down to at least 400 m depth. This gives valuable information about the physic-chemical character of the groundwater within the bedrock. Several fracture zones have been reactivated. It is also suspected that relatively late movements have taken place causing crushing of the rock and only a slight cementation of the crushed material is visible. Some of the fracture zones correspond to mafic dikes. These zones exhibit lower hydraulic conductivity than other zones due to fracture sealing by clay minerals but also by chlorite and calcite. (author)

  16. Incomplete pulmonary fissures evaluated by volumetric thin-section CT: Semi-quantitative evaluation for small fissure gaps identification, description of prevalence and severity of fissural defects

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Radiology Department, German Cancer Research Center (Deutsches Krebsforschungszentrum – DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto – University of Sao Paulo, Av. Bandeirantes 3900, Campus Universitario Monte Alegre, 14048900 Ribeirao Preto, SP (Brazil); Paula, Wagner Diniz de, E-mail: wdpaula@unb.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Department of Radiology, University Hospital of the University of Brasilia, Brasilia, DF (Brazil); Owsijewitsch, Michael, E-mail: michael.owsijewitsch@med.uniheidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Radiology Department, German Cancer Research Center (Deutsches Krebsforschungszentrum – DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Wielpütz, Mark Oliver, E-mail: mark.wielpuetz@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Radiology Department, German Cancer Research Center (Deutsches Krebsforschungszentrum – DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Gompelmann, Daniela, E-mail: daniela.gompelmann@thoraxklinik-heidelberg.de [Pneumology and Respiratory Medicine, Chest Clinic (Thoraxklinik) at University of Heidelberg, Amalienstr. 5, 69126 Heidelberg (Germany); Schlemmer, Heinz-Peter, E-mail: h.schlemmer@dkfz-heidelberg.de [Radiology Department, German Cancer Research Center (Deutsches Krebsforschungszentrum – DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); and others

    2013-12-01

    Objective: To assess the interobserver agreement for a semi-quantitative evaluation of the interlobar fissures integrity in volumetric thin-section CT images, looking for more detailed information regarding fissural defects; and describe prevalence and severity of fissural defects between the different functional groups of subjects. Materials and methods: Volumetric scans of 247 individuals exposed to tobacco with different functional status (normal to severe COPD), were retrospectively and independently evaluated by 2 chest radiologists, with a consensual reading additionally with a third reader in disagreement cases. Right oblique (RO), right horizontal (RH) and left oblique fissures (LO) integrity was estimated using a 5% scale. GOLD classification was available for all subjects. Results: Interobserver agreement (weighted Kappa-index) for fissural categorization was 0.76, 0.70 and 0.75, for RO, RH and LO, respectively. Final evaluation found 81%, 89% and 50% of RO, RH and LO to be incomplete, with respective mean integrity of 80%, 58% and 80%. Small fissure gaps (<10%) were present in 30% of patients. Prevalence and severity of fissural defects were not different between the GOLD categories. Conclusions: A substantial agreement between readers was found in the analysis of interlobar fissures integrity. The semi-quantitative method allowed a detailed description of the fissural defects, information that can be important, for example, in endoscopic lung volume reduction therapies for emphysema. Small fissure gaps, overlooked in previous studies, were found in almost a third of the patients. A higher than previously described prevalence of fissural defects was described, but without significant differences among the distinct functional groups.

  17. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, T; Bower, M

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  18. Research on Integrated Geophysics Detect Potential Ground Fissure in City

    Science.gov (United States)

    Qian, R.

    2017-12-01

    North China confined aquifer lied 70 to 200 meters below the earth's surface has been exploited for several decades, which resulted in confined water table declining and has generated a mass of ground fissure. Some of them has reached the surface and the other is developing. As it is very difficult to stop the ground fissure coming into being, measures of avoiding are often taken. It brings great potential risk to urban architecture and municipal engineering. It is very important to find out specific distribution and characteristic of potential ground fissure in city with high resolution. The ground fissure is concealed, therefor, geophysical method is an important technology to detecting concealed ground fissure. However, it is very difficult to detect the characteristics of the superficial part of ground fissure directly, as it lies dozens of meters below and has only scores of centimeters fault displacement. This paper studies applied ground penetration radar, surface wave and shallow refleciton seismic to detect ground fissure. It sets up model of surface by taking advantage of high resolution of ground penetrating radar data, constrains Reilay wave inversion and improves its resolution. The high resolution reflection seismic is good at detecting the geology structure. The data processing and interpretation technique is developmented to avoid the pitfall and improve the aliability of the rusult. The experiment has been conducted in Shunyi District, Beijing in 2016. 5 lines were settled to collect data of integrated geophysical method. Development zone of concealed ground fissure was found and its ultra shallow layer location was detected by ground penetrating radar. A trial trench of 6 meters in depth was dug and obvious ground fissure development was found. Its upper end was 1.5 meters beneath the earth's surface with displacement of 0.3 meters. The favorable effect of this detection has provided a new way for detecting ground fissure in cities of China, such

  19. Encopresis and anal masturbation.

    Science.gov (United States)

    Aruffo, R N; Ibarra, S; Strupp, K R

    2000-01-01

    Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.

  20. Ante-mortem detection of chronic wasting disease in recto-anal mucosa-associated lymphoid tissues from elk (Cervus elaphus nelsoni) using real-time quaking-induced conversion (RT-QuIC) assay: A blinded collaborative study.

    Science.gov (United States)

    Manne, Sireesha; Kondru, Naveen; Nichols, Tracy; Lehmkuhl, Aaron; Thomsen, Bruce; Main, Rodger; Halbur, Patrick; Dutta, Somak; Kanthasamy, Anumantha G

    2017-11-02

    Prion diseases are transmissible spongiform encephalopathies (TSEs) characterized by fatal, progressive neurologic diseases with prolonged incubation periods and an accumulation of infectious misfolded prion proteins. Antemortem diagnosis is often difficult due to a long asymptomatic incubation period, differences in the pathogenesis of different prions, and the presence of very low levels of infectious prion in easily accessible samples. Chronic wasting disease (CWD) is a TSE affecting both wild and captive populations of cervids, including mule deer, white-tailed deer, elk, moose, muntjac, and most recently, wild reindeer. This study represents a well-controlled evaluation of a newly developed real-time quaking-induced conversion (RT-QuIC) assay as a potential CWD diagnostic screening test using rectal biopsy sections from a depopulated elk herd. We evaluated 69 blinded samples of recto-anal mucosa-associated lymphoid tissue (RAMALT) obtained from USDA Veterinary Services. The results were later un-blinded and statistically compared to immunohistochemical (IHC) results from the USDA National Veterinary Services Laboratories (NVSL) for RAMALT, obex, and medial retropharyngeal lymph node (MRPLN). Comparison of RAMALT RT-QuIC assay results with the IHC results of RAMALT revealed 92% relative sensitivity (95% confidence limits: 61.52-99.8%) and 95% relative specificity (95% confidence limits: 85.13-99%). Collectively, our results show a potential utility of the RT-QuIC assay to advance the development of a rapid, sensitive, and specific prion diagnostic assay for CWD prions.

  1. Factors affecting coke size and fissuring during cokemaking part 2

    Energy Technology Data Exchange (ETDEWEB)

    Merrick Mahoney; Jeff Keating; Susan Woodhouse [BHP Billiton Newcastle Technology Centre (Australia)

    2007-12-15

    This work addressed the mechanism of fissuring during metallurgical cokemaking and extends on a previous ACARP project. Considerable progress has been made in understanding the mechanism by an integrated modelling work; experimental program. The work points to opportunities for controlling the carbonisation process to achieve required outcomes in terms of coke lump size and distribution. Key outcomes of the work included: A methodology for determination of the minimum spacing between fissures, and the time at which period doublings (i.e. every second fissure stopping) occur, has been developed and implemented. Implementation of the methodology allows the determination of the complete fissure pattern (at least those perpendicular to the oven walls) for a given coke oven/charge configuration. A plausible mechanistic explanation of the formation of lateral fissures (those that are parallel to the oven walls) has been developed. Knowledge of the fissure pattern, combined with the lateral fissuring explanation, enables the determination of typical size and shape of lumps after stabilisation of the coke.

  2. Experimental study of strontium sorption on fissure filling material

    Energy Technology Data Exchange (ETDEWEB)

    Eriksen, T E; Cui, Daqing [Royal Institute of Technology, Stockholm (Sweden). Dept. of Chemistry

    1994-12-01

    We have carried out a comparative study of sorption and desorption of strontium in groundwater on separated magnetic and size fractions of fissure filling material taken from natural fissures in granitic rock. Complete reversibility of the sorption process was demonstrated by identical Freundlich isotherms, isotopic exchangeability and pH dependence of the distribution coefficients Rd. The sorption was found to be strongly pH dependent in the range 3-11. The pH effect can be accommodated in the sorption model by considering the surface areas and surface charges of the minerals in the fissure filling material. 20 refs, 9 figs, 3 tabs.

  3. Experimental study of strontium sorption on fissure filling material

    International Nuclear Information System (INIS)

    Eriksen, T.E.; Cui, Daqing

    1994-12-01

    We have carried out a comparative study of sorption and desorption of strontium in groundwater on separated magnetic and size fractions of fissure filling material taken from natural fissures in granitic rock. Complete reversibility of the sorption process was demonstrated by identical Freundlich isotherms, isotopic exchangeability and pH dependence of the distribution coefficients Rd. The sorption was found to be strongly pH dependent in the range 3-11. The pH effect can be accommodated in the sorption model by considering the surface areas and surface charges of the minerals in the fissure filling material. 20 refs, 9 figs, 3 tabs

  4. Radionuclide transport in a single fissure

    International Nuclear Information System (INIS)

    Eriksen, T.E.

    1988-12-01

    The study of radionuclide migration through rock is currently of great interest due to its relevance to the possible escape paths into the biosphere of radionuclides released from high level radioactive wastes burried in deep geological repositories. While water will provide the vehicle for transportation, interaction with geological material may greatly influence the radionuclide movement relative that of water. A flow system for laboratory studies of radionuclide transport in natural fissures in granitic rock under reducing conditions is described. The system based on the use of synthetic ground water equilibrated with granitic rock in a well sealed system, allow experiments to be carried out at -240 mV reduction potential. In flow experiments with technetium the retardation was found to be dependent on the method used for reducing TcO 4 - . The preparation of the tracer solutions is crucial, as some of the redox-reactions may be very slow. The dynamics of the Tc(VII) reduction and also speciation need to be carried out in separate experiments. (4 illustrations, 5 tables)

  5. influence of drying temperature and storage duration on fissuring

    African Journals Online (AJOL)

    User

    age duration on the cracking behaviour and head rice yield of a local rice variety - Jasmine 85. ... harvesting, processing and storage. The rice industry ... cm deep which is within the thickness consid- ered as a ..... Tracing fissure information by.

  6. A study on the anatomical morphology of the minor fissure

    International Nuclear Information System (INIS)

    Lee, Hyeong Gon; Kim, Hyung Jin; You, Jin Jong; Ahn, In Oak; Chung, Sung Hoon

    1993-01-01

    The minor fissure is an important anatomical landmark in the localization of the pulmonary disease. For the evaluation of the normal feature of the minor fissure, we analyzed the high-resolution computed tomography (CT) scans in 51 normal patients. The purpose of this study are to evaluate the normal appearance of the minor fissure on high-resolution CT scans and to compare it with that on the conventional CT and radiographys. We analyzed the morphologic feature of the minor fissure on the high-resolution CT scans in 51 normal patients, and compared it with that on the conventional CT scans. On the high-resolution CT scans, we particularly paid attention to the completeness and types according to Berkmen classification. And finally, we compared the types determined by the high-resolution CT scans with those by the plain radiographys. In most patients (n=47), the minor fissure was seen as a hyperattenuating line or band on the high resolution CT scans. In contrast, it was mostly seen as a lucent zone on the conventional CT scans (n=44). Of 47 patient having a hyperattenuating line or band on the high-resolution CT scans, the minor fissure was considered to be complete in 17 patients (36%), and incomplete in 30 patients (64%), who had a defeat at medial portion of the minor fissure. The most common type of the minor fissure seen on the high-resolution CT scans was type I variety (n=23), followed by tape IIa (n=8). We could not determined the type in six patients. The type determined by the high-resolution CT scans was highly well correlated with that determined by the plain radiographys (p<0.05). In conclusion, the minor fissure was seen CT studies as variable appearances and high-resolution CT scans were superior to the conventional CT scans in the evaluation of the minor fissure. The types of the minor fissure determined by the high-resolution CT scans were well correlated with those seen on the radiographys

  7. New diagnostic technology and hidden pits and fissures caries

    OpenAIRE

    Fabrizio Guerra; Marta Mazur; Francesca Rinaldo; Denise Corridore; Daniele Salvi; Debora Pasqualotto; Gianna Maria Nardi; Livia Ottolenghi

    2015-01-01

    The accuracy in pits and fissures caries detection is of paramount importance in dental caries primary and secondary prevention. A combination of visual examination and probing is currently the mainstay of occlusal caries diagnosis. Unfortunately, these types of inspection alone may leave a certain number of pit and fissure caries undetected. The Vista Cam iX fluorescence camera (Durr Dental, Bietigheim-Bissingen, Germany) is a novel dental diagnostic tool for quantitative assessment of denta...

  8. Differential compaction mechanism for earth fissures near Casa Grande, Arizona.

    Science.gov (United States)

    Jachens, R.C.; Holzer, T.L.

    1982-01-01

    Precise gravity measurements indicate that earth fissures or tension cracks caused by ground-water withdrawal within a 10km2 area SE of Casa Grande are associated with relief on the buried interface between the alluvial aquifer and underlying bedrock. These relations suggest that the fissures are forming in response to localized differential compaction caused by localized variations of aquifer-system thickness. -from Authors

  9. Seeded Amplification of Chronic Wasting Disease Prions in Nasal Brushings and Recto-anal Mucosa-Associated Lymphoid Tissues from Elk by Real-Time Quaking-Induced Conversion.

    Science.gov (United States)

    Haley, Nicholas J; Siepker, Chris; Hoon-Hanks, Laura L; Mitchell, Gordon; Walter, W David; Manca, Matteo; Monello, Ryan J; Powers, Jenny G; Wild, Margaret A; Hoover, Edward A; Caughey, Byron; Richt, Jürgen A

    2016-04-01

    Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since been detected across North America and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction or prevalence studies of large or protected herds, where depopulation may be contraindicated. This study evaluated the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay of recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brushings collected antemortem. These findings were compared to results of immunohistochemistry (IHC) analysis of ante- and postmortem samples. RAMALT samples were collected from populations of farmed and free-ranging Rocky Mountain elk (Cervus elaphus nelsoni;n= 323), and nasal brush samples were collected from a subpopulation of these animals (n= 205). We hypothesized that the sensitivity of RT-QuIC would be comparable to that of IHC analysis of RAMALT and would correspond to that of IHC analysis of postmortem tissues. We found RAMALT sensitivity (77.3%) to be highly correlative between RT-QuIC and IHC analysis. Sensitivity was lower when testing nasal brushings (34%), though both RAMALT and nasal brush test sensitivities were dependent on both thePRNPgenotype and disease progression determined by the obex score. These data suggest that RT-QuIC, like IHC analysis, is a relatively sensitive assay for detection of CWD prions in RAMALT biopsy specimens and, with further investigation, has potential for large-scale and rapid automated testing of antemortem samples for CWD. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  10. 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

    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...

  11. Horizontal fissure on neonatal plain chest radiographs: clinical implications

    International Nuclear Information System (INIS)

    Konarzewska, J.; Zawadzka-Kepczynska, A.; Bianek-Bodzak, A.; Kawinska-Kilianczyk, A.; Domzalska-Popadiuk, I.

    2005-01-01

    Regardless of etiology, pleural fluid, even in small amounts, can be visualized on the neonatal chest x-ray picture within pulmonary fissures. It remains unclear whether a marked horizontal fissure unaccompanied by any other radiological symptoms is of diagnostic value or not. Ninety-one consecutive neonatal chest radiographs with marked horizontal fissure were retrospectively analyzed. The images were made between 1999 and 2005 on 69 newborns admitted to the Neonatology Department, Institute of Obstetrics and Gynecology, Medical University of Gdansk. Analysis of the radiographs was conducted independently by three radiologists based on the following criteria: fissure thickness (marked or thickened), bronchovascular markings (increased or normal), size and shape of the heart (normal or abnormal), presence or absence of pulmonary infiltration, atelectasis, and changes related to wet lung syndrome. Due to divergent interpretations, the ultimate interpretation was established by consensus in 25 cases. The radiological findings were compared with clinical data. The compatibility of the three independent interpreters was statistically significant (p<0.0001). Marked transverse fissure was the only radiological finding on 66 x-rays. In 63 cases (69.2%) the children were asymptomatic as well. In 3 cases (3.3%) clinical symptoms of respiratory tract infection occurred. On the other 25 images, horizontal fissure was accompanied by other radiological symptoms. Chest x-ray results corresponded with clinical symptoms in 24 cases (26.4%). One child (1.1%) with radiological evidence of wet lung syndrome did not present any typical clinical symptoms of it. Horizontal fissure noted on a neonatal chest x-ray seems to be of minor diagnostic value if not accompanied by any other radiological symptoms. (author)

  12. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  13. Treatment of Acute Fissure in Ano using Topical Glycerine Trinitrate ...

    African Journals Online (AJOL)

    RICHY

    longitudinal tear of the lower anal canal. It is one of the painful anal conditions resulting in a lot of ... constipation, doing so with a fresh tear more likely during next defecation. The aetiology varies from precipitous ... increases NO (nitric oxide) which is a very potent muscle relaxant. It acts on vascular smooth muscle there by.

  14. Anal Cancer—Health Professional Version

    Science.gov (United States)

    Anal cancer is a rare malignancy and accounts for a small percentage of cancers of the lower alimentary tract. The most common type of anal cancer is squamous cell carcinoma in the anal canal. Find evidence-based information on anal cancer treatment, causes and prevention, research, and statistics.

  15. New diagnostic technology and hidden pits and fissures caries

    Directory of Open Access Journals (Sweden)

    Fabrizio Guerra

    2015-10-01

    Full Text Available The accuracy in pits and fissures caries detection is of paramount importance in dental caries primary and secondary prevention. A combination of visual examination and probing is currently the mainstay of occlusal caries diagnosis. Unfortunately, these types of inspection alone may leave a certain number of pit and fissure caries undetected. The Vista Cam iX fluorescence camera (Durr Dental, Bietigheim-Bissingen, Germany is a novel dental diagnostic tool for quantitative assessment of dental caries with high specificity for carious lesions detection. In the presented cases photographic images, representing the visual diagnostic approach, are applied as integration to VistaCam iX Proof images. A step-by-step sequence of inspection and assessment of operative treatment need is presented in a case of hidden pit and fissure caries on a permanent molar. Based on the reported case, it could be observed that VistaCam iX Proof shows promising results in hidden pits and fissures caries detection and could be considered a non-invasive examination method that facilitate the detection of early lesions and a potential diagnostic aid.

  16. Research of compression strength of fissured rock mass

    Directory of Open Access Journals (Sweden)

    А. Г. Протосеня

    2017-03-01

    Full Text Available The article examines a method of forecasting strength properties and their scale effect in fissured rock mass using computational modelling with final elements method in ABAQUS software. It shows advantages of this approach for solving tasks of determining mechanical properties of fissured rock mass, main stages of creating computational geomechanic model of rock mass and conducting a numerical experiment. The article presents connections between deformation during loading of numerical model, inclination angle of main fracture system from uniaxial and biaxial compression strength value, size of the sample of fissured rock mass and biaxial compression strength value under conditions of apatite-nepheline rock deposit at Plateau Rasvumchorr OAO «Apatit» in Kirovsky region of Murmanskaya oblast. We have conducted computational modelling of rock mass blocks testing in discontinuities based on real experiment using non-linear shear strength criterion of Barton – Bandis and compared results of computational experiments with data from field studies and laboratory tests. The calculation results have a high-quality match to laboratory results when testing fissured rock mass samples.

  17. Penetration of fluoride-containing self-gelling liquids into human molar occlusal fissures in vitro.

    Science.gov (United States)

    Bottenberg, P; Slop, D; Coomans, D

    1989-01-01

    In this in vitro study the ability and speed of self-gelling liquid compositions to penetrate into fissures were evaluated. Two formulations containing either tetraethylsilicate, ammonium fluoride, and sodium lauryl sulfate or tetraethylsilicate, sodium fluoride, and cetylpyridinium chloride at different concentrations were used. It is shown that fissure penetration occurs when a certain minimum content of surface-active agent is present. Fissure penetration is achieved within 3-4 s, according to the fissure morphology.

  18. Interlobar fissures involvement by lung cancer. Evaluation with thin-section computed tomography images

    International Nuclear Information System (INIS)

    Kato, Yuji; Yamada, Kouzo; Nomura, Ikuo; Noda, Kazumasa; Ishiwa, Naoki; Maehara, Takamitsu; Kameda, Youichi

    1998-01-01

    Pleural involvement of interlobar fissure by a tumor is one of the most important factors in the clinical diagnosis of lung cancer. A positive finding of incomplete interlobar fissure of the lung influences not only the surgical procedure but also the prognosis. The aim of this retrospective study was to investigate the usefulness of thin-section computed tomography (CT) compared with conventional CT in the detection of pleural invasion of the interlobar fissure by lung cancer or incomplete interlobar fissure, and the results of surgery, according to the involvement of the pleural surface. We reviewed 90 patients whose tumors were adjacent to the interlobar fissure of the lung through conventional CT scans and subsequent thoracotomy. A comparison of diagnoses based on the findings of thin-section CT and pathologic examination showed that thin-section CT was 94% accurate for pleural invasion of the interlobar fissure, and 100% for incomplete interlobar fissure. Conventional CT, however, was only 63% accurate for pleural invasion of the interlobar fissure and 31% for incomplete interlobar fissure. This leads us to conclude that thin-section CT is helpful in the accurate evaluation of pleural invasion of the interlobar fissure and in the findings of incomplete interlobar fissure in lung cancer for patients in whom tumors are adjacent to the interlobar fissure on conventional CT findings. (author)

  19. Fecal overflow often affects children with chronic constipation that appears after the age of 2 years.

    Science.gov (United States)

    Kammacher Guerreiro, Mélissa; Bettinville, Aurore; Herzog, Denise

    2014-08-01

    Chronic functional constipation with or without encopresis is a common problem in the pediatric population, and the prevalence of encopresis may be underestimated. The aim of this study was to assess the prevalence and risk factors for overflow incontinence in patients with chronic constipation seen at a pediatric gastroenterology consultation. A retrospective study of 270 files of patients seen between 1997 and 2012 was conducted, and a classification according to Rome III criteria was done. Among 145 (53.7%) boys and 125 (46.2%) girls, 117 had overflow incontinence (43.3%) - 41 (35%) girls and 76 (65%) boys. The first symptoms of chronic constipation appeared at a median age of 30 and 33 months in encopretic and 16 and 12 months in nonencopretic girls and boys, respectively. The first specialized consultation took place after a median disease duration of 26.5 and 24 months in encopretic and 16 and 9 months in nonencopretic girls and boys, respectively. A history of stool retention and the presence of scybala at examination, but not of pain at defecation or anal fissure, were associated with encopresis. The onset of chronic constipation after the age of 2 years, a longer disease duration, male gender, and a history of stool retention were seen as risk factors for the development of encopresis in patients with chronic functional constipation. © The Author(s) 2014.

  20. 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.

  1. 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

  2. Qualidade de vida de mulheres com dor pélvica crônica: um estudo de corte transversal analítico Quality of life of women with chronic pelvic pain: a cross-sectional analytical study

    Directory of Open Access Journals (Sweden)

    Priscilla Rodrigues Barcelos

    2010-05-01

    Full Text Available OBJETIVOS: comparar a qualidade de vida (QV de mulheres com e sem dor pélvica crônica (DPC e investigar os fatores associados à QV de mulheres com DPC. MÉTODOS: conduziu-se estudo de corte transversal, incluindo 30 mulheres com DPC e 20 sem DPC. Foram avaliadas características sociodemográficas e clínicas. A QV foi investigada pelo questionário SF-36, que apresenta oito domínios: capacidade funcional, aspectos físicos, dor, estado geral de saúde, vitalidade, aspectos sociais, aspectos emocionais e saúde mental. Esses domínios podem ser resumidos em dois sumários: sumário do componente físico (SCF e sumário do componente mental (SCM. A intensidade da dor foi pesquisada, aplicando-se a escala visual analógica. Utilizou-se análise de regressão linear para comparação dos escores de QV entre mulheres com e sem DPC e para identificação dos fatores associados à QV de mulheres com DPC. RESULTADOS: a média de idade das mulheres com e sem DPC foi de 35,2±7,5 e de 36±9,3 anos (p=0,77, respectivamente. Mulheres com DPC apresentaram menor renda familiar mensal (p=0,04 e maior prevalência de dismenorreia (87 versus 40%; pPURPOSE: to compare the quality of life (QL of women with and without chronic pelvic pain (CPP and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS and mental component summary (MCS. Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to

  3. Internal anal sphincter: Clinical perspective.

    Science.gov (United States)

    Kumar, Lalit; Emmanuel, Anton

    2017-08-01

    To summarise current knowledge of Internal anal sphincter. The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research. The PubMed database was used to identify relevant studies relating to internal anal sphincter. The available evidence has been summarised and advantages and limitations highlighted for the different diagnostic and therapeutic techniques. Our understanding of the physiology and pharmacology of IAS has increased greatly in the last three decades. Additionally, there has been a rise in diagnostic and therapeutic techniques specifically targeting the IAS. Although these are promising, future research is required before these can be incorporated into the management algorithm. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  4. Anatomy of the minor fissure: assessment with high-resolution CT and classification

    International Nuclear Information System (INIS)

    Ariyuerek, Macit O.; Yelgec, Selcuk N.; Guelsuen, Meltem; Karabulut, Nevzat

    2002-01-01

    The aims of this study were to investigate the anatomy of the minor fissure and its variations on high-resolution CT (HRCT) sections and to propose a detailed classification. The prospective study included 67 patients who were referred to CT for various indications. High-resolution CT examinations (1.5-mm collimation) were obtained through the region of the minor fissure. The CT scans were assessed for the presence, completeness, and configuration of the minor fissure. Various configurations of the minor fissure were classified into four major types, based on whether the highest portion of the middle lobe upper surface was medial (type I), lateral (type II), posterior (type III), or central (type IV). Minor fissure was identified in 65 (97%) of 67 patients, and absent in 2 (3%) cases. The fissure was incomplete in 35 (54%) of 65 patients. Type-I minor fissure is seen in 28 (43%) patients, type II in 22 (34%), type III in 5 (8%), and type IV in 2 (3%) patients. Because the majority of the fissure was absent in 8 (12%) of 35 patients with incomplete fissure, they were considered indeterminate. Comprehensive knowledge of the various configurations of the minor fissure is helpful in correct localization of a lesion and its extension. In equivocal cases, limited thin-section CT scans through the fissure delineate the anatomy more clearly and provide greater degree of precision in localizing pulmonary lesions. (orig.)

  5. Superior vesical fissure concealed by giant omphalocele: A case report

    OpenAIRE

    Hayek, Danial; Massanyi, Eric; Mancuso, Melissa; Krepkovich, Katherine; Garrison, Aaron

    2016-01-01

    Omphalocele is an abdominal wall defect characterized by exteriorization of abdominal viscera that is covered by a membrane. Omphalocele has a well-known association with chromosome abnormalities. Here we present a case of a superior vesical fissure (SVF) initially disguised as a giant omphalocele in a newborn with trisomy 18. We also show unique prenatal imaging and discuss the importance and limitations of prenatal genetic testing.

  6. Superior vesical fissure concealed by giant omphalocele: A case report

    Directory of Open Access Journals (Sweden)

    Danial Hayek

    2016-11-01

    Full Text Available Omphalocele is an abdominal wall defect characterized by exteriorization of abdominal viscera that is covered by a membrane. Omphalocele has a well-known association with chromosome abnormalities. Here we present a case of a superior vesical fissure (SVF initially disguised as a giant omphalocele in a newborn with trisomy 18. We also show unique prenatal imaging and discuss the importance and limitations of prenatal genetic testing.

  7. Fissured and geographic tongue in Williams-Beuren syndrome

    Directory of Open Access Journals (Sweden)

    Neeta Sharma

    2014-01-01

    Full Text Available Williams-Beuren Syndrome (WBS is a rare, most often sporadic, genetic disease caused by a chromosomal microdeletion at locus 7q11.23 involving 28 genes. It is characterized by congenital heart defects, neonatal hypercalcemia, skeletal and renal abnormalities, cognitive disorder, social personality disorder, and dysmorphic facies. A number of clinical findings has been reported, but none of the studies evaluated this syndrome considering oral cavity. We here report a fissured and geographic tongue in association with WBS.

  8. Injectabilite des coulis de ciment dans des milieux fissures

    Science.gov (United States)

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  9. Outcome of peri-anal surgeries without use of prophylactic antibiotics, in terms of post operative wound infection

    International Nuclear Information System (INIS)

    Asif, M.; Mirza, A.A.; Saeed, A.

    2017-01-01

    To determine the outcome of perianal surgeries without use of antibiotics in terms of post operative infection. Study Design: Descriptive study. Place and Duration of study: Department of general surgery, Pakistan Atomic Energy Commission General Hospital, from Jan 2014 to Jun 2015. Material and Methods: All patients, both male and female admitted for hemorrhoidectomy, fistulectomy and lateral internal sphincterotomy for Anal Fissure with minimum 02 months follow-up were included in the study through non probability consecutive sampling technique. The selected patients were not administered any antibiotics pre or postoperatively. All these patients were followed up for any post-operative surgical site infection up to 02 months. Patients were advised only to take pyodine sitz bath regularly. Results: One hundred and eighty two patients were selected for the study. Patients mean age was 48.0 +- 11.4 years. 68.68% were male and 31.3% were female patients. In our study most frequent clinical presentation was hemorrhoids (37.9.0%), followed by anal fissure (33.5%). Least frequent clinical presentation was of anal fistula (28.57%). None of the patients developed surgical site infection post operatively. Conclusions: In our study we found that there was no additional beneficial role of prophylactic antibiotics in perianal surgeries Perianal surgeries can safely be performed without the use pre or post-operative antibiotics there by significantly reducing health care expenses. (author)

  10. The movement of solutes through aqueous fissures in porous rock

    International Nuclear Information System (INIS)

    Glueckauf, E.

    1980-06-01

    A mathematical treatment has been given for the movement of materials dissolved in water flowing through narrow fissures of a micro-porous substrate. As there is no water flow in these micro-pores, equilibrium between the aqueous solution and the micro-porous substrate proceeds only by diffusion, with the result that there arises a gross disequilibrium. Two major effects arise: first, the hold-up in the substrate - even when there is no adsorption taking place - is orders of magnitude larger than on non-porous substrate, and increases even further, if adsorption takes place. Secondly, dispersion caused by non-equilibrium is also orders of magnitude greater than dispersion arising from convection effects of the water flow in interconnecting fissures. As a result, the solutes arrive very much later at the end of the underground fissures, and in concentrations which are very much lower than have been calculated in previous modelling experiments. The significance of these effects is discussed in detail, and this can be helpful in the selection of sites for underground disposal of radioactive waste. It is now quite feasible to specify sites with conditions, where even solutes with minimal adsorption would not return to the surface within a million years, and where solutes of moderately strong adsorption would be effectively immobile. (author)

  11. Thermomechanical behavior of mica layers with lenticular fissures

    Science.gov (United States)

    Yang, Michael Xinyi

    The thermomechanical behavior of natural phlogopite mica specimens from seven different origins is characterized. An initial heat treatment, to a temperature between 300°C and 400°C, is found to form fissures that stabilize in the material. Following the initial heat treatment, all the phlogopite specimens, regardless of their origin and polytype, exhibit the extraordinarily large thermal expansion (intumescence), more than 200% at 600°C, in the direction perpendicular to the basal planes. This phenomenon is strictly reproducible when tested under a range of thermal conditions including thermal shock, multiple thermal fatigue cycles, varying heating or cooling rates and isothermal heating over an extensive period of time at different temperatures up to 585°C. The hysteresis, associated with the thermal cycle, is increased when the specimen is heated or cooled at a faster rate. The maximum coefficient of linear thermal expansion, approximately 10 -2°C-1, is observed over the temperature range 100--120°C. This is due to the non-structural water, entrapped within the layer structure, which undergoes a phase transition and causes the mica layers to expand abruptly. A model of lenticular fissures is developed based on thin-plate mechanics and thermodynamics assumptions. The state of a lenticular fissure with water vapor molecules is determined to correlate the experimental parameters with the material properties. The average density of water vapor molecules within a lenticular fissure is calculated to be ˜1025 m 3 for the temperature interval between 100°C and 275°C. The concentration of non-structure water, based on the model calculation, is less than 0.1% by weight. Acoustic emission (AE) signals have been reported by Pranevicius et al. (1995) to correspond to the microstructure changes as the internal lenticular fissures develop in phlogopite. This technique has also been proven feasible to characterize the thermomechanical behavior of other layer structures

  12. The effect of fissures on the strength of structural timber

    Directory of Open Access Journals (Sweden)

    Íñiguez, Guillermo

    2010-06-01

    Full Text Available Detailed measurements of drying fissures were carried out on 28 pieces of gross cross-section structural Scots pine timber. Different parameters have been proposed to measure their magnitude: length, depth, thickness and slope of grain, as well as an index of area in the neutral axis plane (ratio of effective to total surface. The parameters of fissures have been related to bending strength, shear strength, modulus of elasticity and rupture energy obtained from mechanical tests, considering whether rupture is due to bending or shear. All of the fissures observed allows to classify the pieces as MEG according to the UNE 56544 standard. To quantify the magnitude of fissures the index of areas is proposed, while mechanical properties can be quantified by rupture energy. Analysis of the results does not show any relation between the fissures analyzed and the mode of failure, their magnitude and mechanical properties..

    Se han realizado mediciones detalladas de las fendas de secado en 28 piezas de madera de pino silvestre de gran escuadría. Se han propuesto diferentes parámetros para medir su magnitud en longitud, profundidad, grosor e inclinación, así como un índice de áreas en el plano medio de rasante (superficie eficaz respecto a superficie total. Se han relacionado los parámetros de fendas con resistencia a flexión, resistencia a cortante, módulo de elasticidad y energía de rotura obtenidos mediante ensayos mecánicos, teniendo en cuenta si la rotura se produce por flexión o por cortante. Todas las fendas observadas permiten clasificar las piezas como MEG según la norma UNE 56544. Se propone cuantificar las fendas mediante el índice de áreas y las propiedades mecánicas mediante la energía de rotura. El análisis realizado no muestra una relación significativa entre las fendas analizadas, los modos de rotura o las propiedades mecánicas.

  13. Anal squamous intraepithelial lesions in HIV+ MSM

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, M.L.

    2018-01-01

    In this thesis we report on several aspects of high-grade anal squamous intraepithelial lesions (HSIL) in HIV+ men who have sex with men (MSM). It is estimated that 10% of HIV+ MSM with anal HSIL will develop anal squamous cell carcinoma (ASCC) over 30 years time. Screening programs similar to

  14. Fissuring-chemical damaging on transfers in concrete

    International Nuclear Information System (INIS)

    Tognazzi, C.

    1998-01-01

    Concrete is a material often use in the nuclear wastes disposal. The safety analysis of a long time wastes disposal with concrete requires to verify the concrete behaviour in water. As concretes generally have cracks, it is necessary to study the crack propagation influence on chemical degradation. In this paper, the author presents diffusion tests on fissured and/or chemical aged cement. The chemical degradation of the material leads to a supplementary porosity by the hydrates decalcification and increases its diffusivity. The cracking impact is less important and can be experimentally concealed. (A.L.B.)

  15. [Caesarean section and anal incontinence].

    Science.gov (United States)

    Kalis, V; Stipán, J; Chaloupka, P; Karbanová, J; Rokyta, Z

    2008-04-01

    Summary of the impact of Caesarean section on anal incontinence. Review. Department of Gynaecology and Obstetrics, Charles University and University Hospital Plzen. Review of the current international literature. Currently, Caesarean section is not considered to reduce symptoms of anal incontinence. If there is any reduction of symptoms, that remains only for a short term (40% in 3 months after the delivery in the largest trial). In a long term, virtually in no trial has been observed any difference, and others, non-obstetrical factors (particularly aging) prevail. Current knowledge does not allow to assess sufficiently pros and cons of Caesarean compared to vaginal delivery. High risk groups, that would profit from elective Ceasarean, have not been clearly identified yet.

  16. Groundwater drainage from fissures as a source for lahars

    Science.gov (United States)

    Johnson, P. J.; Valentine, G. A.; Stauffer, P. H.; Lowry, C. S.; Sonder, I.; Pulgarín, B. A.; Santacoloma, C. C.; Agudelo, A.

    2018-04-01

    One mechanism for generating lahars at volcanoes experiencing unrest is the disruption of internal aquifers. These disruptions can trigger releases of large quantities of groundwater. An example of such aquifer disruption occurred at Nevado del Huila Volcano, Colombia, during February and April 2007 when large fractures formed across the summit area of the volcano and lahars were emitted from them. Previous work interpreted that lahar volumes could not be accounted for by melted glacial snow or precipitation, and by elimination suggested that the primary water source was groundwater. Conceptual models have been developed for perched, confined aquifers that have been heated and pressurized by magma intrusions, followed by sudden pressure release and water emission during fracture formation. We consider an alternative end member wherein water release from large fissures at volcanoes is driven by simple gravity drainage. We apply numerical modeling to quantify water discharge from the porous medium surrounding a fissure with a low-elevation free exit. If a long fracture with high vertical extent (on the order of hundreds of meters) intersects a highly connected saturated porous medium, large volumes (on order 103 m3/m of crack length) of water may be released within tens of minutes. The drainage rates from the model may be adequate to account for the Nevado del Huila events if the medium surrounding the crack contains a large volume of water and has high horizontal permeability. This simple but poorly understood mechanism can present a hazard on its own or compound other processes releasing water from volcanoes.

  17. Analysis of some laboratory tracer runs in natural fissures

    International Nuclear Information System (INIS)

    Moreno, L.; Neretnieks, I.

    1984-01-01

    Tracer tests in natural fissures performed in the laboratory are analysed by means of fitting two different models. In the experiments, sorbing and non-sorbing tracers were injected into a natural fissure running parallel to the axis of a drill core. The models take into account advection, diffusion into the rock matrix, sorption onto the rock surface and dispersion. For the last mechanism, one of the models considers hydrodynamic dispersion while the other model assumes channeling dispersion. The models take into account time delays in the inlet and outlet channels. The dispersion characteristics and water residence time were determined from the experiments with non-sorbing tracers. Surface and volume sorption coefficients and data on diffusion into the rock matrix were determined for the sorbing tracers. The results are compared with values independently determined in the laboratory. Good agreement was obtained using either model. When these models are used for prediction of tracer transport over larger distances, the results will depend on the model. The model with channeling dispersion will show a greater dispersion than the model with hydrodynamic dispersion. (author)

  18. Hallazgos ecográficos en la proctalgia espontánea y postoperatoria Ultrasound findings in spontaneous and postoperative anal pain

    Directory of Open Access Journals (Sweden)

    I. Pascual

    2008-12-01

    endoprobe providing 360º images. Results: ninety-five cases of anal pain were studied by endoanal ultrasonography. Sixty-seven cases of anal pain ocurred in patients with previous perineal or pelvic surgery: anal fissure (48, hemorrhoidectomy (12, episiotomy (4, fistula (2, and prostatectomy (1. After fissure surgery, incomplete sphincterotomy was the first cause of anal pain. Twenty-eight patients had no previous surgery, and more than 57.14% of them were found to have internal anal sphincter hypertrophy. Conclusions: patients with anal pain can be studied by endoanal ultrasounds in spite of the use of an endoprobe. With this exploration a cause of pain is found in 81.93% of cases. Internal anal sphincter hypertrophy is the most frequent finding associated with spontaneous anal pain.

  19. Doenças anais concomitantes à doença hemorroidária: revisão de 1.122 pacientes Anal diseases associated to hemorrhoids: review of 1.122 patients

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Gomes da Cruz

    2006-12-01

    main cause of the symptoms presented was achieved in 9,289 patients (27.3% being hemorrhoid associated with several anorectal diseases in 1,122 patients (12.1%. 2,417 patients of the patients underwent hemorrhoidectomy (26.0% and 729 of theese patients were operated on for associated anal diseases at the same time (65.0%. The most frequently diagnosed associated anal diseases were anal fissures (541 cases, 5.8% and hyperthrofied anal papila (312 cases, 3.4% folowed by anal fistulae (117 cases, 1.3%, partial fecal incontinence (112 cases, 1.2%, anal condyloma (37 cases, 0,4% and anal tumors (3 cases, 0,03%. The same order of incidence was verified in relation to the 1,122 cases of associated anal diseases: anal fissures (48.2%, hyperthrofied anal papila (27.8%, anal fistulae (10.4%, partial fecal incontinence (10.0%, anal condyloma (3.3% and anal tumors (0,3%. As far as associated anal diseases are concerned (1,122 cases, the incidence of surgery was 65.5% (729 patients in this order: fissurectomy (317 cases, 28.3%, anal papilectomy (267 cases, 23.8%, anal fistulectomy (89 cases, 7.9%, partial fecal incontinence (31 cases, 2.8%, resection of anal condylomata (22 cases, 1.9%, resection of anal tumors (3 cases, 0.3%. And as far as each associated anal disease is concerned the incidence of surgery was the following: resection of anal tumors (100,0%, papilectomy (85.6%, fistulectomy (76.0%, resection of anal condylomata (59.6%, fissurectomy (58.6% and partial fecal incontinence (25.8%. Associated anal diseases with the highest proportion of confirmation of proctologic diagnosis by the histopathologic examination were anal fistula (100.0% of 89 operated patients, anal condyloma (100.0% of 22 operated patients, hyperthrophied anal papilla (79.0% - 211 - of 267 operated patients, anal fissure (68.5% - 217 - of 317 operated patients and anal cancer (66.7% - 2 of 3 operated patients.

  20. HIV/AIDS, HPV and Anal Cancer

    Science.gov (United States)

    Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.

    2016-01-01

    SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034

  1. IMPORTANCE OF THE ANAL MANOMETRY IN THE JUDICIALMEDICAL EXPERTISE OF THE ANAL PENETRATION

    Directory of Open Access Journals (Sweden)

    Jelica Miljkovic

    2001-11-01

    Full Text Available The forceful anal penetration can leave as a consequence a lasting damage ofthe anal sphincter function. The anal manometry is one of the methods that, in anindirect way, by measuring the pressure in the anal channel, may determine theexistence of the anus-closing muscles' function damage. The importance of the analmanometry application as an objective indicator of a possible damage of the analsphincter function is presented in the cases of the judicial-medical expertise of theanal penetration. Three cases of criminal acts of sexual abuse and rape in which thejudicial-medical expertise by the anal manometry method was applied are analyzed.The anal manometry method is reliable in determining the functional stote of theexternal and the internal anal sphincter and it should be accepted as obligatory indiagnostics and verification of the anal penetration.

  2. Cell Behaviors during Closure of the Choroid Fissure in the Developing Eye

    Directory of Open Access Journals (Sweden)

    Gaia Gestri

    2018-02-01

    Full Text Available Coloboma is a defect in the morphogenesis of the eye that is a consequence of failure of choroid fissure fusion. It is among the most common congenital defects in humans and can significantly impact vision. However, very little is known about the cellular mechanisms that regulate choroid fissure closure. Using high-resolution confocal imaging of the zebrafish optic cup, we find that apico-basal polarity is re-modeled in cells lining the fissure in proximal to distal and inner to outer gradients during fusion. This process is accompanied by cell proliferation, displacement of vasculature, and contact between cells lining the choroid fissure and periocular mesenchyme (POM. To investigate the role of POM cells in closure of the fissure, we transplanted optic vesicles onto the yolk, allowing them to develop in a situation where they are depleted of POM. The choroid fissure forms normally in ectopic eyes but fusion fails in this condition, despite timely apposition of the nasal and temporal lips of the retina. This study resolves some of the cell behaviors underlying choroid fissure fusion and supports a role for POM in choroid fissure fusion.

