WorldWideScience

Sample records for chronic anal fissures

  1. Anal fissure

    Science.gov (United States)

    ... split or tear in the thin moist tissue ( mucosa ) lining the lower rectum (anus). Causes Anal fissures ... Chronic Constipation in infants and children Crohn disease Mucosa Review Date 5/24/2016 Updated by: Mary ...

  2. Chronic anal fissure: new approaches to chemical sphincterotomy

    Directory of Open Access Journals (Sweden)

    Mohammad hassan Emami

    2008-06-01

    Full Text Available

    • An anal fissure is a split in the mucosa extending from the anal verge towards the dentate line. It currently affects 10% of patients attending proctology clinics. Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. Acute fissures usually heal with conservative management. Fissures lasting greater than two months with features of chronicity, are unlikely to heal with conservative management. Lateral internal sphincterotomy has been the treatment of choice for chronic anal fissures. Because of the disability associated with surgery for healing anal fissure and the risk of incontinence, medical alternatives for surgery have been sought. Among different chemical agents, Glyceryl trinitrate (GTN has been shown to be the first line treatment for chronic anal fissure but the transient sphincteric relaxation effect of pharmacologic agents such as GTN, makes them less effective than surgery. Although we have different forms of GTN products, they do not show a long acting effect on relaxing and enhancing the perfusion of anal sphincter, because they are soon metabolized. Most difficulties with current usage of drugs are due to poor compliance of patients. It can be taken into consideration that new formulation and novel combination of GTN with other treatments, in slow releasing forms may lead to acceptable strategies in the management of chronic anal fissure. As authors’ experience in this field, other clinical trials on the drug combination and slow releasing formulations are warranted to generate new data on the subject.
    • Key word: chronic anal fissure, review, chemical sphincterotomy 

  3. Identifying the best therapy for chronic anal fissure

    Institute of Scientific and Technical Information of China (English)

    Mariusz; H; Madalinski

    2011-01-01

    Chronic anal fissure(CAF)is a painful tear or crack which occurs in the anoderm.The optimal algorithm of therapy for CAF is still debated.Lateral internal sphincterotomy(LIS)is a surgical treatment,considered as the’gold standard’therapy for CAF.It relieves CAF symptoms with a high rate of healing.Chemical sphincterotomy(CS)with nitrates,calcium blockers or botulinum toxin(BTX)is safe,with the rapid relief of pain,mild sideeffects and no risk of surgery or anesthesia,but is a statistically less effective therapy for CAF than LIS.This article considers if aggressive treatment should only be offered to patients who fail pharmacological sphincterotomy.Aspects of anal fissure etiology,epidemiology and pathophysiology are considered with their meaning for further management of CAF.A molecular model of chemical interdependence significant for the chemistry of CAF healing is examined.Its application may influence the development of optimal therapy for CAF.BTX is currently considered the most effective type of CS and discussion in this article scrutinizes this method specifically.Although the effectiveness of BTXvs LIS has been discussed,the essential focus of the article concerns identifying the best therapy application for anal fissure.Elements are presented which may help us to predict CAF healing.They provide rationale for the expansion of the CAF therapy algorithm.Ethical and economic factors are also considered in brief.As long as the patient is willing to accept the potential risk of fecal incontinence,we have grounds for the’gold standard’(LIS)as the first-line treatment for CAF.The author concludes that,when the diagnosis of the anal fissure is established,CS should be considered for both ethical and economic reasons.He is convinced that a greater understanding and recognition of benign anal disorders by the GP and a proactive involvement at the point of initial diagnosis would facilitate the consideration of CS at an earlier,more practical stage with

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  5. Sphincter-Preserving Therapy with Topical 2% Diltiazem for Chronic Anal Fissure: Our Experience

    Directory of Open Access Journals (Sweden)