  3. 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....

  4. Anal Sphincter Augmentation Using Biological Material.

    Science.gov (United States)

    Alam, Nasra N; Narang, Sunil K; Köckerling, Ferdinand; Daniels, Ian R; Smart, Neil J

    2015-01-01

    The aim of this review is to provide an overview of the use of biological materials in the augmentation of the anal sphincter either as part of an overlapping sphincter repair (OSR) or anal bulking procedure. A systematic search of PubMed was conducted using the search terms "anal bulking agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies using biological material as part of an overlapping sphincter repair (OSR) or as an anal bulking agent were identified. 122 patients underwent anal bulking with a biological material. Anorectal physiology was conducted in 27 patients and demonstrated deterioration in maximum resting pressure, and no significant change in maximum squeeze increment. Quality of life scores (QoLs) demonstrated improvements at 6 weeks and 6 months, but this had deteriorated at 12 months of follow up. Biological material was used in 23 patients to carry out an anal encirclement procedure. Improvements in QoLs were observed in patients undergoing OSR as well as anal encirclement using biological material. Incontinence episodes decreased to an average of one per week from 8 to 10 preoperatively. Sphincter encirclement with biological material has demonstrated improvements in continence and QoLs in the short term compared to traditional repair alone. Long-term studies are necessary to determine if this effect is sustained. As an anal bulking agent the benefits are short-term.

  5. Demonstration of the pulmonary interlobar fissures on multiplanar reformatted images with 64-slices spiral CT

    International Nuclear Information System (INIS)

    Wang Yafei; Chen Yerong; Shan Xiuhong; Tang Zhiyang; Ni Enzhen; Huang Hao; Wu Shuchun

    2009-01-01

    Objective: To determine the optimal orientation and slice thickness of reformatted images to visualize the interlobar fissures on multiplanar reformation (MPR) images and to recommend MPR imaging protocal for visualizing interlobar fissures in clinical practise. Methods: 64-slices CT scans of chest were obtained in 300 patients without pulmonary diseases. Axial, sagittal and coronal images were reformatted at 1, 2, 3, 7 mm slice thickness respectively from the raw volume data. Three experienced radiologists evaluated all of the MPR images in the lung window and compared the differences in visualization of the interlohar fissures among the three reformatted orientations and at the different slice thicknesses with Fisher test and Friedman test. Results: Fissures on sagittal MPR images using 1, 2, 3, and 7 mm reformatted slice thickness appeared as a fine line and the preference value analysis showed the MPR images with a 3 mm reformatted slice thickness is the best for visualizing the interlobar fissure. Compared to the sagittal orientation, the coronal was not as good and the axial was the worst among the three orientations. The coronal images with a 3 mm reformatted slice thickness were slightly inferior to sagittal images. The right horizontal fissures were observed as a fine line in all coronal image in 94.0% (282)of cases and in some of the images in 6.0% (18) of cases, the right oblique fissures were displayed as a fine line in coronal images in 2.3% (7) of cases and in some images in 85.0% (255) of cases, the left oblique fissures were displayed as a fine line in some coronal images in 35.7% (107) of cases and displayed as a coarse line in 64.3% (193) of cases. On axial MPR images using 3 mm reformation slice thickness, the right oblique fissures and the left oblique fissures were displayed as a fine line in some axial images in 79.3% (238) and 81.0% (243) of cases respectively, none of the images showed horizontal fissures as a fine line. There was

  6. Fissure formation in coke. 2: Effect of heating rate, shrinkage and coke strength

    Energy Technology Data Exchange (ETDEWEB)

    D.R. Jenkins; M.R. Mahoney [CSIRO, North Ryde, NSW (Australia). Mathematical and Information Sciences

    2010-07-15

    We investigate the effects of the heating rate, coke shrinkage and coke breakage strength upon the fissure pattern developed in a coke oven charge during carbonisation. This is done principally using a mechanistic model of the formation of fissures, which considers them to be an array of equally spaced fissures, whose depth follows a 'period doubling' pattern based upon the time history of the fissures. The model results are compared with pilot scale coke oven experiments. The results show that the effect of heating rate on the fissure pattern is different to the effect of coke shrinkage, while the effect of coke breakage strength on the pattern is less pronounced. The results can be seen in both the shape and size of resulting coke lumps after stabilisation. The approach gives the opportunity to consider means of controlling the carbonisation process in order to tune the size of the coke lumps produced. 7 refs., 18 figs., 4 tabs.

  7. Superior orbital fissure syndrome in herpes zoster ophthalmicus.

    LENUS (Irish Health Repository)

    Kirwan, R P

    2012-02-01

    AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report. RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was no relative afferent pupillary defect. He had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and prednisolone led to recovery of visual acuity and ocular motility in addition to resolution of his proptosis and ptosis. CONCLUSION: SOFS is a rare complication of herpes zoster infection. With the appropriate treatment and follow-up, patients may be reassured that recovery of their visual acuity and ocular motility will occur.

  8. Dynamics of leaching a uniformly fissured ore body

    International Nuclear Information System (INIS)

    Ignatov, A.A.; Proskurin, S.A.

    1987-01-01

    Mathematical simulation was used to study the dynamics of mass transfer during the percolation of a reagent solution through a packing of coarse ore particles. The uniformly fissured ore body was represented by a cubic packing of spherical particles of constant radius, formed from a chemically inert silicate cement with a uniformly distributed soluble mineral component. The rate of percolation of the reagent through the packing was constant. The proposed model can be used to find the conditions for underground hydrodynamic leaching. The rate of non-catalytic solid-liquid reaction was deduced on the basis of both the kinetics of dissolution of the mineral component of the ore and the rate of diffusion of the dissolved substance

  9. Fissure sealant materials: Wear resistance of flowable composite resins.

    Science.gov (United States)

    Asefi, Sohrab; Eskandarion, Solmaz; Hamidiaval, Shadi

    2016-01-01

    Background. Wear resistance of pit and fissure sealant materials can influence their retention. Wear characteristics of sealant materials may determine scheduling of check-up visits. The aim of this study was to compare wear resistance of two flowable composite resins with that of posterior composite resin materials. Methods. Thirty-five disk-shaped specimens were prepared in 5 groups, including two flowable composite resins (Estelite Flow Quick and Estelite Flow Quick High Flow), Filtek P90 and Filtek P60 and Tetric N-Ceram. The disk-shaped samples were prepared in 25-mm diameter by packing them into a two-piece aluminum mold and then light-cured. All the specimens were polished for 1minute using 600-grit sand paper. The samples were stored in distilled water at room temperature for 1 week and then worn by two-body abrasion test using "pin-on-disk" method (with distilled water under a 15-Nload at 0.05 m/s, for a distance of 100 meter with Steatite ceramic balls antagonists). A Profilometer was used for evaluating the surface wear. Data were analyzed with the one-way ANOVA. Results. Estelite Flow Quick exhibited 2708.9 ± 578.1 μm(2) and Estelite Flow Quick High Flow exhibited 3206 ± 2445.1 μm(2)of wear but there were no significant differences between the groups. They demonstrated similar wear properties. Conclusion. Estelite flowable composite resins have wear resistance similar to nano- and micro-filled and micro-hybrid composite resins. Therefore, they can be recommended as pit and fissure sealant materials in the posterior region with appropriate mechanical characteristics.

  10. Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions

    Science.gov (United States)

    ... Professional Anal Cancer Treatment Anal Cancer Prevention Research Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions ... randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at ...

  11. Nocturnal faecal soiling and anal masturbation.

    Science.gov (United States)

    Clark, A F; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

  12. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  13. Neuronal hyperplasia in the anal canal

    DEFF Research Database (Denmark)

    Fenger, C; Schrøder, H D

    1990-01-01

    In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which f...

  14. 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...

  15. Modeling and numerical study of transfers in fissured environments; Modelisation et etude numerique des transferts en milieux fissures

    Energy Technology Data Exchange (ETDEWEB)

    Granet, S.

    2000-01-28

    Oil recovery from fractured reservoirs plays a very important role in the petroleum industry. Some of the world most productive oil fields are located in naturally fractured reservoirs. Modelling flow in such a fracture network is a very complex problem. This is conventionally done using a specific idealized model. This model is based on the Warren and Root representation and on a dual porosity, dual permeability approach. A simplified formulation of matrix-fracture fluid transfers uses a pseudo-steady-state transfer equation involving a constant exchange coefficient. Such a choice is one of the main difficulties of this approach. To get a better understanding of the simplifications involved in the dual porosity approach a reference model must be available. To obtain such a fine description, we have developed a new methodology. This technique called 'the fissure element methodology' is based on a specific gridding of the fractured medium. The fissure network is gridded with linear elements coupled with an unstructured triangular grid of matrix. An appropriate finite volume scheme has been developed to provide a good description of the flow. The numerical development of is precisely described. A simulator has been developed using this method. Several simulations have been realised. Comparisons have been done with different dual-porosity dual-permeability models. A reflexion concerning the choice of the exchange coefficient used in the dual porosity model is then proposed. This new tool has permit to have a better understanding of the production mechanisms of a complex fractured reservoir. (author)

  16. Modeling of earth fissures caused by land subsidence due to groundwater withdrawal

    Directory of Open Access Journals (Sweden)

    B. B. Panda

    2015-11-01

    Full Text Available Land subsidence and earth fissures are phenomena related to groundwater withdrawal in a sedimentary basin. If the rock basement or basin lithology is irregular, both vertical and horizontal displacements can be induced due to differential settlement and tensile stresses appearing in the soil mass. If the differential settlement is of sufficient magnitude, earth fissuring can occur within tensile zones. The magnitudes of compaction and fissure geometry are closely related to the thickness and skeletal compressibility of fine-grained sediments within the aquifer system. Land subsidence and earth fissuring were modeled by employing a two-dimensional (2-D coupled seepage and stress-strain finite element analysis. The basin bedrock geometry, lithological variation, measurements of surface displacements, and changes in hydraulic head were the critical input parameter for the subsidence modeling. Simulation results indicate that strain had exceeded the approximate threshold for fissure formation of 0.02 to 0.06 % in the area of the identified fissures. The numerical model was used to predict future subsidence and potential earth fissures for flood control structures within the metro Phoenix area.

  17. Preferential flow in fissured sediments in desert soils related to radioactive waste disposal

    International Nuclear Information System (INIS)

    Scanlon, B.R.; Raney, J.A.

    1992-01-01

    Unsaturated flow in fissured sediments in the Chihuahuan Desert of Texas was examined to determine if these features act as preferred pathways for water and solute transport. Fissures are surface features, or gulleys, that are underlain by fractures filled with sediment derived from surrounding areas. Hydraulic and chemical approaches were used to investigate unsaturated flow processes beneath and adjacent to fissures, and the results were compared with data from surrounding geomorphic systems such as arroyos, ephemeral streams, and interstreams. Typically, high water potentials in surficial sediments result from infiltration of recent precipitation. Below this surficial zone of high water potentials lies a zone of low water potentials that is much thinner beneath the fissure than in adjacent sediments or in sediments beneath ephemeral streams and interstreams. Maximum chloride concentrations in profiles in the near-surface fissured sediments were much lower than those measured in all other geomorphic systems. The corresponding moisture velocities in the fissured sediments ranged from 10 to 70 mm/yr. A tracer experiment demonstrated higher downward water and solute transport in the fracture fill beneath the fissure relative to adjacent sediments. Numerical simulations of the tracer experiment with the computer code TRACR3D reproduced the overall shape of the tracer plume. Sensitivity analyses demonstrated that the tracer plume is most sensitive to spatial variability in soil texture and the corresponding hydraulic parameters. The results from this study suggest that sediments in the fissured area act as preferred pathways in the shallow subsurface because surface runoff is concentrated in the fissures and because underlying fractures and cavities provide avenues for moisture and solute transport

  18. 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

  19. A Mouse Model for Human Anal Cancer

    Science.gov (United States)

    Stelzer, Marie K.; Pitot, Henry C.; Liem, Amy; Schweizer, Johannes; Mahoney, Charles; Lambert, Paul F.

    2010-01-01

    Human anal cancers are associated with high-risk human papillomaviruses (HPVs) that cause other anogenital cancers and head and neck cancers. As with other cancers, HPV16 is the most common high-risk HPV in anal cancers. We describe the generation and characterization of a mouse model for human anal cancer. This model makes use of K14E6 and K14E7 transgenic mice in which the HPV16 E6 and E7 genes are directed in their expression to stratified squamous epithelia. HPV16 E6 and E7 possess oncogenic properties including but not limited to their capacity to inactivate the cellular tumor suppressors p53 and pRb, respectively. Both E6 and E7 were found to be functionally expressed in the anal epithelia of K14E6/K14E7 transgenic mice. To assess the susceptibility of these mice to anal cancer, mice were treated topically with dimethylbenz[a]anthracene (DMBA), a chemical carcinogen that is known to induce squamous cell carcinomas in other sites. Nearly 50% of DMBA-treated HPV16 E6/E7 transgenic mice showed overt signs of tumors; whereas, none of the like treated non-transgenic mice showed tumors. Histopathological analyses confirmed that the HPV16 transgenic mice were increased in their susceptibility to anal cancers and precancerous lesions. Biomarker analyses demonstrated that these mouse anal cancers exhibit properties that are similar to those observed in HPV-positive precursors to human anal cancer. This is the first mouse model for investigating the contributions of viral and cellular factors in anal carcinogenesis, and should provide a platform for assessing new therapeutic modalities for treating and/or preventing this type of cancer. PMID:20947489

  20. Fissures in the commercial cinematic space: Screening Taiwanese documentary blockbusters

    Directory of Open Access Journals (Sweden)

    Hong-Chi Shiau

    2016-12-01

    Full Text Available This study explores the trajectory of how a new wave of documentary making has incorporated or resisted dominant social forces to create fissures in the commercial cinematic spaces. Two documentary blockbusters The Long Goodbye (2010 and Beyond Taiwan (2013 are examined to explicate how the restructuring of cinematic spaces in Taiwan has facilitated changes in documentary screening culture and spectatorships, leading to the recent documentary renaissance. This result suggests that independent filmmakers intervene and create the spaces for their documentaries, financially dependent on advance ticket sales and private sponsorship. However, relational distributive venues of documentary film within a larger public sphere are increasingly privatized and commercialized in the age of global neoliberalism. The various and creative methods applied in the exhibition of documentary blockbusters have illuminated the intersection of documentary and mainstream commercial cinema sites and practices, and have spawned associated, commercially oriented articulations. The reception study reveals that the past decade has witnessed Taiwanese audiences anxiously situate their precarious local identity against a myriad of socio-political crises: an aging and shrinking population, environmental pollution, and stagnant economy.

  1. An MR study on widening of the anterior cerebral longitudinal fissure in patients with schizophrenia

    International Nuclear Information System (INIS)

    Yoshizawa, Masao; Nagumo, Ichiro; Kimura, Hiroko; Yamamoto, Setsuko; Kumagai, Hideo; Ito, Hisao.

    1994-01-01

    One-hundred and four schizophrenics and 27 normal controls underwent magnetic resonance imaging. The angles of the anterior cerebral longitudial (ACL) fissure on T 1 weighted images were measured on the axial slices at the level of the third ventricle. The schizophrenics had significantly larger angles of ACL fissure than controls. However, the effect of aging might be associated with this phenomenon. There was no correlation between subtype of schizophrenia and the augment of the fissure angle, nor correlation between the duration of schizophrenia and that augment. From this study, it can be concluded that if the fissure angle is larger than 12 degree the finding is regarded as abnormal, because 95% confidence region of the control group was at 11.1 degree. Twenty two schizophrenics revealed the findings and great majority of these patients were suffering from emotional withdrawal and blunted affect. (author)

  2. Phreatic explosions during basaltic fissure eruptions: Kings Bowl lava field, Snake River Plain, USA

    Science.gov (United States)

    Hughes, Scott S.; Kobs Nawotniak, Shannon E.; Sears, Derek W. G.; Borg, Christian; Garry, William Brent; Christiansen, Eric H.; Haberle, Christopher W.; Lim, Darlene S. S.; Heldmann, Jennifer L.

    2018-02-01

    Physical and compositional measurements are made at the 7 km-long ( 2200 years B.P.) Kings Bowl basaltic fissure system and surrounding lava field in order to further understand the interaction of fissure-fed lavas with phreatic explosive events. These assessments are intended to elucidate the cause and potential for hazards associated with phreatic phases that occur during basaltic fissure eruptions. In the present paper we focus on a general understanding of the geological history of the site. We utilize geospatial analysis of lava surfaces, lithologic and geochemical signatures of lava flows and explosively ejected blocks, and surveys via ground observation and remote sensing. Lithologic and geochemical signatures readily distinguish between Kings Bowl and underlying pre-Kings Bowl lava flows, both of which comprise phreatic ejecta from the Kings Bowl fissure. These basalt types, as well as neighboring lava flows from the contemporaneous Wapi lava field and the older Inferno Chasm vent and outflow channel, fall compositionally within the framework of eastern Snake River Plain olivine tholeiites. Total volume of lava in the Kings Bowl field is estimated to be 0.0125 km3, compared to a previous estimate of 0.005 km3. The main (central) lava lake lost a total of 0.0018 km3 of magma by either drain-back into the fissure system or breakout flows from breached levees. Phreatic explosions along the Kings Bowl fissure system occurred after magma supply was cut off, leading to fissure evacuation, and were triggered by magma withdrawal. The fissure system produced multiple phreatic explosions and the main pit is accompanied by others that occur as subordinate pits and linear blast corridors along the fissure. The drop in magma supply and the concomitant influx of groundwater were necessary processes that led to the formation of Kings Bowl and other pits along the fissure. A conceptual model is presented that has relevance to the broader range of low-volume, monogenetic

  3. [Application of individually designed trans-fissure approach in brain surgery: analysis of 90 cases].

    Science.gov (United States)

    Zhao, Ji-Zong; Wang, Shuo; Zhang, Mao-Zhi; Wang, Lei; Wang, Rong; Tang, Ya-Juan

    2009-01-06

    To explore the feasibility and value of trans-fissure approaches in brain surgery through individually designed craniotomy. Ninety patients with intracranial space-occupying lesions, 47 males and 58 females, aged (43 +/- 14) (1 - 68), were treated by individualized trans-fissure approach surgeries. Linear scalp incision or "horseshoe shape" scalp incision were designed to perform the operation, with a bone flap 3 - 4 cm in diameter. The shortest approach to reach the lesion was decided under the guidance of neuro-navigation and real-time B-mode ultrasonography. Then the lesions were removed through natural cortical fissures. Another 79 patients with intracranial space-occupying lesions, 53 males and 51 females, aged (42 +/- 11) (15 -73), undergoing classical surgeries in the same period were used as control group. The average operation time, size of bone flap, amount of blood loss, hospitalization time, and hospitalization cost were compared between these 2 groups. The operation time of the individually designed trans-fissure approach group was (3.1 +/- 1.6) hours (1.33 - 10.83 hours), significantly shorter than that of the control group [(4.8 +/- 1.9) hrs, P trans-fissure approach group was (173 +/- 168) ml (20 m - 500 ml), significantly less than that of the control group [(410 +/- 61) ml, P trans-fissure approach group was (12 +/- 5) cm2 [(1 - 25) cm2], significantly smaller than that of the control group [(20. +/- 9) cm2, P trans-fissure approach group received retransfusion, compared to 15 in the control group, during operation. No infection or other significant complications occurred after operation in the individually designed trans-fissure approach group. The hospitalization time of the individually designed trans-fissure approach group was (20 +/- 6) days (9 - 39 days), significantly shorter than that of the control group [(24 +/- 7) days, P trans-fissure approach group was (23171 +/- 7280) yuan RMB; significantly lower than that of the control group

  4. Søvind Marl - Behaviour of a plastic fissured Eocene clay

    DEFF Research Database (Denmark)

    Grønbech, Gitte Lyng

    The thesis regards the characterisation and determination of properties of Søvind Marl, a Danish highly fissured and plastic clay. Highly fissured, plastic clays are present at great depths several places in Denmark, where extensive development activity is currently ongoing. Nonetheless...... will determine the correlation factors from field tests to undrained shear strength. Finally, the thesis is concluded with recommendations for further work within the field of plastic clays....

  5. THE EFFECT OF FISSURES IN DOLOMITE ROCK MASS ON BLASTING PROJECTS

    Directory of Open Access Journals (Sweden)

    Branko Božić

    1989-12-01

    Full Text Available Rock fractures in the form of fissures are one of more important geological features of a tectonic system. They have an effect on mechanical behaviour of rook masses exposed to the actions of surface forces. For exploitation in dolomite quarries carried out by blasting of deep shot holes it is important to know the system of fissures within a rock mass for the rock brakes along already weakened planes (the paper is published in Croatian.

  6. Orientation of the eruption fissures controlled by a shallow magma chamber in Miyakejima

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    Nobuo Geshi

    2016-11-01

    Full Text Available Orientation of the eruption fissures and composition of the lavas of the Miyakejima volcano indicate tectonic influence of a shallow magma chamber on the distribution of eruption fissures. We examined the distributions and magmatic compositions of 23 fissures that formed within the last 2800 years, based on a field survey and a new dataset of 14C ages. The dominant orientation of the eruption fissures in the central portion of the volcano was found to be NE-SW, which is perpendicular to the direction of regional maximum horizontal compressive stress (σHmax. Magmas that show evidences of magma mixing between basaltic and andesitic magmas erupted mainly from the eruption fissures with a higher offset angle from the regional σHmax direction. The presence of a shallow dike-shaped magma chamber controls the distribution of the eruption fissures. The injection of basaltic magma into the shallow andesitic magma chamber caused the temporal rise of internal magmatic pressure in the shallow magma chamber. Dikes extending from the andesitic magma chamber intrude along the local compressive stress field which is generated by the internal excess pressure of the andesitic magma chamber. As the result, the eruption fissures trend parallel to the elongation direction of the shallow magma chamber. Injection of basaltic magma into the shallow andesitic magma chamber caused the magma mixing. Some basaltic dikes from the deep-seated magma chamber reach the ground surface without intersection with the andesitic magma chamber. The patterns of the eruption fissures can be modified in the future as was observed in the case of the destruction of the shallow magma chamber during the 2000 AD eruption.

  7. Homogeneity and fissure determination in uranium bars with solid state nuclear track detectors

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, F. (Universidad Nacional Autonoma de Mexico, Mexico City. Facultad de Ciencias); Gamboa, I.; Espinosa, G.; Tapia, A. (Universidad Nacional Autonoma de Mexico, Mexico City. Inst. de Fisica); Somogyi, G. (Magyar Tudomanyos Akademia, Debrecen. Atommag Kutato Intezete)

    1984-01-01

    A simple and efficient method for determining fissure and concentration inhomogeneity in uranium bars is the alpha-radiographic technique. In our present work uranium bars made by ININ (Mexico) were studied by using CR-39 track detectors. The space inhomogeneity in track density was measured by an optical densitometer. The presence of fissure is determined by a microfiche reader. Such a study takes only few hours and does not require sophisticated instrumentation.

  8. Comparison of various concentrations of tricalcium phosphate nanoparticles on mechanical properties and remineralization of fissure sealants.

    Directory of Open Access Journals (Sweden)

    Sara Tavassoli-Hojjati

    2014-08-01

    Full Text Available The aim of this study was to investigate the mechanical properties (flexural strength, micro-shear bond strength and remineralizing potential of fissure sealants by adding various concentrations of β-tricalcium phosphate nanoparticles.This in-vitro study consisted of five experimental groups containing prepared nano-fisssure sealants (1-5 wt.% β-TCP nanoparticles and two control groups containing a prepared and a commercial fissure sealant. Flexural/micro-shear bond strength values were measured using Zwick test machine. Cavities on sixty healthy premolar teeth were filled with the fissure sealants containing 0-5 wt.% of nano β-TCP. The samples were assessed for remineralization under scanning electron microscopy (SEM and EDAX. Kolmogorov-Smirnov test, One-way ANOVA and Tukey's Post Hoc analysis/HSD were used to analyze the data.There was no significant difference between the flexural strengths/elastic modulus of the 0-5 wt.% nano β-TCP groups (p>0.05. The average flexural strength/elastic modulus of the prepared fissure sealant group (0% was significantly higher than the commercial fissure sealant group (Clinpro (p0.05. Examining the samples under SEM showed a significant increase in thickness of the intermediate layer with increasing concentrations of β-TCP nanoparticles (p<0.05.Addition of 1-5 wt.% β-TCP nanoparticles to the fissure sealants significantly increased the remineralization potential without affecting the mechanical properties.

  9. Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

    Science.gov (United States)

    ElNaggar, Adam C; Santoso, Joseph T; Xie, Huiwen Bill

    2012-02-01

    To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213). Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

    Directory of Open Access Journals (Sweden)

    Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

    2013-03-01

    Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

  11. Numerical simulation of earth fissures caused by overly aquifer exploitation at Guangming Village, China

    Science.gov (United States)

    Ye, S.; Franceschini, A.; Zhang, Y.; Janna, C.; Gong, X.; Yu, J.; Teatini, P.

    2017-12-01

    Earth fissures accompanying anthropogenic land subsidence due to overly aquifer exploitation create significant geohazards in China. In the framework of an efficient and safe management of groundwater, numerical models represent a unique scientific approach to predict the generation and development of earth fissures. However, the common geomechanical simulators fail to reproduce fissure development because, due to compatibility conditions, they cannot be effectively applied in discontinuous mechanics. We present an innovative modelling approach for the simulation of fissure development. Firstly, a regional 3D groundwater model is calibrated on available piezometric records; secondly, the regional outcome is used to define the boundary conditions of a local 3D groundwater model developed at the fissure scale and implementing a refined discretization of the local hydrogeologic setting; finally, the pressure change are used as forcing factor in a local 3D geomechanical model, which combines Finite Elements and Interface Elements to simulate the deformation of the continuous aquifer system and the generation and sliding/opening of earth fissures The approach has been applied to simulate the earth fissure at Guangming Village in Wuxi, China with land subsidence of more than 1 m caused by the overexploitation of the second confined aquifer. The first earth fissure was observed in 1998. It developed fast from 1998 to 2007. The domain addressed by the local simulations is 2 km wide and 5 km long. The thickness of the aquifer system ranges from 0 m, in the proximity of a mountain ridge southward, to 210 m northward and includes a phreatic aquifer, the first and second confined aquifers, and four aquitards. The simulations spanned the period from 1980, i.e. before the inception of large groundwater withdrawals, to 2015. The modelling results highlight that the earth fissures at Guangming Village have been caused by tension and shear, which developed from the land surface

  12. ANAL SPHINCTER INJURIES (OASIS AT DELIVERY

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    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

  13. 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

    PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross......-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women...... 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...

  14. PERBEDAAN TOPICAL FLUORIDE APPLICATION DAN FISSURE SEALANT DALAM MENCEGAH KARIES PADAGIGI MOLAR SATU

    Directory of Open Access Journals (Sweden)

    Pawarti Pawarti

    2017-07-01

    Full Text Available Abstract: Topical Fluoride Application And Fissure Sealant To Prevent Dental Caries Permanent First Molars. Anatomy pits and fissures of teeth are caries initiation vulnerable areas of the permanent molars that grow at the age of 6 years where children can not perform oral hygiene. Caries prevention can be done by closing the pits and fissures or application of fluoride (topical fluoride application on the surface of the teeth. The purpose of this study was to analyze the difference fissure sealants and topical application of fluoride to prevent dental caries of first permanent molars. This study was a quasi-experimental study with time series, a sample was taken by purposive 117-second grade students of SDN District of North Pontianak. Data were analyzed using t-test. The result showed that fissure sealant more effective in caries prevention of first permanent molar than topical fluoride application where there were none caries teeth after and month fissure sealant, 25% sealant partially off and 11% fully off. Teeth that have done fluoride after 6 months of 3.9% of dental caries, the eighth month of 5.4% of dental caries. There was a significant difference between the effectiveness of fissure sealants with topical application of fluoride to prevent dental caries in first permanent molars p-value < 0.05, after 6-month p-value: 0.004 and after 8-month p-value: 0.001. Abstrak: Topical Fluoride Application Dan Fissure Sealant Untuk Mencegah Karies Pada Gigi Molar Satu Permanen. Anatomi pit dan fisura gigi merupakan daerah rentan inisiasi karies gigi molar satu permanen yang tumbuh pada usia 6 tahun anak belum bisa melakukan kebersihan mulutnya. Pencegahan karies dapat dilakukan dengan cara menutup pit dan fissure atau pengolesan fluor (topical fluoride application pada permukaan gigi. Tujuan penelitian ini untuk menganalisis perbedaan efektivitas fissure sealant dan topical fluoride application untuk mencegah karies gigi molar satu permanen anak

  15. Comparing the etiology and treatment of skin fissure in traditional and conventional medicine; a brief review

    Directory of Open Access Journals (Sweden)

    A. Jedkareh

    2016-01-01

    Full Text Available Dry skin is a common problem which affects wound healing, severity of other skin diseases and quality of life of people. One of its undesirable effects is fissure that is a cutaneous condition in which there is a linear loss of epidermis and dermis with sharply defined, nearly vertical walls. In the present study, we have investigated the etiology of the disease and its treatments in conventional medicine and Iranian Traditional Medicine (ITM. Two traditional medicine references, current scientific data bases and medicinal texts were explored with the selected keywords such as "sheqaq-e-poosti", "skin fissure" and "dry skin" to find the etiology and treatment of skin fissure. From the view point of both conventional medicine and ITM, dry skin is the cause of skin fissure and some causes of dry skin are similar. In conventional medicine, moisturizers are mainly used for treatment of dry skin; while in ITM some herbs, oils and other natural remedies have been used. A topical dosage form which was called "qeirooti", a mixture of wax and oil, was used to treat skin fissure in ITM. It comprised of oily ingredients that acted as occlusives and also some herbal components that directly improved dry skin (similar to moisturizers. Components efficacy of traditional dosage forms for treatment of dry skin lead us to study about formulation of “qeirooti” for treatment of dry skin.

  16. In Vitro Comparison of Microleakage of Two Materials Used as Pit and Fissure Sealants

    Directory of Open Access Journals (Sweden)

    Zahra Bahrololoomi

    2011-09-01

    Full Text Available Background and aims. Marginal seal of the material is extremely important in fissure sealant therapy. The aim of this study was to investigate microleakage of flowable composite resins and conventional fissure sealants with or without dentin bonding agent. Materials and methods. The occlusal surface of 60 intact extracted human premolars, divided into four groups, were cleaned with pumice/slurry, etched with 37% phosphoric acid for 15 seconds, rinsed and dried. Groups were treated differently: Excite bonding agent followed by Helioseal F fissure sealant in group1; Helioseal F alone in group 2; Excite bonding agent followed by Tetric Flow in group 3; and Tetric Flow alone in group 4. Light-curing was done after each application. After thermocycling, the whole surface of each specimen was coated with nail varnish except for one millimeter around the fissure sealant. The teeth were immersed in 2% basic fuchsin for 24 hours and then sectioned buccolingually. The sections were analyzed for leakage under a stereomicroscope. Data was analyzed by Kruskal-Wallis and Mann-Whitney tests at a significance level of P 0.05, except for groups 2 and 4 (P = 0.002 and groups 3 and 4 (P = 0.033. Conclusion. Use of a flowable composite with bonding agent is a good alternative for sealing pits and fissures; however, further in vitro and in vivo studies are necessary.

  17. Diagnostic problems in the identification of fissures (incomplete fractures) in horses

    International Nuclear Information System (INIS)

    Huskamp, B.; Stadtbaeumer, G.; Mengeler, U.; Nowak, M.

    1994-01-01

    Diagnosing bone-fissures as part of examinations of lameness often confronts the examining veterinarian with problems, which can end on being forensic matters. A fissure which is an incomplete fracture, whereby the division of the continuity ends in healthy bone tissue may in some cases initially not be shown radiologically. Initially strong superior-lameness combined with part sensitivity of pressure are apparent in the area of the line of fissure without soft-tissue swelling. Depending on the localisation of the fracture minor lameness can be apparent. If a fissure has initially been diagnosed, it is necessary to examine the affected limb radiologically from at least two projections appealing the corresponding date for exposure. If the initial diagnosis can not be confirmed radiologically, diagnostic anaesthesia is permitted in exceptional cases. If there is any doubt about the result, the affected limb must be held at rest until the possibility of a fissure can be excluded. The owner of the horse must be informed about problems of diagnostics and their risks [de

  18. The economics of pit and fissure sealants in preventive dentistry: a review.

    Science.gov (United States)

    Kitchens, Dinah H

    2005-08-15

    Oral diseases are progressive, cumulative, and become more intricate to treat with advancement. While dental caries is an infectious transmissible disease with children being at the highest risk, primary prevention can reduce this risk. Primary prevention in dentistry is usually considered to be community fluoridated water supplies, professional fluoride treatments, and pit and fissure sealants. While community fluoridated water supplies have been proven to be cost-effective, the cost-effectiveness of pit and fissure sealants has primarily been studied in school-based programs of children from low socio-economic backgrounds. Dental sealant programs are just one way to help increase primary prevention in the oral health disparities of children. The purpose of this paper is to review the literature regarding the cost-effectiveness of pit and fissure sealants as a preventive strategy in preventive dentistry.

  19. Newborn with Prenatally Diagnosed Choroidal Fissure Cyst and Panhypopituitarism and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ritu Chitkara

    2011-12-01

    Full Text Available Little has been reported on fetal diagnosis of choroidal fissure cysts and prediction of the clinical complications that can result. We describe the case of a near-term male infant with prenatally diagnosed choroidal fissure cyst and bilateral clubfeet. His prolonged course in the neonatal intensive care nursery was marked by severe panhypopituitarism, late-onset diabetes insipidus, placement of a cystoperitoneal shunt, and episodes of sepsis. Postnatal genetic evaluation also revealed an interstitial deletion involving most of band 10q26.12 and the proximal half of band 10q26.13. The patient had multiple readmissions for medical and surgical indications and died at 6 months of age. This case represents the severe end of the spectrum of medical complications for children with choroidal fissure cysts. It highlights not only the importance of comprehensive evaluation and multidisciplinary management and counseling in such cases, but also the need for heightened vigilance in these patients.

  20. The Lobe Fissure Tracking by the Modified Ant Colony Optimization Framework in CT Images

    Directory of Open Access Journals (Sweden)

    Chii-Jen Chen

    2014-11-01

    Full Text Available Chest computed tomography (CT is the most commonly used technique for the inspection of lung lesions. However, the lobe fissures in lung CT is still difficult to observe owing to its imaging structure. Therefore, in this paper, we aimed to develop an efficient tracking framework to extract the lobe fissures by the proposed modified ant colony optimization (ACO algorithm. We used the method of increasing the consistency of pheromone on lobe fissure to improve the accuracy of path tracking. In order to validate the proposed system, we had tested our method in a database from 15 lung patients. In the experiment, the quantitative assessment shows that the proposed ACO method achieved the average F-measures of 80.9% and 82.84% in left and right lungs, respectively. The experiments indicate our method results more satisfied performance, and can help investigators detect lung lesion for further examination.

  1. HPV infection, anal intra-epithelial neoplasia (AIN and anal cancer: current issues

    Directory of Open Access Journals (Sweden)

    Stanley Margaret A

    2012-09-01

    Full Text Available Abstract Background Human papillomavirus (HPV is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia, when compared to cervical cancer and CIN (cervical intraepithelial neoplasia. This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer.

  2. Endosonographic and manometric assessment of the anal sphincters after ileal pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Ciesielski, A.; Bielecki, K.; Baczuk, L.; Tarnowski, W.

    2003-01-01

    Background. The aim of this study was to compare endosonography and manometry of the anal sphincters in patients after ileal pouch-anal anastomosis (IPAA). Patients and methods. Ten patients aged between 23 and 50 years with IPAA performed for ulcerative colitis were examined with anal endosonography (AES) and manometry. Results. AES visualised abnormal image of the internal anal sphincter (IAS) in 9 patients (90%). Defects of the external anal sphincter (EAS) and puborectalis muscle (PR) were shown in 4 patients (40%). In 5 patients (50%) correlation between endosonographic and manometric assessment for the all analysed muscles: IAS, EAS and PR was found. In 4 cases (40%) both methods correlated with the evaluation of the EAS only and in 1 patient (10%) no correlation was found. Correlation between both methods for the IAS was found in half of the patients (50%) while in the evaluation of the EAS and PR dynamic activity, it was found in 9 cases (90%). Conclusions. Anal endosonography and manometry allow us to assess the morphology as well as the function of the anal sphincters in patients with IPAA. The methods mentioned above show high correlation in the assessment of the EAS function (9 cases; 90%) whereas in the case of IAS, manometry frequently (5 patients; 50%) does not confirm endosonografically detected defects. (author)

  3. Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto - University of Sao Paulo, Av. Bandeirantes 3900, Campus Universitario Monte Alegre, 14048 900 Ribeirao Preto, SP (Brazil); Puderbach, Michael [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix [Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Heussel, Claus Peter [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany)

    2012-12-15

    Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

  4. Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

    International Nuclear Information System (INIS)

    Koenigkam-Santos, Marcel; Puderbach, Michael; Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix; Kauczor, Hans-Ulrich; Heussel, Claus Peter

    2012-01-01

    Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

  5. Traumatic superior orbital fissure syndrome: assessment of cranial nerve recovery in 33 cases.

    Science.gov (United States)

    Chen, Chien-Tzung; Wang, Theresa Y; Tsay, Pei-Kwei; Huang, Faye; Lai, Jui-Pin; Chen, Yu-Ray

    2010-07-01

    Superior orbital fissure syndrome is a rare complication that occurs in association with craniofacial trauma. The characteristics of superior orbital fissure syndrome are attributable to a constellation of cranial nerve III, IV, and VI palsies. This is the largest series describing traumatic superior orbital fissure syndrome that assesses the recovery of individual cranial nerve function after treatment. In a review from 1988 to 2002, 33 patients with superior orbital fissure syndrome were identified from 11,284 patients (0.3 percent) with skull and facial fractures. Severity of cranial nerve injury and functional recovery were evaluated by extraocular muscle movement. Patients were evaluated on average 6 days after initial injury, and average follow-up was 11.8 months. There were 23 male patients. The average age was 31 years. The major mechanism of injury was motorcycle accident (67 percent). Twenty-two received conservative treatment, five were treated with steroids, and six patients underwent surgical decompression of the superior orbital fissure. After initial injury, cranial nerve VI suffered the most damage, whereas cranial nerve IV sustained the least. In the first 3 months, recovery was greatest in cranial nerve VI. At 9 months, function was lowest in cranial nerve VI and highest in cranial nerve IV. Eight patients (24 percent) had complete recovery of all cranial nerves. Functional recovery of all cranial nerves reached a plateau at 6 months after trauma. Cranial nerve IV suffered the least injury, whereas cranial nerve VI experienced the most neurologic deficits. Cranial nerve palsies improved to their final recovery endpoints by 6 months. Surgical decompression is considered when there is evidence of bony compression of the superior orbital fissure.

  6. Causes of the fissure formation with shrinkage of metal on low carbon steel slabs

    International Nuclear Information System (INIS)

    Ksenzuk, F.A.; Khudas, A.L.; Zelenskaya, D.P.

    1977-01-01

    The causes have been investigated underlying the formation of fissures with spread of metal on low-carbon steel slabs during hot rolling. Metallographic investigations of templates from various sections of work pieces from 15-ton ingots of 08 ps (kp) steels have indicated that the fissures on the slabs are formed after the metal spreads along the small plane and the work piece thins out in the course of rolling because of the opening of large thin-walled honeycomb bubbles. The phenomenon was confirmed schematically on a model in the form of a slab-shaped lead specimen with longitudinal hole of a variable diameter close to one of the edges

  7. Pit and fissure sealants for preventing dental decay in permanent teeth

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Forss, Helena; Walsh, Tanya

    2017-01-01

    to 3 August 2016), and Embase Ovid (1980 to 3 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 3 August 2016. No restrictions were placed on language or date of publication. Selection criteria......Background: Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries....... Further research with long follow-up is needed....

  8. Anal Cancer Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Anal cancer is uncommon, but often curable with treatment. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information about anal cancer including risk factors, symptoms, diagnosis, prognosis, and treatment in this expert-reviewed summary.

  9. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  10. Novel QTLs affecting rice kernel fissure resistance discovered in the cultivar ‘Saber’ augment those from ‘Cybonnet’

    Science.gov (United States)

    Kernel fissures in rice (Oryza sativa L.) caused by pre- or post-harvest stresses are the leading cause of breakage among milled rice. Such breakage causes economic losses for producers, millers, and marketers. Five QTLs for kernel fissure resistance (FR) were identified among a set of 275 RILs de...

  11. Complex anal fistulas: plug or flap?

    Science.gov (United States)

    Muhlmann, Mark D; Hayes, Julian L; Merrie, Arend E H; Parry, Bryan R; Bissett, Ian P

    2011-10-01

    Rectal mucosal advancement flaps (RMAF) and fistula plugs (FP) are techniques used to manage complex anal fistulas. The purpose of this study was to review and compare the results of these methods of repair. A retrospective review of all complex anal fistulas treated by either a RMAF or a FP at Auckland City Hospital from 2004 to 2008. Comparisons were made in terms of successful healing rates, time to failure and the use of magnetic resonance imaging. Overall, 70 operations were performed on 55 patients (55.7% male). The mean age was 44.9 years. Twenty-one patients (30%) had had at least one previous unsuccessful repair. Indications for repair included 57 high cryptoglandular anal (81%), 4 Crohn's anal (6%), 7 rectovaginal (10%), 1 rectourethral (1%) and 1 pouch-vaginal fistula (1%). All patients were followed up with a mean of 4.5 months. Forty-eight RMAFs (69% of total) were performed with 16 successful repairs (33%). Twenty-two FPs (31% of total) were performed with 7 successful repairs (32%, P = 0.9). In failed repairs, there was no difference in terms of mean time to failure (RMAF 4.8 months versus FP 4.1 months, P = 0.62). Magnetic resonance imaging was performed in 21 patients (37%) before the repair. The success rate in these patients was 20%. The results of treatment of complex anal fistulas are disappointing. The choice of operation of either a RMAF or a FP did not alter the poor healing rates of about one third of patients in each group.

  12. Calcul statistique du volume des blocs matriciels d'un gisement fissuré The Statistical Computing of Matrix Block Volume in a Fissured Reservoir

    Directory of Open Access Journals (Sweden)

    Guez F.

    2006-11-01

    Full Text Available La recherche des conditions optimales d'exploitation d'un gisement fissuré repose sur une bonne description de la fissuration. En conséquence il est nécessaire de définir les dimensions et volumes des blocs matriciels en chaque point d'une structure. Or la géométrie du milieu (juxtaposition et formes des blocs est généralement trop complexe pour se prêter au calcul. Aussi, dans une précédente communication, avons-nous dû tourner cette difficulté par un raisonnement sur des moyennes (pendages, azimuts, espacement des fissures qui nous a conduits à un ordre de grandeur des volumes. Cependant un volume moyen ne peut pas rendre compte d'une loi de répartition des volumes des blocs. Or c'est cette répartition qui conditionne le choix d'une ou plusieurs méthodes successives de récupération. Aussi présentons-nous ici une méthode originale de calcul statistique de la loi de distribution des volumes des blocs matriciels, applicable en tout point d'un gisement. La part de gisement concernée par les blocs de volume donné en est déduite. La connaissance générale du phénomène de la fracturation sert de base au modèle. Les observations de subsurface sur la fracturation du gisement en fournissent les données (histogramme d'orientation et d'espacement des fissures.Une application au gisement d'Eschau (Alsace, France est rapportée ici pour illustrer la méthode. The search for optimum production conditions for a fissured reservoir depends on having a good description of the fissure pattern. Hence the sizes and volumes of the matrix blocks must be defined at all points in a structure. However, the geometry of the medium (juxtaposition and shapes of blocks in usually too complex for such computation. This is why, in a previous paper, we got around this problem by reasoning on the bases of averages (clips, azimuths, fissure spacing, and thot led us to an order of magnitude of the volumes. Yet a mean volume cannot be used to explain

  13. Preconsolidation of Søvind Marl - a highly fissured Eocene clay

    DEFF Research Database (Denmark)

    Grønbech, Gitte Lyng; Ibsen, Lars Bo; Nielsen, Benjaminn Nordahl

    2015-01-01

    Determination of the preconsolidation stresses is a key tool in geotechnical engineering used to evaluate and estimate the behavior of soils. However, it has been proven difficult to accurately estimate the preconsolidation in highly fissured overconsolidated clays, due to the effect of the fissu...

  14. Capillary Discourses, Fissure Points, and Tacitly Confessing the Self: Foucault's Later Work and Educational Research

    Science.gov (United States)

    Worthman, Christopher; Troiano, Beverly

    2016-01-01

    This article draws on Foucault's later work to consider in an exploratory but specific way how that work can inform educational research. It introduces the concepts of "capillary discourses" and "fissure points" to show, by way of example, how a regime of truth such as neoliberalism shapes lifelong learning theory, the pedagogy…

  15. Spontaneous Cerebrospinal Fluid Otorrhea from a Persistent Tympanomeningeal Fissure Presenting as Recurrent Serous Otitis Media

    DEFF Research Database (Denmark)

    Zakaryan, Arman; Poulsgaard, Lars; Hollander, Camilla

    2015-01-01

    We describe spontaneous cerebrospinal fluid (CSF) otorrhea through a patent tympanomeningeal (Hyrtl) fissure presenting as recurrent serous otitis media. The CSF leak was observed when a drain was placed through the tympanic membrane by an otologist. The diagnosis was then confirmed by computed...

  16. Tensions and Fissures: The Politics of Standardised Testing and Accountability in Ontario, 1995-2015

    Science.gov (United States)

    Pinto, Laura Elizabeth

    2016-01-01

    While Ontario has received international accolades for its enactment of province-wide standardised testing upon the formation of the Education Quality and Accountability Office (EQAO), a closer look at provincial assessments over a 20-year span reveals successes as well as systemic tensions and fissures. The purpose of this paper is twofold.…

  17. Tracer movement in a single fissure in granitic rock - some experimental results and their interpretation

    International Nuclear Information System (INIS)

    Neretnieks, I.; Eriksen, T.; Taetinen, P.

    1980-08-01

    Radionuclide migration was studied in a natural fissure in a granite core. The fissure was oriented parallel to the axis in a cylindrical core 30 cm long and 20 in diameter. The traced solution was injected at one end of the core and collected at the other. Breakthrough curves were obtained for the nonsorbing tracers tritiated water, and a large molecular weight lignosulphonate molecule and the sorbing tracers cesium and strontium. From the breakthrough curves for the nonsorbing tracers it could be concluded that channeling occurs in the single fissure. A 'dispersion' model based on channeling is presented. The results from the sorbing tracers indicate that there is substantial diffusion into and sorption in the rock matrix. Sorption on the surface of the fissure also accounts for a part of the retardation effect of the sorbing species. A model which includes the mechanisms of channeling, surface sorption matrix diffusion and matrix sorption is presented. The experimental breakthrough curves can be fitted fairly well by this model by use of independently obtained data on diffusivities and matrix sorption. (author)

  18. Tracer Movement in a Single Fissure in Granitic Rock: Some Experimental Results and Their Interpretation

    Science.gov (United States)

    Neretnieks, Ivars; Eriksen, Tryggve; TäHtinen, PäIvi

    1982-08-01

    Radionuclide migration was studied in a natural fissure in a granite core. The fissure was oriented parallel to the axis in a cylindrical core 30 cm long and 20 cm in diameter. The traced solution was injected at one end of the core and collected at the other. Breakthrough curves were obtained for the nonsorbing tracers, tritiated water, and a large-molecular-weight lignosulphonate molecule and for the sorbing tracers, cesium and strontium. From the breakthrough curves for the nonsorbing tracers it could be concluded that channeling occurs in the single fissure. A `dispersion' model based on channeling is presented. The results from the sorbing tracers indicate that there is substantial diffusion into and sorption in the rock matrix. Sorption on the surface of the fissure also accounts for a part of the retardation effect of the sorbing species. A model which includes the mechanisms of channeling, surface sorption, matrix diffusion, and matrix sorption is presented. The experimental breakthrough curves can be fitted fairly well by this model by use of independently obtained data on diffusivities and matrix sorption.

  19. The Use of Pit and Fissure Sealants—A Literature Review

    Directory of Open Access Journals (Sweden)

    Reem Naaman

    2017-12-01

    Full Text Available This paper reviews the literature and discusses the latest updates on the use of pit and fissure sealants. It demonstrates the effectiveness of pit and fissure sealants in preventing caries and the management of early carious lesions. It compares the use of different sealant materials and their indications. It describes the application technique for sealants. It also reviews the cost-effectiveness of sealants as a preventive strategy. From this review and after the discussion of recently published studies on pit and fissure sealants, it is evident that sealants are effective in caries prevention and in preventing the progression of incipient lesions. It is therefore recommended that pit and fissure sealant be applied to high-caries-risk children for optimum cost-effectiveness. It is a highly sensitive technique that needs optimum isolation, cleaning of the tooth surface, etching, and the application of a thin bonding layer for maximum benefit. Recall and repair, when needed, are important to maximize the effectiveness of such sealant use.

  20. The Use of Pit and Fissure Sealants—A Literature Review

    Science.gov (United States)

    Naaman, Reem; El-Housseiny, Azza A.; Alamoudi, Najlaa

    2017-01-01

    This paper reviews the literature and discusses the latest updates on the use of pit and fissure sealants. It demonstrates the effectiveness of pit and fissure sealants in preventing caries and the management of early carious lesions. It compares the use of different sealant materials and their indications. It describes the application technique for sealants. It also reviews the cost-effectiveness of sealants as a preventive strategy. From this review and after the discussion of recently published studies on pit and fissure sealants, it is evident that sealants are effective in caries prevention and in preventing the progression of incipient lesions. It is therefore recommended that pit and fissure sealant be applied to high-caries-risk children for optimum cost-effectiveness. It is a highly sensitive technique that needs optimum isolation, cleaning of the tooth surface, etching, and the application of a thin bonding layer for maximum benefit. Recall and repair, when needed, are important to maximize the effectiveness of such sealant use. PMID:29563440

  1. Abnormalities of cerebellar foliation and fissuration: classification, neurogenetics and clinicoradiological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P. [University Hospital, Department of Radiology, Herestraat 49, 3000 Leuven (Belgium)

    2002-08-01

    Several genes have been found to influence the different cells involved in the processes of foliation and fissuration in the mouse and rat cerebellum. In the light of these new concepts and on the basis of the imaging findings in 42 patients, a classification is proposed for abnormalities of foliation and fissuration. On the basis of recent genetic and experimental evidence on mechanisms which control the origin of the cerebellum, it is suggested that abnormalities of foliation and fissuration form a single group, with a spectrum of severity. Some patients have only abnormal fissuration of the anterior lobe (type 1a) and others additional dysplasia of the anterior and part of the posterior lobe (type 1b). Extension of abnormalities into the hemispheres is often seen in the latter group. A second group has vermian and hemisphere abnormalities (type 2). In addition to the malformation of the anterior lobe of the vermis, three different hemispheric lesions can be seen in this group: cortical dysgenesis, hypertrophy of the cerebellar cortex, and malorientation of the folia. The mild abnormalities (type 1a) can be considered an incidental observation without clinical relevance. The moderate and severe cerebellar anomalies (type 1b and 2) are always associated with cerebellar symptoms and/or signs. (orig.)

  2. Abnormalities of cerebellar foliation and fissuration: classification, neurogenetics and clinicoradiological correlations

    International Nuclear Information System (INIS)

    Demaerel, P.

    2002-01-01

    Several genes have been found to influence the different cells involved in the processes of foliation and fissuration in the mouse and rat cerebellum. In the light of these new concepts and on the basis of the imaging findings in 42 patients, a classification is proposed for abnormalities of foliation and fissuration. On the basis of recent genetic and experimental evidence on mechanisms which control the origin of the cerebellum, it is suggested that abnormalities of foliation and fissuration form a single group, with a spectrum of severity. Some patients have only abnormal fissuration of the anterior lobe (type 1a) and others additional dysplasia of the anterior and part of the posterior lobe (type 1b). Extension of abnormalities into the hemispheres is often seen in the latter group. A second group has vermian and hemisphere abnormalities (type 2). In addition to the malformation of the anterior lobe of the vermis, three different hemispheric lesions can be seen in this group: cortical dysgenesis, hypertrophy of the cerebellar cortex, and malorientation of the folia. The mild abnormalities (type 1a) can be considered an incidental observation without clinical relevance. The moderate and severe cerebellar anomalies (type 1b and 2) are always associated with cerebellar symptoms and/or signs. (orig.)

  3. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents

    DEFF Research Database (Denmark)

    Hiiri, Anne; Ahovuo-Saloranta, Anneli; Nordblad, Anne

    2010-01-01

    the effectiveness of pit and fissure sealants to be statistically significantly higher than an application of fluoride varnish every 6 months in preventing occlusal decays of first molars at 23 months (with a RR of 0.74, 95% confidence interval (CI) 0.58 to 0.95); and at 4 years and 9 years (with a RR of 0.42, 95...... caries on the fluoride varnished tooth surfaces, compared to sealed plus fluoride varnished surfaces, with a RR of 0.36 (95% CI 0.21 to 0.61). AUTHORS' CONCLUSIONS: There was some evidence on the superiority of pit and fissure sealants over fluoride varnish application in the prevention of occlusal......BACKGROUND: The majority of the detected increment in dental caries among children and adolescents is confined to pit and fissure surfaces of first molars. OBJECTIVES: The objective of this study was to compare the effectiveness of pit and fissure sealants with fluoride varnishes in the prevention...

  4. Giant desiccation fissures on the Black Rock and Smoke Creek Deserts, Nevada

    Science.gov (United States)

    Willden, R.; Mabey, D.R.

    1961-01-01

    Open fissures, from 100 to several hundred feet apart, that have produced polygonal patterns on the Black Rock Desert, Nevada, are believed to be giant desiccation cracks resulting from a secular trend toward aridity in the last few decades. Similar features on the Smoke Creek Desert probably have the same origin.

  5. Rice fissure resistance QTLs from ‘Saber’ complement those from ‘Cypress’

    Science.gov (United States)

    The economic value of broken rice is about half that of whole milled rice, so one goal of producers, millers, and rice breeders is to reduce grain breakage during the dehusking and milling processes. One of the primary causes of rice breakage is fissuring, or cracking, of the rice before it enters ...

  6. Identification of genetic loci underlying the kernel fissure-resistance exhibited by 'cypress' and 'saber'

    Science.gov (United States)

    The economic value of broken rice is about half that of whole milled rice, so one goal of producers, millers, and rice breeders is to reduce broken grains that result from the dehusking and milling processes One of the primary causes of rice breakage is fissuring, or cracking, of the rice before it ...

  7. Comparative study of resin sealant and resin modified glass ionomer as pit and fissure sealant

    Directory of Open Access Journals (Sweden)

    Shirin Malek

    2017-02-01

    Full Text Available The purpose of the present study was to compare the marginal integrity of resin modified glass ionomer cement with that of resin sealant, in vitro. Forty artificial pit and fissure cavities were prepared in occlusal surface of extracted premolar teeth by using ¼ round carbide bur. Cavities were condensed with artificial organic debris followed by cleaning with prophylaxis pumice brush and paste and then separated into two treatment groups. In Group A, 15 fissure cavities were sealed by resin sealant and in Group B, 15 fissure cavities were sealed by resin modified glass ionomer sealant. These specimens were subjected to thermo-cycling followed by dye penetration test. The remaining 5 cavities from each group were analyzed for debris score by the SEM. The results of the microleakage test showed that the efficacy of preventing microleakage of samples sealed by resin modified glass ionomer sealant was higher than the samples sealed by resin sealant. However, no significant differences were found. It can be concluded that use of resin modified glass ionomer sealant is a good alternative for sealing pits and fissures.

  8. A comparison between three different pit and fissure sealants with regard to marginal integrity.

    Science.gov (United States)

    Fernandes, Kristlee Sabrin; Chalakkal, Paul; de Ataide, Ida de Noronha; Pavaskar, Rajdeep; Fernandes, Precylia Philo; Soni, Harleen

    2012-04-01

    THE AIM OF THIS STUDY IS TO COMPARE THE OCCURRENCE OF ENAMEL FRACTURES, SEALANT FRACTURES AND MARGINAL FISSURES AFTER PLACEMENT OF THREE SEALANTS: Helioseal F, Conseal F and Clinpro. Thirty individuals between 13 and 15 years of age, diagnosed with pit and fissure caries by visual and DIAGNOdent examination, were chosen for sealant placement on their mandibular molars. The sealants were placed at random, after which, impressions were made with polyvinyl siloxane and casts were fabricated. Dies were prepared, each of which were sputter coated with gold in order to be examined under a scanning electron microscope. The following morphologies were analyzed from dies from each of the sealant groups: Continuous margins, sealant fractures, marginal fissures and enamel fractures. After six months, they were recalled for impression making. Dies were prepared and microscopically analyzed as mentioned. Based on the time of evaluation, there were two groups: Initial group (soon after placement) and final group (after six months). Statistical analysis was done using the paired 't' test and One-way analysis of variance (ANOVA). Clinpro had the greatest fracture resistance, followed by Conseal F and Helioseal F. The occurrence of marginal fissure was found to be least with Clinpro.

  9. Effect of an Antibacterial Monomer on the Antibacterial Activity of a Pit-and-Fissure Sealant.

    Directory of Open Access Journals (Sweden)

    Fan Yu

    Full Text Available Resin-based pit-and-fissure sealants are often used to form a barrier on the occlusal surface of molars to treat caries lesions; however, bacteria can remain in the pit and fissures without detection, increasing the risk of secondary caries. Sealants with antimicrobial properties or microbial repellent actions might be advantageous. The aim of this study was to assess the inhibitory effect of a 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB-incorporated sealant against Streptococcus mutans. MAE-DB (4% wt was incorporated into a commercially available sealant, Eco-S resin-based pit-and-fissure sealant (Vericom Co., Ltd., Korea; a sealant without MAE-DB served as a negative control, and Clinpro™ Sealant (3M™ ESPE™, a fluoride-releasing resin, was used as a commercial control. The effects of the cured sealants and their eluents on the growth of S. mutans were determined according to colony-forming unit counts and metabolic tests. The effects of the cured sealants on the adherence and membrane integrity of S. mutans were investigated using confocal laser-scanning microscopy (CLSM in conjunction with fluorescent indicators. Compared with the negative control and commercial control, the cured MAE-DB-incorporated pit-and-fissure sealant exhibited a significant inhibitory effect on the growth of S. mutans (P < 0.05, whereas the eluents did not show any detectable antibacterial activity. The commercial control also showed no detectable bactericidal activity. Moreover, the aged experimental material retained its property of contact inhibition of biofilm formation. The fluorescence analysis of CLSM images demonstrated that the cured MAE-DB-incorporated sealant could hamper the adherence of S. mutans and exert a detrimental effect on bacterial membrane integrity. The incorporation of MAE-DB can render a pit-and-fissure sealant with contact antibacterial activity after polymerization via influencing the growth, adherence, and membrane

  10. Methods for monitoring land subsidence and earth fissures in the Western USA

    Directory of Open Access Journals (Sweden)

    K. C. Fergason

    2015-11-01

    Full Text Available Depletion of groundwater resources in many deep alluvial basin aquifers in the Western USA is causing land subsidence, as it does in many regions worldwide. Land subsidence can severely and adversely impact infrastructure by changing the ground elevation, ground slope (grade and through the development of ground cracks known as earth fissures that can erode into large gullies. Earth fissures have the potential to compromise the foundations of dams, levees, and other infrastructure and cause failure. Subsequent to an evaluation of the overall subsidence experienced in the vicinity of subsidence-impacted infrastructure, a detailed investigation to search for earth fissures, and design and/or mitigation of potentially effected infrastructure, a focused monitoring system should be designed and implemented. Its purpose is to provide data, and ultimately knowledge, to reduce the potential adverse impacts of land subsidence and earth fissure development to the pertinent infrastructure. This risk reduction is realized by quantifying the rate and distribution of ground deformation, and to detect ground rupture if it occurs, in the vicinity of the infrastructure. The authors have successfully designed and implemented monitoring systems capable of quantifying rates and distributions of ground subsidence and detection of ground rupture at multiple locations throughout the Western USA for several types of infrastructure including dams, levees, channels, basins, roadways, and mining facilities. Effective subsidence and earth fissure monitoring requires understanding and quantification of historic subsidence, estimation of potential future subsidence, delineation of the risk for earth fissures that could impact infrastructure, and motivation and resources to continue monitoring through time. A successful monitoring system provides the means to measure ground deformation, grade changes, displacement, and anticipate and assess the potential for earth fissuring

  11. Dysregulation of Autophagy Contributes to Anal Carcinogenesis.

    Directory of Open Access Journals (Sweden)

    Evie H Carchman

    Full Text Available Autophagy is an intracellular catabolic process that removes and recycles unnecessary/dysfunctional cellular components, contributing to cellular health and survival. Autophagy is a highly regulated cellular process that responds to several intracellular signals, many of which are deregulated by human papillomavirus (HPV infection through the expression of HPV-encoded oncoproteins. This adaptive inhibitory response helps prevent viral clearance. A strong correlation remains between HPV infection and the development of squamous cell carcinoma (SCC of the anus, particularly in HIV positive and other immunosuppressed patients. We hypothesize that autophagy is inhibited by HPV-encoded oncoproteins thereby promoting anal carcinogenesis (Fig 1.HPV16 transgenic mice (K14E6/E7 and non-transgenic mice (FVB/N, both of which do not spontaneously develop anal tumors, were treated topically with the chemical carcinogen, 7,12-Dimethylbenz[a]anthracene (DMBA, to induce anal cancer. The anuses at different time points of treatment (5, 10, 15 and 20 weeks were analyzed using immunofluorescence (IF for two key autophagy marker proteins (LC3β and p62 in addition to histological grading. The anuses from the K14E6/E7 mice were also analyzed for visual evidence of autophagic activity by electron microscopy (EM. To see if there was a correlation to humans, archival anal specimens were assessed histologically for grade of dysplasia and then analyzed for LC3β and p62 protein content. To more directly examine the effect of autophagic inhibition on anal carcinogenesis, nontransgenic mice that do not develop anal cancer with DMBA treatment were treated with a known pharmacologic inhibitor of autophagy, chloroquine, and examined for tumor development and analyzed by IF for autophagic proteins.Histologically, we observed the progression of normal anoderm to invasive SCC with DMBA treatment in K14E6/E7 mice but not in nontransgenic, syngeneic FVB/N background control mice

  12. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women

    Directory of Open Access Journals (Sweden)

    Sedigheh Amir Ali Akbari

    2014-01-01

    Full Text Available Background: Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous breastfeeding women. Materials and Methods: This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm and to measure the severity of damage, Amir scale (1-10 cm were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. Results: The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74 and day 10 after delivery (4.26 ± 1.57 and before treatment and day 14 after delivery in the case group (1.32 ± 1.02 had a significant difference (P < 0.001. Nipple discharge between the two groups, before treatment (%75.2 and day 10 after delivery (%31.6 and before treatment and day 14 after delivery (%15.7, the case group had a significant difference (P < 0.001. Conclusion: Menthol essence can improve nipple fissures in the primiparous breastfeeding women.

  13. Microleakage, adaptation ability and clinical efficacy of two fluoride releasing fissure sealants

    Directory of Open Access Journals (Sweden)

    Marković Dejan

    2012-01-01

    Full Text Available Background/Aim. Retention of fissure sealants and good adaptation to enamel are essential for their success. Fluoride releasing resin-based materials are widely accepted for pit and fissure sealing, but newly designed glass ionomers can serve as a good alternative. The aim of this study was to evaluate microleakage and sealing ability in vitro, and to clinically assess two fluoride releasing fissure sealants. Methods. The sample for experimental study consisted of 20 freshly extracted intact human third molars, divided in two experimental groups according to the sealing material: fluoride releasing resin-based (Heliosel F and glass ionomer (Fuji Triage material. Digital images and scanning electron microscope were used to assess microleakage and adaptation ability. Sample for clinical study consisted of 60 children, aged 6-8 years, with high caries risk, divided in two groups according to the sealant material. Fissure sealant was applied to all erupted, caries-free first permanent molars. Sealants were evaluated after 3, 6 and 12 months using modified Ryge criteria for retention, marginal adaptation, colour match, surface smoothness and caries. Results. Microleakage was detected in more than half of the specimen, without significant differences between the two groups (p > 0.05. Both materials exhibited acceptable sealing ability. Complete retention at the end of the observation period was 81.8% for resin-based, and 21.1% for glass-ionomer fissure sealant (p < 0.001. The presence of caries in sealed molars has been detected in one patient in both groups. During the 12-month observation period, Helioseal F demonstrated better retention, marginal adaptation and surface smoothness (p < 0.001. There were no differences between the two materials regarding caries and color match (p > 0.05. Conclusion. Both tested materials demonstrate satisfactory clinical and caries prophylactic characteristics that justify their use in contemporary preventive

  14. Land subsidence, Ground Fissures and Buried Faults: InSAR Monitoring of Ciudad Guzmán (Jalisco, Mexico

    Directory of Open Access Journals (Sweden)

    Carlo Alberto Brunori

    2015-07-01

    Full Text Available We study land subsidence processes and the associated ground fissuring, affecting an active graben filled by thick unconsolidated deposits by means of InSAR techniques and fieldwork. On 21 September 2012, Ciudad Guzmán (Jalisco, Mexico was struck by ground fissures of about 1.5 km of length, causing the deformation of the roads and the propagation of fissures in adjacent buildings. The field survey showed that fissures alignment is coincident with the escarpments produced on 19 September 1985, when a strong earthquake with magnitude 8.1 struck central Mexico. In order to detect and map the spatio-temporal features of the processes that led to the 2012 ground fissures, we applied InSAR multi-temporal techniques to process ENVISAT-ASAR and RADARSAT-2 satellite SAR images acquired between 2003 and 2012. We detect up to 20 mm/year of subsidence of the northwestern part of Ciudad Guzmán. These incremental movements are consistent with the ground fissures observed in 2012. Based on interferometric results, field data and 2D numerical model, we suggest that ground deformations and fissuring are due to the presence of areal subsidence correlated with variable sediment thickness and differential compaction, partly driven by the exploitation of the aquifers and controlled by the distribution and position of buried faults.

  15. Numerical analysis on the crack propagation and failure characteristics of rocks with double fissures under the uniaxial compression

    Directory of Open Access Journals (Sweden)

    Leyong Chen

    2015-12-01

    Full Text Available The fissures and rock bridges with different dips had different contributions to crack's initiation, propagation, convergence and penetration. In this paper, based on the rock fracture theory, the crack's propagation and evolution process on rock specimen with double fissures under uniaxial compression was simulated. As a result, the crack propagation and evolution law of rocks with different fissure dips (α = 0°, 15°, 30°, 45°, 60°, 75°, 90°; β = 45° and different rock bridge dips (β = 0°, 30°, 45°, 60°, 90°; α = 45° was obtained by numerical tests. Meanwhile, the fissure and rock bridge dips influence on the macro mechanical properties of rock was analyzed. Besides, the paper investigated the influences of different fissure dips and different rock bridge dips on the bridge transfixion. The study is of great significance to reveal the impact of different dips on the mechanical mechanism of multiple-fissures rock under specific conditions, and it also has important theoretical significance for the research on multiple-fissure rock.

  16. Anal sphincter responses after perianal electrical stimulation

    DEFF Research Database (Denmark)

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

    1982-01-01

    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...... 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...... stimulation to a minimum of 30-60 ms. This response represented the clinical observable spinal reflex, "the classical anal reflex". The latencies of the two first responses were so short that they probably do not represent spinal reflexes. This was further supported by the effect of epidural anaesthesia which...

  17. 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

  18. 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...... 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...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  19. Retention of fissure sealants in young permanent molars affected by dental fluorosis: a 12-month clinical study.

    Science.gov (United States)

    Hasanuddin, S; Reddy, E R; Manjula, M; Srilaxmi, N; Rani, S T; Rajesh, A

    2014-10-01

    To evaluate and compare retention and caries occurance following placement of Clinpro and FUJI VII fissure sealants, by two different techniques simultaneously in unsealed, contralateral young permanent molars of 7- to 10-year-old children affected by mild to moderate dental fluorosis at various recall intervals of 1 week, 1, 3, 6 and 12 months. 80 schoolchildren with mild to moderate dental fluorosis were assigned to Group A and Group B with 40 children in each group. In Group A Clinpro fissure sealant and in Group B Fuji VII fissure sealant was used. In both the groups fissure sealants were applied by conventional fissure sealant technique (CST) on one side and enameloplasty sealant technique (EST) on the other side of the same arch. The applied fissure sealants were evaluated clinically for retention and caries incidence. Clinpro fissure sealant showed a retention rate of 95% when compared with Fuji VII (57.5%) at the end of 12 months, which was statistically significant. Regarding techniques, EST showed better results than CST in both the groups. Comparison of groups with respect to retention and techniques at different time periods was performed using Mann-Whitney U test (p < 0.05). Comparison of different time periods with respect to retention and technique in all the groups was performed using Wilcoxon matched pairs test by ranks (p < 0.05). Clinpro fissure sealant showed better retention at all treatment intervals, when compared with Fuji VII. Further follow-up is required to study the efficacy of the fissure sealant placement techniques.

  20. Clinical Evaluation of applying a hydrophobic and a hydrophilic bonding agent on the retention and durability of fissure sealant therapy

    Directory of Open Access Journals (Sweden)

    Mostafa GHandi

    2016-03-01

    Full Text Available Background and Aims: As in fissure sealant therapy the tooth surface is mostly enamel, the use of an enamel bonding agent (hydrophobic bonding agent may be more cost effective than that of newer generations of bonding (hydrophilic bonding agents. The aim of this study was to compare the retention and durability of fissure sealant therapy when applying an enamel bonding agent, a dentin bonding agent and no bonding agent during 4 years. Materials and Methods: This study was done on the first permanent molars of the upper and lower jaws of 24 students of the first grade of a primary school (6-7 years old. On 36 teeth, a dentin bonding agent (Excite was applied under the fissure sealant and on 36 teeth an enamel bonding agent (Margin bond was applied under the fissure sealant. Then, 24 teeth were selected from these two groups and were compared with a group (including 24 teeth with no bonding agent under the fissure sealant (as control group. All the fissures of the teeth were evaluated annually for 4 years to find out the presence or absence of fissure sealant substance. Data were analyzed using Wilcoxon test. Results: From the statistical analysis, there was no significant difference in retention and durability of the fissure sealant substance comparing the group with dentin bonding agent (Excite and the group with enamel bonding agent (Margin bond. Also, using a bonding agent made no significant difference (P>0.05. Conclusion: According to the results of this study, using a bonding agent made no improvement in the retention and durability of fissure sealant substance.

  1. Anal canal plasmacytoma - An uncommon presentation site

    International Nuclear Information System (INIS)

    Antunes, M. I.; Bujor, L.; Grillo, I. M.

    2011-01-01

    Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma. (authors)

  2. 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.

  3. 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

  4. King's Bowl Pit Crater, Lava Field and Eruptive Fissure, Idaho - A Multipurpose Volcanic Planetary Analog

    Science.gov (United States)

    Hughes, S. S.; Garry, B.; Kobs-Nawotniak, S. E.; Sears, D. W. G.; Borg, C.; Elphic, R. C.; Haberle, C. W.; Kobayashi, L.; Lim, D. S. S.; Sears, H.; Skok, J. R.; Heldmann, J. L.

    2014-12-01

    King's Bowl (KB) and its associated eruptive fissure and lava field on the eastern Snake River Plain, is being investigated by the NASA SSERVI FINESSE (Field Investigations to Enable Solar System Science and Exploration) team as a planetary analog to similar pits on the Moon, Mars and Vesta. The 2,220 ± 100 BP basaltic eruption in Craters of the Moon National Monument and Preserve represents early stages of low shield growth, which was aborted when magma supply was cut off. Compared to mature shields, KB is miniscule, with ~0.02 km3 of lava over ~3 km2, yet the ~6 km long series of fissures, cracks and pits are well-preserved for analog studies of volcanic processes. The termination of eruption was likely related to proximity of the 2,270 ± 50 BP eruption of the much larger Wapi lava field (~5.5 km3 over 325 km2 area) on the same rift. Our investigation extends early work by R. Greeley and colleagues, focusing on imagery, compositional variations, ejecta distribution, dGPS profiles and LiDAR scans of features related to: (1) fissure eruptions - spatter ramparts, cones, feeder dikes, extension cracks; (2) lava lake formation - surface morphology, squeeze-ups, slab pahoehoe lava mounds, lava drain-back, flow lobe overlaps; and (3) phreatic steam blasts - explosion pits, ejecta blankets of ash and blocks. Preliminary results indicate multiple fissure eruptions and growth of a basin-filled lava lake up to ~ 10 m thick with outflow sheet lava flows. Remnant mounds of original lake crust reveal an early high lava lake level, which subsided as much as 5 m as the molten interior drained back into the fissure system. Rapid loss of magma supply led to the collapse of fissure walls allowing groundwater influx that triggered multiple steam blasts along at least 500 m. Early blasts occurred while lake magma pressure was still high enough to produce squeeze-ups when penetrated by ejecta blocks. The King's Bowl pit crater exemplifies processes of a small, but highly energetic

  5. Can earthquake fissures predispose hillslopes to landslides? - Evidence from Central and East Asia

    Science.gov (United States)

    Sidle, Roy C.; Gomi, Takashi; Rajapbaev, Muslim; Chyngozhoev, Nurstan

    2017-04-01

    Factors affecting earthquake-initiated landslides include earthquake magnitude, focal depth, and seismic wave propagation and attenuation. In contrast to rainfall-initiated landslides, earthquake-induced landslides often occur on convex slopes and near ridgelines. Here we present evidence from Fergana Basin, Kyrgyzstan and Kumamoto, Japan on how fissures developed during earthquakes may promote subsequent initiation of rainfall-triggered landslides. More than 1800 recent major landslides in hilly terrain and soft sediments of the Fergana Basin have been largely attributed to accumulation of heavy rainfall and snowmelt. While no large earthquakes have occurred in the Fergana Basin, smaller earthquakes have generated fissures near ridgelines and on convex slopes. The connection of fissures, developed years or decades before slope failure, with preferential transport of rainwater and runoff into the soil has not been previously investigated. Fissures have been observed to expand with time, particularly during subsequent minor earthquakes, further promoting preferential infiltration. Because the soil mantle does not have large contrasts in permeability that would define a slip plane for landslides, it appears that the position and depth of these fissures may control the location and depth of failures. Zones in the soil where surficial inputs of water are preferentially transported, augment natural subsurface accumulation of antecedent rainfall. Many landslides in the eastern Fergana Basin occur after several months of accumulated precipitation and groundwater has been observed emerging on critical hillside locations (near ridgelines and on convex slopes) prior to slope failure. During the 2016 Kumamoto Earthquake (M 7.3), many landslides were triggered in forest and grassland hillslopes near Mount Aso. All of these earthquakes were shallow (focal depths about 10 km), causing high shaking intensity and ground rupturing. Because soils were relatively dry during these

  6. Simulation of the Flow Through Porous Layers Composed of Converging-Diverging Capillary Fissures or Tubes

    Science.gov (United States)

    Walicka, A.

    2018-02-01

    In this paper, a porous medium is modelled by a network of converging-diverging capillaries which may be considered as fissures or tubes. This model makes it necessary to consider flows through capillary fissures or tubes. Therefore an analytical method for deriving the relationships between pressure drops, volumetric flow rates and velocities for the following fluids: Newtonian, polar, power-law, pseudoplastic (DeHaven and Sisko types) and Shulmanian, was developed. Next, considerations on the models of pore network for Newtonian and non-Newtonian fluids were presented. The models, similar to the schemes of central finite differences may provide a good basis for transforming the governing equations of a flow through the porous medium into a set of linear or quasi-linear algebraic equations. It was shown that the some coefficients in these algebraic equations depend on the kind of the capillary convergence.

  7. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Hiiri, Anne; Nordblad, Anne

    2008-01-01

    BACKGROUND: Although pit and fissure sealants are effective in preventing caries, their efficacy may be related to the caries prevalence in the population. OBJECTIVES: The primary objective of this review was to evaluate the caries prevention of pit and fissure sealants in children and adolescents...... for comparison of sealant versus sealant. Five split-mouth studies and one parallel group study with 5 to 10 year old children found a significant difference in favour of second or third generation resin-based sealants on first permanent molars, compared to a control without sealant, with a pooled RR of 0.13 (95...... sealant group; 27% of sealed surfaces were decayed compared to 77% of surfaces without sealant.The results of the studies comparing different sealant materials were conflicting. AUTHORS' CONCLUSIONS: Sealing is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars...

  8. [Banana peel: a possible source of infection in the treatment of nipple fissures].

    Science.gov (United States)

    Novak, Franz Reis; de Almeida, João Aprígio Guerra; de Souza e Silva, Rosana

    2003-01-01

    To study the microbiology of banana peel being sold in the city of Rio de Janeiro, in an attempt to determine the possibility that the peel may represent a source of infection for women who use it to treat nipple fissures. The following microorganisms were studied in 20 banana peel samples: mesophiles, total coliforms, fecal coliforms, Pseudomonas aeruginosa, lipolytic and proteolytic microorganisms, molds and yeasts, lactic bacteria, and coagulase-positive staphylococcus. The microbiological analyses revealed the occurrence of several typical groups of microorganisms, with the following distribution of positive results being detected in banana peel samples: mesophiles, 100%; total coliforms, 20%; coagulase-positive staphylococcus, 25%; molds and yeasts, 30%; proteolytic microorganisms, 70%; lipolytic microorganisms, 30%, and lactic bacteria, 95%. Fecal coliforms and Pseudomonas aeruginosa were not isolated. The results show the presence of potentially pathogenic microorganisms in levels which could compromise the microbiological quality of the banana peel. Its use for the treatment of nipple fissures can initiate an infectious process.

  9. Flows of Newtonian and Power-Law Fluids in Symmetrically Corrugated Cappilary Fissures and Tubes

    Science.gov (United States)

    Walicka, A.

    2018-02-01

    In this paper, an analytical method for deriving the relationships between the pressure drop and the volumetric flow rate in laminar flow regimes of Newtonian and power-law fluids through symmetrically corrugated capillary fissures and tubes is presented. This method, which is general with regard to fluid and capillary shape, can also be used as a foundation for different fluids, fissures and tubes. It can also be a good base for numerical integration when analytical expressions are hard to obtain due to mathematical complexities. Five converging-diverging or diverging-converging geometrics, viz. wedge and cone, parabolic, hyperbolic, hyperbolic cosine and cosine curve, are used as examples to illustrate the application of this method. For the wedge and cone geometry the present results for the power-law fluid were compared with the results obtained by another method; this comparison indicates a good compatibility between both the results.

  10. Interaction of groundwater and fresh basalt fissure surfaces and its effect on the migration of actinides

    International Nuclear Information System (INIS)

    Vandegrift, G.F.; Bowers, D.L.; Gerding, T.J.; Fried, S.M.; Wilbur, C.K.; Seitz, M.G.

    1983-01-01

    Experiments are being performed at Argonne National Laboratory (ANL): (1) to identify interactions of radionuclides and repository components that effect nuclide migration, and (2) to assess changes in nuclide migration caused by modifications expected upon aging of the waste, clay backfill, and rock. The experiments are conducted with radioactive borosilicate glass, bentonite and mechanically fissured basalt rock in flowing water analogous to their configuration in a breach of a nuclear waste repository. Changes undergone by the groundwater as it passed through the fissure include: (1) drop in pH from 10 to 8, (2) loss of suspended particulate, and (3) loss of dissolved/suspended U, Np, and Pu. These effects, also studied as functions of radiation dose and of laboratory aging of the repository components, are related to the predicted long-term performance of a nuclear waste repository

  11. Flows of Newtonian and Power-Law Fluids in Symmetrically Corrugated Cappilary Fissures and Tubes

    Directory of Open Access Journals (Sweden)

    Walicka A.

    2018-02-01

    Full Text Available In this paper, an analytical method for deriving the relationships between the pressure drop and the volumetric flow rate in laminar flow regimes of Newtonian and power-law fluids through symmetrically corrugated capillary fissures and tubes is presented. This method, which is general with regard to fluid and capillary shape, can also be used as a foundation for different fluids, fissures and tubes. It can also be a good base for numerical integration when analytical expressions are hard to obtain due to mathematical complexities. Five converging-diverging or diverging-converging geometrics, viz. wedge and cone, parabolic, hyperbolic, hyperbolic cosine and cosine curve, are used as examples to illustrate the application of this method. For the wedge and cone geometry the present results for the power-law fluid were compared with the results obtained by another method; this comparison indicates a good compatibility between both the results.

  12. Ground fissures in the area of Mavropigi Village (N. Greece): Seismotectonics or mining activity?

    Science.gov (United States)

    Kalogirou, Eleni; Tsapanos, Theodoros; Karakostas, Vassilios; Marinos, Vassilios; Chatzipetros, Alexandros

    2014-12-01

    In the beginning of July 2010, a ground fissure was observed in the field near the village of Mavropigi (Northern Greece) and specifically in its NW side. Later on (early September), a second ground fissure was perceived, close and almost parallel to the first one and very close to the limits of the lignite exploitation mine (by the Public Power Corporation, PPC). It was observed that the village of Mavropigi slides away slowly towards the PPC lignite mine. Geological, seismological, as well as geotechnical survey in the field indicated that the phenomenon is related to the coal mining exploitation in the near vicinity of the village rather than to any seismotectonic activity in the surrounding area.

  13. Avaliação manométrica anal de crianças com encoprese Anal manometric evaluation of children with encopresis

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2010-12-01

    Full Text Available INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes com encoprese, pois pode trazer informações sobre o mecanismo evacuatório e possíveis lesões esfincterianas anais. OBJETIVO: Verificar alterações manométricas em pacientes com encoprese. MÉTODOS: Foi realizado estudo de 40 manometrias anais de crianças constipadas com encoprese (G1 e 12 crianças constipados sem encoprese (G2. Foram obtidos os seguintes dados: pressões de repouso, contração e evacuação do canal anal e ampola retal, ponto de maior pressão, reflexo inibitório anal e sensibilidade retal. As manometrias foram realizadas com o aparelho Alacer de perfusão com 8 canais. RESULTADOS: Não foram encontradas diferenças nas pressões de repouso, contração e evacuação do canal anal entre os grupos. Chamou-nos a atenção a ausência de necessidade de maior volume retal para desencadear o reflexo inibitório anal. Não houve diferença da incidência de anismus entre os dois grupos, demonstrando que não se trata de fator importante na manutenção da encoprese, mas sim da constipação. CONCLUSÃO: Não houve necessidade de maior volume para desencadear o reflexo inibitório anal. O anismus não foi diferente entre os dois grupos, não sendo importante na manutenção da encoprese.INTRODUCTION: Chronic constipation is a common childhood disorder that affects 5 to 10% of pediatric patients, being the second most common cause for seeking medical help, with the encopresis arising out of severe constipation

  14. The effect of different enamel surface treatments on microleakage of fissure sealants

    Directory of Open Access Journals (Sweden)

    Asli Topaloglu-Ak

    2013-11-01

    Full Text Available Objective. The aim of this study was to evaluate the effects of different techniques of surface treatment on the microleakage of fissure sealants in permanent molar teeth in vitro. Materials and methods. 96 extracted impacted human third molars were randomly divided into 8 surface treatment groups (n=12/group as 1. Er: YAG laser; (Fidelis II, Fotona, Ljubljana, Slovenia (125 mj, 20Hz. 2. Er: YAG laser + 37% H3PO4 (15s; 3. ER: AG laser + 37% H3PO4+Prime&Bond NT; 4. Er: YAG laser + G Bond; 5. Er: YAG laser + Prime&Bond NT; 6. 37% H3PO4; 7. 37% H3PO4 + Prime &Bond NT; 8. G Bond. Sealant material (Clinpro, 3M ESPE, Seefeld, Germany, was applied into the fissures and light-cured for 20s with LED (Bluephase C5, Ivoclar-Vivadent, Schaan, Liechtenstein. Specimens were subjected to thermocycling (1000×, 5-55°C, dwell time: 15s and immersed in 0.5% basic fuchsin solution for 24h at 37°C. The samples were sectioned and scored on a 3 point rating scale using a light microscope with a magnification of ×20. One-way analysis of variance was used to analyze data. Multiple comparisons were analyzed using Bonferroni test (p=0.05. Results. Er:YAG laser showed the highest microleakage scores whereas Er YAG laser + 37% H3PO4 showed the lowest. Although 37% H3PO4 group showed higher scores than Er:YAG laser + 37% H3PO4, the difference was not statistically significant. Conclusion. Etching fissures with phosphoric acid is sufficient prior to fissure sealant application.

  15. Groundwater flow through fissured rock: field investigations and interpretation in the Albigna dam area, Graubuenden, Switzerland

    International Nuclear Information System (INIS)

    Kovari, K.; Arn, Th.; Gmuender, Ch.

    1989-11-01

    The rock foundation of a dam was chosen as the site for repeated observations of flow patterns in a fissured rock. Our project was carried out at the Albigna Dam in the Canton of Graubuenden, Switzerland, where the greatest fluctuation in the level of the lake was approximately 100 m. In the area of the dam the rock consists of a fresh, solid granite, whose fissure systems were well known as regards position and distribution. The measurement program for assessing the flow conditions consisted of two elements: piezometric pressure measurements in boreholes and strain measurements in boreholes. Pressure measurements were accomplished to define the potential field. Strain measurements were accomplished to detect fracture opening and closing as a function of the fluctuations in the lake level. From a combination of the two sets of observations it was hoped to be able to determine the interaction between hydraulics and mechanics, i.e. the coupling of two key processes with a possible influence on a changing permeability of the rock. Using the 'sliding micrometer', the continuous strain distribution was determined along two boreholes in the measuring plane. Pressures were measured using the 'Piezodex' system. Mathematical investigations were conducted with the AQUA-ROCK finite element program on a 2D-model. From just a visual comparison of the measured and calculated values it is clear that a different model achieves the best correlation depending on the level of the lake. For the maximum lake level, however, it is essential to take account of the action of the fissures either by way of the idealization according to Snow (main model 2) or by considering the individual fissures (main model 3). (author) figs., tabs., 12 refs

  16. Migration of radionuclides in fissured rock: The influence of micropore diffusion and longitudinal dispersion

    International Nuclear Information System (INIS)

    Rasmuson, A.; Neretnieks, I.

    1981-01-01

    The migration of radionuclides in the fissures in the bedrock surrounding a repository is discussed. A one-dimensional transport model is presented. It includes diffusion of the nuclides into the microfissures of the rock, and linear sorption, and longitudinal dispersion in the bedrock. An analytical solution to the model is given in terms of an infinite integral. The integrand is a sometimes highly oscillatory function of the system parameters. A special integration method is developed to evaluate the infinite integral. The method utilizes the oscillatory behavior of the integrand. The assessment of input parameters is discussed in some detail. Dimensionless breakthrough curves are given for the approximate range of variation of the input parameters. Calculations are made for a repository of spent fuel surrounded by fissured but fairly good rock (K/sub p/ = 10 -9 m/s and fissure spacing S = 50 m). Longitudinal dispersion may significantly affect the amount of radioactive material reaching the biosphere. Radionuclides, which would decay completely without longitudinal dispersion, may arrive in nonnegligible concentrations. Dispersion effects of the magnitude considered in this study can significantly diminish the retardation effects of matrix diffusion

  17. Migration of radionuclides in fissured rock - The influence of micropore diffusion and longitudinal dispersion

    International Nuclear Information System (INIS)

    Rasmuson, A.; Neretnieks, I.