    Manish Swarnkar

    2015-10-01

    Full Text Available Background: Chronic anal fissure is a common problem across the world treated largely by surgical methods. Studies have demonstrated the efficacy of topical agents like Glyceryl Trinitrate (GTN in anal fissure but it has been shown to have side effects like headache and dizziness. There is a need for a pharmacological therapy for fissure which has fewer side effects. Hence, this study was taken up to assess the efficacy and adverse effects of topical 2% Diltiazem (DTZ gel. Aim & Objectives: To assess the efficacy and side effect of topical treatment with 2% DTZ gel in patient with chronic anal fissure. Material and Methods: Consecutive fifty adult patients with symptomatic chronic anal fissure attending the surgery clinic were enrolled in the study form February 2014- July 2014 and they were treated with regular topical application of 2% DTZ cream. Patients were followed up at regular intervals for symptomatic relief and healing of fissure. Results: In our study postdefecatory pain, bleeding and irritation were significantly reduced after 2week of therapy and a th primary healing rate of 86% (43 out of 50 at 6 week of therapy. The primary side-effects of 2% DTZ gel appeared to be perianal dermatitis and pruritis ani in 14% cases. Conclusion: Topical 2% DTZ gel is an effective agent in the treatment of chronic anal fissure. The need for hospital stay is abolished; psychological and financial burden on the patient is reduced. With a healing rate close to 90%, topical DTZ can be easily advised as the first line of treatment of chronic anal fissure.

  6. [Perianal fistula and anal fissure].

    Science.gov (United States)

    Heitland, W

    2012-12-01

    CRYPTOGLANDULAR ANAL FISTULA: Perianal abscesses are caused by cryptoglandular infections. Not every abscess will end in a fistula. The formation of a fistula is determined by the anatomy of the anal sphincter and perianal fistulas will not heal on their own. The therapy of a fistula is oriented between a more aggressive approach (operation) and a conservative treatment with fibrin glue or a plug. Definitive healing and the development of incontinence are the most important key points. ANAL FISSURES: Acute anal fissures should be treated conservatively by topical ointments, consisting of nitrates, calcium channel blockers and if all else fails by botulinum toxin. Treatment of chronic fissures will start conservatively but operative options are necessary in many cases. Operation of first choice is fissurectomy, including excision of fibrotic margins, curettage of the base and excision of the sentinel pile and anal polyps. Lateral internal sphincterotomy is associated with a certain degree of incontinence and needs critical long-term observation.

  7. Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ulusoy Nefise B

    2004-03-01

    Full Text Available Abstract Background Although lateral internal sphincterotomy is the gold-standard treatment for chronic anal fissure, intrasphincteric injection of botulinum toxin seems to be a reliable new option. The aim of this non-randomized study is to compare the effect of lateral internal sphincterotomy and botulinum toxin injection treatments on the outcome and reduction of anal sphincter pressures in patients with chronic anal fissure. Methods Patients with chronic anal fissure were treated with either botulinum toxin injection or lateral internal sphincterotomy by their own choice. Maximal resting pressure and maximal squeeze pressure measurements were performed before and 2 weeks after treatments by anal manometry. Patients were followed for fissure relapse during 14 months. Results Twenty-one consecutive outpatients with posterior chronic anal fissure were enrolled. Eleven patients underwent surgery and ten patients received botulinum toxin injection treatment. Before the treatment, anal pressures were found to be similar in both groups. After the treatment, the maximal resting pressures were reduced from 104 ± 22 mmHg to 86 ± 15 mmHg in the surgery group (p 0.05 in the surgery group, and from 117 ± 62 mmHg to 76 ± 34 (p 0.05. There were no relapses during the 14 months of follow up. Conclusion Lateral internal sphincterotomy and botulinum toxin injection treatments both seem to be equally effective in the treatment of chronic anal fissure.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Botulinum toxin for chronic anal fissure after biliopancreatic diversion for morbid obesity

    Institute of Scientific and Technical Information of China (English)

    Serafino Vanella; Giuseppe Brisinda; Gaia Marniga; Anna Crocco; Giuseppe Bianco; Giorgio Maria