    1979-12-01

    The migration of radionuclides in the fissures in the bedrock surrounding a repository is discussed. A one-dimensional transport model is presented. It includes diffusion of the nuclides into the microfissures of the rock, and linear sorption and longitudinal dispersion in the bedrock. An analytical solution to the model is given in terms of an infinite integral. The integrand is a sometimes highly oscillatory function of the system parameters. A special integration method is developed to evaluate the infinite integral. The method utilizes the oscillatory behavior of the integrand. The assessment of input parameters is discussed in some detail. Dimensionless breakthrough curves are given for the approximate range of variation of the input parameters. Calculations are made for a repository of spent fuel surrounded by fissured but fairly good rock (K(sub)p=10- 9 m/s and fissure spacing S=50 m). Longitudinal dispersion may significantly affect the amount of radioactive material reaching the biosphere. Radionuclides, which would decay completely without longitudinal dispersion, may arrive in non-negligible concentrations. Dispersion effects of the magnitude considered in this study can significantly diminish the retardation effects of matrix diffusion. (authors)

  18. The movement of solutes through aqueous fissures in micro-porous rock during borehole experiments

    International Nuclear Information System (INIS)

    Glueckauf, E.

    1981-02-01

    When a tracer is injected for a short period into a solution flowing through a fissure in micro-porous rock, that tracer is not only carried along by the aqueous stream, but its local concentration is also markedly affected by hydro-dynamic dispersion and by sideway diffusion and adsorption in the micro-porous rock. The process has been simulated by computer calculations and these have made it possible to obtain from the concentration-time curves observed in borehole experiments an assessment of the physical parameters involving the water velocity and the hydro-dynamic dispersion in the fissure, and the diffusion and adsorption in the micro-porous rock. With these parameters it was then possible to recalculate quantitatively the local concentration-time history. However, in actual borehole experiments, the velocity of the water stream in the fissure is not known, and numerous side effects can distort the shape of the observed tracer curves. In order to test the theoretical interpretation more thoroughly, it is therefore proposed to carry out a laboratory experiment which simulates the borehole test under strictly defined conditions. (author)

  19. Landslide Fissure Inference Assessment by ANFIS and Logistic Regression Using UAS-Based Photogrammetry

    Directory of Open Access Journals (Sweden)

    Ozgun Akcay

    2015-10-01

    Full Text Available Unmanned Aerial Systems (UAS are now capable of gathering high-resolution data, therefore, landslides can be explored in detail at larger scales. In this research, 132 aerial photographs were captured, and 85,456 features were detected and matched automatically using UAS photogrammetry. The root mean square (RMS values of the image coordinates of the Ground Control Points (GPCs varied from 0.521 to 2.293 pixels, whereas maximum RMS values of automatically matched features was calculated as 2.921 pixels. Using the 3D point cloud, which was acquired by aerial photogrammetry, the raster datasets of the aspect, slope, and maximally stable extremal regions (MSER detecting visual uniformity, were defined as three variables, in order to reason fissure structures on the landslide surface. In this research, an Adaptive Neuro Fuzzy Inference System (ANFIS and a Logistic Regression (LR were implemented using training datasets to infer fissure data appropriately. The accuracy of the predictive models was evaluated by drawing receiver operating characteristic (ROC curves and by calculating the area under the ROC curve (AUC. The experiments exposed that high-resolution imagery is an indispensable data source to model and validate landslide fissures appropriately.

  20. Fissure formation in coke. 3: Coke size distribution and statistical analysis

    Energy Technology Data Exchange (ETDEWEB)

    D.R. Jenkins; D.E. Shaw; M.R. Mahoney [CSIRO, North Ryde, NSW (Australia). Mathematical and Information Sciences

    2010-07-15

    A model of coke stabilization, based on a fundamental model of fissuring during carbonisation is used to demonstrate the applicability of the fissuring model to actual coke size distributions. The results indicate that the degree of stabilization is important in determining the size distribution. A modified form of the Weibull distribution is shown to provide a better representation of the whole coke size distribution compared to the Rosin-Rammler distribution, which is generally only fitted to the lump coke. A statistical analysis of a large number of experiments in a pilot scale coke oven shows reasonably good prediction of the coke mean size, based on parameters related to blend rank, amount of low rank coal, fluidity and ash. However, the prediction of measures of the spread of the size distribution is more problematic. The fissuring model, the size distribution representation and the statistical analysis together provide a comprehensive capability for understanding and predicting the mean size and distribution of coke lumps produced during carbonisation. 12 refs., 16 figs., 4 tabs.

  1. Subpial Hematoma and Extravasation in the Interhemispheric Fissure with Subarachnoid Hemorrhage

    Science.gov (United States)

    Matsuoka, Go; Abe, Kayoko; Okada, Yoshikazu; Sakai, Shuji

    2015-01-01

    A recent report on computed tomography (CT) findings of contrast extravasation in subarachnoid hemorrhage (SAH) with Sylvian hematoma suggests that the occurrence of the hematoma is secondary to bleeding in the subpial space. Our patient was in his sixties and was admitted to the hospital because of loss of consciousness (Glasgow Coma Scale E4V1M4). SAH was diagnosed in plain head CT, and growing hematomas were observed in the Sylvian and interhemispheric fissures following a subarachnoid hemorrhage. CT angiography (CTA) using a dual-phase scan protocol revealed contrast extravasation in both the fissures in the latter phase, and hematoma in the interhemispheric fissure contained multiple bleeding points. This case indicates that the occurrence of subpial hematoma such as Sylvian hematoma can be a secondary event following subpial bleeding from damaged small vessels elsewhere in the cranium. Instead of four-dimensional (4D) CT, the dual-phase CTA technique may help detect minor extravasations with usual helical CT scanner. PMID:25963159

  2. Microleakage assessment of fissure sealant following fissurotomy bur or pumice prophylaxis use before etching

    Directory of Open Access Journals (Sweden)

    Ali Bagherian

    2013-01-01

    The aim of this investigation was to compare the microleakage level of fissure sealants prepared by a fissurotomy bur or pumice prophylaxis prior to acid etching. Materials and Methods: Ninety freshly extracted healthy maxillary premolar teeth were randomly selected for this investigation. Teeth were then divided into three fissure sealant preparatory groups of A: Fissurotomy bur + acid etch; B: Pumice prophylaxis + acid etch and C: Acid etch alone. Sealant was applied to the occlusal fissures of all specimens using a plastic instrument. This was to avoid any air trap under the sealant. Sample teeth were first thermocycled (1000 cycles, 20 s dwell time and then coated with two layers of nail varnish leaving 2 mm around the sealant. This was then followed by immersion in basic fuchsin 3%. Processed teeth were sectioned longitudinally and examined under a stereomicroscope for microleakage assessment using a score of 0-3. Collected data was then subjected to Kruskall-Wallis Analysis of Variance and Mann-Whitney U-test. P < 0.05 was considered as significant. Results: Teeth in fissurotomy bur and pumice prophylaxis groups had significantly reduced level of microleakage than those in acid etch alone (P = 0.005 and P = 0.003, respectively. Conclusion: Use of fissurotomy bur and pumice prophylaxis accompanied with acid etching appears to have a more successful reduction of microleakage than acid etch alone.

  3. A 1-year clinical evaluation of fissure sealants on permanent first molars

    Directory of Open Access Journals (Sweden)

    Nupur Ninawe

    2012-01-01

    Full Text Available Objective : To evaluate and compare the retention, marginal discoloration, surface texture and anatomical form of pit and fissure sealants. Materials and Methods : Thirty children between the ages of 6 and 10 years, who were attending the school health program regularly, had participated in the study. A split-mouth design was used in which the two fissure sealants (Helioseal-F and Glass ionomer Fuji VII were randomly placed in 60 matched contralateral pairs of permanent molar teeth. Sealants were rated by a single trained and calibrated examiner using mouth mirrors and probes following the US Public Health Service criteria. The sealants were evaluated at 3 months, 6 months and 1 year intervals. Results : The data obtained for retention, marginal discoloration, surface texture and anatomical form of pit and fissure sealants were tabulated and compared statistically using the Chi-square test of significance. Conclusion : The Helioseal-F sealant was better than the Glass ionomer Fuji VII sealant with respect to retention, anatomical form and surface texture. Both the materials showed similar results with respect to marginal discoloration.

  4. Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications.

    Science.gov (United States)

    Dallan, Iacopo; Castelnuovo, Paolo; de Notaris, Matteo; Sellari-Franceschini, Stefano; Lenzi, Riccardo; Turri-Zanoni, Mario; Battaglia, Paolo; Prats-Galino, Alberto

    2013-05-01

    The superior orbital fissure is a critical three-dimensional space connecting the middle cranial fossa and the orbit. From an endoscopic viewpoint, only the medial aspect has a clinical significance. It presents a critical relationship with the lateral sellar compartment, the pterygopalatine fossa and the middle cranial fossa. The connective tissue layers and neural and vascular structures of this region are described. The role of Muller's muscle is confirmed, and the utility of the maxillary and optic strut is outlined. Muller's muscle extends for the whole length of the inferior orbital fissure, passes over the maxillary strut and enters the superior orbital fissure, representing a critical surgical landmark. Dividing the tendon between the medial and inferior rectus muscle allows the identification of the main trunk of the oculomotor nerve, and a little laterally, it is usually possible to visualize the first part of the ophthalmic artery. Based on a better knowledge of anatomy, we trust that this area could be readily addressed in clinical situations requiring an extended approach in proximity of the orbital apex.

  5. Soil gas geochemistry in relation to eruptive fissures on Timanfaya volcano, Lanzarote Island (Canary Islands, Spain)

    Science.gov (United States)

    Padrón, Eleazar; Padilla, Germán; Hernández, Pedro A.; Pérez, Nemesio M.; Calvo, David; Nolasco, Dácil; Barrancos, José; Melián, Gladys V.; Dionis, Samara; Rodríguez, Fátima

    2013-01-01

    We report herein the first results of an extensive soil gas survey performed on Timanfaya volcano on May 2011. Soil gas composition at Timanfaya volcano indicates a main atmospheric source, slightly enriched in CO2 and He. Soil CO2 concentration showed a very slight deep contribution of the Timanfaya volcanic system, with no clear relation to the main eruptive fissures of the studied area. The existence of soil helium enrichments in Timanfaya indicates a shallow degassing of crustal helium and other possible deeper sources probably form cooling magma bodies at depth. The main soil helium enrichments were observed in good agreement with the main eruptive fissures of the 1730-36 eruption, with the highest values located at those areas with a higher density of recent eruptive centers, indicating an important structural control for the leakage of helium at Timanfaya volcano. Atmospheric air slightly polluted by deep-seated helium emissions, CO2 degassed from a cooling magma body, and biogenic CO2, might be the most plausible explanation for the existence of soil gas. Helium is a deep-seated gas, exhibiting important emission rates along the main eruptive fissure of the 1730-36 eruption of Timanfaya volcano.

  6. 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.

  7. An Experimental and Numerical Study on Cracking Behavior of Brittle Sandstone Containing Two Non-coplanar Fissures Under Uniaxial Compression

    Science.gov (United States)

    Yang, Sheng-Qi; Tian, Wen-Ling; Huang, Yan-Hua; Ranjith, P. G.; Ju, Yang

    2016-04-01

    To understand the fracture mechanism in all kinds of rock engineering, it is important to investigate the fracture evolution behavior of pre-fissured rock. In this research, we conducted uniaxial compression experiments to evaluate the influence of ligament angle on the strength, deformability, and fracture coalescence behavior of rectangular prismatic specimens (80 × 160 × 30 mm) of brittle sandstone containing two non-coplanar fissures. The experimental results show that the peak strength of sandstone containing two non-coplanar fissures depends on the ligament angle, but the elastic modulus is not closely related to the ligament angle. With the increase of ligament angle, the peak strength decreased at a ligament angle of 60°, before increasing up to our maximum ligament angle of 120°. Crack initiation, propagation, and coalescence were all observed and characterized from the inner and outer tips of pre-existing non-coplanar fissures using photographic monitoring. Based on the results, the sequence of crack evolution in sandstone containing two non-coplanar fissures was analyzed in detail. In order to fully understand the crack evolution mechanism of brittle sandstone, numerical simulations using PFC2D were performed for specimens containing two non-coplanar fissures under uniaxial compression. The results are in good agreement with the experimental results. By analyzing the stress field, the crack evolution mechanism in brittle sandstone containing two non-coplanar fissures under uniaxial compression is revealed. These experimental and numerical results are expected to improve the understanding of the unstable fracture mechanism of fissured rock engineering structures.

  8. 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

  9. Carcinoma of the anal canal: radiation or radiation plus chemotherapy

    International Nuclear Information System (INIS)

    Cummings, B.J.

    1983-01-01

    An editorial is presented which discusses the treatment of carcinoma of the anal canal. Following the initial report of the successful preoperative use of combined chemotherapy and radiation by Nigro in 1974, several centers have confirmed the effectiveness of such combinations either as preoperative or as definitive treatment of anal carcinomas, and many patients are now being referred for radiation therapy. The article by Cantril in this issue describe the successful treatment of anal carcinomas by radiation alone, and raises the important issue of whether radiation plus chemotherapy is more effective treatment than radiation alone for squamous or cloacogenic carcinomas arising in the anal canal or perianal area. Several studies are cited

  10. A model of hydrological and mechanical feedbacks of preferential fissure flow in a slow-moving landslide

    Directory of Open Access Journals (Sweden)

    D. M. Krzeminska

    2013-03-01

    Full Text Available The importance of hydrological processes for landslide activity is generally accepted. However, the relationship between precipitation, hydrological responses and movement is not straightforward. Groundwater recharge is mostly controlled by the hydrological material properties and the structure (e.g., layering, preferential flow paths such as fissures of the unsaturated zone. In slow-moving landslides, differential displacements caused by the bedrock structure complicate the hydrological regime due to continuous opening and closing of the fissures, creating temporary preferential flow paths systems for infiltration and groundwater drainage. The consecutive opening and closing of fissure aperture control the formation of a critical pore water pressure by creating dynamic preferential flow paths for infiltration and groundwater drainage. This interaction may explain the seasonal nature of the slow-moving landslide activity, including the often observed shifts and delays in hydrological responses when compared to timing, intensity and duration of precipitation. The main objective of this study is to model the influence of fissures on the hydrological dynamics of slow-moving landslide and the dynamic feedbacks between fissures, hydrology and slope stability. For this we adapt the spatially distributed hydrological and slope stability model (STARWARS to account for geotechnical and hydrological feedbacks, linking between hydrological response of the landside and the dynamics of the fissure network and applied the model to the hydrologically controlled Super-Sauze landslide (South French Alps.

  11. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br, E-mail: marcelk46@usp.b [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas da Faculdade de Medicina; Paula, Wagner Diniz de [University of Brasilia (UnB), DF (Brazil). Brasilia University Hospital; Gompelmann, Daniela [University of Heidelberg (Germany). Department of Pneumology and Respiratory Medicine of the Chest Clinic (Thoraxklinik); Kauczor, Hans-Ulrich [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology; Heussel, Claus Peter; Puderbach, Michael [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology with Nuclear Medicine of the Chest Clinic (Thoraxklinik)

    2013-01-15

    Objective: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA) in a population of severe emphysematous patients submitted to endobronchial valves (EBV) implantation. Materials and Methods: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss) was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. Results: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV) (mean 542 ml), reduced EBV-submitted LV (700 ml) and reduced emphysema volume (331.4 ml) in the positive response group, which also showed improved functional tests. Conclusion: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis. (author)

  12. 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.

  13. 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...

  14. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    Science.gov (United States)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  15. 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

  16. Conservative management of anal and rectal cancer

    International Nuclear Information System (INIS)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X.

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

  17. 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

  18. 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...

  19. Anal Cancer Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Anal cancer is often curable with treatment. Major prognostic factors are site, size, and nodal status. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information for anal cancer risk factors, classification, staging, prognosis, and treatment in this summary for clinicians.

  20. Magnetic resonance imaging anatomy of the anal canal

    International Nuclear Information System (INIS)

    Kashyap, P.; Bates, N.

    2004-01-01

    The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams. Copyright (2004) Blackwell Science Pty Ltd

  1. Leiomyoma of the anal canal: report of two cases.

    Science.gov (United States)

    Witz, M; Bernheim, J; Griffel, B; Dinbar, A

    1986-10-01

    Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

  2. 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 bee...

  3. 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

  4. 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.

  5. Dose escalation without split-course chemoradiation for anal cancer: results of a phase II RTOG study

    International Nuclear Information System (INIS)

    John, Madhu; Pajak, Thomas; Kreig, Richard; Pinover, Wayne H.; Myerson, Robert

    1997-01-01

    PURPOSE: An attempt at radiotherapy (RT) dose escalation (from 45 Gy to 59.6 Gy) in a Radiation Therapy Oncology Group (RTOG) chemoradiation protocol for advanced anal cancers had resulted in an unexpectedly high 1-year colostomy rate (23%) and local failure (The Cancer Journal from Scientific American 2 (4):205-211, 1996). This was felt to be probably secondary to the split course chemoradiation (CR) that was mandated in the protocol. A second phase of this dose escalation study was therefore undertaken without a mandatory split and with an identical RT dose (59.6 Gy) and chemotherapy. MATERIALS AND METHODS: Twenty patients with anal cancers ≥2 cms were treated with a concurrent combination of 59.6 Gy to the pelvis and perineum (1.8 Gy daily, 5 times per week in 33 fractions over 6 (1(2)) weeks) and two cycles of 5 fluorouracil infusion (1000 mg/m 2 over 24 hours for 4 days) and mitomycin C (10 mg/m 2 bolus). A 10 day rest period was allowed only for severe skin reactions. A comparative analysis was made with the 47 patients in the earlier phase of this study who were treated with the identical chemoradiation course but with a mandatory 2-week break at the 36.00 Gy level. RESULTS: Predominant Grade 3 and 4 toxicities in 18 evaluable patients with dermatitis ((14(18)) or 78%), hematologic ((14(18)) or 78%), infection ((3(18)) or 17%) and gastrointestinal ((5(18)) or 28%). There were no fatalities. Nine patients (50%) completed the planned course without a break; 9 others (50%) had their treatments interrupted for a median of 11 days (range 7-19 days) at a median dose of 41.4 Gy (range 32.4 to 48.6 Gy). This compared to (40(47)) patients (85%) who had a 12 day treatment interruption at 36 Gy total dose in a planned break group. One patient had an abdomino-perineal resection (APR) for persistent disease and another for an anal fissure for (2(18)) or 11% 1-year colostomy rate. This was again favorably comparable to 23% 1-year colostomy rate for the earlier group of

  6. 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.

  7. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    Directory of Open Access Journals (Sweden)

    Oblak Irena

    2016-03-01

    Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

  8. Land subsidence and earth fissures in south-central and southern Arizona, USA

    Science.gov (United States)

    Conway, Brian D.

    2016-05-01

    Land subsidence due to groundwater overdraft has been an ongoing problem in south-central and southern Arizona (USA) since the 1940s. The first earth fissure attributed to excessive groundwater withdrawal was discovered in the early 1950s near Picacho. In some areas of the state, groundwater-level declines of more than 150 m have resulted in extensive land subsidence and earth fissuring. Land subsidence in excess of 5.7 m has been documented in both western metropolitan Phoenix and Eloy. The Arizona Department of Water Resources (ADWR) has been monitoring land subsidence since 2002 using interferometric synthetic aperture radar (InSAR) and since 1998 using a global navigation satellite system (GNSS). The ADWR InSAR program has identified more than 25 individual land subsidence features that cover an area of more than 7,300 km2. Using InSAR data in conjunction with groundwater-level datasets, ADWR is able to monitor land subsidence areas as well as identify areas that may require additional monitoring. One area of particular concern is the Willcox groundwater basin in southeastern Arizona, which is the focus of this paper. The area is experiencing rapid groundwater declines, as much as 32.1 m during 2005-2014 (the largest land subsidence rate in Arizona State—up to 12 cm/year), and a large number of earth fissures. The declining groundwater levels in Arizona are a challenge for both future groundwater availability and mitigating land subsidence associated with these declines. ADWR's InSAR program will continue to be a critical tool for monitoring land subsidence due to excessive groundwater withdrawal.

  9. Isotope techniques in the study of the hydrology of fractured and fissured rocks

    International Nuclear Information System (INIS)

    1989-01-01

    It is generally agreed that the hydrology of fractured rocks refers to the occurrence and movement of groundwater in rocks whose porosity is due to cracks, fissures and fractures in compact rocks. Until recently, crystalline rocks were considered to be impervious (the role of karst reservoirs for groundwater storage is already known). Thus, although fractured rocks cover approximately one-third of the Earth's surface, knowledge of groundwater flow dynamics still needs to be substantively improved. The Proceedings include the papers presented at the Advisory Group Meeting on the Application of Isotope Techniques in the Study of the Hydrology of Fractured and Fissured Rocks, which took place in Vienna from 17 to 21 November 1986. The meeting was attended by 21 scientists from 10 Member States. The Group agreed that the following topics should be given the highest priority: (1) Protection of groundwater resources should be incorporated into all future activities. This implies that recharge areas have to be delineated, not only using nuclear techniques but also other hydrogeological and geochemical methods. Research efforts in this direction should be intensified. (2) The Group was aware that new isotope techniques are being developed in hydrogeology and agreed that their application in fractured and fissured rocks showed promise. It was therefore suggested that information on new isotopes such as 36 Cl and 129 I should be gathered, either in the form of the various techniques currently being used by different laboratories or through the various activities that are being undertaken. Ways of co-ordinating the work being done and exchanging information at the international level should be encouraged. The Proceedings should be of interest to scientists responsible for the evaluation of water resources in crystalline rocks. It is hoped that hydrologists and hydrogeologists working in such terrains who are not familiar with the use of isotope techniques will find ideas and

  10. Fissured Tongue

    Science.gov (United States)

    ... in life. Although the cause is unknown, it is not a contagious disease and people cannot pass it to anyone else. Prepared by L. Radfar and the AAOM Web Writing Group Reviewed 13 May 2015 Japanese Translation - 日本語訳 Spanish Translation - Traducción Español ...

  11. Results from impression packer technique for location of fissures in boreholes in white chalk, Mors, Denmark

    International Nuclear Information System (INIS)

    Andersen, L.J.; Byrne, L.; Frykman, P.

    1981-01-01

    In connection with site investigations to evaluate the possibility of geological disposal of radioactive waste in a salt dome a Hydrogeological Programme was carried out. A number of bore holes were drilled to depths of 550 m. Geological and hydrogeological investigations were performed. The hydrogeological tests were carried out as packer tests, bottomhole tests using one packer, or straddle-packer test using two packers. In connection with these tests a rubber sleeve was installed over the packer and sidewall impressions of the hole were taken. Irregularities such as faults and fissures and possibly solution features were localized. The paper describes the method, procedure, equipment and the results achieved

  12. Fissure sealants in caries prevention:a practice-based study using survival analysis

    OpenAIRE

    Leskinen, K. (Kaja)

    2010-01-01

    Abstract The purpose of this study was to analyse the effectiveness and cost of fissure sealant treatment in preventing dental caries in children in a practice-based research network using survival analysis. The survival times of first permanent molars in children were analysed in three countries: in Finland (age cohorts 1970–1972 and 1980–1982), in Sweden (1980–1982) and in Greece (1980–1982), and additionally at two municipal health centres in Finland (age cohorts 1988–1990 in Kemi...

  13. Analysis of radionuclide transport through fissured porous media with a perturbation method

    Energy Technology Data Exchange (ETDEWEB)

    Banat, M [JGC Corp., Tokyo (Japan)

    1995-04-01

    This paper presents a specific procedure for obtaining solutions for the transport of radionuclides in a fissured porous media. The concentration profiles are deduced for a wide range of Peclet numbers using a perturbation method with a multiscale of time. Results show clearly that because of an increase of longitudinal dispersion, the radionuclide moves faster with respect to the case of zero dispersion (i.e. an infinite Peclet number). The main purpose of this paper is to demonstrate the practical advantage of the present calculation method with respect to the classical numerical and analytical methods used for radionuclide transport. (author).

  14. Skin hydration of the heel with fissure in patients with diabetes: a cross-sectional observational study

    Directory of Open Access Journals (Sweden)

    Oe M

    2018-06-01

    Full Text Available Makoto Oe,1 Kimie Takehara,2 Hiroshi Noguchi,3 Yumiko Ohashi,4 Mayu Fukuda,1 Takashi Kadowaki,5 Hiromi Sanada1,6 1Global Nursing Research Center, 2Department of Advanced Nursing Technology, 3Department of Life Support Technology (Molten, Graduate School of Medicine, The University of Tokyo, 4Department of Nursing, The University of Tokyo Hospital, 5Department of Diabetes and Metabolic Diseases, 6Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Purpose: Foot fissure should be prevented in patients with diabetes due to the likelihood of subsequent diabetic ulcer. The purpose of this study was to investigate a cutoff point for skin hydration with fissure and the factors associated with low skin hydration in patients with diabetes. Subjects and methods: Subjects were patients with diabetes who visited the diabetic foot clinic and were evaluated for skin hydration on the heel between April 2008 and March 2015. Information about fissure, skin hydration, age, sex, autonomic neuropathy, angiopathy, and tinea pedis were collected from the medical charts. Skin hydration on the heel was measured using a moisture checker. Skin hydration was compared between heels with and without fissure, and a cutoff for skin hydration with fissure was determined using receiver operating characteristic analysis. Based on the determined cutoff, factors associated with lower skin hydration were analyzed using logistic regression analysis. Results: Participants comprised 693 patients. Mean±SD age was 66.8±10.8 years, and 57.0% of subjects were male. The frequency of fissures on the heels was 10.4%. Area under the receiver operating characteristic curve for skin hydration in the presence of fissure was 0.717. Twenty percent was selected as the cutoff point, offering sensitivity of 0.478 and specificity of 0.819. Logistic regression analysis showed correlations between three factors (male sex, tinea

  15. A method for the automatic quantification of the completeness of pulmonary fissures: evaluation in a database of subjects with severe emphysema

    Energy Technology Data Exchange (ETDEWEB)

    Rikxoort, Eva M. van; Goldin, Jonathan G.; Galperin-Aizenberg, Maya; Abtin, Fereidoun; Kim, Hyun J.; Lu, Peiyun; Shaw, Greg; Brown, Matthew S. [University of California-Los Angeles, Center for Computer Vision and Imaging Biomarkers and Thoracic Imaging Research Group, Department of Radiological Sciences, David Geffen School of Medicine, Los Angeles, CA (United States); Ginneken, Bram van [Radboud University Nijmegen Medical Centre, Diagnostic Image Analysis Group, Department of Radiology, Nijmegen (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Department of Radiology, Utrecht (Netherlands)

    2012-02-15

    To propose and evaluate a technique for automatic quantification of fissural completeness from chest computed tomography (CT) in a database of subjects with severe emphysema. Ninety-six CT studies of patients with severe emphysema were included. The lungs, fissures and lobes were automatically segmented. The completeness of the fissures was calculated as the percentage of the lobar border defined by a fissure. The completeness score of the automatic method was compared with a visual consensus read by three radiologists using boxplots, rank sum tests and ROC analysis. The consensus read found 49% (47/96), 15% (14/96) and 67% (64/96) of the right major, right minor and left major fissures to be complete. For all fissures visually assessed as being complete the automatic method resulted in significantly higher completeness scores (mean 92.78%) than for those assessed as being partial or absent (mean 77.16%; all p values <0.001). The areas under the curves for the automatic fissural completeness were 0.88, 0.91 and 0.83 for the right major, right minor and left major fissures respectively. An automatic method is able to quantify fissural completeness in a cohort of subjects with severe emphysema consistent with a visual consensus read of three radiologists. (orig.)

  16. Anal manometric evaluation of children with encopresis

    OpenAIRE

    CESAR, Maria Auxiliadora Prolungatti; MOURA, Brenda C de; SILVA, Fernanda Perez Adorno da; BARBIERI, Dorina; BRUNO, Rodrigo Ciotolla; BERTOLI, Ciro João; ORTIZ, Jorge Alberto

    2010-01-01

    INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes c...

  17. Deformation at longyao ground fissure and its surroundings, north China plain, revealed by ALOS PALSAR PS-InSAR

    Science.gov (United States)

    Yang, Chengsheng; Lu, Zhong; Zhang, Qin; Zhao, Chaoying; Peng, Jianbing; Ji, Lingyun

    2018-05-01

    The Longyao ground fissure (LGF) is the longest and most active among more than 1000 ground fissures on the North China Plain. There have been many studies on the formation mechanism of the LGF, due to its scientific importance and its potential for damage to the environment. These studies have been based on both regional tectonic analysis and numerical simulations. In order to provide a better understanding of the formation mechanism, the deformation of the crack and its surrounding environment should be taken into consideration. In this paper, PS-InSAR technology was employed to assess the ground deformation of LGF and its surrounding area, using L-band ALOS-1 PALSAR images from 2007 to 2011. The characteristics of ground deformation, relationships between fissure activity and surrounding faults and groundwater exploitation were analyzed. This study shows that the north side of Longyao fault (LF) is uplifting while the south side is subsiding. This provides the tectonic conditions responsible for the activity of the ground fissure. Local groundwater exploitation also plays an important role in the development of ground fissures. InSAR observations were modeled to infer the loading depth (-2.8 km) and the slip rate (31.1 mm/yr) of LF.

  18. Utility of Indocyanine Green Video Angiography for Sylvian Fissure Dissection in Subarachnoid Hemorrhage Patients - Sylvian ICG Technique.

    Science.gov (United States)

    Toi, Hiroyuki; Matsushita, Nobuhisa; Ogawa, Yukari; Kinoshita, Keita; Satoh, Kohei; Takai, Hiroki; Hirai, Satoshi; Hara, Keijiro; Matsubara, Shunji; Uno, Masaaki

    2018-02-15

    Indocyanine green (ICG) emits fluorescence in the far-red domain under light excitation. ICG video angiography (ICG-VA) has been established as a useful method to evaluate blood flow in the operative field. We report the usefulness of ICG-VA for Sylvian fissure dissection in patients with subarachnoid hemorrhage (SAH). Subjects comprised 7 patients who underwent ICG-VA before opening the Sylvian fissure during neck clipping for ruptured cerebral aneurysm. We observed contrasted Sylvian veins before opening the Sylvian fissure using surgical microscopes. This procedure was termed "Sylvian ICG". We observed ICG fluorescence quickly in all cases. Sylvian veins that appeared unclear in the standard microscopic operative field covered with subarachnoid hemorrhage were extremely clearly depicted. These Sylvian ICG findings were helpful in identifying entry points and the dissecting course of the Sylvian fissure. At the time of clipping, no residual fluorescence from Sylvian ICG was present, and aneurysm clipping was not impeded. Sylvian ICG for SAH patients is a novel technique to facilitate dissection of the Sylvian fissure. We believe that this technique will contribute to improved safety of clipping surgery for ruptured aneurysms.

  19. Different scale land subsidence and ground fissure monitoring with multiple InSAR techniques over Fenwei basin, China

    Directory of Open Access Journals (Sweden)

    C. Zhao

    2015-11-01

    Full Text Available Fenwei basin, China, composed by several sub-basins, has been suffering severe geo-hazards in last 60 years, including large scale land subsidence and small scale ground fissure, which caused serious infrastructure damages and property losses. In this paper, we apply different InSAR techniques with different SAR data to monitor these hazards. Firstly, combined small baseline subset (SBAS InSAR method and persistent scatterers (PS InSAR method is used to multi-track Envisat ASAR data to retrieve the large scale land subsidence covering entire Fenwei basin, from which different land subsidence magnitudes are analyzed of different sub-basins. Secondly, PS-InSAR method is used to monitor the small scale ground fissure deformation in Yuncheng basin, where different spatial deformation gradient can be clearly discovered. Lastly, different track SAR data are contributed to retrieve two-dimensional deformation in both land subsidence and ground fissure region, Xi'an, China, which can be benefitial to explain the occurrence of ground fissure and the correlation between land subsidence and ground fissure.

  20. 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.

  1. Permeability of fissured rock - an experimental study with special regard to the water injection test

    International Nuclear Information System (INIS)

    Schneider, H.J.

    1987-01-01

    The permeability to water of fissured rock is one of the most important design parameters for many underground projects, such as, e.g. the final deposition of radioactive waste. Because the conventional water injection test according to LUGEON for the calculation of permeability to water is associated with a high degree of uncertainty, new test equipment was developed. This equipment works on the principle of the water injection tracer test and multi-level measurements, enabling detailed measurement of the flow process at injection site and in the rock. The tests were carried out in Bunter sandstone and granite. The LUGEON test concept was varied in short-term and long-term tests at identical geological boundary conditions, and with test control at constant pressure on the one hand and at constant injection volume on the other. The test results show that non-steady-state flow occurs with short injection times, whereby the range is limited to the local rock at injection site. An increasing in injection time can lead to an increase in range by a number of factors as well as to steady-state flow conditions. The permeability of the rock types investigated is inhomgeneous and anistropic as a result of the fissured structure. (orig./HP) With 114 figs., 4 tabs [de

  2. Prevalence of Dental Caries and Fissure Sealants in a Portuguese Sample of Adolescents

    Science.gov (United States)

    Veiga, Nélio J.; Pereira, Carlos M.; Ferreira, Paula C.; Correia, Ilidio J.

    2015-01-01

    Introduction The aims of this study were to assess the prevalence of dental caries and the DMFT index, as well as the distribution pattern of pit and fissure sealants on permanent teeth in a Portuguese sample of adolescents, and to assess whether the existing usage of sealants and socio-demographic factors are correlated to caries prevalence on the examined sample. Materials and Methods A cross-sectional study was designed with a sample of 447 adolescents aged 12 to 18 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire with questions about oral health behaviours and socio-economic status was answered by adolescents in the classroom. Clinical examination of oral health status and assessment of fissure sealants were accomplished by only one trained member of the research team. Results We obtained a DMFT index of 3.32 (2.92), which indicates a moderate level of prevalence of dental caries. When considering a DMFT = 0, we found significant statistical differences between the parents´ level of education (≤ 4th grade = 26.3 vs 5th–12th grade = 18.8 vs Portuguese adolescents. The establishment of a more targeted preventive program with better and more effective oral health education is essential, having into account socio-demographic aspects. PMID:25803849

  3. Evaluation of microtensile bond strength of different fissure sealants to bovine enamel.

    Science.gov (United States)

    Sen Tunc, E; Bayrak, S; Tuloglu, N; Ertas, E

    2012-03-01

    The aim of this study was to evaluate the microtensile bond strength (μTBS) of a new fissure sealant and compare it with conventional sealants which are applied to enamel alone, and also with self-etch and etch-and-rinse adhesives. Enamel specimens were prepared and randomly distributed into three groups according to fissure sealant (Aegis, Helioseal F, Helioseal Clear). Each group was then subdivided according to adhesive system (Clearfil S3, Single Bond, no adhesive). A universal testing machine was used to measure μTBS, and data were analysed using one-way ANOVA and Tukey's tests. μTBS values for all Aegis subgroups were significantly lower than for comparable Helioseal F and Helioseal Clear subgroups (p 0.05). In the Helioseal Clear group, μTBS values for Single Bond were significantly higher than for Clearfil S3 (p adhesive subgroups in the Aegis or Helioseal F groups (p > 0.05). Sealant μTBS values may be affected by material content. The addition of an adhesive may improve μTBS values of sealant to enamel. © 2012 Australian Dental Association.

  4. Application of passive type radon detectors to find fissures in banks caused by the southern Hyogo prefectural earthquake in Japan

    International Nuclear Information System (INIS)

    Saegusa, J.; Yamasaki, K.; Tsujimoto, T.; Morishima, H.; Shimo, M.; Murakami, A.; Hasegawa, T.

    1996-01-01

    Innumerable fissures were formed widely in Hanshin area in Japan by the former southern Hyogo prefectural earthquake occurred on Jan.17, 1995. In this study, as a preliminary investigation, we applied passive type radon detector Pico-Rad (U.S. Packard Instrument Co. Ltd.) with hemispheric plastic cover over them around the fissure along on the bank of two reservoirs to examine whether there is possibility to find fissures using the characteristics of 222 Rn migration. One of the reservoir, Taniyamakami-ike, is located at the north of the Awaji-shima island at a distance of about 4 km from the seismic center of this earthquake. On the whole, 222 Rn exhalation rates were high on a line of 2 m below the edge of the bank and got lower in proportion to the distance from this line. Those top of the bank had middle values among the lines. The mean 222 Rn exhalation rate was 4.7 mBq m -2 s -1 , and in these data we found some singularly high 222 Rn points. The other reservoir named Hosho-ike is located at northwestern Nagaokakyo city of Kyoto prefecture and the Komyoji active faulting runs from north to south parallel with the bank about 120 m to the west. In this bank, a fissure about 50 m in length and 0.1 m in width was taken shape. 222 Rn exhalation rates were relatively high on the top of the bank compared with on the slope of the bank. The mean 222 Rn exhalation rate of 5 points which were measured on the fissure was 16 mBq m -2 s -1 , and that which were measured on about 1 m to the east from the fissure was 4.9 mBq m -2 s -1 and in case about 1 m to the west was 4.2 mBq m -2 s -1 . From these results we concluded that there is a possibility to find fissures inside the bank using the characteristics of 222 Rn migration. Our future objective is to find fissures inside banks non-destructively. (author)

  5. Ettevõtte konkurentsieelis inimeste analüüsi abil / Mait Raava

    Index Scriptorium Estoniae

    Raava, Mait

    2015-01-01

    Ettevõtte töötajate analüüsimisest, analüütika tulemuste rakendamisest juhtivates ettevõttes. Viiest sambast, millel põhineb inimeste analüüsi edukas rakendamine, analüütika rakendamise etapid

  6. Fine mapping and introgressing qFIS1-2, a major QTL for kernel fissure resistance in rice (Oryza sativa L.)

    Science.gov (United States)

    Rice (Oryza sativa L.) kernel fissuring increases breakage during milling and decreases the value of processed rice. This study employed molecular gene tagging methods to fine-map a fissure resistance (FR) locus in ‘Cybonnet’, a semidwarf tropical japonica cultivar, as well as transfer this trait to...

  7. [Proctalgia fugax. Differential diagnosis and therapy of fleeting anal cramp].

    Science.gov (United States)

    Staude, G

    1992-05-30

    Proctalgia fugax--short-lived anal spasm--is a common, extremely unpleasant, painful condition that occurs completely unexpectedly, often waking the victim at night. Scientific assessment is difficult on account of the functional nature of the condition and its multifactorial genesis. Before the patient is labeled "anal neurotic", however, he/she should be investigated by a specialist. The results of treating the rarely absent pathological organic findings give rise to optimism.

  8. 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.

  9. Physical simulation and theoretical evolution for ground fissures triggered by underground coal mining.

    Science.gov (United States)

    Yang, Jing-Hu; Yu, Xiang; Yang, Yi; Yang, Zeng-Qiang

    2018-01-01

    Underground coal mining activities are prone to cause movement and breakage in geological strata and also lead to mining subsidence and even ground fissures. Along the direction working panel advancing, ground fissures may occur in roof in front and/or behind working panel. However, the investigations of previous similarity tests in lab only emphasize on the region behind working panel. By improving strata material property in construction and mounting artificial pressure devices, two physical simulation tests were conducted and successfully investigated the simulated results. Then, the mechanical model of "cantilever beam and elastic foundation beam" was proposed to calculate the stress distribution and the crack initiation angle in overlying strata and it well explains the mechanisms of ground fissures generation and propagation. Results show that, the maximum internal force in roof always occurred in front of working panel. However, because the void space in gob due to excavation is large enough to cause the bend and rotation of roof strata, compare to the triaxially compressed region in front of working panel, the roof always broke off at some positions above gob since the stress concentration resulting from such bend and rotation of strata could easily reach the limit strength of strata rocks. Also, the length of cantilever beam changed dynamically as respect to the panel advancing and the breakage intervals. Thus, the breakage position where the internal force first reached the limit tensile strength is not fixed and there will be two different kinds of relative positions between the crack initiation point and the working panel. The crack initiation direction is always perpendicular to the internal force, and the crack propagation direction is affected by the initiation angle, overburden-separation degree and the position of the hydraulic shields. If there is no overburden-separation or less, the roofs will break off as a composite beam and the propagation

  10. Physical simulation and theoretical evolution for ground fissures triggered by underground coal mining

    Science.gov (United States)

    Yu, Xiang; Yang, Yi; Yang, Zeng-Qiang

    2018-01-01

    Underground coal mining activities are prone to cause movement and breakage in geological strata and also lead to mining subsidence and even ground fissures. Along the direction working panel advancing, ground fissures may occur in roof in front and/or behind working panel. However, the investigations of previous similarity tests in lab only emphasize on the region behind working panel. By improving strata material property in construction and mounting artificial pressure devices, two physical simulation tests were conducted and successfully investigated the simulated results. Then, the mechanical model of “cantilever beam and elastic foundation beam” was proposed to calculate the stress distribution and the crack initiation angle in overlying strata and it well explains the mechanisms of ground fissures generation and propagation. Results show that, the maximum internal force in roof always occurred in front of working panel. However, because the void space in gob due to excavation is large enough to cause the bend and rotation of roof strata, compare to the triaxially compressed region in front of working panel, the roof always broke off at some positions above gob since the stress concentration resulting from such bend and rotation of strata could easily reach the limit strength of strata rocks. Also, the length of cantilever beam changed dynamically as respect to the panel advancing and the breakage intervals. Thus, the breakage position where the internal force first reached the limit tensile strength is not fixed and there will be two different kinds of relative positions between the crack initiation point and the working panel. The crack initiation direction is always perpendicular to the internal force, and the crack propagation direction is affected by the initiation angle, overburden-separation degree and the position of the hydraulic shields. If there is no overburden-separation or less, the roofs will break off as a composite beam and the

  11. [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.

  12. Results of the study of a new Groznensky Field with fissured reservoir rocks

    Energy Technology Data Exchange (ETDEWEB)

    Lebedinets, N P; Merkulov, A V; Pristanskii, G T; Postash, M F

    1970-06-01

    Geological information on the Eldarovsky field, situated in the central part of Tersky anticlinal zone and discovered in 1964, is given. Commercial quantities of oil were discovered in the foraminifera (thickness 40 to 70 m) and Upper Cretaceous (305 to 330 m thickness) deposits, consisting of fissured limestones and marls. Both the foraminifera and Upper Cretaceous deposits are divided into various zones which are hydrodynamically connected with each other and constitute a single pool. No hydrodynamical connection was observed between the Eldarovsky pools and surrounding oil fields. The secondary porosity of the Upper Cretaceous and forammifera deposits is 0.49% and 0.2%, respectively, and is responsible for most of the oil reserves. The analysis of the pressure buildup curves shows that the field has an elastic water drive.

  13. Fissure sealants: in vitro evaluation of abrasion wear and superficial roughness

    Directory of Open Access Journals (Sweden)

    Vanessa Pardi

    2008-06-01

    Full Text Available The aim of this study was to compare the in vitro wear and superficial roughness of four materials (Delton Dyract Flow, Dentsply; Filtek Flow, Vitremer, 3M ESPE used as fissure sealant in 32 extracted human molars divided in four groups (n = 8 after abrasion with toothbrush/dentifrice. Impressions of each occlusal surface were made to analyze wear and circular specimens were prepared to analyze the roughness. Teeth and specimens were mounted in a toothbrushing machine. The replicas were observed using a SEM to determine the superficial wear. Wear: there were no statistically significant differences either between Delton and Filtek Flow or between Dyract Flow and Vitremer. Roughness: there were no statistical differences between Filtek Flow and Dyract Flow, Dyract Flow and Vitremer, Vitremer and Delton., Considering the clinical practice, if caries activity is present the use of Vitremer is suggested not only for its well known fluoride release, but it presented good roughness results.

  14. Enamel pretreatment with Er:YAG laser: effects on the microleakage of fissure sealant in fluorosed teeth

    Directory of Open Access Journals (Sweden)

    Mahtab Memarpour,

    2014-08-01

    Full Text Available Objectives The purpose of this in vitro study was to evaluate the microleakage and penetration of fissure sealant in permanent molar teeth with fluorosis after pretreatment of the occlusal surface. Materials and Methods A total of 120 third molars with mild dental fluorosis were randomly divided into 6 groups (n = 20. The tooth surfaces were sealed with an unfilled resin fissure sealant (FS material. The experimental groups included: 1 phosphoric acid etching (AE + FS (control; 2 AE + One-Step Plus (OS, Bisco + FS; 3 bur + AE + FS; 4 bur + AE + OS + FS; 5 Er:YAG laser + AE + FS; and 6 Er:YAG laser + AE + OS + FS. After thermocycling, the teeth were immersed in 0.5% fuchsin and sectioned. Proportions of mircoleakage (PM and unfilled area (PUA were measured by digital microscope. Results Overall, there were significant differences among all groups in the PM (p = 0.00. Group 3 showed the greatest PM, and was significantly different from groups 2 to 6 (p < 0.05. Group 6 showed the lowest PM. Pretreatment with Er:YAG with or without adhesive led to less PM than bur pretreatment. There were no significant differences among groups in PUA. Conclusions Conventional acid etching provided a similar degree of occlusal seal in teeth with fluorosis compared to those pretreated with a bur or Er:YAG laser. Pretreatment of pits and fissures with Er:YAG in teeth with fluorosis may be an alternative method before fissure sealant application.

  15. Sealing effectiveness of fissure sealant bonded with universal adhesive systems on saliva-contaminated and noncontaminated enamel.

    Science.gov (United States)

    Memarpour, Mahtab; Shafiei, Fereshteh; Zarean, Mehran; Razmjoei, Faranak

    2018-01-01

    The effectiveness of sealants is dependent upon their adhesion to enamel surface. The aim of the study was to evaluate the sealing ability of a pit and fissure sealant used with a universal adhesive (etch-and-rinse vs. self-etch modes) when the site is contaminated with saliva. Adhesive properties were evaluated as microleakage and scanning electron microscopic (SEM) characteristics. A total of 72 mandibular third molars were randomly divided into 6 groups (n=12). Occlusal pits and fissures were sealed with an unfilled resin fissure sealant (FS) material with or without saliva contamination. The groups included: 1) phosphoric acid etching + FS (control), 2) phosphoric acid etching + Scotchbond Universal (etch-and-rinse) + FS, 3) phosphoric acid etching + saliva + Scotchbond Universal (etch-and-rinse) + FS, 4) Scotchbond Universal (self-etching) + FS,5) Scotchbond Universal (self-etching) + saliva + FS, and 6) Scotchbond Universal (self-etching) + saliva + Scotchbond Universal + FS. After thermocycling, the teeth were placed in 0.5% fuchsin, sectioned, and evaluated by digital microscopy. Two samples from each group were also observed by SEM. The data were analyzed with Kruskal-Wallis and Mann-Whitney tests for a significance of p universal adhesive in etch-and-rinse or self-etch modes was similar to that of conventional acid etching. Saliva contamination had a negative effect on sealant adhesion to pretreated enamel. Key words: Pit and fissure sealant, Universal adhesive, Saliva.

  16. Clinical effectiveness and cost-effectiveness of fissure sealants in children and adolescents with a high caries risk

    Directory of Open Access Journals (Sweden)

    Neusser, Silke

    2014-10-01

    Full Text Available [english] In Germany, the application of resin-based pits and fissures sealants on the occlusal surfaces of permanent molars is part of individual prophylaxis for children and adolescents between six and 18 years. The individual prophylaxis is covered by the Statutory Health Insurance since 1993.The report addresses questions on medical effectiveness, cost-effectiveness, as well as ethical, social, and legal implications of pit and fissure sealants in preventing dental caries for children and adolescents at high caries risk. The results of the studies indicate a protective effect of pit and fissure sealants, particularly for children and adolescents at high caries risk. Additionally, the economic evaluation suggests a tendency for cost savings in this group. Nevertheless, a general expansion of the intervention cannot be recommended. All studies show a risk of bias in favour of pit and fissure sealing and a limited transferability to the German health care system. Studies included in the economic evaluation revealed methodological flaws. Both the economic models and primary studies do not provide reliable results.

  17. Frequency of remnants of sealants left behind in pits and fissures of occlusal surfaces after 2 and 3 years.

    NARCIS (Netherlands)

    Hu, X.; Zhang, W.; Fan, M.; Mulder, J.; Frencken, J.E.F.M.

    2017-01-01

    OBJECTIVES: The null-hypothesis tested was that there was no difference in the frequency of remnants of high-viscosity glass-ionomer sealants left behind in pits and fissures of occlusal surfaces of first permanent molars and that of resin composite and glass-carbomer sealants. MATERIALS AND

  18. 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...... anal cancers in the Danish Cancer Register in the period 1978-2008 and all cases of AIN2/3 in the Danish Registry of Pathology. Overall and age-, period- and histology-specific incidence rates were estimated. During the 30-year period, 2187 anal cancers were identified, two thirds of which were...... 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...

  19. Comparison of six different methods of cleaning and preparing occlusal fissure surface before placement of pit and fissure sealant: An in vitro study

    Directory of Open Access Journals (Sweden)

    A Agrawal

    2012-01-01

    Full Text Available Aim & Objectives : The purpose of this in vitro study was to evaluate and compare the microleakage of pit and fissure sealants after using six different preparation techniques: (a brush, (b pumice slurry application, (c bur, (d air polishing, (e air abrasion, and (f longer etching time. Material & Method : The study was conducted on 60 caries-free first premolars extracted for orthodontic purpose. These teeth were randomly assigned to six groups of 10 teeth each. Teeth were prepared using one of six occlusal surface treatments prior to placement of Clinpro" 3M ESPE light-cured sealant. The teeth were thermocycled for 500 cycles and stored in 0.9% normal saline. Teeth were sealed apically and coated with nail varnish 1 mm from the margin and stained in 1% methylene blue for 24 hours. Each tooth was divided buccolingually parallel to the long axis of the tooth, yielding two sections per tooth for analysis. The surfaces were scored from 0 to 2 for the extent of microleakage. Statistical Analysis : Results obtained for microleakage were analyzed by using t-tests at sectional level and chi-square test and analysis of variance (ANOVA at the group level. Results : The results of round bur group were significantly superior when compared to all other groups. The application of air polishing and air abrasion showed better results than pumice slurry, bristle brush, and longer etching time. Round bur group was the most successful cleaning and preparing technique. Air polishing and air abrasion produced significantly less microleakage than traditional pumice slurry, bristle brush, and longer etching time.

  20. Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

    International Nuclear Information System (INIS)

    Cakur, Binali; Sumbullu, Muhammed Akif; Durna, Dogan; Akgul, Hayati Murat

    2011-01-01

    Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study

  1. Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Cakur, Binali; Sumbullu, Muhammed Akif; Durna, Dogan; Akgul, Hayati Murat (Dept. of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Ataturk Univ., Erzurum (Turkey)), email: bcakur@atauni.edu.tr

    2011-06-15

    Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study

  2. Effect of Intermittent Drying Conditions on Fissuring Percentage and Process Duration of Long and Medium Rough Rice Varieties

    Directory of Open Access Journals (Sweden)

    A. Ghasemi

    2016-02-01

    Full Text Available One of the factors which affect the quality of rice during milling is internal fissures created during and after drying operation. In many industrial countries intermittent drying method is hired to reduce the moisture content of rough rice in order to reduce the drying time and maintain the quality of the final product. A high percentage of rice breakage during milling process, at least in Iran, necessitates performing the intermittent drying process and optimize it for Iranian varieties. In this study, the effect of this method (drying-tempering and continuous drying method (no tempering on fissuring percentage of Hashemi (long grain and Koohsar (medium grain varieties was investigated. The experiments were carried out at constant drying and tempering temperature of 60 °C, drying durations of 20, 40 and 60 min, and tempering durations of 0 (continuous drying, 40, 80, 120, 160, 200, 240 min. The results revealed that the tempering process significantly reduced the drying time and fissured kernels percentage. Moreover, for both varieties it was observed that the rice fissuring decreased significantly by continuing the tempering process until certain durations. Overall, for optimization of intermittent drying process in terms of the considered qualitative parameters, i.e. reducing energy consumption and losses, conducting 160 and 200 min tempering process after 40 min drying was found appropriate for Hashemi and Koohsar varieties, respectively. In addition, according to the higher fissuring for Koohsar (medium grain compared to Hashemi (long grain, it can be concluded that physical properties such as kernel slenderness ratio is effective on its fissuring.

  3. A Novel Approach to Model Earth Fissure Caused by Extensive Aquifer Exploitation and its Application to the Wuxi Case, China

    Science.gov (United States)

    Ye, Shujun; Franceschini, Andrea; Zhang, Yan; Janna, Carlo; Gong, Xulong; Yu, Jun; Teatini, Pietro

    2018-03-01

    Initially observed in the semiarid basins of southwestern USA, earth fissures due to aquifer over-exploitation are presently threatening a large number of subsiding basins in various countries worldwide. Different mechanics have been proposed to explain this process, such as differential compaction, horizontal movements, and fault reactivation. Numerical modeling and prediction of this major geohazard caused by overuse of groundwater resources are challenging because of two main requirements: shifting from the classical continuous to discontinuous geomechanics and incorporating two-dimensional features (the earth fissures) into large three-dimensional (3-D) modeling domain (the subsiding basin). In this work, we proposed a novel modeling approach to simulate earth fissure generation and propagation in 3-D complex geological settings. A nested two-scale approach associated with an original nonlinear elastoplastic finite element/interface element simulator allows modeling the mechanics of earth discontinuities, in terms of both sliding and opening. The model is applied on a case study in Wuxi, China, where groundwater pumping between 1985 and 2004 has caused land subsidence larger than 2 m. The model outcomes highlight that the presence of a shallow (˜80 m deep) bedrock ridge crossing the Yangtze River delta is the key factor triggering the earth fissure development in this area. Bending of the alluvial deposits around the ridge tip and shear stress due to the uneven piezometric change and asymmetrical shape of the bedrock have caused the earth fissure to onset at the land surface and propagate downward to a maximum depth of about 20-30 m. Maximum sliding and opening are computed in the range of 10-40 cm, in agreement with the order of magnitude estimated in the field.

  4. Dominant Role of HPV16 E7 in Anal Carcinogenesis

    Science.gov (United States)

    Thomas, Marie K.; Pitot, Henry C.; Liem, Amy; Lambert, Paul F.

    2011-01-01

    Ninety percent of anal cancer is associated with human papilloma viruses (HPVs). Using our previously established HPV transgenic mouse model for anal cancer, we tested the role of the individual oncogenes E6 and E7. K14E6 and K14E7 transgenic mice were treated with dimethylbenz[a]anthracene (DMBA) to the anal canal and compared to matched nontransgenic and doubly transgenic K14E6/E7 mice. K14E7 and K14E6/E7 transgenic mice developed anal tumors (papillomas, atypias and carcinomas combined) at significantly higher rates (88% and 100%, respectively) than either K14E6 or NTG mice (18% and 19%, respectively). Likewise, K14E7 and K14E6/E7 transgenic mice developed frank cancer (carcinomas) at significantly higher rates (85% and 85%, respectively) than either K14E6 or NTG mice (18% and 10%, respectively). These findings indicate that E7 is the more potent oncogene in anal cancer caused by HPVs. PMID:21999991

  5. Vascularized anal autotransplantation model in rats: preliminary report.

    Science.gov (United States)

    Araki, J; Mihara, M; Narushima, M; Iida, T; Sato, T; Koshima, I

    2011-11-01

    Ostomy has served as an effective surgery for various anorectal disfunctions. However, it must also be noted that those patients suffered greatly from stresses caused by their stoma. Many alternative therapies have been developed, but none have solved this critical issue. Meanwhile, due to the improvements in operative methods and immunosuppressive therapy, allotranplantation has gained great popularity in recent years. Therefore, we began development of an anal transplantation model. The operation was performed in six adult Wistar rats that were divided into two groups. Group 1 underwent vascular anastomoses, while group 2 did not Group 1 grafts survived, fully recovering anal function. However, many of the group 2 grafts did not survive; those that did survive showed major defects in their anus, never recovering anal function. We succeeded in establishing the rat anal transplantation model utilizing super-microsurgery. While research in anal transplantation was behind compared to that in other fields, we hope that this model will bring significant possibilities for the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Sonographic appearance of anal cushions of hemorrhoids.

    Science.gov (United States)

    Aimaiti, Adilijiang; A Ba Bai Ke Re, Ma Mu Ti Jiang; Ibrahim, Irshat; Chen, Hui; Tuerdi, Maimaitituerxun; Mayinuer

    2017-05-28

    venous dilatation were obvious in the anal cushion of hemorhoidal tissues. After pathological results with arteriovenous fistulas were taken as the standard reference, we evaluated the compatibility between the two methods according to the Cohen's kappa co-efficiency calculation. The compatibility (Cohein kappa co-efficiency value) between "mosaic pattern" in the TPUS and arteriovenous fistula in pathology was very good (ĸ = 0.8939). When compared between different groups, TRUS presented the advantage that the mosaic pattern could be confirmed in more patients, especially for group A. There was a statistical difference when comparing group A with group B or C ( P hemorrhoids present with a pathologically abnormal cushion which usually appears as a "mosaic pattern" in sonography, which is in accord with an arteriovenous fistula in pathology. There are clearly different hemorrhoid structures shown by sonography. "Mosaic pattern" may be a parameter for surgical indication of grades III and IV hemorrhoids.

  7. 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

  8. 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...... 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...... 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...

  9. 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.

  10. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  11. The identification of specialized pacemaking cells in the anal sphincters.

    Science.gov (United States)

    Shafik, Ahmed; El Sibai, Olfat; Ahmed, Ismail

    2006-07-01

    Interstitial cells of Cajal (ICC) are claimed to generate the electrical activity in the colon and stomach. As the external (EAS) and internal (IAS) anal sphincters exhibit resting electrical activity, we hypothesized the presence of ICC in these sphincters. This hypothesis was investigated in the current study. Specimens from the EAS and IAS were taken from normal areas of the anorectum which had been surgically excised by abdominoperineal operation for rectal cancer of 28 patients (16 men, 12 women, mean age 42.2+/-4.8 years). The specimens were subjected to c-kit immunohistochemistry. Controls for the specificity of the antisera consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. Fusiform, c-kit positive, ICC-like cells were detected in the anal sphincters; they had dendritic processes. They were clearly distinguishable from the non-branching, c-kit negative smooth and striated muscle cells of the anal sphincters. The specimens contained also c-kit positive mast cells, but they had a rounded body with no dendritic processes. Immunoreactivity was absent in negative controls in which the primary antibody was omitted. We have identified, for the first time, cells in EAS and IAS with morphological and immunological phenotypes similar to ICCs of the gut. These cells appear to be responsible for initiating the slow waves recorded from the anal sphincters and for controlling their activity. A deficiency or absence of these cells may affect the anal motile activity. Studies are needed to explore the role of these cells in anal motility disorders.

  12. Inorganic carbon cycle in soil-rock-groundwater system in karst and fissured aquifers

    Directory of Open Access Journals (Sweden)

    Ajda Koceli

    2013-12-01

    Full Text Available The paper presents a systematic analysis of the isotopic composition of carbon (δ13CCaCO3 in carbonate rocks in central Slovenia, representing karst and fissured aquifers, and share of carbon contributions from carbonate dissolution and degradation of organic matter in aquifers, calculated from the mass balance equation. 59 samples of rocks (mainly dolomites from Upper Permian to Upper Triassic age were analyzed. Samples of carbonate rocks were pulverized and ground to fraction of 45 μm and for determination of δ13CCaCO3 analyzed with mass spectrometer for analyses of stable isotopes of light elements-IRMS. The same method was used for determination of isotopic composition of dissolved inorganic carbon (δ13CDIC in groundwater for 54 of 59 locations. Values of δ13CCaCO3 are in the range from -2.0 ‰ to +4.1 ‰, with an average δ13CCaCO3 value of +2.2 ‰. These values are typical for marine carbonates with δ13CCaCO3 around 0 ‰, although δ13CCaCO3 values differ between groups depending on the origin and age. Early diagenetic dolomites have relatively higher values of δ13CCaCO3 compared to other analyzed samples. The lowest values of δ13CCaCO3 were observed in Cordevolian and Bača dolomite, probably due to late diagenesis, during which meteoric water with lower isotopic carbon composition circulated in the process of sedimentation. Values of δ13CDIC range from -14.6 ‰ to -8.2 ‰. Higher δ13CDIC values (-8.2 ‰ indicate a low proportion of soil CO2 in the aquifer and rapid infiltration, while lower values (-14.6 ‰ indicate higher proportion of soil CO2 in the aquifer and slower infiltration. Calculated contributions of carbon from organic matter / dissolution of carbonates in the karstic and fissured aquifers s how a similar proportion (50 % : 50 %.

  13. 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

  14. 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

  15. 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

  16. Retention of a resin-based sealant and a glass ionomer used as a fissure sealant: A comparative clinical study

    Directory of Open Access Journals (Sweden)

    Subramaniam P

    2008-09-01

    Full Text Available Sealing occlusal pits and fissures with resin-based sealants is a proven method of preventing occlusal caries. Retention of the sealant is very essential for its efficiency. This study evaluated the retention of glass ionomer used as a fissure sealant when compared to a self-cure resin-based sealant. One hundred and seven children between the ages of 6-9 years, with all four newly erupted permanent first molars were selected. Two permanent first molars on one side of the mouth were sealed with Delton, a resin-based sealant, and the contralateral two permanent first molars were sealed with Fuji VII glass ionomer cement. Evaluation of sealant retention was performed at regular intervals over 12 months, using Simonsen′s criteria. At the end of the study period, the retention of the resin sealant was seen to be superior to that of the glass ionomer sealant.

  17. Genetic Susceptibility to Dental Caries on Pit and Fissure and Smooth Surfaces

    Science.gov (United States)

    Shaffer, J.R.; Wang, X.; DeSensi, R.S.; Wendell, S.; Weyant, R.J.; Cuenco, K.T.; Crout, R.; McNeil, D.W.; Marazita, M.L.

    2012-01-01

    Carious lesions are distributed nonuniformly across tooth surfaces of the complete dentition, suggesting that the effects of risk factors may be surface-specific. Whether genes differentially affect caries risk across tooth surfaces is unknown. We investigated the role of genetics on two classes of tooth surfaces, pit and fissure surfaces (PFS) and smooth surfaces (SMS), in more than 2,600 subjects from 740 families. Participants were examined for surface-level evidence of dental caries, and caries scores for permanent and/or primary teeth were generated separately for PFS and SMS. Heritability estimates (h2, i.e. the proportion of trait variation due to genes) of PFS and SMS caries scores were obtained using likelihood methods. The genetic correlations between PFS and SMS caries scores were calculated to assess the degree to which traits covary due to common genetic effects. Overall, the heritability of caries scores was similar for PFS (h2 = 19–53%; p caries scores for both PFS and SMS in the primary dentition was greater than in the permanent dentition and total dentition. With one exception, the genetic correlation between PFS and SMS caries scores was not significantly different from 100%, indicating that (mostly) common genes are involved in the risk of caries for both surface types. Genetic correlation for the primary dentition dfs (decay + filled surfaces) was significantly less than 100% (p caries risk in PFS versus SMS in the primary dentition. PMID:22286298

  18. An Experimental Study of the Fracture Coalescence Behaviour of Brittle Sandstone Specimens Containing Three Fissures

    Science.gov (United States)

    Yang, S. Q.; Yang, D. S.; Jing, H. W.; Li, Y. H.; Wang, S. Y.

    2012-07-01

    To analyse the fracture coalescence behaviour of rock, rectangular prismatic sandstone specimens (80 × 160 × 30 mm in size) containing three fissures were tested under uniaxial compression. The strength and deformation behaviours of the specimens are first analysed by investigating the effects of the ligament angle β2 on the peak strength, peak strain and crack initiation stress of the specimens. To confirm the sequence of crack coalescence, a photographic monitoring technique is used throughout the entire period of deformation. Based on the results, the relationship between the real-time crack coalescence process and the axial stress-strain curve of brittle sandstone specimens is also developed, and this relationship can be used to evaluate the macroscopic deformation characteristics of pre-cracked rock. The equivalent strain evolution fields of the specimen, with α = β1 = 45° and β2 = 90°, are obtained using the digital image correlation technique and show good agreement with the experimental results of pre-cracked brittle sandstone. These experimental results are expected to improve the understanding of fracture mechanisms and be used in rock engineering with intermittent structures, such as deep underground excavated tunnels.

  19. Evaluation of a fissure sealant program as part of community-based teaching and training.

    Science.gov (United States)

    van Wyk, Philippus J; Kroon, Jeroen; White, John G

    2004-01-01

    Since 1995 the Department of Community Dentistry of the University of Pretoria has been involved in the rendering of mobile primary oral health care services to children in the Hammanskraal area of Gauteng, South Africa, as part of their students' community-based training. Mokonyama Primary School was identified as the first school where a primary oral health care service could be rendered. The objective of this study was to evaluate the impact (outcomes) of a fissure sealant program on the dentition status of the school children. Seven years after the implementation of the program, the dentition status of children at Mokonyama was compared with that of a comparable group of children from the same area who were not exposed to the program. The results showed that the decayed, missing, and filled teeth in the primary dentition (dmft) in the six-year-old group in Mokonyama (1.74) did not differ significantly from the dmft (1.43) of the control group (p = 0.49). The decayed, missing, and filled teeth in the permanent dentition (DMFT) of 0.59 for the fifteen-year-old group in Mokonyama, however, differed significantly (p = 0.0001) from the DMFT of the control group (2.38). Fifteen-year-old children in Mokonyama had 75.2 percent fewer caries than their counterparts in the control group.

  20. Transection of inferior orbital fissure contents for improved access and visibility in orbital surgery.

    Science.gov (United States)

    Ricketts, Sophie; Chew, Hall F; Sunderland, Ian R P; Kiss, Alex; Fialkov, Jeffrey A

    2014-03-01

    Selective inferior orbital fissure (IOF) content transection for the purpose of surgical access to the posterior orbital floor is a technique that facilitates visualization of the posterior bony ledges of traumatic orbital floor defects. It also has potential advantages in achieving stable placement of reconstructive materials. Although not new, the surgical technique has not yet been described, and the morbidity of the technique has not been quantified. This article describes the procedure and assesses the morbidity specific to the division of related neural structures. The technique and surgical anatomy are described and illustrated with intraoperative photographs. Postoperative assessment of neural structures relevant to the division of IOF contents is performed. These values are compared with the nonoperated side to evaluate the morbidity of the technique. The technique, which is consistently used by the senior author in the repair of orbital floor defects with very small posterior ledges or which extend to and involve the IOF, facilitates better visualization of the posterior ledge and posterolateral ledge in such cases. Surgical outcomes including facial sensation and lacrimal function on the operated side remain within the reference range and are not significantly different when compared with the contralateral nonoperated side. Selective IOF transection aids in the direct visualization of the posterior bony ledges in the repair of posterior orbital floor defects. It therefore may facilitate the placement of reconstructive materials on bony ledges circumferentially, providing stable reconstruction, potentially reducing implant-related complications without causing increased morbidity.

  1. Sylvian Fissure and Parietal Anatomy in Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Tracey A. Knaus

    2012-01-01

    Full Text Available Autism spectrum disorder (ASD is characterized by deficits in social functioning and language and communication, with restricted interests or stereotyped behaviors. Anatomical differences have been found in the parietal cortex in children with ASD, but parietal subregions and associations between Sylvian fissure (SF and parietal anatomy have not been explored. In this study, SF length and anterior and posterior parietal volumes were measured on MRI in 30 right-handed boys with ASD and 30 right-handed typically developing boys (7–14 years, matched on age and non-verbal IQ. There was leftward SF and anterior parietal asymmetry, and rightward posterior parietal asymmetry, across groups. There were associations between SF and parietal asymmetries, with slight group differences. Typical SF asymmetry was associated with typical anterior and posterior parietal asymmetry, in both groups. In the atypical SF asymmetry group, controls had atypical parietal asymmetry, whereas in ASD there were more equal numbers of individuals with typical as atypical anterior parietal asymmetry. We did not find significant anatomical-behavioral associations. Our findings of more individuals in the ASD group having a dissociation between cortical asymmetries warrants further investigation of these subgroups and emphasizes the importance of investigating anatomical relationships in addition to group differences in individual regions.

  2. Assessment of effectiveness of geologic isolation systems. Analytic modeling of flow in a permeable fissured medium

    International Nuclear Information System (INIS)

    Strack, O.D.L.

    1982-02-01

    An analytic model has been developed for two dimensional steady flow through infinite fissured porous media, and is implemented in a computer program. The model is the first, and major, step toward the development of a model with finite boundaries, intended for use as a tool for numerical experiments. These experiments may serve to verify some of the simplifying assumptions made in continuum models and to gain insight in the mechanics of the flow. The model is formulated in terms of complex variables and the analytic functions presented are closed-form expressions obtained from singular Cauchy integrals. An exact solution is given for the case of a single crack in an infinite porous medium. The exact solution is compared with the result obtained by the use of an independent method, which assumes Darcian flow in the crack and models the crack as an inhomogeneity in the permeability, in order to verify the simplifying assumptions. The approximate model is compared with solutions obtained from the above independent method for some cases of intersecting cracks. The agreement is good, provided that a sufficient number of elements are used to model the cracks

  3. Geographic Tongue and Fissured Tongue in 348 Patients with Psoriasis: Correlation with Disease Severity

    Directory of Open Access Journals (Sweden)

    Bruna L. S. Picciani

    2015-01-01

    Full Text Available Geographic tongue (GT and fissured tongue (FT are the more frequent oral lesions in patients with psoriasis. The aims of this study were to compare the prevalence of GT/FT between psoriasis group (PG and healthy controls (HC and investigate the correlation between GT/FT and psoriasis severity using the PASI and age of psoriasis onset. Three hundred and forty-eight PG and 348 HC were selected. According to the age of psoriasis onset, the individuals were classified as having early psoriasis and late psoriasis. The severity of vulgaris psoriasis was determined according to PASI. A follow-up was conducted in patients with psoriasis vulgaris (PV with GT to evaluate the progression of oral and cutaneous lesions. The FT and GT were more frequent in PG than in HC. The incidence of GT was higher in patients with early psoriasis and that of FT in late-psoriasis. There is association between psoriasis intensity and GT; and a higher monthly decrease of PASI score in patients without GT. The presence of GT and FT is higher in PG than in the HC. GT is associated with disease severity and may be a marker of the psoriasis severity.

  4. Does the high-intensity zone (HIZ) of lumbar Intervertebral discs always represent an annular fissure?

    Energy Technology Data Exchange (ETDEWEB)

    Shan, Zhi; Chen, Huanhuan; Liu, Junhui; Ren, Hong; Zhang, Xuyang; Zhao, Fengdong [Zhejiang University, Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Hangzhou (China)

    2017-03-15

    The aim of this study was to examine high-intensity zone (HIZ) characteristics on both T1- and T2-weighted sagittal magnetic resonance (MR) images, and to reveal their exact nature. Seventy-three patients with low back pain and HIZs (identified on T2-weighted images) were included. Patients, aged 25-80 years (mean 51), were divided into two groups: the 'single-HIZ' group exhibited HIZs only on T2-weighted images, while the 'dual-HIZ' group exhibited HIZs on both T2-weighted and T1-weighted images. Tissue corresponding to the HIZ was harvested from surgery for analysis. Eighty-two discs were studied, from 39 patients with single HIZs, 30 with dual HIZs, and four with both in the posterior annulus. HIZ volume, volume ratio, and signal intensity on T2-weighted images from the dual-HIZ group were significantly greater. Surgery was able to successfully restore patients' ability in both groups, while conservative treatments were less effective for patients with dual HIZs. Histology revealed outer annular fissures invaded by granulation tissue in the single-HIZ group. In dual-HIZ discs, Von Kossa staining and CT scans showed more calcified or ossified lesions (94.1 vs. 0 %, P<0.001), and chemical analysis showed significantly higher calcium content. HIZs on both T2- and T1-weighted images represent calcified tissue, possibly from a vertebral endplate. A new concept of dual HIZ should be defined. (orig.)

  5. Using of thermoradiotherapy on treatment of cancerous growths of anal canal

    International Nuclear Information System (INIS)

    Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

    1997-01-01

    In this chapter of book authors investigated using of thermoradiotherapy on treatment of cancerous growths of anal canal, methods of using of thermoradiotherapy at morbid with anal cancer, methods of irradiation, the characteristic of clinical observations, using of thermoradiotherapy at treatment of epidermoid cancer of anal zone, using of thermoradiotherapy at treatment of non epithelial cancer of anal zone and using thermoradiotherapy at others types of cancerous growths

  6. Blurring of the vessels of the interhemispheric fissure in multislice CT angiography: a sign of meningeal carcinomatosis

    International Nuclear Information System (INIS)

    Ertl-Wagner, Birgit B.; Hoffmann, Ralf-Thorsten; Herrmann, Karin; Reiser, Maximilian F.; Bruening, Roland; Dichgans, Martin

    2004-01-01

    Meningeal carcinomatosis remains a challenging diagnosis to make, with both cerebrospinal fluid (CSF) analysis and radiological methods having a limited sensitivity. We aimed at describing a possible diagnostic sign of multislice CT angiography (MS-CTA) in the diagnosis of meningeal carcinomatosis. Upon retrospective analysis of MSCT angiographies of the brain, a conspicuous sign of the vessels of the interhemispheric fissure was noted in five patients. Cranial MSCT angiographies were performed with a standardized protocol (120 kV, 200 mA s, collimation of 4 x 1 mm, table feed per rotation 4 mm). We injected 120 ml of nonionic contrast medium as a bolus, and data acquisition was started after a fixed delay of 35 s. In order to elucidate the finding, correlation with clinical follow-up and/or CSF findings was performed for all patients. In five patients there was a blurring, an increased number, and a pathologic configuration of the vessels of the interhemispheric fissure. All five patients with this sign had clinical signs and symptoms of meningeal carcinomatosis. Three patients had positive CSF cytology, one further patient had follow-up spinal MRI 6 weeks later demonstrating meningeal carcinomatosis. One patient declined lumbar puncture. MS-CTA has the capacity to demonstrate a pathologic configuration of the vessels of the interhemispheric fissure in patients with meningeal carcinomatosis. This sign may serve as an indicator of meningeal carcinomatosis and should raise the suspicion of this disease entity. (orig.)

  7. Parents' Attitude towards the Use of Fluorides and Fissure Sealants and its Effect on their Children's Oral Health.

    Science.gov (United States)

    Blumer, Sigalit; Ratson, Tal; Peretz, Benjamin; Dagon, Nurit

    To characterize the attitudes of Israeli parents towards caries preventive measures. participating parents completed a 21-item questionnaire on their demographics, dental history, attitudes and satisfaction from fluorides and fissure sealants. One hundred parents (average age 41.62±4.9 years, 85 females) participated. Most of the parents (88% of the mothers and 84% of the fathers) had an academic education. Most of the parents (54%) had a favorable attitude towards the use of fluoridated gels, while only 37% of them had a positive opinion regarding fluoridated water. The satisfaction levels were very high regarding fissure sealants, fluoridated mouth rinses and fluoridated gels (78.1%, 73.6% and 72.5% respectively). The satisfaction from fluoridated water was split almost equally (50.8% were 'pleased' and 49.2% 'not pleased'). The main source for parental oral health knowledge was the dentist (83%). Parents' attitude towards caries preventive measures was significantly correlated to their gender, dental experience, level of education and the number of children in the family. positive attitude towards caries preventive measures was found among parents with higher awareness for preventive oral health measures and among bigger families. Mothers were more positive about fissure sealants than fathers. Mothers with up to 12 years of education tended to have a positive opinion regarding water fluoridation.

  8. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  9. 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

  10. 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 ...

  11. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  12. 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)

  13. Short linear shadows connecting pulmonary segmental arteries to oblique fissures in volumetric thin-section CT images: comparing CT, micro-CT and histopathology

    International Nuclear Information System (INIS)

    Guan, Chun-Shuang; Ma, Da-Qing; Chen, Jiang-Hong; Chen, Bu-Dong; Cui, Dun; Zhang, Yan-Song; Liu, Wei-Hua

    2016-01-01

    To retrospectively evaluate short linear shadows connecting pulmonary segmental arteries to oblique fissures in thin-section CT images and determine their anatomical basis. CT scanning was performed on 108 patients and 11 lung specimens with no lung diseases around the oblique fissures or hilar. Two radiologists evaluated the imaging. The parameters included length, thickness of short linear shadows, pulmonary segmental artery variations, and traction interlobar fissures, etc. The short linear shadows were not related to sex, age, or smoking history. The lengths of the short linear shadows were generally within 10 mm. The thicknesses of the short linear shadows ranged from 1 to 2 mm. Of the patients, 26.9 % showed pulmonary segmental artery variations; 66.7 % of short linear shadows pulled oblique fissures. In three-dimensional images, the short linear shadows appeared as arc planes, with one side edge connected to the oblique fissure, one side edge connected to a pulmonary segmental artery. On the tissue slices, the short linear shadow exhibited a band structure composed of connective tissues, small blood vessels, and small lymphatic vessels. Short linear shadows are a type of normal intrapulmonary membranes and can maintain the integrity of the oblique fissures and hilar structure. (orig.)

  14. Salt geologic evaluation of the impact of cryogenic fissures and halokinetic deformation processes on the integrity of the geological barrier of the salt dome Gorleben

    International Nuclear Information System (INIS)

    Hammer, Joerg; Fleig, Stephanie; Mingerzahn, Gerhard

    2012-07-01

    In several salt domes of the area close to Hannover fissures were observed that might be caused by thermally induced fissure formation due to cold periods (cryogenic fissures). Comprehensive substantial-structural analyses are performed as an example for the salt dome Bokeloh with respect to genesis and transferability to the salt dome Gorleben. Based on recent structure-geological, mineralogical-geochemical and micro-paleontological studies and thermo-mechanical modeling a solely thermally induced fissure formation due to cold periods is unlikely for the salt dome Bokeloh. There is a direct relation between the genesis of the salt dome Bokeloh, its regional tectonic site and the fissure formation. Due to the completely different genesis and another regional-tectonic situation the existence of cryogenic fissures is excluded for the salt dome Gorleben. The salt-geologic and experimental studies on the deformation of anhydrite layers in salt domes are summarized and evaluated with respect to the long-term consequences for a potential final repository for high-level heat-generating radioactive waste in the salt dome Gorleben. The studies confirm the older BGR studies that anhydrite layers do not represent hydraulic potential ling-distance liquid paths.

  15. 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

  16. Effect of artificial aging on the bond durability of fissure sealants.

    Science.gov (United States)

    Yun, Xiaofei; Li, Wei; Ling, Chen; Fok, Alex

    2013-06-01

    To evaluate the effect of artificial aging on the bond durability of fissure sealants in vitro. Twenty bovine incisors received 4 different sealant treatments and were divided into four groups: 1. Ultraseal XT plus (UX); 2. Enamel Loc (EL); 3. 35% phosphoric acid plus Enamel Loc (PEL); 4. Adper Prompt L-Pop plus Clinpro (PPC). Beam-shaped specimens were prepared and randomly divided into three subgroups. One subgroup underwent the microtensile bond strength (µTBS) test after 24-h storage in 37°C water. The other two subgroups were also subjected to the microtensile bond strength test after 5000 and 10,000 thermal cycles, respectively. Another twelve intact human third molars were sealed using 1 of 3 methods and were divided into 3 groups of 4 each: 1. Ultraseal XT plus; 2. Adper Prompt L-Pop plus Clinpro; and 3. Enamel Loc. Two specimens from each group were immersed in a 50% silver nitrate solution for 24 h, followed by exposure to fluorescent light for 8 h, before being scanned in a micro-CT (microcomputer tomography) machine. The other two were handled in the same way after undergoing 10,000 thermal cycles. The CT images obtained were evaluated. All samples from the EL group were broken during preparation, so no µTBS results were available. After 5000 thermal cycles, the bond strengths of the three other groups (UX, PEL, PPC) decreased significantly (p artificial aging. Micro-CT, a nondestructive analytical tool, may be used to evaluate the sealant/enamel interface effectively.

  17. Effect of irradiation times on the polymerization depth of contemporary fissure sealants with different opacities

    Directory of Open Access Journals (Sweden)

    Boniek Castillo Dutra Borges

    2011-04-01

    Full Text Available The aim of this study was to evaluate the depth of curing of 10 contemporary blue light-activated dental flowable materials at several opacities, influenced by different irradiation times using FT-IR spectroscopy. Fifty-five specimens (n = 5 with a 5-mm diameter and 1-mm thickness of translucent (Opallis Flow T, yellowed (Master Flow A2; Opallis Flow A2; Natural Flow A2; Fluroshield Yellowed, and opaque materials (Master Flow OA2; Natural Flow O; Opallis Flow OA3.5; Opallis Flow OP; Fluroshield White were obtained at six curing times (10s, 20s, 30s, 40s, 50s, and 60s using a high-intensity LED (Coltolux, Coltène/Whaledent. The degree of conversion (DC (% was obtained using the Nexus 470 FTIR Spectrometer (Nicolet Instruments, USA. The FTIR-ATR spectra for uncured and cured samples were analyzed using a ZnSe crystal. The top and bottom surfaces of the cured specimens were analyzed to obtain the depth of curing. Two-way ANOVA was used to analyze the data. The highest curing depth was obtained by Natural Flow OA2, while the lowest was shown by Master Flow OA2. The shortest curing time generated similar depths of cure in comparison with the most extensive for Opallis Flow A2 and Fluroshield Yellowed. Therefore, depth of curing, influenced by the irradiation time, was dependent on the materials. Using the Natural Flow OA2 opaque sealant and the 10-s curing time for Opallis Flow A2 and Fluroshield Yellowed may represent alternative approaches to sealing tooth fissures.

  18. Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Maria do Socorro Nobre

    2016-05-01

    Full Text Available The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64. Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5% had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR = 2.46; p = 0.03. In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR = 2.81; p = 0.02. This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer.

  19. 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

    with greater sensitivity and discriminatory ability than conventional anal manometry. OBJECTIVE: The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry. DESIGN: This was an age-matched study......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...... of continent and incontinent men. SETTINGS: The study was conducted at a university teaching hospital. PATIENTS: Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from...

  20. Chronic constipation - the role of clinical assessment and colorectal physiologic tests to obtain an etiologic diagnosis O papel da avaliação clínica e dos testes de fisiologia colo-reto anal no diagnóstico etiológico da constipação intestinal crônica

    Directory of Open Access Journals (Sweden)

    Antônio Lacerda-Filho

    2008-03-01

    Full Text Available BACKGROUND: Diagnosis of subtypes of chronic constipation has been considered difficult to achieve even in specialized centers. Although colorectal physiologic tests have brought an important contribution, it remains unclear in which patients these tests should be indicated for. AIMS: This study aims to establish a differential diagnosis for chronic constipation cases using clinical assessment and physiologic tests and to identify clinical parameters that could predict which patients need physiologic tests. METHODS: One hundred and seventy nine patients (83% females; mean age, 45 with chronic constipation according to Rome II criteria were initially treated by dietary advice and functional reeducation and those unresponsive (110 or 61.5% were submitted to colonic transit time, defecography, anorectal manometry and electromyography, as needed. RESULTS: A differential diagnosis was achieved in 63.6% of patients tested. However, 61.5% of 179 patients with chronic constipation (69 with no need to tests and 40 with normal tests have etiologic diagnosis established only on clinical basis. Irritable bowel syndrome (32%, pelvic floor dysfunction (29% and functional constipation due to faulty diet and life style habits (22% were the main causes of chronic constipation. Alternating constipation and nausea/vomiting were symptoms significantly related to the diagnosis of irritable bowel syndrome; younger age, larger intervals between bowel movements, occurrence of fecal impaction and necessity of enema were related to the diagnosis of non-chagasic megacolon and digital assistance to evacuate and large rectocele or spastic pelvic floor on rectal exam were associated to pelvic floor dysfunction. Patients with long-standing constipation, fecal impaction, abdominal pain not eased after defecation, necessity for enemas, digital assistance and evidence of rectocele tended to be in need for physiologic tests to define the cause of chronic constipation. CONCLUSIONS

  1. 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

  2. A trial of radiofrequency ablation for anal intraepithelial neoplasia.

    Science.gov (United States)

    Goldstone, Robert N; Hasan, Shirin R; Drury, Steven; Darragh, Teresa M; van Zante, Annemieke; Goldstone, Stephen E

    2017-03-01

    Radiofrequency ablation (RFA) effectively treats esophageal high-grade dysplasia, but its efficacy in treating anal canal high-grade squamous intraepithelial lesions (HSILs) is unsubstantiated. This prospective study assessed the safety and efficacy of applying hemi-circumferential RFA to anal canal HSIL. Twenty-one HIV-negative participants with HSIL occupying ≤ half the anal canal circumference were treated with hemi-circumferential anal canal RFA. Participants were assessed every 3 months for 12 months with high-resolution anoscopy; recurrence in the treatment zone was re-treated with focal RFA. Twenty-one participants with a mean of 1.7 lesions (range 1-4) enrolled and completed the trial. Six (29 %) participants had recurrent HSIL within the treated hemi-circumference within 1 year. Four participants (19 %) had persistence of an index lesion at 3 months. One (2.9 %) index HSIL persisted again at 12 months. No participants had more than two RFA treatments. KM curve-predicted HSIL-free survival within the treatment zone at 1 year was 76 % (95 % CI 52-89 %). Comparing the first 7 and last 14 participants, the predicted 1-year HSIL-free survivals are 43 % (95 % CI 10-73 %) and 93 % (95 % CI 59-99 %), respectively (p = 0.008), suggesting a learning curve with the treating physician. Multivariable analysis showed decreased recurrence in the last 14 participants (HR 0.02; 95 % CI 0.001-0.63) while increasing BMI increased recurrence (HR 1.43, 95 % CI 1.01-2.01). No participants had device or procedure-related serious adverse events, anal stricture, or heavy bleeding. Hemi-circumferential RFA yielded a high rate of anal HSIL eradication in HIV-negative patients at 1 year with minimal adverse events. Lesion persistence was probably related to incomplete initial ablation.

  3. 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

  4. 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

  5. Patients with newly diagnosed cervical cancer should be screened for anal human papilloma virus and anal dysplasia: Results of a pilot study using a STELLA computer simulation and economic model

    OpenAIRE

    Eli D. Ehrenpreis; Dylan G. Smith

    2018-01-01

    Background: Women with cervical cancer often have anal human papillomavirus (HPV) infection and anal dysplasia. However, effectiveness of anal HPV screening is unknown. Methods: A dynamic model was constructed using STELLA. Populations are represented as ''stocks'' that change according to model rates. Initial anal cytology in new cervical cancer patients, dysplasia progression and regression, cost of treating high-grade squamous intraepithelial lesions (HSIL), and lifetime costs for anal can...

  6. Clinical and functional results of laparoscopic intersphincteric resection for ultralow rectal cancer: is there a distinction between the three types of hand-sewn colo-anal anastomosis?

    Science.gov (United States)

    Zhang, Bin; Zhao, Ke; Liu, Quanlong; Yin, Shuhui; Zhuo, Guangzuan; Zhao, Yujuan; Zhu, Jun; Ding, Jianhua

    2017-04-01

    The purpose of this study is to compare the clinical and functional outcomes of three types of hand-sewn colo-anal anastomosis (CAA) after laparoscopic intersphincteric resection (Lap-ISR) for patients with ultralow rectal cancer. A total of 79 consecutive patients treated by Lap-ISR for low-lying rectal cancer in an academic medical center from June 2011 to February 2016. According to the distal tumor margin and individualized anal length, the patients underwent three types of hand-sewn CAA including partial-ISR, subtotal-ISR, and total-ISR. Of the 79 patients, 35.4% required partial-ISR, 43% adopted subtotal-ISR, and 21.5% underwent total-ISR. R0 resection was achieved in 78 patients (98.7%). In addition to distal resection margin, there were no significant differences in clinicopathological parameters and postoperative complications between the three groups. The type of hand-sewn CAA did not influence the 3-year disease-free survival (DFS) or local relapse-free survival (LFS). At 24-months follow-up, in spite of higher incontinence scores in total-ISR group, there were not statistically significant differences in functional outcomes including Wexner score or Kirwan grade between the groups. Nevertheless, patients with chronic anastomotic stricture showed worse anal function than those without the complication. The type of hand-sewn CAA after Lap-ISR may not influence oncological and functional outcomes, but chronic stricture deteriorates continence status.