    2012-01-01

    AIM:To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity.METHODS:Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study.The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment.All data were analyzed in univariate and multivariate analysis.RESULTS:Two months after treatment,65.4% of the patients had a healing scar.Only one patient had mild incontinence to flatus that lasted 3 wk after treatment,but this disappeared spontaneously.In the multivariate analysis of the data,two registered months after the treatment,sex (P =0.01),baseline resting anal pressure (P =0.02) and resting anal pressure 2 mo after treatment (P < 0.0001) were significantly related to healing rate.CONCLUSION:Botulinum toxin,despite worse results than in non-obese individuals,appears the best alternative to surgery for this group of patients with a high risk of incontinence.

  10. Aggressive treatment of acute anal fissure with 0.5%nifedipine ointment prevents evolution to chronicity

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; Jannis Kountouras; George Paroutoglou; Athanasios Beltsis; Grigoris Chatzimavroudis; Christos Zavos; Taxiarchis Katsinelos; Basilis Papaziogas

    2006-01-01

    AIM: To investigate the efficacy of topical application of 0.5% nifedipine ointment in healing acute anal fissue and preventing its progress to chronicity.METHODS: Thirty-one patients (10 males, 21 females)with acute anal fissure from September 1999 to January 2005 were treated topically with 0.5% nifedipine ointment (t.i.d.) for 8 wk. The patients were encouraged to follow a high-fiber diet and assessed at 2, 4 and 8wk post-treatment. The healing of fissure and any side effects were recorded. The patients were subsequently followed up in the outpatient clinic for one year and contacted by phone every three months thereafter,while they were encouraged to come back if symptoms recurred.RESULTS: Twenty-seven of the 31 patients completed the 8-wk treatment course, of them 23 (85.2%)achieved a complete remission indicated by resolution of symptoms and healing of fissure. Of the remaining four unhealed patients (14.8%), 2 opted to undergo lateral sphincterotomy and the other 2 to continue therapy for four additional weeks, resulting in healing of fissure. All the 25 patients with complete remission had a mean follow-up of 22.9 ± 14 (range 6-52) mo. Recurrence of symptoms occurred in four of these 25 patients (16%)who were successfully treated with an additional 4-wk course of 0.5% nifedipine ointment. Two of the 27 (7.4%)patients who completed the 8-wk treatment presented with moderate headache as a side effect of nifedipine.CONCLUSION: Topical 0.5% nifedipine ointment, used as an agent in chemical sphincterotomy, appears to offer a significant healing rate for acute anal fissure and might prevent its evolution to chronicity.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Dermal flap advancement combined with conservative sphincterotomy in the treatment of chronic anal fissure.

    Science.gov (United States)

    Theodoropoulos, George E; Spiropoulos, Vasileios; Bramis, Konstantinos; Plastiras, Aris; Zografos, George

    2015-02-01

    Lateral internal sphincterotomy (LIS) is considered the surgical treatment of choice for chronic anal fissure (CAF). Flap techniques for fissure coverage have the advantage of primary wound healing, potentially providing better functional results and faster pain relief. The standard surgical strategy for CAF consisting of conventional LIS (CLIS) up to the dentate line was modified by "tailoring" the LIS to the apex of the CAF, but never greater than 1 cm, and by advancing a dermal flap for coverage of the CAF (LIS + flap) after fissurectomy. Thirty consecutive patients who underwent "LIS + flap" were compared with 32 patients who had been previously treated by CLIS. A modified, trapezoid-like Y-V flap from perianal skin was advanced into the CAF base. Pain at the first postoperative day, pain at defecation during the first week, postoperative use of analgesics, and time for patients' pain relief were significantly less at the "LIS + flap" group (P < 0.01). Objective healing was achieved faster (P < 0.01) and soiling episodes were less (P < 0.05) after "LIS + flap." The addition of a dermal flap after "conservative" LIS resulted in better healing and significantly less postoperative discomfort than the isolated application of CLIS.