  7. 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

  8. 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, ...

  9. 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.   ...

  10. 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)

  11. 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.

  12. 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)

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

    International Nuclear Information System (INIS)

    Kachnic, Lisa A.; Tsai, Henry K.; Coen, John J.; Blaszkowsky, Lawrence S.; Hartshorn, Kevan; Kwak, Eunice L.; Willins, John D.; Ryan, David P.; Hong, Theodore S.

    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.

  14. 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.

  15. [Evaluation of the effect of one-step self etching adhesives applied in pit and fissure sealing].

    Science.gov (United States)

    Su, Hong-Ru; Xu, Pei-Cheng; Qian, Wen-Hao

    2016-06-01

    To observe the effect of three one-step self etching adhesive systems used in fit and fissure sealant and explore the feasibility of application in caries prevention in school. Seven hundred and twenty completely erupted mandibular first molars in 360 children aged 7 to 9 years old were chosen. The split-mouth design was used to select one side as the experimental group, divided into A1(Easy One Adper), B1(Adper Easy One), and C1(iBond SE).The contra lateral teeth served as A2,B2 and C2 groups (phosphoric acid). The retention and caries status were regularly reviewed .The clinical effect of the two groups was compared using SPSS19.0 software package for Chi - square test. At 3 and 6 months, pit and fissure sealant retention rate in A1 and A2, B1 and B2,C1 and C2 group had no significant difference. At 12 months, sealant retention in A1 and B1 group was significantly lower than A2 and B2 group (P0.05). At 24 months, sealant retention rate in A1, B1 and C1 group was significantly lower than A2, B2 and C2 group (P0.05). The clinical anticariogenic effect of three kinds of one-step etching adhesives and phosphoric acid etching sealant was similar .One-step self etching adhesive system was recommended for pit and fissure sealant to improve the students' oral health. The long-term retention rate of one-step self etching adhesive system was lower than the phosphoric acid method to long term observation is needed.

  16. Origins of feeding arteries of hepatocellular carcinoma located near the umbilical fissure of the left hepatic lobe: angiographic evaluation.

    Science.gov (United States)

    Miyayama, Shiro; Yamashiro, Masashi; Shibata, Yoshihiro; Hashimoto, Masahiro; Yoshida, Miki; Tsuji, Kazunobu; Toshima, Fumihito; Matsui, Osamu

    2012-12-01

    To analyze the origins of the feeding arteries of hepatocellular carcinomas (HCCs) near the umbilical fissure of the left hepatic lobe. Twenty-eight HCCs with a mean ± SD tumor diameter of 3.4 ± 1.0 cm (range 1-4.4 cm) in contact with the right or left side of the umbilical fissure were treated by superselective transcatheter arterial chemoembolization (TACE). The origins of the tumor-feeding arteries were analyzed with arteriograms and computed tomography or cone-beam computed tomography images obtained during and 1 week after TACE. Twenty-one HCC lesions were located in segment 3 and seven were located in segment 4. Of 21 tumors in segment 3, 13 (61.9%) were supplied by the lateral inferior subsegmental artery (A3), three (14.3%) by the medial subsegmental artery (A4), three (14.3%) by both A4 and A3, one (4.8%) by a branch arising from the left lateral hepatic artery, and one (4.8%) by a branch of the right gastric artery. In particular, all tumor-feeding branches arising from A4 were the first branch of A4. Of seven tumors in segment 4, four (57.1%) were supplied by A4 and three (42.9%) by A3. In particular, all tumor-feeding branches arising from A3 were the first branch of A3. This study demonstrates crossover blood supply to HCC lesions located near the umbilical fissure, in addition to direct feeding from a separate branch. In particular, the first branch of the opposite subsegmental artery may feed tumors when crossover blood supply is present.

  17. Origins of Feeding Arteries of Hepatocellular Carcinoma Located Near the Umbilical Fissure of the Left Hepatic Lobe: Angiographic Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Miyayama, Shiro, E-mail: s-miyayama@fukui.saiseikai.or.jp; Yamashiro, Masashi; Shibata, Yoshihiro; Hashimoto, Masahiro; Yoshida, Miki; Tsuji, Kazunobu; Toshima, Fumihito [Fukuiken Saiseikai Hospital, Department of Diagnostic Radiology (Japan); Matsui, Osamu [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan)

    2012-12-15

    Purpose: To analyze the origins of the feeding arteries of hepatocellular carcinomas (HCCs) near the umbilical fissure of the left hepatic lobe. Methods: Twenty-eight HCCs with a mean {+-} SD tumor diameter of 3.4 {+-} 1.0 cm (range 1-4.4 cm) in contact with the right or left side of the umbilical fissure were treated by superselective transcatheter arterial chemoembolization (TACE). The origins of the tumor-feeding arteries were analyzed with arteriograms and computed tomography or cone-beam computed tomography images obtained during and 1 week after TACE.ResultsTwenty-one HCC lesions were located in segment 3 and seven were located in segment 4. Of 21 tumors in segment 3, 13 (61.9%) were supplied by the lateral inferior subsegmental artery (A3), three (14.3%) by the medial subsegmental artery (A4), three (14.3%) by both A4 and A3, one (4.8%) by a branch arising from the left lateral hepatic artery, and one (4.8%) by a branch of the right gastric artery. In particular, all tumor-feeding branches arising from A4 were the first branch of A4. Of seven tumors in segment 4, four (57.1%) were supplied by A4 and three (42.9%) by A3. In particular, all tumor-feeding branches arising from A3 were the first branch of A3. Conclusion: This study demonstrates crossover blood supply to HCC lesions located near the umbilical fissure, in addition to direct feeding from a separate branch. In particular, the first branch of the opposite subsegmental artery may feed tumors when crossover blood supply is present.

  18. Fractal dimension and image statistics of anal intraepithelial neoplasia

    International Nuclear Information System (INIS)

    Ahammer, H.; Kroepfl, J.M.; Hackl, Ch.; Sedivy, R.

    2011-01-01

    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.

  19. 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)

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2012-12-01

    Full Text Available 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, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

  2. The differences of saliva pH before and after application of Bis-GMA resin based-pit and fissure sealant

    Directory of Open Access Journals (Sweden)

    Ayub Irmadani Anwar

    2016-06-01

    Full Text Available Pit and fissure sealant applications is one way to prevent caries. One of the effective ingredient as a pit and fissure sealant is a Bis-GMA resin. One of the active components  of  Bis-GMA  resin  is  sodium  fluoride,  which is capable  of releasing fluoride ions to the tooth surface and able to improve the repair and remineralization process through the replacement  of  calcium and phosphate ions found in saliva to increase the pH of saliva. This study was to determine the effect of pit and fissure sealant applications made from Bis-GMA resin to pH of saliva in children aged 6-12 years. The study design is pre and post test with control group design. Saliva samples were derived from 15 pediatric patients has met the criteria. The pH of saliva were taken before and after the application of pit and fissure sealant made from Bis-GMA and measured with pH meter. This study used a non-parametric test, the Wilcoxon Signed Rank test. The results of this study are also supported by the results of statistical tests showed p-: 0.005 (p<0.05 value, which means that there are significant differences in pH of saliva before and after the application of pit and fissure sealant made from Bis-GMA resin.

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

    Directory of Open Access Journals (Sweden)

    Lêda Pereira de Barcellos

    2014-01-01

    Full Text Available Objectives: To verify the value of conventional cytology for the diagnosis of macroscopic le- sions 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 elements repre- sentative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion: The study demonstrates the feasibility of using conventional anal cytology in outpatients. Resumo: Objetivo: verificar o valor da citologia convencional no diagnóstico de lesões macroscópicas do canal anal e descrever as limitações das amostras obtidas. Método: avaliamos 395 exames citológicos convencionais obtidos por escovado do canal anal de pacientes predominantemente do sexo masculino, soropositivos para HIV, e com- paramos com a presença de lesões macroscópicas do canal anal constatadas ao exame proctológico. Resultado: o percentual de amostras adequadas foi de 91,6%, e os elementos celulares re- presentativos da zona de transformação anal foram observados em 63,5% das amostras. Encontramos sensibilidade de 80% e 31% na presença ou ausência desta celularidade, res- pectivamente. Conclusão: O estudo demonstra a possibilidade de utilização da citologia anal convencional no rastreio de lesões macroscópicas do canal anal em pacientes ambulatoriais. Keywords: HPV Prevention of anal neoplasia Conventional cytology, Palavras-chave: HPV Prevenção de neoplasia anal Citologia convencional

  4. A clinical trial to evaluate the retention of a silver cermet-ionomer cement used as a fissure sealant.

    Science.gov (United States)

    Mills, R W; Ball, I A

    1993-01-01

    A randomized clinical trial was under-taken to compare the retention of a silver cermet-ionomer cement, Ketac Silver, with a conventional, autopolymerizing BIS-GMA resin sealant, Delton, using matched pairs of fissure sites within each subject's mouth. One hundred twenty matched contralateral pairs of fissure sites in first and second permanent molars of 53 school children were sealed with the two materials. The choice of site and material was selected at random. The ages of the children ranged from five to 16 years; first permanent molars were sealed in the five- to 10-year age group, and second permanent molars in the 11- to 16-year age group. Sealants were assessed as present, partly present, or absent at 6, 12, and 24 months. The number of pairs of sites available for reassessment declined from 102 at six months to 59 at 24 months as patients were lost to the study. Retention rates were higher for the Ketac Silver sealants at all three inspection intervals (P cermet cement was better retained than conventional resin sealants in younger children.

  5. Knowledge, value, opinion and practice about usage of pit and fissure sealant among dental professionals in Chennai, Tamil Nadu, India.

    Science.gov (United States)

    Nagappan, N; Dhamodhar, M Dinesh; Nithin, M G; Kumar, E Senthil

    2015-12-01

    A study was aimed to assess the knowledge, value, opinion, and practice regarding the use of dental sealants among private dental practitioners in Chennai, Tamil Nadu, India. A self-administrated questionnaire were distributed to 192 private dental practitioners in Chennai, Tamil Nadu, India by using simple random sampling. A convenience sampling technique was employed. The questionnaire consisted of 28 items, which included information about knowledge, value, opinion, and practice regarding dental sealants. The questionnaire was obtained from the study by San Martin et al. 2013 and Kailash Asawa et al. 2014. Frequency distribution was tabulated. For frequency distribution strongly, strongly agree, and agree were combined as "agree" and strongly disagree and disagree were combined as "disagree." There were no changes in "neutral." Among the 196 study subjects 56.2% were males and 43.8% were females with their clinical experience of 52.1% for 15 years. The mean scores for knowledge, value, opinion, and practice were 41.8 ± 3.7, 18.7 ± 2.8, 18.1 ± 1.4, and 12.9 ± 2.3, respectively. The results suggest that dental practitioners had satisfactory knowledge about pit and fissure sealant and had neutral attitudes about sealants being effective. Dental practitioners adequately used the pit and fissure sealants but they did not follow the standardized procedures and specific guidelines.

  6. Comparative efficacy of nanofilled and microfilled resin-modified glass ionomer as pits and fissure sealant in permanent molar teeth

    Directory of Open Access Journals (Sweden)

    Manzuma Akhter Zakaria

    2017-05-01

    Full Text Available The purpose of the present study was to compare the efficacy of nanofilled and microfilled resin- modified glass ionomer as pits and fissure sealants in permanent molar teeth. Ninety six teeth having fissure at the occlusal surface were randomly divided into two groups: Group I: Treated by nanofilled resin-modified glass ionomer sealant and Group II: Treated by microfilled resin- modified glass ionomer sealants. Clinical assessment was performed by modified Ryge´s criteria by means of retention, color match, marginal adaptation at 3, 6, and 12 months follow-up visit. Chi-square test was used for testing differences between the two groups; a value of p<0.05 was considered as statistically significant. The results revealed that at 12 months observation period, nanofilled resin-modified glass ionomer sealant showed better retention, color stability and marginal adaptation than that of microfilled resin-modified glass ionomer sealants. Furthermore, the differences between two groups in respect to marginal adaptation and color match were statistically significant (p<0.05. It can be concluded that nanofilled resin-modified glass ionomer sealant could be a better alternative to microfilled resin- modified glass ionomer sealant.

  7. 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.

  8. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin.

    Science.gov (United States)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-03-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190-0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375-9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167-4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

  9. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    International Nuclear Information System (INIS)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-01-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer

  10. Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2016-01-01

    . DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

  11. Abnormal rectoanal function in children recovered from chronic constipation and encopresis.

    Science.gov (United States)

    Loening-Baucke, V A

    1984-12-01

    It is unknown if abnormal anal sphincter function as assessed by anorectal manometry is still present years after resolution of chronic constipation and encopresis. Twenty healthy controls, 12 children with constipation but no encopresis, and 20 children with chronic constipation and encopresis underwent anorectal manometric testing, using intraluminal pressure transducers and a balloon for rectal distention. Anorectal measurements were repeated in the 20 constipated and encopretic children 2.5-4 yr after treatment began; 11 children had recovered for at least 1 yr. The mean values of anal resting tone and of anal pull-through pressure were lower in the constipated and encopretic children than in the 20 control children (p less than 0.003). Percent relaxation of the rectosphincteric reflex after rectal distention of 30 and 60 ml was lower in constipated children with and without encopresis than in controls (p less than 0.003), whereas the means of rectosphincteric reflex threshold were comparable in the three groups of children. Three years after initiation of treatment with milk of magnesia, high-fiber diet, and bowel training techniques, the mean values of anal resting tone, anal pull-through pressure, and percent relaxation of rectosphincteric reflex remained significantly lower in both recovered and nonrecovered constipated and encopretic patients compared with controls. It was suggested that the underlying cause of chronic constipation is the decreased ability of the internal anal sphincter to relax with rectal distention, and the hypotonia of the anal canal is responsible for the encopresis. Abnormal anorectal functions were still present years after cessation of treatment and recovery and put the recovered patient at risk for recurrence of chronic constipation and encopresis.

  12. Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping

    Directory of Open Access Journals (Sweden)

    Omar Clavero

    2017-06-01

    Full Text Available Background: Human papillomavirus (HPV-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ. We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and –positive patients. Methods: Histopathology identified 47 squamous intraepithelial lesions (SILs adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Results: Sixteen (16/47 of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47 were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM; Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Conclusions: Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Keywords: Anal squamocolumnar junction, Low-grade squamous intraepithelial lesion (LSIL, High-grade squamous intraepithelial lesion (HSIL, Papillary immature metaplasia (PIM, HPV, HIV

  13. Biofeedback training in chronic constipation.

    Science.gov (United States)

    Benninga, M A; Büller, H A; Taminiau, J A

    1993-01-01

    Twenty nine patients, aged 5-16 years, were studied to evaluate whether biofeedback training is effective in treating children with chronic constipation and encopresis; the clinical outcome at six weeks and 12 months was also evaluated. Patients received on average five biofeedback training sessions. The existence of external anal contraction or decreased rectal sensation in 16 (55%) and eight (27%) of the children, respectively was identified on manometry. After biofeedback training, 26 (90%) of the patients learned to relax the external anal sphincter; 18 (63%) normalised rectal sensation. The training resulted in a significant increase in defecation frequency and a significant decrease in encopresis. At six weeks, 16 (55%) of the patients were clinically symptom free. At follow up after 12 months the results were sustained. Only three patients showed a relapse within six months, of whom two were successfully treated with one extra training session. Biofeedback training might be a useful therapeutical approach in children with chronic constipation and encopresis. PMID:8434996

  14. US Intergroup Anal Carcinoma Trial: Tumor Diameter Predicts for Colostomy

    Science.gov (United States)

    Ajani, Jaffer A.; Winter, Kathryn A.; Gunderson, Leonard L.; Pedersen, John; Benson, Al B.; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael G.; Rich, Tyvin A.; Willett, Christopher G.

    2009-01-01

    Purpose The US Gastrointestinal Intergroup Radiation Therapy Oncology Group 98-11 anal carcinoma trial showed that cisplatin-based concurrent chemoradiotherapy resulted in a significantly higher rate of colostomy compared with mitomycin-based therapy. Established prognostic variables for patients with anal carcinoma include tumor diameter, clinical nodal status, and sex, but pretreatment variables that would predict the likelihood of colostomy are unknown. Methods A secondary analysis was performed by combining patients in the two treatment arms to evaluate whether new predictive and prognostic variables would emerge. Univariate and multivariate analyses were carried out to correlate overall survival (OS), disease-free survival, and time to colostomy (TTC) with pretreatment and treatment variables. Results Of 682 patients enrolled, 644 patients were assessable and analyzed. In the multivariate analysis, tumor-related prognosticators for poorer OS included node-positive cancer (P ≤ .0001), large (> 5 cm) tumor diameter (P = .01), and male sex (P = .016). In the treatment-related categories, cisplatin-based therapy was statistically significantly associated with a higher rate of colostomy (P = .03) than was mitomycin-based therapy. In the pretreatment variables category, only large tumor diameter independently predicted for TTC (P = .008). Similarly, the cumulative 5-year colostomy rate was statistically significantly higher for large tumor diameter than for small tumor diameter (Gray's test; P = .0074). Clinical nodal status and sex were not predictive of TTC. Conclusion The combined analysis of the two arms of RTOG 98-11, representing the largest prospective database, reveals that tumor diameter (irrespective of the nodal status) is the only independent pretreatment variable that predicts TTC and 5-year colostomy rate in patients with anal carcinoma. PMID:19139424

  15. FDG-PET/CT in the evaluation of anal carcinoma

    International Nuclear Information System (INIS)

    Cotter, Shane E.; Grigsby, Perry W.; Siegel, Barry A.

    2006-01-01

    Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was with standard Nigro regimen. Results: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination

  16. 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.

  17. 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

  18. Unexpected Anal Squamous Cells Carcinoma after Open Hemorrhoidectomy

    Directory of Open Access Journals (Sweden)

    Navarra Luca

    2015-01-01

    Full Text Available We report a case of unexpected anal squamous cells carcinoma found in hemorrhoidectomy specimen. The patient had a 3-year history of prolapsing hemorrhoids. A prolapsing hemorrhoid was present at eleven o’clock in lithotomy. Milligan-Morgan was performed and gross examination of the specimen was unremarkable. Histopathologic evaluation showed noninvasive squamous cells carcinoma. The present case report evidences the opportunity of routine histopathologic analysis of hemorrhoidal specimens particularly in case of long-standing prolapse. Questions arise in the option of those techniques where no specimens are collected or tissue is excised far from deceased area.

  19. [Anal sphincter injury caused by falling off a trampoline].

    Science.gov (United States)

    Pakarinen, Mikko

    2013-01-01

    A girl of preschool age fell off a trampoline in a sitting position onto an iron bar sticking up from the ground. In addition to a laceration of the terminal portion of the rectum, she was found to have a severe sphincter injury. The sphincters were repaired by a surgeon the next morning. After one month from the surgery the anal canal pressure was found to be symmetrical with good contractile force of the sphincters. No abnormalities were found in a contrast study or in rectoscopy. The protective stoma was closed after three months from the injury and fecal continence was normal after one and a half years.

  20. La Contabilidad Analítica en los Hospitales Públicos

    OpenAIRE

    Ma Silvia Fresneda Fuentes

    1998-01-01

    La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye co...

  1. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants.

    Science.gov (United States)

    Bonetti, Debbie; Johnston, Marie; Clarkson, Jan E; Grimshaw, Jeremy; Pitts, Nigel B; Eccles, Martin; Steen, Nick; Thomas, Ruth; Maclennan, Graeme; Glidewell, Liz; Walker, Anne

    2010-04-08

    Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour -- the placing of fissure sealants. Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs) in Scotland. Outcomes were behavioural simulation (scenario decision-making), and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model, and knowledge (a non-theoretical construct). Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value. Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT), timeline acute (CS-SRM), and outcome expectancy (SCT) entered the equation, together explaining 38% of the variance. Behavioural intention - theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT) and attitude (TPB) entered the equation, together explaining 68% of the variance in intention. The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for identifying factors that may predict clinical behaviour

  2. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants

    Directory of Open Access Journals (Sweden)

    Maclennan Graeme

    2010-04-01

    Full Text Available Abstract Background Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour -- the placing of fissure sealants. Methods Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs in Scotland. Outcomes were behavioural simulation (scenario decision-making, and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB, Social Cognitive Theory (SCT, Common Sense Self-regulation Model (CS-SRM, Operant Learning Theory (OLT, Implementation Intention (II, Stage Model, and knowledge (a non-theoretical construct. Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value Results Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT, timeline acute (CS-SRM, and outcome expectancy (SCT entered the equation, together explaining 38% of the variance. Behavioural intention - theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT and attitude (TPB entered the equation, together explaining 68% of the variance in intention. Summary The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for

  3. Prevalence of anal cytological abnormalities in women with positive cervical cytology.

    Science.gov (United States)

    Calore, Edenilson E; Giaccio, Claudia Maria Serafim; Nadal, Sidney R

    2011-05-01

    The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc. Copyright © 2010 Wiley-Liss, Inc.

  4. 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

  5. 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

  6. Paroxysmal anal hyperkinesis: a characteristic feature of proctalgia fugax.

    Science.gov (United States)

    Rao, S S; Hatfield, R A

    1996-10-01

    Proctalgia fugax is a common problem, yet its pathophysiology is poorly understood. The objective was to characterise colorectal disturbances in a paraplegic patient with a 10 year history of proctalgia fugax that began two years after an attack of transverse myelitis. Standard anorectal manometry and prolonged 33 hour ambulatory colonic manometry at six sites in the colon were performed together with myoelectrical recording of the anus. Provocative tests designed to simulate psychological and physical stress and two types of meals were included. Anorectal manometry showed normal internal sphincter tone and normal rectoanal inhibitory reflex but an inability to squeeze or to bear down or to expel a simulated stool. Rectal sensation (up to 360 ml inflation) was absent. Pudendal nerve latency was prolonged (4.5 ms (normal 3.2 mv), high frequency (5-50/min) anal myoelectrical activity, particularly after stress tests, meals, and at night. The myoelectrical disturbance only occurred with proctalgia. Intermittently, 16 bursts of 3 cycles/ min phasic rectal contractions were seen, but only six were associated with proctalgia. Colonic motility was reduced compared with normal subjects. The temporal association between a high amplitude, high frequency myoelectrical activity of the anal sphincter, and the occurrence of proctalgia suggests that paroxysmal hyperkinesis of the anus may cause proctalgia fugax.

  7. 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)

  8. Automatic classification of pulmonary peri-fissural nodules in computed tomography using an ensemble of 2D views and a convolutional neural network out-of-the-box

    NARCIS (Netherlands)

    Ciompi, Francesco; de Hoop, Bartjan; van Riel, Sarah J.; Chung, Kaman; Scholten, Ernst Th.; Oudkerk, Matthijs; de Jong, Pim A.; Prokop, Mathias; van Ginneken, Bram

    2015-01-01

    In this paper, we tackle the problem of automatic classification of pulmonary peri-fissural nodules (PFNs). The classification problem is formulated as a machine learning approach, where detected nodule candidates are classified as PFNs or non-PFNs. Supervised learning is used, where a classifier is

  9. Detection of occlusal caries with impedance spectroscopy and laser fluorescence before and after placement of fissure sealants: An in vitro study

    DEFF Research Database (Denmark)

    Mortensen, Diana; Ekstrand, Kim; Twetman, Svante

    2016-01-01

    , the DIAGNOdent pen and ICDAS at baseline, after bleaching, etching and placement of a clear fissure sealant. A digital radiograph was exposed at baseline. After the assessments, the actual lesion depth was histologically determined.  Results : Bleaching did not affect the readings but significantly higher ACIS...

  10. Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Araiz Cajueiro Carneiro Pereira

    Full Text Available Abnormalities found with anuscopy under colposcopic vision, anal cytology and anal biopsy were evaluated in 21 men with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS at the Federal University of Pernambuco Hospital in Brazil. Mean age was 38.4 ± 6.0 years, and mean time of HIV infection was 8.3 ± 5.1 years; 95.2% of the patients had been on highly active antiretroviral therapy (HAART for an average of 6.6 ± 4.5 years. Mean CD4+ cell count was 482.2 ± 173.75 cells/mm³, and 80.9% presented a HIV viral load of < 5,000 copies/mL. Reported sexual preference was 52.4% homosexuals, 28.6% bisexuals, and 19.0%heterosexuals; 81% reported having had receptive anal intercourse and 61.9% reported more than 10 sexual partners of the same sex. Results of anuscopy under colposcopic vision revealed 17 (81.0% low-grade lesions and/or condylomata or micropapillae and four (19.0% high-grade lesions with or without condylomata. Among the 21 anal cytology examinations, seven (33.3% revealed low-grade squamous intraepithelial lesions (LSIL; three (14.3% presented atypical squamous cells of undetermined significance (ASCUS and 11 (52.4% were normal. Seventeen patients were submitted to anal biopsy with the following findings: three patients (17.6% with normal epithelium, one (5.9% with infection by HPV, three (17.6% with condylomatas, two (11.8% with AIN 1, four (23.6% with AIN 2, three (17.6% with AIN 3, and one (5.9% with PAIN 2. Anuscopy under colposcopic vision was found to be useful for detecting anal lesions and for guiding anal biopsies. Anal cytology was less useful, as it underestimated the frequency of lesions.

  11. Tunni analüüs - mis see on? / Peep Leppik

    Index Scriptorium Estoniae

    Leppik, Peep

    2001-01-01

    Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

  12. Prolonged-Release Oxycodone/Naloxone Improves Anal Sphincter Relaxation Compared to Oxycodone Plus Macrogol 3350

    DEFF Research Database (Denmark)

    Poulsen, Jakob Lykke; Brock, Christina; Grønlund, Debbie

    2017-01-01

    /naloxone or PR oxycodone plus macrogol 3350. Resting anal pressure, anal canal distensibility, and relaxation of the internal sphincter to rectal distension were evaluated before treatment (baseline) and on day 5. The Patient Assessment of Constipation Symptom (PAC-SYM) questionnaire, stool frequency, and stool...

  13. Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men

    NARCIS (Netherlands)

    Richel, O.; Wieland, U.; de Vries, H. J. C.; Brockmeyer, N. H.; van Noesel, C.; Potthoff, A.; Prins, J. M.; Kreuter, A.

    2010-01-01

    Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical

  14. High-Resolution Anoscopy: Clinical Features of Anal Intraepithelial Neoplasia in HIV-positive Men

    NARCIS (Netherlands)

    Richel, Olivier; Hallensleben, Nora D. L.; Kreuter, Alexander; van Noesel, Carel J. M.; Prins, Jan M.; de Vries, Henry J. C.

    2013-01-01

    BACKGROUND: High-resolution anoscopy is increasingly advocated to screen HIV+ men who have sex with men for anal cancer and its precursor lesions, anal intraepithelial neoplasia. A systematic comparison between clinical features and the histopathology of suspect lesions is lacking. OBJECTIVE: This

  15. The increasing incidence of anal cancer: can it be explained by trends in risk groups?

    NARCIS (Netherlands)

    van der Zee, R. P.; Richel, O.; de Vries, H. J. C.; Prins, J. M.

    2013-01-01

    Anal cancer incidence is gradually increasing. The cause of this increase is not exactly known. This systematic literature review aimed to investigate the trend in time of anal cancer incidence and to find an explanation for the supposed increase. The TRIP database and PubMed were searched for

  16. 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

  17. 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.

  18. 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…

  19. Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

    Science.gov (United States)

    Kamm, M A; Hoyle, C H; Burleigh, D E; Law, P J; Swash, M; Martin, J E; Nicholls, R J; Northover, J M

    1991-03-01

    A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. Constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. In vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance P, calcitonin gene-related peptide, galanin, neuropeptide Y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.

  20. [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.

  1. De chirurgische betekenis van de inwendige kringspier van het anale kanaal : een klinisch en manometrisch onderzoek

    NARCIS (Netherlands)

    W.R. Schouten (Ruud)

    1990-01-01

    textabstractThe high pressure zone within the anal canal is largely due to the activity of the internal anal sphincter and provides an effective barrier against rectal pressure. The continuous contraction of the internal sphincter also has a congesting effect on the vascular cushions, thereby

  2. 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.

  3. Influence of Fissure Number on the Mechanical Properties of Layer-Crack Rock Models under Uniaxial Compression

    Directory of Open Access Journals (Sweden)

    Yun-liang Tan

    2018-01-01

    Full Text Available Many case studies have revealed that rock bursts generally occur in the high stress concentration area where layer-crack structures often exist, especially for brittle coal or rock masses. Understanding the mechanical properties of layer-crack rock models is beneficial for rational design and stability analysis of rock engineering project and rock burst prevention. This study experimentally investigated the influence of fissure number on the mechanical properties of layer-crack rock models through uniaxial compression tests. The digital speckle correlation method (DSCM and acoustic emission (AE techniques were applied to record and analyze the information of deformation and failure processes. Test results show the following: the bearing capacity of layer-crack specimen decreases compared with intact specimen, but their failure modes are similar, which are the splitting failure accompanied with local shear failure; the nonuniform deformation phenomenon begins to appear at the elastic deformation stage for layer-crack specimens; the AE behavior of intact specimens consists of three stages, that is, active stage, quiet stage, and major active stage, but for layer-crack specimens, it is characteristic by three peaks without quiet stage. In addition, as the fissure number of layer-crack specimens increases, the bearing capacity of specimens decreases, the appearing time of nonuniform deformation phenomenon in the specimen surface decreases, the AE events are denser and denser in each peak stage, and the risk of dynamic instability of layer-crack structure increases. At last, the failure mechanism of layer-crack structure and the related mitigation advices were discussed based on the test results. In general, the novelty is that this paper focuses on the failure mechanism of layer-crack structure directly.

  4. Three-armed rifts or masked radial pattern of eruptive fissures? The intriguing case of El Hierro volcano (Canary Islands)

    Science.gov (United States)

    Becerril, L.; Galindo, I.; Martí, J.; Gudmundsson, A.

    2015-04-01

    Using new surface structural data as well as subsurface structural data obtained from seventeen water galleries, we provide a comprehensive model of the volcano-tectonic evolution of El Hierro (Canary Islands). We have identified, measured and analysed more than 1700 volcano-structural elements including vents, eruptive fissures, dykes and faults. The new data provide important information on the main structural patterns of the island and on its stress and strain fields, all of which are crucial for reliable hazard assessments. We conducted temporal and spatial analyses of the main structural elements, focusing on their relative age and association with the three main cycles in the construction of the island: the Tiñor Edifice, the El Golfo-Las Playas Edifice, and the Rift Volcanism. A radial strike distribution, which can be related to constructive episodes, is observed in the on-land structures. A similar strike distribution is seen in the submarine eruptive fissures, which are radial with respect to the centre of the island. However, the volcano-structural elements identified onshore and reflecting the entire volcano-tectonic evolution of the island also show a predominant NE-SW strike, which coincides with the main regional trend of the Canary archipelago as a whole. Two other dominant directions of structural elements, N-S and WNW-ESE, are evident from the establishment of the El Golfo-Las Playas edifice, during the second constructive cycle. We suggest that the radial-striking structures reflect comparatively uniform stress fields during the constructive episodes, mainly conditioned by the combination of overburden pressure, gravitational spreading, and magma-induced stresses in each of the volcanic edifices. By contrast, in the shallower parts of the edifice the NE-SW, N-S and WNW-ESE-striking structures reflect local stress fields related to the formation of mega-landslides and masking the general and regional radial patterns.

  5. Acid neutralizing, mechanical and physical properties of pit and fissure sealants containing melt-derived 45S5 bioactive glass.

    Science.gov (United States)

    Yang, Song-Yi; Piao, Yin-Zhu; Kim, Sung-Min; Lee, Yong-Keun; Kim, Kyoung-Nam; Kim, Kwang-Mahn

    2013-12-01

    The aim of this study was to examine the effects of 45S5 bioactive glass (BAG) on the acid neutralizing, mechanical and physical properties of pit and fissure sealants. 45S5BAG (glass (180 ± 30 nm) and added into a resin matrix [Bis-GMA/TEGDMA 50/50 (wt%) containing 1% of DMAEMA/CQ 2:1 (wt%)] with varying filler proportions; 0% 45S5BAG+50% glass (BAG0); 12.5% 45S5BAG+37.5% glass (BAG12.5); 25% 45S5BAG+25% glass (BAG25); 37.5% 45S5BAG+12.5% glass (BAG37.5); and 50% 45S5BAG+0% glass (BAG50). To evaluate the acid neutralizing properties, specimens were immersed in lactic acid solution (pH 4.0). Then, the change in pH and the time required to raise the pH from 4.0 to 5.5 were measured. In addition, flexural strength, water sorption and solubility were analyzed. The acid neutralizing properties of each group exhibited increasing pH values as more 45S5BAG was added, and the time required to raise the pH from 4.0 to 5.5 became shorter as the proportion of 45S5BAG increased (P0.05), except for BAG50. The novel pit and fissure sealants neutralized the acid solution (pH 4.0) and exhibited appropriate mechanical and physical properties. Therefore, these compounds are suitable candidates for caries-inhibiting dental materials. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  6. Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study.

    Science.gov (United States)

    Tucker, Julie; Clifton, Vicki; Wilson, Anne

    2014-08-01

    Obstetric anal sphincter injury (OASIS) following vaginal delivery increases the risk of anal incontinence (AI). Subsequent vaginal delivery and ageing increase the risk of worsening symptoms. Very little literature describes any in-depth understanding of what it is like to live with AI following a history of known OASIS. To describe and interpret women's experience of AI following OASIS and its impact on quality of life. An interpretive phenomenological study was conducted in a level 2 tertiary hospital in South Australia. Women with a history of OASIS and AI were purposefully recruited. The St Marks Vaizey score was utilised to identify symptom severity. Semi-structured open-ended interviews were conducted, and data were analysed utilising Van Manen thematic analysis. Participants (n = 10) aged 26-56 years. All women were symptomatic of AI following OASIS, and 80% had received a primary OASIS at their first vaginal delivery. The St Marks Vaizey score mean was 9.1 (range within 4-22). Three essential themes grieving for loss, silence, striving for normality with eight subthemes identified a significant sense of loss and psychological impact of AI for this group of women. Health professionals require a greater understanding of the negative impact of OASIS and AI on women's quality of life. This may improve the management, education and clinical care of this condition which may result as a consequence of OASIS. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Regenerative medicine provides alternative strategies for the treatment of anal incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-01-01

    of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem...... cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. CONCLUSION: Cellular therapies with myogenic cells...... and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most...

  8. 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

  9. [Detection and analysis of the characteristic expression of microRNAs of anal fistula patients].

    Science.gov (United States)

    Qiu, Jianming; Yu, Jiping; Yang, Guangen; Xu, Kan; Tao, Yong; Lin, Ali; Wang, Dong

    2016-07-01

    To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance. The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(Pcharacteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.

  10. 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.

  11. Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

    Science.gov (United States)

    Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

    2012-01-01

    The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

  12. HAART slows progression to anal cancer in HIV-infected MSM.

    Science.gov (United States)

    Duncan, Katrina C; Chan, Keith J; Chiu, Connie G; Montaner, Julio S G; Coldman, Andy J; Cescon, Angela; Au-Yeung, Christopher G; Wiseman, Sam M; Hogg, Robert S; Press, Natasha M

    2015-01-28

    Antiretrovirals do not prevent anal intraepithelial neoplasia. However, the influence of antiretrovirals in the natural history of invasive anal cancer is less clear. The objective is to investigate the impact of antiretrovirals in the time to the development of anal cancer in HIV-positive MSM. A retrospective analysis of cases of anal cancer in a cohort of HIV-positive MSM receiving antiretrovirals between 1988 and 2008. Time from first CD4 cell count or HIV RNA viral load test to anal cancer diagnosis was analysed using Cox regression and Kaplan-Meier curves. Anal cancer cases treated in the era prior to HAART (cancer cases (n = 37) were compared with a cohort of 1654 HIV-positive MSM on antiretrovirals. Antiretrovirals were started in the pre-HAART era by 70% of cancer cases, and median CD4 cell count nadir was 70 cells/μl (10-130). Time to development of anal cancer was shorter for cases treated during the pre-HAART era [adjusted hazard ratio (AHR) 3.04, 95% confidence interval (95% CI) 1.48-6.24, P = 0.002], with a CD4 cell count nadir less than 100 cells/μl (AHR 2.21, 95% CI 1.06-4.62, P = 0.035) and longer duration of CD4 cell count less than 100 cells/μl (AHR 1.33, 95% CI 1.11-1.58, P = 0.002). Results show that severe immunosuppression and starting therapy pre-HAART are associated with an increased risk of anal cancer. HIV-positive MSM initiating antiretrovirals during the HAART era (1996-2008) had a longer time to the development of anal cancer than those treated pre-HAART. Our results suggest that early use of HAART may delay progression to anal cancer.

  13. Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report

    Directory of Open Access Journals (Sweden)

    Noone Robert

    2010-02-01

    Full Text Available Abstract Introduction High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States. The treatment of choice is surgical resection with anal mapping. However, this disease often recurs or persists, requiring additional surgery for these patients. This can compromise the anal sphincter leading to leakage. In this case report, we discuss the efficacy of radiation therapy as a modality to treat post-excisional recurrent Bowen's disease, which may prevent sphincter compromise, leading to improved quality of life. Case presentation An 84-year-old Caucasian woman presented with post-excisional persistent/recurrent squamous cell carcinoma in-situ. The initial lesion measured 3 cm in diameter on the right lateral side of the anal margin. A standard surgery consisting of wide local excision with anal mapping was performed. The margins were clear and our patient was followed up. Our patient recurred with a 1.2 × 0.8 cm lesion on the left anal verge extending to the anal canal. A biopsy along with mapping was done, and 2 of the 17 mapping specimens were positive for carcinoma in-situ, one in the anal canal. Due to the location of the positive anal mapping, and in order to prevent sphincter compromise on re-excision, our patient was offered definitive radiation therapy. Two years after radiation therapy, our patient showed no signs of recurrent disease and had good sphincter control. Conclusion Although the main treatment modality for treating persistent/recurrent Bowen's disease is surgery, an alternative approach using external beam radiation for CIS may be enough to provide a cure for some patients with recurrent disease.

  14. Incontinence after primary repair of obstetric anal sphincter tears is related to relative length of reconstructed external sphincter

    DEFF Research Database (Denmark)

    Norderval, S; Røssaak, K.; Markskog, A

    2012-01-01

    To determine if anatomic primary repair with end-to-end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared...

  15. Surgical Treatment of Anal Stenosis with Diamond Flap Anoplasty Performed in a Calibrated Fashion.

    Science.gov (United States)

    Gülen, Merter; Leventoğlu, Sezai; Ege, Bahadir; Menteş, B Bülent

    2016-03-01

    Regarding anoplasty for anal stenosis, it is not clear to what extent the final anal caliber should be targeted. The aim of this study was to investigate the results of diamond-flap anoplasty performed in a calibrated manner for the treatment of severe anal stenosis due to a previous hemorrhoidectomy. Prospectively prepared standard forms were evaluated retrospectively. Anoplasty with unilateral or bilateral diamond flaps was performed for moderate or severe anal stenosis, targeting a final anal caliber of 25 to 26 mm. The demographic characteristics, causes of anal stenosis, number of previous surgeries, anal stenosis staging (Milsom and Mazier), anal calibers (millimeter), the Cleveland Clinic Incontinence Score, and the modified obstructed defecation syndrome Longo score were recorded on pre-prepared standard forms, as well as postoperative complications and the time of return to work. From January 2011 to July 2013, 18 patients (12 males, 67%) with a median age of 39 years (range, 27-70) were treated. All of the patients had a history of previous hemorrhoidectomy. The number of previous corrective interventions was 2.1 ± 1.8 (range, 0-4), and 2 patients had a history of failed anoplasty. Five patients (28%) had moderate anal stenosis and 13 (72%) had severe anal stenosis. Preoperative, intraoperative, and 12-month postoperative anal calibration values were 9 ± 3 mm (range, 5-15), 25 ± 0.75 mm (range, 24-26), and 25 ± 1 mm (range, 23-27) (p < 0.0001, for immediate postoperative and 12-month postoperative anal calibers compared with the intraoperative). Preoperative and 12-month postoperative Cleveland Clinic Incontinence Scores were 0.83 ± 1.15 (range, 0-4) and 0.39 ± 0.70 (range, 0-2) (p = 1.0). The clinical success rate was 88.9%. No severe postoperative complications were observed. This study was limited because it was a single-armed, retrospective analysis of prospectively designed data. Diamond-flap anoplasty performed in a standardized and calibrated

  16. Overdiagnosis and rising rate of obstetric anal sphincter injuries (OASIS): time for reappraisal.

    Science.gov (United States)

    Sioutis, D; Thakar, R; Sultan, A H

    2017-11-01

    To determine the accuracy of clinical diagnosis of obstetric anal sphincter injuries (OASIS) using three-dimensional (3D) endoanal ultrasound (EA-US) and to compare symptoms and anal manometry measurements between women with anal sphincters adequately repaired and those with persistent anal sphincter defects. The EA-US images of women with clinically diagnosed and repaired OASIS, defined as third- or fourth-degree perineal tear, who attended the perineal clinic at Croydon University Hospital over a 10-year period (2003-2013) were reanalyzed by a single expert blind to symptoms and the results of clinical examination. St Mark's Incontinence Scores (SMIS) and anal manometry measurements were obtained and compared between women with an intact anal sphincter and those with an anal sphincter scar and between those with an intact anal sphincter and those with a defect. Anal manometry measurements were compared between women with an external anal sphincter (EAS) defect and those with an internal anal sphincter (IAS) defect. The images of 908 women were reanalyzed. No evidence of OASIS was found in 64 (7.0%) women, an EAS scar alone was detected in 520 (57.3%) and an anal sphincter defect in 324 (35.7%). Of the 324 women with a defect, 112 had an EAS defect, 90 had an IAS defect and 122 had a combined IAS and EAS defect. SMIS results were significantly higher in women with an anal sphincter defect compared with those with no evidence of OASIS (P = 0.018), but there was no significant difference in scores between women with an intact sphincter and those with an EAS scar only. Women with a defect had a significantly lower maximum resting pressure (median (range), 44 (8-106) vs 55 (29-86) mmHg; P 40) vs 25 (10-40) mm; P = 0.003). Seven percent of women with a clinical diagnosis of OASIS were wrongly diagnosed. We believe that this rate may differ from that of other units but training methods and competency assessment tools for the diagnosis and repair of OASIS need

  17. Successful implantation of physiologically functional bioengineered mouse internal anal sphincter.

    Science.gov (United States)

    Raghavan, Shreya; Miyasaka, Eiichi A; Hashish, Mohamed; Somara, Sita; Gilmont, Robert R; Teitelbaum, Daniel H; Bitar, Khalil N

    2010-08-01

    We have previously developed bioengineered three-dimensional internal anal sphincter (IAS) rings from circular smooth muscle cells isolated from rabbit and human IAS. We provide proof of concept that bioengineered mouse IAS rings are neovascularized upon implantation into mice of the same strain and maintain concentric smooth muscle alignment, phenotype, and IAS functionality. Rings were bioengineered by using smooth muscle cells from the IAS of C57BL/6J mice. Bioengineered mouse IAS rings were implanted subcutaneously on the dorsum of C57BL/6J mice along with a microosmotic pump delivering fibroblast growth factor-2. The mice remained healthy during the period of implantation, showing no external signs of rejection. Mice were killed 28 days postsurgery and implanted IAS rings were harvested. IAS rings showed muscle attachment, neovascularization, healthy color, and no external signs of infection or inflammation. Assessment of force generation on harvested IAS rings showed the following: 1) spontaneous basal tone was generated in the absence of external stimulation; 2) basal tone was relaxed by vasoactive intestinal peptide, nitric oxide donor, and nifedipine; 3) acetylcholine and phorbol dibutyrate elicited rapid-rising, dose-dependent, sustained contractions repeatedly over 30 min without signs of muscle fatigue; and 4) magnitudes of potassium chloride-induced contractions were 100% of peak maximal agonist-induced contractions. Our preliminary results confirm the proof of concept that bioengineered rings are neovascularized upon implantation. Harvested rings maintain smooth muscle alignment and phenotype. Our physiological studies confirm that implanted rings maintain 1) overall IAS physiology and develop basal tone, 2) integrity of membrane ionic characteristics, and 3) integrity of membrane associated intracellular signaling transduction pathways for contraction and relaxation by responding to cholinergic, nitrergic, and VIP-ergic stimulation. IAS smooth muscle

  18. Anal channel neoplasm: a neoplasm radio chemo curable

    International Nuclear Information System (INIS)

    Torres Lopez, M.; Avondet, I.; Vazquez, J.; Santini Blasco, A.