  13. A Prospective Randomized Trial of Diltiazem Gel and Glyceryl Trinitrate Ointment on Treatment of Chronic Anal Fissure

    Directory of Open Access Journals (Sweden)

    M Akhondi-Meybodi

    2014-12-01

    Methods: This semi-experimental study consisted of sixty six outpatients (34 females and 32 males with chronic anal fissure, who referred to the gastroenterology clinic. Patients were randomly classified into two groups. Group A received GTN ointment (0.03%, whereas group B was treated with Diltiazem gel (2%. The treatment was administered twice daily for 8 weeks. Healing and side-effects were recorded to be compared after 8 weeks. Results: In group A, the anal fissure was thoroughly healed within 53.3% of patients, moderately healed for 6.7% of patients and not healed in 25.8% of patients. Moreover, side-effects were noted in 15(46.9% patients (P= 0.482. Two (6.2% patients had intolerable headache and discontinued the study, 11 (34.3% patients suffered from headache and 2 patients (6.2% were reported to have orthostatic hypotension. In group B, healing occurred in 21(67.7% out of 31 patients and 1 (3.2% case of headache was noted(P= 0.0001. Conclusion: The present study has demonstrated that topical diltiazem can be preferable to GTN owing to the absence of side-effects.

  14. STUDY ON USE OF TOPICAL DILTIAZEM VERSUS TOPICAL GLYCERYL TRINITRATE (GTN IN THE TREATMENT OF CHRONIC ANAL FISSURE: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Madhu Lata

    2014-10-01

    Full Text Available OBJECTIVE: To compare the efficacy, associated side effects in short term as well as long term use of topical Diltiazem and topical GTN in the management of chronic anal fissure. MATERIAL AND METHODS: Out patients records of 231 patients with chronic anal fissure who reported to hospital from August 2011 to August 2014 and treated were randomly selected for both types of management of which 118 patients had received topical 2% diltiazem and 113 were treated with 0.2% glyceryl trinitrate topical ointment thrice daily for 6 weeks. They were assessed at the time of presentation, then at the end of 1st week, 3rd week and at the end of 6th week of treatment. Records of patients with anal fissure due to other diseases like inflammatory bowel disease, malignancy, sexually transmitted diseases, previous treatment with local ointment or surgery, patients who required anal surgery for any concurrent disease like hemorrhoids, pregnant women, patients with significant cardiovascular conditions and patients who did not turned up for follow up were excluded. Signs and symptoms and side-effects were noted at the given time. RESULTS: The study results are comparable to national figures and other studies. CONCLUSION: Topical application of both the ointments, 2% Diltiazem and 0.2% Glyceryl trinitrate observed to be quite effective in treatment of chronic fissure in Ano. However, topical Diltiazem is preferred to topical glyceryl trinitrate due to its lesser side effects and long term better control

  15. Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano)

    OpenAIRE

    2014-01-01

    Background: Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano. Aim: To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano. Materials and Methods: Total 100 pati...

  16. Hypertrophied anal papillae and fibrous anal polyps, should they be removed during anal fissure surgery?

    Institute of Scientific and Technical Information of China (English)

    Pravin J. Gupta

    2004-01-01

    AIM: Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice.They are mostly ignored being considered as normal structures. The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus.METHODS: Two groups of patients were studied. A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm. Another group of a hundred patients who also had papillae or fibrous polyps, were treated by lateral sphincterotomy alone. They were followed up for one year.RESULTS: Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated. Group A patients showed a marked reduction with regard to pain and irritation during defecation (P= 0.0011),pricking or foreign body sensation in the anus (P = 0.0006)and pruritus or wetness around the anal verge (P = 0.0008).CONCLUSION: Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure. This would add to effectiveness and completeness of the procedure.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial.