    1997-01-01

    Presently work is made an exhaustive revision of the anatomy of the region, the history of the treatments and of the current treatments of channel cancer anal. It makes emphasis in the importance of the conservative treatment with radiochemotherapy (RQT). The present is a prospective study,longitudinal and descriptive. Material and method: between January of 1989 and December of 1994 20 patients attended with cancer of anal channel with an illness metastasis. An average age it was of 62.4 years.The sex, 16 men and 4 women. The performance status 0,1 or 2 of the scale of the ECOQ. In the pathological anatomy: 15 patient epidermic neoplasm, 5 patient basal neoplasm. State I: 2 patients, II: 12 patients, III: 6 patients, IV: 0 patients.Treatment: the radiotherapy one carries out with cobalt 60 and it irradiates the primary tumour and the ganglion structures region, pelvic and inguinal. It surrendered to Gy/dia from Monday to Friday up to 50 Gy. The chemotherapy one carries out with mitomicine C 10 mg/ previous day to the radiotherapy and 5-UGH 1 intravenous g/my in infusion the days from 1 to 4 and from 29 to 32 after the radiotherapy.Results: to) control locorregional patient RC-16 (80%) ,RP 2 patients (10%) , without answer or with progression lesional a patient (5%) .b) State vital: living 15 patients, died 5 patients(continuation 12 to 60 months) .e)Tolerance: there were not deaths for the gastrointestinal treatment and haematological with toxicity moderate.To conclude:1) The radiochemotherapy is the treatment of elect.2)A feasible treatment of being carried out in our environment.3)Required of a good relationship predictable interdisciplinary.4)Toxicity and tolerable.5)Results of conservation of the sphincter in 80%(AU) [es

  19. Postpartum two- and three-dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury.

    Science.gov (United States)

    Ros, C; Martínez-Franco, E; Wozniak, M M; Cassado, J; Santoro, G A; Elías, N; López, M; Palacio, M; Wieczorek, A P; Espuña-Pons, M

    2017-04-01

    To compare the sensitivity and specificity of two- (2D) and three- (3D) dimensional transperineal ultrasound (TPUS) and 3D endovaginal ultrasound (EVUS) with the gold standard 3D endoanal ultrasound (EAUS) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). External (EAS) and internal (IAS) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS. 2D-TPUS was evaluated in real-time, whereas 3D-TPUS, 3D-EVUS and 3D-EAUS volumes were evaluated offline by six blinded readers. The presence/absence of any tear in EAS or IAS was recorded and defects were scored according to the Starck system. Sensitivity, specificity and predictive values were calculated, using 3D-EAUS as reference standard. Inter- and intraobserver analyses were performed for all 3D imaging modalities. Association between patients' symptoms (Wexner score) and ultrasound findings (Starck score) was calculated. Images from 55 patients were analyzed. Compared with findings on 3D-EAUS, the agreement for EAS evaluation was poor for 3D-EVUS (κ = 0.01), fair for 2D-TPUS (κ = 0.30) and good for 3D-TPUS (κ = 0.73). The agreement for IAS evaluation was moderate for both 3D-EVUS (κ = 0.41) and 2D-TPUS (κ = 0.52) and good for 3D-TPUS (κ = 0.66). Good intraobserver (3D-EAUS, κ = 0.73; 3D-TPUS, κ = 0.78) and interobserver (3D-EAUS, κ = 0.68; 3D-TPUS, κ = 0.60) agreement was reported. Significant association between Starck and Wexner scores was found only for 3D-EAUS (Spearman's rho = 0.277, P = 0.04). 2D-TPUS and 3D-EVUS are not accurate modalities for the assessment of anal sphincters after repair of OASIS. 3D-TPUS shows good agreement with the gold standard 3D-EAUS and a high sensitivity in detecting residual defects. It, thus, has potential as a screening tool after primary repair of OASIS. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG

  20. 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

  1. Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

    Directory of Open Access Journals (Sweden)

    Yuzuru Tamaru

    2015-04-01

    Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

  2. An integrative review of guidelines for anal cancer screening in HIV-infected persons.

    Science.gov (United States)

    Wells, Jessica S; Holstad, Marcia M; Thomas, Tami; Bruner, Deborah Watkins

    2014-07-01

    HIV-infected individuals are 28 times more likely than the general population to be diagnosed with anal cancer. An integrative review of recommendations and guidelines for anal cancer screening was performed to provide a succinct guide to inform healthcare clinicians. The review excluded studies that were of non-HIV populations, redundant articles or publications, non-English manuscripts, or nonclinical trials. The review found no formal national or international guidelines exist for routine screening of anal cancer for HIV-infected individuals. To date, no randomized control trial provides strong evidence supporting efficaciousness and effectiveness of an anal cancer screening program. The screening recommendations from seven international-, national-, and state-based reports were reviewed and synthesized in this review. These guidelines suggest anal cancer screening, albeit unproven, may be beneficial at decreasing the incidence of anal cancer. This review highlights the paucity of screening-related research and is an area of need to provide clear direction and to define standard of care for anal cancer screening in HIV-infected persons.

  3. Anal HPV infection in HIV-positive men who have sex with men from China.

    Directory of Open Access Journals (Sweden)

    Lei Gao

    Full Text Available BACKGROUND: Anal HPV infection, which contributes to the development of anal warts and anal cancer, is well known to be common among men who have sex with men (MSM, especially among those HIV positives. However, HIV and anal HPV co-infection among MSM has not been addressed in China. METHODS: A cross-sectional study was conducted in Beijing and Tianjin, China. Study participants were recruited using multiple methods with the collaboration of local volunteer organizations. Blood and anal swabs were collected for HIV-1 serological test and HPV genotyping. RESULTS: A total of 602 MSM were recruited and laboratory data were available for 578 of them (96.0%. HIV and anal HPV prevalence were 8.5% and 62.1%, respectively. And 48 MSM (8.3% were found to be co-infected. The HPV genotypes identified most frequently were HPV06 (19.6%, HPV16 (13.0%, HPV52 (8.5% and HPV11 (7.6%. Different modes of HPV genotypes distribution were observed with respect to HIV status. A strong dose-response relationship was found between HIV seropositivity and multiplicity of HPV genotypes (p<0.001, which is consistent with the observation that anal HPV infection was an independent predictor for HIV infection. CONCLUSIONS: A high prevalence of HIV and anal HPV co-infection was observed in the MSM community in Beijing and Tianjin, China. Anal HPV infection was found to be independently associated with increased HIV seropositivity, which suggests the application of HPV vaccine might be a potential strategy to reduce the acquisition of HIV infection though controlling the prevalence of HPV.

  4. Utilidade da citologia anal no rastreamento dos homens heterossexuais portadores do HPV genital Anal cytology for screening heterosexual men harboring genital HPV infection

    Directory of Open Access Journals (Sweden)

    Raphael Marianelli

    2010-09-01

    Full Text Available Os papilomavírus humanos (HPV de alto risco estão fortemente relacionados à etiologia do carcinoma espinocelular (CEC anogenital e suas lesões precursoras. O HPV-16 é o tipo mais freqüente, estando presente em até 87% dos CEC do canal anal HPV-positivo. Apesar de ser relativamente raro, vem sendo cada vez mais diagnosticado, nas últimas décadas, sobretudo em indivíduos do sexo masculino. A incidência é ainda mais elevada nos grupos considerados de risco, particularmente, os homens e as mulheres HIV-positivo e os homens que fazem sexo com homens (HSH. Grande parte das pesquisas direcionadas à infecção anal pelo HPV e sua relação com neoplasia intraepitelial-anal (NIA e com o carcinoma esteve focada nos grupos de risco. Pouco interesse vem sendo destinado à investigação dos homens heterossexuais. Estudos epidemiológicos da prevalência da infecção pelo HPV em homens, mostraram que os heterossexuais masculinos apresentavam infecção anal pelo HPV em até 12%. As Sociedades médicas e os especialistas recomendam o rastreamento dos portadores de imunodepressão e dos HSH com citologia do raspado do canal anal. Entretanto, até o momento, não há recomendação de rastreamento para homens que fazem sexo com mulheres.The oncogenic human papillomaviruses (HPV are straightly associated with anogenital cancer and dysplasia. The HPV-16 is the most common type, isolated in 87% of the HPV-positive anal squamous cell carcinoma (SCC. Despite being a rare tumor, the incidence of SCC has increased in the last decades, especially in males. Incidence is particularly high amongst men who have sex with men (MSM and among HIV infected men and women. For decades anogenital HPV researches have largely focused risk groups. Poor interest was intended to men who have sex with women (MSW. Prevalence studies of HPV infection in MSW have demonstrated that anal infection was identified in as far as 12%. Medical societies and specialists recommend anal

  5. Conversor analógico digital basado en oscilador controlado por tensión

    OpenAIRE

    Cardes García, Fernando

    2012-01-01

    Convencionalmente, los micrófonos dan una salida analógica debida a la variación de presión que produce el sonido, y esta señal se digitaliza por medio de conversores analógico digitales tradicionales. En este proyecto se aborda el diseño de un sistema que obtenga como salida un código digitalizado a partir del sonido recibido por la cápsula microfónica. La principal ventaja de utilizar este sistema es que el circuito analógico que acondiciona la señal se simpli ca considerable...

  6. 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.

  7. Chronic Pancreatitis.

    Science.gov (United States)

    Stram, Michelle; Liu, Shu; Singhi, Aatur D

    2016-12-01

    Chronic pancreatitis is a debilitating condition often associated with severe abdominal pain and exocrine and endocrine dysfunction. The underlying cause is multifactorial and involves complex interaction of environmental, genetic, and/or other risk factors. The pathology is dependent on the underlying pathogenesis of the disease. This review describes the clinical, gross, and microscopic findings of the main subtypes of chronic pancreatitis: alcoholic chronic pancreatitis, obstructive chronic pancreatitis, paraduodenal ("groove") pancreatitis, pancreatic divisum, autoimmune pancreatitis, and genetic factors associated with chronic pancreatitis. As pancreatic ductal adenocarcinoma may be confused with chronic pancreatitis, the main distinguishing features between these 2 diseases are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. La Contabilidad Analítica en los Hospitales Públicos

    Directory of Open Access Journals (Sweden)

    Ma Silvia Fresneda Fuentes

    1998-06-01

    Full Text Available La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye como un componente más de dichos sistemas y está llamada a alcanzar dos objetivos muy claros, por un lado, la determinación del coste del producto hospitalario para en base a él realizar una presupuestación prospectiva, y por otro, suministrar información interna que permita llevar a cabo un verdadero Control de Gestión. Con este trabajo se pretenden describir los modelos de costes alternativos propuestos por la literatura especializada, señalando su idoneidad en base a la consecución de los objetivos que la Contabilidad Analítica debe satisfacer. Se pondrá de manifiesto la tendencia actual a establecer modelos basados en la nueva definición de producto hospitalario, los cuales tienen como finalidad la determinación de los costes totales de dicho producto, dejando a un lado el objetivo del control de la eficacia y eficiencia de la gestión.The development of strict Public Budgets in order to reach the goals settled by Maastricht agreements have caused a deep concern in the Public Sector and mostly in hospitals in order to brake the growth of costs. Such a situation has stated clearly the necessity of implementing Management Accounting Systems in Public Hospitals organizations. Therefore, costs accounting cames to be a part of such systems, which is to reach two very clear objetives. In one hand, the definition of the hospital product cost using it as the base to develop the hospital budget. On the other hand, to supply internal

  9. Genome-wide association studies of pit-and-fissure- and smooth-surface caries in permanent dentition.

    Science.gov (United States)

    Zeng, Z; Shaffer, J R; Wang, X; Feingold, E; Weeks, D E; Lee, M; Cuenco, K T; Wendell, S K; Weyant, R J; Crout, R; McNeil, D W; Marazita, M L

    2013-05-01

    While genetics clearly influences dental caries risk, few caries genes have been discovered and validated. Recent studies have suggested differential genetic factors for primary dentition caries and permanent dentition caries, as well as for pit-and-fissure- (PF) and smooth- (SM) surface caries. We performed separate GWAS for caries in permanent-dentition PF surfaces (1,017 participants, adjusted for age, sex, and the presence of Streptococcus mutans) and SM surfaces (1,004 participants, adjusted for age, education group, and the presence of Streptococcus mutans) in self-reported whites (ages 14 to 56 yrs). Caries scores were derived based on visual assessment of each surface of each tooth; more than 1.2 million SNPs were either successfully genotyped or imputed and were tested for association. Two homologous genes were suggestively associated: BCOR (Xp11.4) in PF-surface caries (p value = 1.8E-7), and BCORL1 (Xq26.1) in SM-surface caries (p value = 1.0E-5). BCOR mutations cause oculofaciocardiodental syndrome, a Mendelian disease involving multiple dental anomalies. Associations of other plausible cariogenesis genes were also observed for PF-surface caries (e.g., INHBA, p value = 6.5E-6) and for SM-surface caries (e.g., CXCR1 and CXCR2, p value = 1.9E-6). This study supports the notion that genes differentially affect cariogenesis across the surfaces of the permanent dentition, and nominates several novel genes for investigation.

  10. Fissure zeolite mineralization of the intermediate rocks of Central Slovakian neovolcanites; Puklinova zeolitova mineralizacia intermediarnych hornin stredoslovenskych neovulkanitov

    Energy Technology Data Exchange (ETDEWEB)

    Smal, P [Univerzita Komenskeho v Bratislave, Prirodovedecka fakulta, Katedra mineralogie a petrologie, 84215 Bratislava (Slovakia)

    2012-04-25

    This contribution summarizes the results of the study of fissure zeolite mineralization at several locations in the intermediate rocks of the Central Slovakian neovolcanites. These locations were monitored: Kremnica, Pila by Zarnovica, Sklene Teplice, Takyl, Banska Stiavnica, Hodrusa-Hamre, Prencov and Brehy by Nova Bana, Biely Vrch and Slatinske Lazy. Zeolites have been identified as follows: laumontite, chabazite, heulandite, stilbite, natrolite and thomsonite. They occurred in simple associations - mainly laumontite with calcite and stilbite from Pila, or natrolite with thomsonit from Kremnica. From the morphological point of view laumontite formed prismatic needle crystals and adhesions according to (100) or it was massive. Chabazite was formed as pseudo-cubic and in a form of interpenetration adhesions. Heulandite featured druses with crystal size up to 4 mm. Analyses focused on crystallo-chemical study to find out the contents of exchangeable cations or of water and try to interpret their influence on the crystal structure. Ca was a dominant cation in all the zeolites except natrolite. Influence of K and of a ratio of Si / Al on structure of laumontite was proved. (author)

  11. Comparison of microleakage between flowable nanocomposite, flowable Composite and Conventional sealant in fissure sealant therapy of the permanent teeth: an in- vitro study

    Directory of Open Access Journals (Sweden)

    Sara Maleki Kambakhsh

    2016-11-01

    Full Text Available Background and Aim: Novel dental materials including nanocomposites have been introduced in recent years. It is claimed that they have superior properties such as high esthetic., low wear, increased filler content resulting in better mechanical properties, and releasing ions i.e. fluoride and amorphous calcium phosphate that are important for enamel remineralization. Considering these features, if they have retention and microleakage rates comparable with conventional sealants, these materials can be appropriate alternatives to conventional resin sealants in future. The current study aimed at comparing . microleakage of a flowable nanocomposite, a flowable composite , and a conventional sealant in fissure sealant therapy of the permanent teeth. Materials and Methods: First of all ,42 extracted sound human maxillary first premolars were collected and were randomly divided into 3 equal groups. Then the teeth were embedded in self-cure acrylic resin. Occlusal fissures of the samples were cleaned using explorer, enameloplasty with ¼ round diamond bur and water/air spray was done. The prepared surfaces were etched using 36% phosphoric acid gel for 15s, rinsed and dried. Bonding agent was placed in the pits and fissures, cured for 10s after thinning with air. In the first, second , and the third group conventional sealant, flowable composite , and flowable nanocomposite were placed, respectively; and light cured for 40s. The samples were thermocycled (1000 cycles between 5-55ºC and then immersed in 2% basic Fuchsine solution for 24hs. They were then cut bucculingually and microleakage evaluation was done using stereomicroscope. The obtained data was analyzed using Kruskal wallis tests. Results: There was no significant difference in microleakage rate of the study groups. (P>0.05. Conclusion: Considering the condition of the study, it can be concluded that flowable composite and flowable nanocomposite can be used as suitable alternatives to

  12. D/N and /sup 18/O//sup 16/O in magmatic waters and gases of the Great Tolbachik fissure eruption, Kamchatka

    Energy Technology Data Exchange (ETDEWEB)

    Menyailov, I A; Vetshtein, V E; Nikitina, L P; Artemchuk, V G [AN SSSR, Petropavlovsk-Kamchatskii. Inst. Vulkanologii; AN Ukrainskoj SSR, Kiev. Inst. Geokhimii i Fiziki Mineralov)

    1981-01-01

    Isotope content of magmatic gases and their condensates (magmatic waters) is studied on the basis of the Great Tolbachik fissure eruption, Kamchatka. The phenomenon of regular increase of deuterium content in magmatic water and protium content in gases is found out. It is supposed that this fact is conditioned by isotope fractionation during phase transitions in liquid-steam-gas system in the process of the formation of magmatic hearth and gas release from magma during eruption.

  13. Hypoplasia of the basi-occipital bone and persistance of the spheno-occipital synchondrosis in a patient with transitory supplementary fissure of the basi-occipital

    International Nuclear Information System (INIS)

    Wackenheim, A.

    1985-01-01

    The author had the opportunity to observe the progressive development of a special form of basilar impression characterized by transitory supplementary fissure of the basi-occipital bone, persistance of the spheno-occipital synchondrosis and hypoplasia of the basi-occipital. He proposes to dissociate the general concept of basilar impression and to consider anatomo-clinical entities such as the example described in this paper. (orig.)

  14. Chronic Pericarditis

    Science.gov (United States)

    ... surgery) and is considered subacute. Causes Usually, the cause of chronic effusive pericarditis is unknown. However, it may be caused by cancer, tuberculosis , or an underactive thyroid gland ( hypothyroidism ), and it occasionally occurs in people with chronic ...

  15. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  16. Modeling of the pollutant transport in fissured-porous media under consideration of colloids using the transport codes FRAME and COFRAME; Modellierung des Schadstofftransports in geklueftet-poroesen Medien unter Beruecksichtigung von Kolloiden mit den Transportprogrammen FRAME und COFRAME

    Energy Technology Data Exchange (ETDEWEB)

    Reiche, Tatiana; Noseck, Ulrich; Wolf, Jens Wilhelm

    2014-05-15

    For the long-term safety analysis of final nuclear waste repositories the transport of pollutants from the repository into the biosphere three mostly independent subsystems are considered: the near field, the geosphere and the biosphere. Normally rocks include fissures or other disturbances. Porous materials in the rock matrix have usually a high water content and acts as storage for pollutants due to sorption and diffusion processes. The aim of the project is the development of calculation modules for the code RepoTREND that simulate the pollutant transport in saturated fissured-porous media taking into account the effect of colloids. FRAME describes the pollutant dispersion in a fissured-porous medium and COFRAME the colloid influenced transport in a fissured-porous medium.

  17. Anal carcinoma in HIV-infected patients in the period 1995-2009

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

    2013-01-01

    Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

  18. Riskide analüüs aitab kriisi puhuks varusid planeerida / Janis Toomla

    Index Scriptorium Estoniae

    Toomla, Janis

    2005-01-01

    Riskide hindamisele järgnevast organisatsiooni jätkusuutlikkuse planeerimise faasist, kus toimub kriisistsenaariumide analüüs, võimalike kahjude suuruse hindamine ja taasteaja määratlemine (Business Impact Analyse)

  19. Treating High-grade Lesions to Prevent Anal Cancer in HIV-infected People

    Science.gov (United States)

    This study, called the ANCHOR trial, will investigate whether screening and prevention methods similar to those used to prevent cervical cancer can help prevent anal cancer in HIV-infected men and women.

  20. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands

    Directory of Open Access Journals (Sweden)

    Priya Subashchandrabose

    2015-01-01

    Full Text Available Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  1. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands.

    Science.gov (United States)

    Subashchandrabose, Priya; Esakkai, Muthuvel; Venugopal, Palani; Kannaiyan, Ilavarasan; Srinivasan, Chitra; Reddy, Punuru Tejashwini; Ebenezer, Evelyn Elizabeth

    2015-01-01

    Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  2. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Directory of Open Access Journals (Sweden)

    Darin Ruanpeng

    Full Text Available Anal cancer, one of human papillomavirus (HPV related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM and HIV-infected (HIV+ persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL using Papanicolau (Pap screening among MSM in northern Thailand and its associated factors.Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification.Mean age was 27.2 years (range 18-54. Overall, 86 (43.0% had ASIL: 28 (14.2% with atypical cells of undetermined significance (ASCUS, 1 (0.5% with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 56 (28.4% with low-grade squamous intraepithelial lesion (LSIL, and 1 (0.5% with high-grade squamous intraepithelial lesion (HSIL. ASIL was associated by univariate analysis (p ≤0.05 with older age, gender identity other than bisexual (i.e., gay men and transgender women, rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002 and HIV infection (p = 0.01.ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA, not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  3. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Science.gov (United States)

    Ruanpeng, Darin; Chariyalertsak, Suwat; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

    2016-01-01

    Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  4. Viscoelastic assessment of anal canal function using acoustic reflectometry: a clinically useful technique.

    Science.gov (United States)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J; Hosker, Gordon L; Lose, Gunnar; Kiff, Edward S

    2012-02-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis. The aim of this study was to assess whether the parameters measured in anal acoustic reflectometry are clinically valid between continent and fecally incontinent subjects. This was an age- and sex-matched study of continent and incontinent women. The study was conducted at a university teaching hospital. One hundred women (50 with fecal incontinence and 50 with normal bowel control) were included in the study. Subjects were age matched to within 5 years. Parameters measured with anal acoustic reflectometry and manometry were compared between incontinent and continent groups using a paired t test. Diagnostic accuracy was assessed by the use of receiver operator characteristic curves. Four of the 5 anal acoustic reflectometry parameters at rest were significantly different between continent and incontinent women (eg, opening pressure in fecally incontinent subjects was 31.6 vs 51.5 cm H2O in continent subjects, p = 0.0001). Both anal acoustic reflectometry parameters of squeeze opening pressure and squeeze opening elastance were significantly reduced in the incontinent women compared with continent women (50 vs 99.1 cm H2O, p = 0.0001 and 1.48 vs 1.83 cm H2O/mm, p = 0.012). In terms of diagnostic accuracy, opening pressure at rest measured by reflectometry was significantly superior in discriminating between continent and incontinent women in comparison with resting pressure measured with manometry (p = 0.009). Anal acoustic reflectometry is a new, clinically valid technique in the assessment of continent and incontinent subjects. This technique, which assesses the response of the anal canal to distension and relaxation, provides a detailed viscoelastic assessment of anal canal function. This technique

  5. Desenvolvimento das fissuras cerebrais fetais: avaliação com ultrassonografia tridimensional Fetal brain fissures development a three-dimensional ultrasonography study

    Directory of Open Access Journals (Sweden)

    Cynthia Maria Soares Alves

    2011-03-01

    Full Text Available OBJETIVO: avaliar a distância das fissuras cerebrais fetais à borda interna da calota craniana por meio da ultrassonografia tridimensional (US3D. MÉTODOS: realizou-se um estudo de corte transversal em 80 gestantes normais entre a 21ª e 34ª semanas de gestação. Avaliou-se a distância entre a tábua óssea interna da calota craniana fetal e as fissuras de Sylvius, parieto-occipital, hipocampo e calcarina. Para a obtenção desta distância para as três primeiras fissuras, realizou-se uma varredura tridimensional através do plano axial (nível dos ventrículos laterais. Para a obtenção da distância da fissura calcarina utilizou-se uma varredura coronal (nível dos lobos occiptais. Para avaliar a correlação entre as fissuras e a idade gestacional foram realizadas regressões de primeiro grau, sendo os ajustes calculados pelo coeficiente de determinação (R². Foram determinados percentis 5, 50 e 95 para cada fissura. Avaliou-se ainda a correlação entre a distância destas fissuras com os diâmetros biparietal (DBP e circunferência craniana (CC utilizando o coeficiente de correlação de Pearson (r. RESULTADOS: todas as medidas das fissuras apresentaram correlação linear com a idade gestacional (Sylvius: R²=0,5; parieto-occipital: R²=0,7; hipocampo: R²=0,3 e calcarina: R²=0,3. A média da distância das fissuras variou de 7,0 a 14,0 mm, 15,9 a 28,7 mm, 15,4 a 25,4 mm e 15,7 a 24,8 mm para as fissuras de Sylvius, parieto-occipital, hipocampo e calcarina, respectivamente. As fissuras de Sylvius e parieto-occipital apresentaram as maiores correlações com o DBP (r=0,8 e 0,7, respectivamente e a CC (r=0,7 e 0,8, respectivamente. CONCLUSÕES: a distância das fissuras cerebrais fetais à borda interna da calota craniana por meio da US3D apresentou correlação positiva com a idade gestacional.PURPOSE: to assess the distance of the fetal cerebral fissures from the inner edge of the skull by three-dimensional ultrasonography (3DUS

  6. Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Camillo ANAUATE-NETTO

    Full Text Available Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a “rather low” to “very high” caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL and contralateral teeth receiving Icon infiltrant (DMG. Caries progression was monitored by clinical (laser fluorescence caries detection and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05. No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p0.05. SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

  7. Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

    Science.gov (United States)

    ANAUATE-NETTO, Camillo; BORELLI, Laurindo; AMORE, Ricardo; DI HIPÓLITO, Vinicius; D’ALPINO, Paulo Henrique Perlatti

    2017-01-01

    Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a “rather low” to “very high” caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis. PMID:28877284

  8. Correlates of anal sex roles among Malay and Chinese MSM in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Dangerfield, Derek T; Gravitt, Patti; Rompalo, Anne M; Tai, Raymond; Lim, Sin How

    2016-03-01

    Identifying roles for anal sex is an important issue for populations of MSM. We describe the prevalence of identifying as being 'top', 'bottom', 'versatile', or 'don't know/not applicable' among Malay and Chinese MSM in Kuala Lumpur, Malaysia, and behavioural outcomes according to these labels for sexual role identity. Data analysis was conducted on a survey administered during weekly outreach throughout Kuala Lumpur in 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of MSM who reported roles for anal sex. Binary logistic regression was used to explore the odds of behavioural outcomes among MSM who identified as 'bottom', 'versatile,' and 'don't know' compared to MSM who reported that 'top' was their sexual role. Labels for anal sex roles were significantly associated with condom use for last anal sex. Among MSM who used labels for anal sex roles, MSM who identified as 'bottom' had highest level of not using condoms for last anal sex (24.1%, p = .045). In binary logistic regression model, identifying as 'top' was significantly associated with reporting using a condom during last anal sex and reported consistent condom use for anal sex in the past six months (p = .039 and .017, respectively). With regard to sexual role identity, some MSM may be a part of a special subgroup of at-risk men to be targeted. Future research should evaluate the origins, meanings, and perceptions of these labels, and the developmental process of how these MSM identify with any of these categories. Research should also uncover condom use decision making with regard to these labels for sexual positioning. © The Author(s) 2016.

  9. Analüütikud soovitavad Eesti Energia börsile viia / Piret Reiljan

    Index Scriptorium Estoniae

    Reiljan, Piret, 1983-

    2008-01-01

    Kohalikud analüütikud soovitavad viia Eesti Energia börsile, kuna see elavdaks aktsiaturgu ja tõmbaks ligi välisinvestoreid. Vt. samas: Raivo Vare: raske aeg töötab Eesti Energia börsiletoomise kasuks; Analüüs ootab pääsu valitsuskabinetti; Juhid ei püsi enam Eesti Energias. Diagrammid: Majandusnäitajad; Varade maht

  10. Regenerative medicine provides alternative strategies for the treatment of anal incontinence.

    Science.gov (United States)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-03-01

    Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. Animal studies have demonstrated that cellular therapy in the form of local injections of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. Cellular therapies with myogenic cells and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most intensively investigated and several clinical trials were ongoing at the time of this report. The cost-effectiveness of such a therapy is an issue and muscle fragmentation is suggested as a simple alternative.

  11. Analysis and description of disease-specific quality of life in patients with anal fistula.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2018-04-01

    In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. 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.

  13. Hereditary vacuolar internal anal sphincter myopathy causing proctalgia fugax and constipation: a new case contribution.

    Science.gov (United States)

    de la Portilla, Fernando; Borrero, Juan José; Rafel, Enrique

    2005-03-01

    Hereditary anal sphincter myopathy is rare. We present a family with one affected member with proctalgia fugax, constipation and internal anal sphincter hypertrophy. Ultrastructural findings show vacuolization of smooth muscle cells without the characteristic polyglucosan inclusion. Further relief of symptoms was obtained using an oral calcium antagonist. Based on clinical presentation, endosonography and morphological findings, we consider our case is a histological variant of the vacuolar myopathy originally described.

  14. 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.

  15. Vaccine-preventable anal human papillomavirus in Australian gay and bisexual men

    Directory of Open Access Journals (Sweden)

    I. Mary Poynten

    2017-06-01

    Full Text Available Objective: HPV causes ~90% of anal cancer and HPV16 is the type most commonly associated with anal cancer. Gay and bisexual men (GBM are at greatly increased risk. We investigated patterns of vaccine-preventable anal HPV in older GBM. Methods: The Study of the Prevention of Anal Cancer (SPANC is an ongoing, prospective cohort study of HIV-positive and HIV-negative Australian GBM. Participants completed questionnaires and underwent an anal swab for HPV genotyping using Roche Linear Array. We analysed baseline data from SPANC by HPV type, mean number of types, stratified by age and HIV status. Results: Anal HPV results from 606 (98.2% of 617 participants (median age 49 years, 35.7% HIV-positive showed 525 (86.7% had ≥1 HPV type and 178 (29.4% had HPV16. Over one third of participants (214, 35.3% had no nonavalent vaccine-preventable types detected. Two (0.3% participants had all quadrivalent types and none had all nonavalent vaccine types. HIV-positive participants (p<0.001 and younger participants (p=0.059 were more likely to have more vaccine-preventable HPV types detected. Conclusion: Anal HPV was highly prevalent in this largely community-based GBM cohort. Vaccine-preventable HPV16 was detected in approximately one third of participants. These findings suggest that the potential efficacy of HPV vaccination of older GBM should be explored. Keywords: Human papillomavirus, HPV, Anal, Vaccine, Prevalence, Gay and bisexual men, MSM, HIV

  16. Analüütilised voolud psühholoogias ja nende rakendamine pedagoogikas / Aleksander Elango

    Index Scriptorium Estoniae

    Elango, Aleksander, 1902-2004

    2001-01-01

    Analüütise psühholoogia kolm koolkonda - S.Freudì koolkond e. päris-psühhoanalüüs, A.Adlerì koolkond e. individuaalpsühholoogia ja C.G.Jungì psühhoanalüüsi ja individuaalpsühholoogia sünteesi luua püüdev koolkond. Analüütise psühholoogia koolkondade ja pedagoogika suhetest

  17. Successful Implantation of Bioengineered, Intrinsically Innervated, Human Internal Anal Sphincter

    Science.gov (United States)

    Raghavan, Shreya; Gilmont, Robert R.; Miyasaka, Eiichi A.; Somara, Sita; Srinivasan, Shanthi; Teitelbaum, Daniel H; Bitar, Khalil N.

    2011-01-01

    Background & Aims To restore fecal continence, the weakened pressure of the internal anal sphincter (IAS) must be increased. We bioengineered intrinsically innervated human IAS, to emulate sphincteric physiology, in vitro. Methods We co-cultured human IAS circular smooth muscle with immortomouse fetal enteric neurons. We investigated the ability of bioengineered innervated human IAS, implanted in RAG1−/− mice, to undergo neovascularization and preserve the physiology of the constituent myogenic and neuronal components. Results The implanted IAS was neovascularized in vivo; numerous blood vessels were observed with no signs of inflammation or infection. Real-time force acquisition from implanted and pre-implant IAS showed distinct characteristics of IAS physiology. Features included the development of spontaneous myogenic basal tone; relaxation of 100% of basal tone in response to inhibitory neurotransmitter vasoactive intestinal peptide (VIP) and direct electrical field stimulation of the intrinsic innervation; inhibition of nitrergic and VIPergic EFS-induced relaxation (by antagonizing nitric oxide synthesis or receptor interaction); contraction in response to cholinergic stimulation with acetylcholine; and intact electromechanical coupling (evidenced by direct response to potassium chloride). Implanted, intrinsically innervated bioengineered human IAS tissue preserved the integrity and physiology of myogenic and neuronal components. Conclusion Intrinsically innervated human IAS bioengineered tissue can be successfully implanted in mice. This approach might be used to treat patients with fecal incontinence. PMID:21463628

  18. Latvijas importa analīze un prognoze

    OpenAIRE

    Vasiļenko, Oļegs

    2010-01-01

    Viena no nozīmīgākām pazīmēm, kuras raksturo valsts ekonomikas stāvokli un attīstības līmeni, ir ārējās tirdzniecības bilance. Sakarā ar Latvijas ekonomikas situācijas pasliktināšanu, un, ar to saistītu, ārējās tirdzniecības negatīvās bilances strauju pieaugumu, importa analīzes un prognozes jautājuma nozīme vairāk kārt pieauga. Jau ilgāku laiku pieaug bezdarba līmenis Latvijā, līdz ar ko pasliktinās iedzīvotāju pirktspēja, kura, neapšaubāmi, ietekmē valsts ārējo tirdzniecību. ...

  19. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    Science.gov (United States)

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. © 2015 Society for Public Health Education.

  20. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    Science.gov (United States)

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  1. 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.

  2. Characterization and modelling of fluid flows in fissured and fractured media. relation with hydrothermal alterations and paleo-stress quantification; Caracterisation et modelisation des ecoulements fluides en milieu fissure. relation avec les alterations hydrothermales et quantification des paleocontraintes

    Energy Technology Data Exchange (ETDEWEB)

    Sausse, J.

    1998-10-15

    In all materials (rocks, concretes, ceramics,...), the presence of fractures at different scales implies high permeability and often oriented fluid flows. These fluid circulations in fractures induce more or less intense fluid-rock interactions with mineral crystallisation and/or dissolution. These phenomena directly depend on the nature of the fluids and the rocks, the physical and chemical properties of the media and the rate of fluid renewal (permeabilities). Usually, the development of such alterations leads to a massive sealing of the fractures (vein alterations) and of the fissures (fluid inclusion planes and microcracks, pervasive alteration). Therefore, their study brings us precious indications for the understanding of the mechanisms of fluid migrations in fossil systems. A geometrical study of the fracture systems at micro or macroscopic scales, based on the spatial distribution of sealing minerals, is applied to two different granites: the Soultz-sous-Foret granite (Bas-Rhin, France) and the Brezouard granite (Vosges, France). At the macroscopic scale, a new graphical method is proposed in order to study drilling data (Soultz granite). It allows to identify the presence of three independent mineral associations (quartz - illite, calcite-chlorite and hematite) in independent fracture systems characterised by a specific 3D geometry and hydraulic properties. These three types of vein alteration correspond to distinct and non contemporaneous fluid percolations. At the microscopic scale, the reconstitution of crack opening - fluid percolation - crack sealing stages is delicate. However, the study of their geometrical characteristics (orientations, radius, volume densities) and thereby the quantification of their porosities, exchange surfaces and permeabilities, allow to identify their respective roles in the fluid propagation. These microstructures, which are very numerous in granites, imply high but variable matrix permeabilities. This has been confirmed by

  3. The anal canal as a risk organ in cervical cancer patients with hemorrhoids undergoing whole pelvic radiotherapy.

    Science.gov (United States)

    Jang, Hyunsoo; Baek, Jong Geun; Jo, Sunmi

    2015-01-01

    Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. The anal verge was located an average of 1.2 cm (range -0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range -0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.

  4. Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Cherie Amsale

    2012-01-01

    Full Text Available Abstract Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190 and that of anal sex was 4.3% (154. Of these 51.6% (98 had oral sex and 57.1% (87 had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2 and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5. Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4, and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7. Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to

  5. Correlates of unprotected anal intercourse: the influence of anal sex position among men who have sex with men in Beijing, china.

    Science.gov (United States)

    Zhang, Heng; Lu, Hongyan; Pan, Stephen W; Xia, Dongyan; Zhao, Yuejuan; Xiao, Yan; He, Xiong; Yue, Hai; Sun, Zheya; Xu, Yunan; Ruan, Yuhua; Shao, Yiming

    2015-02-01

    Understanding barriers to consistent condom use among men who have sex with men (MSM) requires consideration of the context in which risk behaviors occur. Anal sex position is one such context. This pooled cross-sectional study used survey data from 1,230 MSM and their 2,618 reported male sexual partnerships. Overall, nearly half of the participants engaged in unprotected anal intercourse (UAI) with at least one of upto three partners in the past 6 months. "Insertive" men engaged in less UAI (39 %) than "receptive" (53 %) or "versatile" (51 %) men. Regardless of sexual position, UAI was associated with cohabiting with a male or female partner and perceiving great or moderate risk of HIV from male contact at the individual level, and steady (vs. casual) partnership at the dyad level. However, early MSM anal sex debut, high number of male partners, alcohol use, receiving and buying condoms, HIV testing, and MSM sex-seeking venues were found to be only statistically significantly correlated with UAI among some but not all sexual positions, implying that interventions to increase condom use should take into account how anal sex position may influence willingness and ability to engage in safer sex. Dyad level data appear to provide additional insight into the influence of sexual positions, and should be used to complement individual data for future intervention designs.

  6. 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

  7. Dynamics of waterflooding massive oil deposits in the Chechen Ingush ASSR, including fissured reservoirs in the late stages of development

    Energy Technology Data Exchange (ETDEWEB)

    Tatashev, K.Kh.; Soboleva, G.N.; Tagunova, A.V.

    1979-01-01

    In 1956 in the Chechen Ingush ASSR a number of massive oil deposits located in fissured cavernous Upper Cretaceous limestone were developed. The deposits were developed by water-oil displacement from the edges and pericline toward the dome of the structure using the natural water pressure drive as well as artificial marginal flooding. The great oil-bearing capacity, the good hydrodynamic link with the deposit, the close magnitude of oil viscosity and water under the layer conditions and the significant difference in their density (0.4-0.5 g/cm/sup 3/) practically guarantees pistonlike oil displacement. Based on the deposit's geologic-physical characteristics, the late stage of development may be characterized by noncontinuous time and a sharp increase in well waterflooding to maintain full flooding. However, the data obtained from working the field suggest that a sharp increase in waterflooding will be substituted by a slow increase, by stabilization and possibly even a decrease in the percentage of water over the last 3-6 years. This occurred in a number of cases where measures were taken to limit the liquid flow, to periodically operate the well with isolated waterflooding and pereclinal perforation at intervals. This also occurred in a number of cases where the rate of fluid yield was naturally lowered by decreasing the number of producing wells due to waterflooding and disengagement. To more completely extract the oil from relatively low permeable areas of the deposits and to develop them in the later stages, it is useful to use a slow tempo once all wells have been brought to perclinal interval operation.

  8. Comparison of elective inguinal node irradiation techniques in anal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  9. 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.

  10. The Results of Curative Concurrent Chemoradiotherapy for Anal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jae Uk; Yoon, Mee Sun; Song, Ju Young; Ahn, Sung Ja; Chung, Woong Ki; Nah, Byung Sik; Nam, Taek Keun [Chonnam National University School of Medicine, Seoul (Korea, Republic of)

    2010-11-15

    To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39-89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0-64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. The median follow--up time was 62 months (2-202 months).The 5-year overall survival, locoregional relapse-free survival, disease-free survival, and colostomy-free survival rates were 86.0%, 71.7%, 71.7%, 78.2%, respectively. Regarding overall survival, the Eastern Cooperative Oncology Group (ECOG) performance status and complete response were found to be significant prognostic factors on univariate analysis. For multivariate analysis, only the ECOG performance status was significant. No significant factor was found for locoregional relapse-free survival or disease-free survival and similarly for treatment response, no significant factor was determined on logistic regression analysis. There were 7 patients who had local or regional recurrences and one patient with distant metastasis. The only evaluable toxicity in all patients was radiation dermatitis of perianal skin (grade 3), which developed in 4 patients (9.5%) and grade 2 in 22 patients (52.4%). This study revealed that patients with a performance score of ECOG 0-1 survived significantly longer than those with a poorer score. Finally, there was no significant predicting factors tested for treatment response.

  11. IMRT treatment of anal cancer with a scrotal shield

    International Nuclear Information System (INIS)

    Hood, Rodney C.; Wu, Q. Jackie; McMahon, Ryan; Czito, Brian; Willett, Christopher

    2012-01-01

    The risk of sterility in males undergoing radiotherapy in the pelvic region indicates the use of a shielding device, which offers protection to the testes for patients wishing to maintain fertility. The use of such devices in the realm of intensity-modulated radiotherapy (IMRT) in the pelvic region can pose many obstacles during simulation, treatment planning, and delivery of radiotherapy. This work focuses on the development and execution of an IMRT plan for the treatment of anal cancer using a scrotal shielding device on a clinical patient. An IMRT plan was developed using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA), using a wide array of gantry angles as well as fixed jaw and fluence editing techniques. When possible, the entire target volume was encompassed by the treatment field. When the beam was incident on the scrotal shield, the jaw was fixed to avoid the device and the collimator rotation optimized to irradiate as much of the target as possible. This technique maximizes genital sparing and allows minimal irradiation of the gonads. When this fixed-jaw technique was found to compromise adequate coverage of the target, manual fluence editing techniques were used to avoid the shielding device. Special procedures for simulation, imaging, and treatment verification were also developed. In vivo dosimetry was used to verify and ensure acceptable dose to the gonads. The combination of these techniques resulted in a highly conformal plan that spares organs and risk and avoids the genitals as well as entrance of primary radiation onto the shielding device.

  12. IMRT treatment of anal cancer with a scrotal shield.

    Science.gov (United States)

    Hood, Rodney C; Wu, Q Jackie; McMahon, Ryan; Czito, Brian; Willett, Christopher

    2012-01-01

    The risk of sterility in males undergoing radiotherapy in the pelvic region indicates the use of a shielding device, which offers protection to the testes for patients wishing to maintain fertility. The use of such devices in the realm of intensity-modulated radiotherapy (IMRT) in the pelvic region can pose many obstacles during simulation, treatment planning, and delivery of radiotherapy. This work focuses on the development and execution of an IMRT plan for the treatment of anal cancer using a scrotal shielding device on a clinical patient. An IMRT plan was developed using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA), using a wide array of gantry angles as well as fixed jaw and fluence editing techniques. When possible, the entire target volume was encompassed by the treatment field. When the beam was incident on the scrotal shield, the jaw was fixed to avoid the device and the collimator rotation optimized to irradiate as much of the target as possible. This technique maximizes genital sparing and allows minimal irradiation of the gonads. When this fixed-jaw technique was found to compromise adequate coverage of the target, manual fluence editing techniques were used to avoid the shielding device. Special procedures for simulation, imaging, and treatment verification were also developed. In vivo dosimetry was used to verify and ensure acceptable dose to the gonads. The combination of these techniques resulted in a highly conformal plan that spares organs and risk and avoids the genitals as well as entrance of primary radiation onto the shielding device. Copyright © 2012 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  13. Comparison of elective inguinal node irradiation techniques in anal cancer

    International Nuclear Information System (INIS)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub

    2011-01-01

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  14. Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

    Science.gov (United States)

    Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

    2010-03-01

    To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

  15. Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

    Science.gov (United States)

    Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

    2014-08-01

    Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered. © 2014 Steunstichting ESOT.

  16. 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

  17. Successful endoscopic treatment of fecalith blocking sinus in a patient with ileal pouch-anal anastomosis

    Directory of Open Access Journals (Sweden)

    Jessica Ma

    2014-07-01

    Full Text Available Background: Ulcerative colitis patients who underwent restorative proctocolectomy with ileal pouch-anal anastomosis can develop various mechanical complications. Among them is presacral sinus resulting from chronic anastomotic leak. Methods: We present a symptomatic patient with a large fecalith blocking the sinus which was successfully treated with Doppler ultrasound guided endoscopic needle knife sinusotomy along with fecalith extraction. Results: A 67-year-old female presented with a 4-month history of perianal pain and urgency. Pouchocopy showed a 3-cm deep wide-mouthed anastomotic sinus, the orifice of which was blocked by a large hard fecalith. Removal of the fecalith using RothNet, Tripod, or Basket were made but failed. Then needle knife was applied to cut the orifice to enlarge the opening of the sinus. One month later, the patient returned and the fecalith was successfully removed with two Baskets and two Rothnets. Six months after fecalith extraction, pouchoscopy showed a compartalized distal pouch sinus with two cavities, which was treated by two sessions of Doppler ultrasound guided endoscopic needle knife sinusotomy. Six months following the treatment, the sinus was completed healed. The patient tolerated all procedures well without any complication. Conclusion: Fecalith blocking pouch anastomotic sinus is a rare complication in patients with restorative proctocolectomy. In our case, this surgical complication was successfully treated with a carefully planned, stepwise endoscopy approach. Resumo: Experiência: Pacientes com colite ulcerativa tratados por proctocolectomia restauradora com anastomose bolsa ileal-anal podem ser acometidos por diversas complicações mecânicas. Entre elas, cita-se o seio pré-sacral resultante de vazamento crônico pela anastomose. Métodos: Apresentamos uma paciente sintomática com um grande fecálito bloqueando o seio, com tratamento bem-sucedido com sinusotomia por bisturi-agulha guiado por

  18. Anal Human Papillomavirus Infection among HIV-Infected Men in Korea.

    Directory of Open Access Journals (Sweden)

    Chang Hun Lee

    Full Text Available Little is known about the epidemiology on human papillomavirus (HPV infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea.A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour.A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM and 68 from men who have sex with women (MSW. Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW (P < 0.001. High-risk HPV (HR-HPV prevalence was higher among MSM (47.4% than MSW (25.0%; P = 0.002. The HR-HPV types identified most frequently were HPV 16 (11%, HPV 18 (9.9%, and HPV 58 (5% in MSM, and HPV 58(11% and HPV 16 (8.9% in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001. Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001. In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection.Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age.

  19. Samatähenduslike sünteetiliste ja analüütiliste verbide kasutamine

    Directory of Open Access Journals (Sweden)

    Pille Eslon

    2015-10-01

    Full Text Available Huvi samatähenduslike sünteetiliste ja analüütiliste verbide vastu tekkis artikli esimesel autoril vene-eesti-vene tõlkesõnastikke toimetades, kui silma hakkasid regulaarsed valikud vene verbi grammatilise aspekti ning eesti keele sünteetiliste ja analüütiliste verbide vahel. Kuigi tegu on raskesti märgatava ja sugugi mitte sagedase nähtusega, tekitab see küsimusi: millal eelistab emakeelekõneleja kasutada sünteetilist, millal analüütilist verbi; kas lisaks samatähenduslikkusele ja vormilisele lihtsusele (sünteetiline verb koosneb ühest komponendist või keerukusele (analüütiline verb vähemalt kahest komponendist on veel tunnuseid, mis sünteetilise ja analüütilise verbi valikuid piiravad. Käesoleva uurimuse eesmärk on leida nendele küsimustele vastuseid. Analüüsitakse viit samatähendusliku sünteetilise ja analüütilise verbi paari (igatsema – igatsust tundma, lahkuma – ära minema, nõustuma – nõus olema, muretsema – muret tundma, töötama – tööd tegema, otsitakse mõlema verbi kasutusele omaseid keelestruktuure, analüüsitakse nende leksikaalsemantilise ja morfosüntaktilise varieerumise piire, võrreldakse verbide tähendusi. Nende tunnuste põhjal saab teha mõningaid järeldusi selle kohta, kas tegu võiks olla ühe verbi kahe vormiga või kahe erineva verbiga. Uurimuse empiiriline aspekt on seotud hüpoteesiga semantiliselt lähedaste sünteetiliste ja analüütiliste verbide tõmbumisest, millega kaasnevad ühelt poolt struktuursed, morfoloogilised, morfosüntaktilised ja leksikaalsemantilised kasutuspiirangud ning teisalt vaba varieerumine. Sisuliselt vastandlikud tendentsid – kinnistumine ja varieerumine – toimivad keele leksikaalgrammatilises perifeerias sama eesmärgi nimel, tagades keele pideva uuenemise ja säilimise.

  20. Primena cost-benefit-benefit analize u vrednovanju i izboru javnih projekata (ekonomski aspekt

    Directory of Open Access Journals (Sweden)

    Dragana N. Petrović

    2013-10-01

    Full Text Available Cost-benefit analiza je celovita analiza koristi i troškova koje jedan projekat donosi samom vlasniku projekta i društvu u celini (uključujući i investitora. Izbor najbolje investicione alternative ostvaruje na osnovu finansijske i ekonomske analize, kao dva integralna dela cost-benefit analize. Prvu od ovih analiza obradila je ista grupa autora u članku „Primena cost-benefit analize u vrednovanju i izboru javnih projekata (finansijski aspekt“, objavljenom u prethodnom broju časopisa Vojnotehnički glasnik. Predmet obrade ovog rada je ekonomska analiza, kao logički nastavak prethodnog rada. Zbog toga se na brojne oznake tabela, uključenih u sadržaj finansijske analize (1-–5, nadovezuju (prema hronološkom redu oznake tabela koje pripadaju ekonomskoj analizi (6–8 Sprovođenje ekonomske analize ostvaruje se prema određenoj, dosta složenoj proceduri, a završava se utvrđivanjem kriterijuma ekonomske (društvene isplativosti projekta. U radu su obrađeni osnovni pokazatelji ekonomskog (društvenog prinosa projekta,  kao što su: neto sadašnja vrednost novčanih tokova i cost-benefit koeficijent.

  1. Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries.

    Science.gov (United States)

    Frost, Jonathan; Gundry, Rowan; Young, Helen; Naguib, Adel

    2016-08-01

    To determine whether the introduction of a multidisciplinary intrapartum perineal-care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012-2013) a multidisciplinary training program was implemented was compared with the rate after (2013-2014) implementation using logistic regression analysis. The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493-0.899; P = 0.008). The integration of intrapartum perineal-care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    Energy Technology Data Exchange (ETDEWEB)

    Roos, A.-M., E-mail: annemarie.roos@gmail.com [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom); Abdool, Z. [Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria (South Africa); Sultan, A.H.; Thakar, R. [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom)

    2011-07-15

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  3. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    International Nuclear Information System (INIS)

    Roos, A.-M.; Abdool, Z.; Sultan, A.H.; Thakar, R.

    2011-01-01

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  4. Avaliação da qualidade de vida na incontinência anal: validação do questionário FIQL (Fecal Incontinence Quality of Life Evaluation of quality of life in anal incontinence: validation of the questionnaire FIQL (Fecal Incontinence Quality of Life

    Directory of Open Access Journals (Sweden)

    Sonia Ahlaim Ibrahim Yusuf

    2004-09-01

    avaliação da qualidade de vida na incontinência anal em nossa população.BACKGROUND: Anal incontinence causes physical and psychological incapacity, determining impact on quality of life. However, there are no specific tools to quantify this impact in our population. AIM: The evaluation of quality of life in anal incontinence, through validation of the FIQL ("Fecal Incontinence Quality of Life Scale". FIQL is a questionnaire composed of 29 questions, grouped into four domains: lifestyle, behavior, depression and embarrassment. For each question, the scale ranges from 1 to 4, except questions 1 and 4, which ranges from 1-5 and 1-6, respectively. MATERIAL AND METHOD: FIQL scale underwent both translation and cultural adaptation processes, giving rise to a final Portuguese version. This version was then used in a validation study to test measurement properties (reproducibility and validity. The reproducibility was tested through application of FIQL questionnaire by two observers in 50 patients with anal incontinence. After a period of 7 to 10 days, the questionnaire was applied again by one of the observers. The constructive validity was assessed by correlating the FIQL questionnaire results with both, a generic questionnaire for quality of life (SF-36 and the Jorge-Wexner incontinence score results. The discriminative validity was evaluated comparing the results of the FIQL to incontinence group with two other groups: healthy volunteers and patient with chronic idiopathic constipation. RESULTS: The correlation among results domains of FIQL questionnaire and results of short form-36 and the incontinence score were statistically significant. The quality of life is impaired in all of domains of FIQL for incontinent patients: lifestyle: 2.4 behaviour:2.0, depression:2.5 and embarrassment:1.9, when compared to healthy volunteers (3.9, 3.9, 4.1 and 4.0, and patients with chronic constipation (3.7, 3.8, 3.6 and 3.8, respectively. CONCLUSION: The FIQL questionnaire is

  5. Sorption and diffusion of cobalt, strontium, cesium and americium in natural fissure surfaces and drill core cups studied by autoradiography, 1

    International Nuclear Information System (INIS)

    Pinnioja, S.; Kaemaeraeinen, E.L.; Jaakkola, T.; Siitari, M.; Muuronen, S.; Lindberg, A.

    1985-06-01

    A method based on autoradiography was developed to determine the diffusion of radionuclides into the rock matrix. To investigate the diffusion the samples, which has been in contact with radioactive tracer solution up to 6 months, were splitted by sawing. From the autoradiograms of the cross sections the penetration depths of radionuclides were determined and the apparent diffusion coefficient Dsup(a) calculated. The filled and unfilled natural fissure surfaces chosen to this study were bars of drilling cores and drill core cups of tonalite, mica gneiss and rapakivi granite. After contact time of 3 months the highest penetration depths of cesium were observed for natural fissure surface sample of rapakivi granite up to 2.5 mm and of mica gneiss up to 3.7 mm. For strontium the penetration depths of 6 mm and 11 mm for unfilled and filled natural fissure samples of rapakivi granite were found. Dsup(a)-values for cesium varied between 1.5 x 10 -15 and 3.2 x 10 -14 , for strontium between 3.5 x 10 -14 and 2.1 x 10 -13 m 2 /s. D-value obtained for cobalt (drill core cup sample, tonalite) was 5.4 x 10 -17 m 2 /s. 241 Am was only sorbed on the surface of the sample and thus no apparent diffusion coefficient could be calculated. Filling materials, chlorite and secondary minerals in tonalite and rapakivi granite increased diffusion into the mother rock. Radionuclides were sorbed both into the filling material and through fillers into the rock matrix. Cs and Sr penetrated though calcite filling material in mica gneiss into the mother rock. Calcite didn't influence on diffusion of radionuclides. Penetration depths of Cs and Sr were about the same for filled and unfilled samples

  6. Hypohidrotic Ectodermal, Dysplasia with Features of Acanthosis Nigricans and Chronic Candidiasis

    Directory of Open Access Journals (Sweden)

    Lalit Mohan

    1985-01-01

    Full Text Available Three siblings having hypohidrotic ectodermal dysplasia are described. In addition to trichodysplasia, odonto- dysplasia and they had acanthosis nigrilcans of the, ano-genitat area and lesions suggestive of candida infection as evidenced by chronic paronychia in the finger and toe-nail folds, and maceration in the groins.The youngest brother also had a cutaneous horn in the sacral region. Eyes showed a small interpalpebral fissure, myopia, dull foveal reflex and a convergent squint. Parents were non consanguinous. There was no demonstrable cell mediated immune defect.

  7. The effect of a chlorhexidine-fluoride varnish on mutans streptococci counts and laser fluorescence readings in occlusal fissures of permanent teeth

    DEFF Research Database (Denmark)

    Lipták, Lídia; Bársony, Nóra; Twetman, Svante

    2016-01-01

    Objective: To evaluate the effect of a new chlorhexidinefluor ide varnish on mutans streptococci (MS) counts and laser fluorescence (LF) readings in fissures of permanent molars. Method and Materials: The study group consisted of 57 healthy schoolchildren (7 to 14 yrs) that volunteered after...... informed consent. A double-blind split-mouth design was employed and 87 pairs of non-cavitated permanent molars were randomly assigned to treatments with either chlorhexidine- fluoride varnish (CHX-F) or chlorhexidine-thymol varnish (CHX-T, Cervitec Plus) as active control. The varnishes were topically...

  8. Tectono-volcanic control of fissure type vents for the 28 Ma Panalillo ignimbrite in the Villa de Reyes Graben, San Luis PotosI, Mexico

    International Nuclear Information System (INIS)

    Tristan-Gonzalez, Margarito; Labarthe-Hernandez, Guillermo; Aguillon-Robles, Alfredo; Aguirre-DIaz, Gerardo J

    2008-01-01

    The volcano-tectonic events at the Villa de Reyes Graben (VRG), in the southern Sierra Madre Occidental, Mexico, include 1) a regional NNE fault system developed before 32 Ma, 2) this pre-32 Ma faulting controlled the emplacement of 31.5 Ma dacitic domes, 3) NE faulting at 28 Ma that displaced the 31.5 Ma dacitic domes and formed the VRG, as well as the oblique grabens of Bledos and Enramadas oriented NW, 4) emplacement of Panalillo ignimbrite at 28 Ma filling the VRG and erupting from fissures related to the oblique grabens, and eruption of Placa basalt apparently also from fault-controlled vents.

  9. Tectono-volcanic control of fissure type vents for the 28 Ma Panalillo ignimbrite in the Villa de Reyes Graben, San Luis PotosI, Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Tristan-Gonzalez, Margarito; Labarthe-Hernandez, Guillermo; Aguillon-Robles, Alfredo [Instituto de Geologia/DES IngenierIa, UASLP, Av. Dr. Manuel Nava 5, Zona Universitaria, C.P. 78240, San Luis PotosI, S.L.P. (Mexico); Aguirre-DIaz, Gerardo J [Centro de Geociencias, Universidad Nacional Autonoma de Mexico, Campus Juriquilla, Queretaro, 76230 (Mexico)], E-mail: mtiistan@uasln.mx, E-mail: ger@geociencias.unam.mx

    2008-10-01

    The volcano-tectonic events at the Villa de Reyes Graben (VRG), in the southern Sierra Madre Occidental, Mexico, include 1) a regional NNE fault system developed before 32 Ma, 2) this pre-32 Ma faulting controlled the emplacement of 31.5 Ma dacitic domes, 3) NE faulting at 28 Ma that displaced the 31.5 Ma dacitic domes and formed the VRG, as well as the oblique grabens of Bledos and Enramadas oriented NW, 4) emplacement of Panalillo ignimbrite at 28 Ma filling the VRG and erupting from fissures related to the oblique grabens, and eruption of Placa basalt apparently also from fault-controlled vents.

  10. Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Carey Kate B

    2011-10-01

    Full Text Available Abstract Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.

  11. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Alves Ramos

    2002-01-01

    Full Text Available O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psychologist and swiss psychiatrist Carl Gustav Jung: it defines the concept of Analytical Psychology, brings a summarized biography of Carl Gustav Jung, indicates the main differences between Analytical Psychology and the Psychoanalysis, describes the structure and the functioning of psyche and, finally, presents synthetically the characteristics of the types of personalities traced by Jung.

  12. 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

  13. Oral and Anal vaccination against enteric red mouth disease protection against yersiniosis

    DEFF Research Database (Denmark)

    Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

    dose of ERM bacterin fully protected rainbow trout when they are vaccinated anally. Oral vaccination can also induce full protection but the dose of the bacterin has to be 100 times higher than if the fish was to be vaccinated anally. This indicates that much of the oral feed bacteria is digested...... in the stomach of rainbow trout. This work has shown that it is possible to vaccinated orally against ERM, but the bacteria has to be coated in order to avoid digestion. Protection mechanisms will be discussed....... fish. The objective for this project is to investigate whether oral and anal vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge.The rainbow trout were given oral...

  14. O terapêutico e o analítico em Freud

    Directory of Open Access Journals (Sweden)

    Vinicius Anciães Darriba

    2013-06-01

    Full Text Available Este artigo tem como objetivo investigar, na obra de Freud, a demarcação que se institui entre o terapêutico e o analítico. Tal investigação enfoca, primeiramente, a passagem da hipnose à associação livre e o direcionamento do autor à questão da causa, o que estabelece uma visada para a cura analítica em confluência com o que se desdobra da exploração do campo do inconsciente e da consideração de um domínio pulsional. Delimitados por esta via os objetivos terapêuticos e analíticos, interroga-se, em seguida, como a dimensão do terapêutico se veria reintroduzida nos termos da nova direção de cura proposta por Freud.

  15. Incertidumbre en métodos analíticos de rutina.

    OpenAIRE

    Maroto Sánchez, Maria Alicia

    2002-01-01

    Para que los laboratorios de análisis puedan acreditarse según la norma ISO 17025, es necesario que los resultados analíticos vayan acompañados de dos parámetros de calidadbásicos: su trazabilidad y su incertidumbre. Esto ha hecho que, hoy en día, la verificaciónde la trazabilidad y el cálculo de la incertidumbre de los resultados analíticos sea cada vezmás importante. En esta tesis doctoral hemos propuesto diversas metodologías para calcularla incertidumbre en métodos analíticos que se utili...

  16. ESTUDIOS MACRO Y MICROSCOPICO DEL SACO ANAL DEL COIPO (Myocastor coypus)

    OpenAIRE

    Rafasquino, Marta E.; Ramos, Pablo A.; Alonso, Cristina R.; Idiart, Julio R.

    1998-01-01

    RESUMEN:Fue realizada la disección del saco anal de 44 coipos, de ambos sexos, de distintas edades y procedencias, observándose algunas características similares a los sacos anales del perro y gato, aunque es impar y está ubicado en ventral del ano. Es ovoídeo o piriforme, siendo más grande en los adultos y, entre éstos, más aún en los machos que en las hembras; posee un conducto que desemboca en el canal anal a un centímetro del ano y que se exterioriza en el momento de secretar el producto ...

  17. Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis

    DEFF Research Database (Denmark)

    Mark-Christensen, A; Erichsen, R; Brandsborg, S

    2018-01-01

    BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulc......BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients......-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved....

  18. Design of sEMG assembly to detect external anal sphincter activity: a proof of concept.

    Science.gov (United States)

    Shiraz, Arsam; Leaker, Brian; Mosse, Charles Alexander; Solomon, Eskinder; Craggs, Michael; Demosthenous, Andreas

    2017-10-31

    Conditional trans-rectal stimulation of the pudendal nerve could provide a viable solution to treat hyperreflexive bladder in spinal cord injury. A set threshold of the amplitude estimate of the external anal sphincter surface electromyography (sEMG) may be used as the trigger signal. The efficacy of such a device should be tested in a large scale clinical trial. As such, a probe should remain in situ for several hours while patients attend to their daily routine; the recording electrodes should be designed to be large enough to maintain good contact while observing design constraints. The objective of this study was to arrive at a design for intra-anal sEMG recording electrodes for the subsequent clinical trials while deriving the possible recording and processing parameters. Having in mind existing solutions and based on theoretical and anatomical considerations, a set of four multi-electrode probes were designed and developed. These were tested in a healthy subject and the measured sEMG traces were recorded and appropriately processed. It was shown that while comparatively large electrodes record sEMG traces that are not sufficiently correlated with the external anal sphincter contractions, smaller electrodes may not maintain a stable electrode tissue contact. It was shown that 3 mm wide and 1 cm long electrodes with 5 mm inter-electrode spacing, in agreement with Nyquist sampling, placed 1 cm from the orifice may intra-anally record a sEMG trace sufficiently correlated with external anal sphincter activity. The outcome of this study can be used in any biofeedback, treatment or diagnostic application where the activity of the external anal sphincter sEMG should be detected for an extended period of time.

  19. Does endoscopic ultrasound improve detection of locally recurrent anal squamous-cell cancer?

    Science.gov (United States)

    Peterson, Carrie Y; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Garcia-Aguilar, Julio; Patil, Sujata; Temple, Larissa K

    2015-02-01

    Evaluating patients for recurrent anal cancer after primary treatment can be difficult owing to distorted anatomy and scarring. Many institutions incorporate endoscopic ultrasound to improve detection, but the effectiveness is unknown. The aim of this study is to compare the effectiveness of digital rectal examination and endoscopic ultrasound in detecting locally recurrent disease during routine follow-up of patients with anal cancer. This study is a retrospective, single-institution review. This study was conducted at an oncologic tertiary referral center. Included were 175 patients with nonmetastatic anal squamous-cell cancer, without persistent disease after primary chemoradiotherapy, who had at least 1 posttreatment ultrasound and examination by a colorectal surgeon. The primary outcomes measured were the first modality to detect local recurrence, concordance, crude cancer detection rate, sensitivity, specificity, and predictive value. Eight hundred fifty-five endoscopic ultrasounds and 873 digital rectal examinations were performed during 35 months median follow-up. Overall, ultrasound detected 7 (0.8%) mesorectal and 32 (3.7%) anal canal abnormalities; digital examination detected 69 (7.9%) anal canal abnormalities. Locally recurrent disease was found on biopsy in 8 patients, all detected first or only with digital examination. Four patients did not have an ultrasound at the time of diagnosis of recurrence. The concordance of ultrasound and digital examination in detecting recurrent disease was fair at 0.37 (SE, 0.08; 95% CI, 0.21-0.54), and there was no difference in crude cancer detection rate, sensitivity, specificity, and negative or positive predictive values. The heterogeneity of follow-up timing and examinations is not standardized in this study but is reflective of general practice. Endoscopic ultrasound did not provide any advantage over digital rectal examination in identifying locally recurrent anal cancer, and should not be recommended for

  20. Diversity of human papillomavirus in the anal canal of men: the HIM Study.

    Science.gov (United States)

    Sichero, L; Nyitray, A G; Nunes, E M; Nepal, B; Ferreira, S; Sobrinho, J S; Baggio, M L; Galan, L; Silva, R C; Lazcano-Ponce, E; Giuliano, A R; Villa, L L

    2015-05-01

    Human papillomavirus (HPV) infections are associated with the development of anogenital lesions in men. There are no reports describing the distribution of non-α HPV types in the anal canal of a sexually diverse group of men. The HPV Infection in Men (HIM) Study is a multicentre study on the natural history of HPV infection in Brazil, Mexico, and the USA. At baseline, 12% of anal canal PCR HPV-positive specimens were not typed by the Roche Linear Array, and were considered to be unclassified. Our goals were to characterize HPVs among these unclassified specimens at baseline, and to assess associations with participant socio-demographic and behavioural characteristics. Unclassified HPVs were typed by sequencing of amplified PGMY09/11 products or cloning of PGMY/GP + nested amplicons followed by sequencing. Further analysis was conducted with FAP primers. Of men with unclassified HPV in the anal canal, most (89.1%) were men who have sex with women. Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. Eighteen, 26 and three different α-HPV, β-HPV and γ-HPV types were detected, respectively. α-HPVs were more commonly detected among young men (18-30 years) than among older men (45-70 years), whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than among non-heterosexual men. All β-HPVs detected among non-heterosexual men were β2-HPV types. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  1. The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

    Directory of Open Access Journals (Sweden)

    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  2. A presença de retocele interfere nos resultados de exames de fisiologia anal? Rectocele influences results of anal physiological examinations?

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2008-09-01

    Full Text Available INTRODUÇÃO: A retocele é causa comum de constipação por defecação obstruída. Freqüentemente está relacionada com outras causas de defecação obstruída, e os exames de fisiologia anal são importantes para o diagnóstico preciso da causa de constipação intestinal. OBJETIVO: observar a influência da retocele nos exames de fisiologia anal, e a necessidade da realização desses após o diagnóstico da retocele. MÉTODO: Para este trabalho foram estudados 40 pacientes com diagnóstico de defecação obstruída. Todos os pacientes foram submetidos aos exames de manometria, sensibilidade retal, eletromiografia, latência do nervo pudendo e proctografia, e foram separados em 2 grupos: portadores e não portadores de retocele . Foram encontrados 18 pacientes com retocele, e o diagnóstico mais freqüentemente associado foi o anismus . Em relação aos exames foi encontrada diferença significante apenas na proctografia no ângulo ano retal, demonstrando que a presença de retocele não interferiu nos resultados de exames de fisiologia anal quando comparados com outros constipados, mas esteve associada a outras causas de constipação, como anismus que necessita de outro tipo de tratamento. CONCLUSÃO: A retocele não interferiu nos valores dos exames de fisiologia anal, mas esteve associada a outros diagnósticos, sendo importante a realização dos mesmos.INTRODUCTION: Rectocele is a common cause of constipation for obstructed defecation. It often is related with other causes of outlet obstruction and the examinations of anal physiology tests are important for necessary diagnosis of the constipation cause. OBJECTIVE: To observe the influence of rectocele in the anal physiology tests and the necessity of its accomplishment to the diagnosis of rectocele. METHOD: In this study, 40 patients with diagnosis of outlet obstruction had been analyzed. All the patients had been submitted to manometry, rectal sensitivity, electromyography, pudendal

  3. The prevalence of anal human papillomavirus among young HIV negative men who have sex with men

    Directory of Open Access Journals (Sweden)

    Zou Huachun

    2012-12-01

    Full Text Available Abstract Men who have sex with men (MSM especially those who are HIV positive are at risk for HPV-associated anal cancer. We systematically reviewed studies with data on the prevalence of vaccine preventable anal HPV among men who have sex with men aged 25 or younger and identified 6 studies. None of these studies were specifically designed to determine the prevalence of HPV in this population. Available data, albeit limited, suggest many young MSM may not already be HPV infected. Further studies using representative sampling focused on teenage MSM are required to confirm this.

  4. 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

    Full Text Available Background: Vaginal delivery is the most important risk factors for development of faecal incontinence, which significantly affects quality of life. Foreign studies show OASIS occur at 20 to 40 % of vaginal deliveries. In Slovenia we recognize sphincter injuries at 1.7 % of deliveries, while true incidence of OASIS in our population remains unknown. Caesarean section prevents anal sphincter injuries. Known risk factors in foreign studies include prolonged second stage of labour, fetal weight > 3500 g, malpresentation, forceps delivery, maternal age more than 35 years at the time of first delivery, first delivery. Few women complain about defecatory problems in puerperium unless they are directly asked about them, so true incidence of such injuries is grossly underestimated. Previously compensated anal sphincter dysfunction can clinically manifest as late as in menopause. The most probable cause is atrophy of muscle and fibrous tissue of pelvic floor and anal sphincter due to lack of estrogen support in this period. With anal ultrasound we tried to determine the incidence of occult damage to anal sphincter in primiparas after vaginal delivery and the relation of injury to symptoms 6 weeks after delivery and identify possible risk factors in our population. We also tried to find out how many patients with anal sphincter injury become symptomatic immediately after deliv- ery. Methods: From January to June 2009 we examined 26 primiparas after vaginal delivery in the Ljubljana Maternity Hospital with anal ultrasound and compared various data about the delivery from our national delivery form. We excluded all patients with caesarean section, recognized anal sphincter injury at the time of the delivery or previous anorectal surgery, history of irritable bowel syndrome or pre-existing inflammatory bowel disease. All patients completed a bowel-function questionnaire, which included questions about faecal urgency and involuntary passing of gas, liquid or

  5. Differential gene expression in patients with anal fistula reveals high levels of prolactin recepetor

    Directory of Open Access Journals (Sweden)

    Song Yi-Huan

    2017-01-01

    Full Text Available Background/Aim. There are limited data examining variations in the local expression of inflammatory mediators in anal fistulas where it is anticipated that an improved understanding of the inflammatory milieu might lead to the potential therapeutic option of instillation therapy in complicated cases. The aim of the present study was to examine prolactin receptors (PRLR as inflammatory markers and to correlate their expression with both the complexity of anal fistulas and the likelihood of fistula recurrence. Methods. Microarray was used to screen the differentially expressed gene profile of anal fistula using anal mucosa samples with hemorrhoids with ageand sex-matched patients as controls and then a prospective analysis of 65 patients was conducted with anal fistulas. PRLR immunohistochemistry was performed to define expression in simple, complex and recurrent anal fistula cases. The quantitative image comparison was performed combining staining intensity with cellular distribution in order to create high and low score PRLR immunohistochemical groupings. Results. A differential expression profile of 190 genes was found. PRLR expression was 2.91 times lower in anal fistula compared with control. Sixty-five patients were assessed (35 simple, 30 complex cases. Simple fistulas showed significantly higher PRLR expression than complex cases with recurrent fistulae showing overall lower PRLR expression than de novo cases (p = 0.001. These findings were reflected in measurable integrated optical density for complex and recurrent cases (complex cases, 8.31 ± 4.91 x 104 vs simple cases, 12.30 ± 6.91 x 104; p < 0.01; recurrent cases, 7.21 ± 3.51 x 104 vs primarily healing cases, 8.31 ± 4.91 x 104; p < 0.05. In univariate regression analysis, low PRLR expression correlated with fistula complexity; a significant independent effect maintained in multivariate analysis odds ratio [(OR low to high PRLR expression = 9.52; p = 0.001]. Conclusion. PRLR

  6. Familial disseminated plaque type porokeratosis with multiple horns and squamous cell carcinoma involving anal skin

    Directory of Open Access Journals (Sweden)

    Sarma Nilendu

    2009-01-01

    Full Text Available Porokeratosis is a disorder of keratinization showing a well-defined lesion with a hyperkeratotic ridge on the border that contains the coronoid lamella. We report familial (autosomal dominant with reduced penetrance disseminated plaque type (Mibelli′s type porokeratosis in a father and son. In the father, there were multiple horns and a large squamous cell carcinoma in a large lesion over the perianal region that reached up to the squamo-columnar junction of the anal mucosa and even invaded the anal sphincteric muscles. Disseminated lesions of the Mibelli′s type, development of horns, and malignancy in this unusual location have not been previously reported.

  7. Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

  8. El juego simbólico una alternativa en las dilataciones anales

    OpenAIRE

    Aguinaga B. Oscar William

    1993-01-01

    "Las malformaciones ano-rectales están entre las más comunes de las malformaciones de tipo congénito causadas por anormalidades del desarrollo, aproximadamente uno de cada cinco mil partos con producto vivo, en Estados Unidos". Clasificaciones existen muchas, pero la de uso más generalizado y tenida en cuenta en el Hospital de la Misericordia, servicio de quirúrgicas, es: Estenosis anal congénita, agenecia anal, atresia rectal, fístula rectoperineal, fístula rectovaginal.

     

    ...

  9. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles. PMID:28234947

  10. The deposition of anal excretions by Melipona favosa foragers (Apidae: Meliponinae): behavioural observations concerning the location of food sources

    NARCIS (Netherlands)

    Aguilar, I. (Ingrid); Sommeijer, M.J.

    2000-01-01

    Melipona favosa consistently deposited anal excretions while foraging. Anal depositions were released more frequently and by more bees on artificial food sources at a greater distance from the nest. Our hypothesis that these deposits serve as scent marks is supported by experimental evidence

  11. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  12. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Directory of Open Access Journals (Sweden)

    Ashlyn Swift-Gallant

    Full Text Available Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333 completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role. In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  13. Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization

    Directory of Open Access Journals (Sweden)

    Antônio Arildo Reginaldo de Holanda

    2007-01-01

    Full Text Available OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica de candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45ºC e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69% dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (pPURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology

  14. Prevalence of Anal HPV Infection Among HIV-Positive Men Who Have Sex With Men in India.

    Science.gov (United States)

    Hernandez, Alexandra L; Karthik, Rajiv; Sivasubramanian, Murugesan; Raghavendran, Anantharam; Gnanamony, Manu; Lensing, Shelly; Lee, Jeannette Y; Kannangai, Rajesh; Abraham, Priya; Mathai, Dilip; Palefsky, Joel M

    2016-04-01

    India has a large population of HIV-positive individuals, including men who have sex with men (MSM), and the incidence of human papillomavirus (HPV)-related cancers is high. In developed countries, HIV-positive MSM exhibit the highest prevalence of anal HPV infection and incidence of anal cancer. Little is known about anal HPV infection in HIV-positive Indian MSM. We evaluated 300 HIV-positive MSM from 2 cities in India. Men were tested for anal HPV infection using L1-HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. CD4 level and plasma HIV viral load were measured. Participants completed an interviewer-administered questionnaire including a sexual history. The prevalence of anal HPV was 95% (95% confidence interval: 91% to 97%). The 3 most common types were HPV 35 (20%), HPV 16 (13%), and HPV 6/11 (13%). History of taking antiretroviral medications decreased risk of anal HPV 16 infection [relative risk (RR): 0.6 (0.4-1.0)]. Having an increased number of vaginal sex partners lowered risk of any anal HPV infection. Ever having receptive sex increased risk of any anal HPV [RR: 1.2 (1.1-1.4)] and anal HPV 16 [RR: 6.5 (1.8-107)]. Almost all Indian HIV-positive MSM had anal HPV infection. The prevalence of HPV 16 was lower and the prevalence of other oncogenic HPV types was higher than in similar populations in North America and Europe. Vaccine-based prevention strategies for HPV infection in India should consider potential differences in HPV type distribution among HIV-infected MSM when designing interventions.

  15. Health-Related Quality of Life and Sexual Functioning of HIV-Positive Men Who Have Sex With Men Who Are Treated for Anal Intraepithelial Neoplasia

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, Matthijs L.; Richel, Olivier; Nieuwkerk, Pythia T.; de Vries, Henry J. C.; Prins, Jan M.

    2016-01-01

    The impact of the treatment of precursor lesions of anal cancer (anal intraepithelial neoplasia) on health-related quality of life has not been investigated. This study aimed to evaluate the impact of 3 treatment options for anal intraepithelial neoplasia on health-related quality of life and sexual

  16. Recto-anal junction (RAJ) microbiota composition in Escherichia coli O157:H7 shedding cattle

    Science.gov (United States)

    Introduction: Cattle are the asymptomatic reservoirs of Escherichia coli O157:H7 (O157) that tend to preferentially colonize the bovine recto-anal junction (RAJ). Therefore, understanding the taxonomic profile, microbial diversity, and microbiota-O157 interactions at the RAJ could give insights into...

  17. 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)

  18. Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

    Science.gov (United States)

    Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

    2009-01-01

    Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

  19. External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects continence after sphincteroplasty

    NARCIS (Netherlands)

    Briel, J. W.; Stoker, J.; Rociu, E.; Laméris, J. S.; Hop, W. C.; Schouten, W. R.

    1999-01-01

    There is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging

  20. Parlamentide info- ja analüüsiteenistuste koostöövõrgud / Aare Kasemets

    Index Scriptorium Estoniae

    Kasemets, Aare, 1963-

    2003-01-01

    Euroopa parlamentide teabe- ja analüüsiteenistused ning raamatukogud teevad koostööd mitmes võrgustikus, millest kaks suuremat on Euroopa Parlamendiuuringute ja -dokumentatsiooni Keskus (ECPRD) ning Rahvusvaheline Raamatukoguühingute ja -institutsioonide Liidu (IFLA) parlamendisektsioon. Ülevaade koostöövõrgustikest. Tabel: ECPRD seminarid 2002. ja 2003. aastal

  1. Assessing the impact of FDG-PET in the management of anal cancer

    International Nuclear Information System (INIS)

    Nguyen, Brandon T.; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Rykers, Kym; Kai, Cynleen; Zupan, Eddy; Scott, Andrew

    2008-01-01

    Purpose: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. Methods and materials: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. Results: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. Conclusions: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies

  2. Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Andrew Austin Gassman

    2012-01-01

    Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

  3. Tehnoloogia aitab varusid juhtida ja analüüsida / Aleksei Dobrõshman

    Index Scriptorium Estoniae

    Dobrõshman, Aleksei

    2005-01-01

    Autor tutvustab logistikavaldkonnas kasutatavaid uusi tarkvaralahendusi: marketingi- ja CRM-süsteemi, elektrooniliste dokumentide vahetamise süsteemi, juhtimise ja analüüsi süsteemi, täiustatud veebitellimuste süsteemi, kliendihaldussüsteemi liikuvatele töötajatele. Lisa: Veebilahendus on mugavam

  4. Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation

    DEFF Research Database (Denmark)

    Klaaborg, K E; Qvist, N; Kronborg, O

    1985-01-01

    The results of abdominal mobilization of the rectum and repair of the pelvic floor behind the anorectal junction are reported in 23 patients with rectal prolapse, being accompanied by some form of anal incontinence in 12. Within 20 months, on the average, three patients had recurrent prolapse. Tw...

  5. PR-spetsid annavad Partsile nõu puhata ja analüüsida

    Index Scriptorium Estoniae

    2005-01-01

    TÜ avalikkussuhete õppejõud Kaja Saksakulm-Tampere soovitab Juhan Partsil toimunut analüüsida, suhtekorraldusspetsialist Ivo Rulli arvates oleks Juhan Partsil mõistlik võtta oma edasises avalikus elus pikem paus, taanduda Res Publica esimehe kohalt ja tegutseda parlamendis opositsioonis

  6. Laevade erinevate soetamisviiside kommertstingimuste võrdlev analüüs / Ain Eidast, Allan Kivi

    Index Scriptorium Estoniae

    Eidast, Ain, 1939-2013

    2005-01-01

    Laevade erinevate soetamisviiside analüüs näitab, et ühtse, kõikidele osapooltele vastuvõetavate tingimuste väljatöötamine ja rakendamine ei ole tehniliselt võimalik ning majanduslikult õigustatud. Tabelid. Diagrammid

  7. Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity

    DEFF Research Database (Denmark)

    Pedersen, E; Petersen, T; Schrøder, H D

    1986-01-01

    The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely de...

  8. Assertividade e autocontrole: interpretação analítico-comportamental

    Directory of Open Access Journals (Sweden)

    Vívian Marchezini-Cunha

    Full Text Available Questões relacionadas à assertividade têm recebido atenção por parte de terapeutas comportamentais há mais de três décadas. É mais recente, porém, o esforço de terapeutas analítico-comportamentais para examinar problemas dessa ordem com os mesmos recursos conceituais e metodológicos empregados por seus pares da pesquisa básica e conceitual. O presente trabalho tem como objetivo oferecer uma interpretação analítico-comportamental para padrões de comportamento assertivos, agressivos e passivos. Recuperamos algumas definições de assertividade/agressividade/passividade e examinamos os fenômenos correspondentes enquanto relações comportamentais; discutimos alguns aspectos da abordagem analítico-comportamental para o autocontrole; e sugerimos que as relações comportamentais definidas como assertividade/agressividade/passividade podem ser interpretadas enquanto instâncias de autocontrole ou impulsividade. A abordagem pode abrir novas perspectivas de investigação clínica de habilidades sociais sob um enfoque analítico-comportamental.

  9. High survivin expression as a risk factor in patients with anal carcinoma treated with concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Fraunholz, Ingeborg; Rödel, Claus; Distel, Luitpold; Rave-Fränk, Marget; Kohler, Daniela; Falk, Stefan; Rödel, Franz

    2012-01-01

    To investigate the prognostic value of survivin expression in pretreatment specimens from patients with anal cancer treated with concurrent 5-FU and mitomycin C-based chemoradiation (CRT). Immunohistochemical staining for survivin was performed in pretreatment biopsies of 62 patients with anal carcinoma. Survivin expression was correlated with clinical and histopathological characteristics as well as local failure free- (LFFS), distant metastases free- (DMFS), cancer specific- (CSS), and overall survival (OS). Survivin staining intensity was weak in 10%, intermediate in 48% and intense in 42% of the patients. No association between survivin expression and clinicopathologic factors (tumor stage, age and HIV status) could be shown. In univariate analysis, the level of survivin staining was significantly correlated with DMFS (low survivin vs. high survivin: 94% vs. 74%, p = 0.04). T-stage, N-stage and the tumor grading were significantly associated with OS and CSS and with DMFS and LFFS, respectively. In multivariate analysis, survivin was confirmed as independent prognostic parameter for DMFS (RR, 0.04; p = 0.02) and for OS (RR, 0.27; p = 0.04). Our results demonstrated that the level of pretreatment survivin is correlated with the clinical outcome in patients with anal carcinoma treated with concurrent CRT. Further studies are warranted to elucidate the complex role of survivin for the oncologic treatment and to exploit the protein as a therapeutic target in combined modality treatment of anal cancer

  10. Problems and personal preferences in the therapy of rectal and anal cancers

    International Nuclear Information System (INIS)

    Rangabashyam, N.

    1985-01-01

    The three modalities of treatment for rectal cancer are radiotherapy chemotherapy and surgery. The problems in the therapy of rectal and anal cancers are discussed. For maximum benefit a combination of pre-operative irradiation and chemotherapy followed by surgery and if needed continued post-operative irradiation therapy is recommended. (author)

  11. Clinical application of continent anal plug in bedridden patients with intractable diarrhea.

    Science.gov (United States)

    Kim, J; Shim, M C; Choi, B Y; Ahn, S H; Jang, S H; Shin, H J

    2001-08-01

    Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

  12. A case of anal canal cancer which developed fournier's syndrome after chemoradiotherapy

    International Nuclear Information System (INIS)

    Momma, Tomoyuki; Kikuchi, Daiki; Watanabe, Yohei; Onozawa, Hisashi; Suzuki, Satoshi; Nakamura, Izumi; Ohki, Shinji; Takenoshita, Seiichi; Yoshida, Noriyuki

    2013-01-01

    Fournier's syndrome is an acute necrotizing fasciitis of the perineum which progresses rapidly, resulting in poor prognosis if not treated appropriately at an early stage. Here we report a case of anal canal cancer which developed Fournier's syndrome after chemoradiotherapy (CRT). A 79-year-old man with anal canal cancer received a double-barrel sigmoid colostomy followed by concurrent CRT (50.4 Gy) with S-1 (100 mg/body). Although the patient was discharged after CRT, he developed a fever at 10 days after discharge and visited our hospital complaining of pain in the anal region. He was hospitalized with a diagnosis of Fournier's syndrome. Extensive drainage, administration of antibiotics, additional drainage and continuous irrigation of the affected region improved the symptoms of Fournier's syndrome. Multiple liver metastases were found on a CT scan at 3 months after onset of Fournier's syndrome, and the patient was transferred to another hospital for systemic chemotherapy. There have been no reports on the onset of Fournier's syndrome after CRT for rectal cancer with anal canal involvement; we report this case with a review of the literature. (author)

  13. Dialoogiaktid ja suhtlusstrateegiad : eesti dialoogikorpuse analüüs / Liina Eskor

    Index Scriptorium Estoniae

    Eskor, Liina

    2005-01-01

    Artikkel põhineb autori magistritööl, mille eesmärgiks oli kohandada soome arvutilingvisti Kristiina Jokineni suhtlusstrateegiate teooriat eestikeelse infodialoogiga ning leida ja analüüsida strateegiate ja dialoogiaktide seoseid. Tutvustatakse ka eesti dialoogikorpust ja dialoogiaktide tüpoloogiat

  14. Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

    Science.gov (United States)

    D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

    2013-01-01

    Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low int