    Science.gov (United States)

    Rahmani, N; Khademloo, M; Vosoughi, K; Assadpour, S

    2014-01-01

    Aloe vera is a medicinal plant that promotes wound healing in burn injuries. A prospective clinical trial was conducted to evaluate the effects of a topical cream containing 0.5% Aloe vera juice powder in the treatment of chronic anal fissures. The aloe cream was applied by the patients to the wound site 3 times per day for 6 weeks following the instructions of a physician. Pain was assessed with a visual analog scale before treatment and at the end of each week of treatment. Wound healing and the amount and severity of bleeding were examined and evaluated before and at the end of each week of treatment. There were statistically significant differences in chronic anal fissure pain, hemorrhaging upon defection and wound healing before and at the end of the first week of treatment also in comparison with control group (p aloe vera juice was an effective treatment for chronic anal fissures. This is a promising result indicating that further comparative studies are justified.

  19. Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial

    OpenAIRE

    Golfam, Farzaneh; Golfam, Parisa; Golfam, Babak; Pahlevani, Puyan

    2014-01-01

    Background: Medical sphincterotomy has gained popularity as a treatment for anal fissure. Calcium channel blockers in topical forms could also be appropriate with low adverse effects. Objectives: This was a prospective randomized controlled trial to compare topical and oral nifedipine in the treatment of chronic anal fissure. Patients and Methods: A prospective randomized controlled trial was conducted at two centers of Shahed University. One hundred and thirty patients with chronic anal fiss...

  20. Neuromyogenic properties of the internal anal sphincter: therapeutic rationale for anal fissures.

    Science.gov (United States)

    Bhardwaj, R; Vaizey, C J; Boulos, P B; Hoyle, C H

    2000-06-01

    Lateral sphincterotomy diminishes internal anal sphincter hypertonia and thereby reduces anal canal pressure. This improves anal mucosal blood flow and promotes the healing of anal fissures. However, sphincterotomy can be associated with long term disturbances of sphincter function. The optimal treatment for an anal fissure is to induce a temporary reduction of anal canal resting pressure to allow healing of the fissure without permanently disrupting normal sphincter function. Broader understanding of the intrinsic mechanisms controlling smooth muscle contraction has allowed pharmacological manipulation of anal sphincter tone. We performed an initial Medline literature search to identify all articles concerning "internal anal sphincter" and "anal fissures". This review is based on these articles and on additional publications obtained by manual cross referencing. Internal anal smooth muscle relaxation can be inhibited by stimulation of non-adrenergic non-cholinergic enteric neurones, parasympathetic muscarinic receptors, or sympathetic beta adrenoceptors, and by inhibition of calcium entry into the cell. Sphincter contraction depends on an increase in cytoplasmic calcium and is enhanced by sympathetic adrenergic stimulation. Currently, the most commonly used pharmacological agent in the treatment of anal fissures is topical glyceryl trinitrate, a nitric oxide donor. Alternative agents that exhibit a similar effect via membrane Ca2+ channels, muscarinic receptors, and alpha or beta adrenoceptors are also likely to have a therapeutic potential in treating anal fissures.

  1. Maintenance Therapy with Partially Hydrolyzed Guar Gum in the Conservative Treatment of Chronic Anal Fissure: Results of a Prospective, Randomized Study

    Directory of Open Access Journals (Sweden)

    Antonio Brillantino

    2014-01-01

    Full Text Available Purpose. This study was designed to evaluate the role of maintenance therapy with partially hydrolyzed guar gum (PHGG after topical application of glyceryl trinitrate (GTN in the conservative treatment of chronic anal fissure (CAF. Methods. From all the patients with CAF observed during the study period, 165 subjects with healed CAF after standard therapy with topical GTN 0.4% ointment were randomized to receive (group II or not (group I maintenance therapy with PHGG for 10 months. Clinical and manometric followup was carried out 6 and 12 months after treatment. Results. At six-month followup, median visual analogue scale score was significantly higher in group I if compared with group II. The success and recurrence rate at 12-month followup were, respectively, 38.3% (28/73 in group I versus 58.5% (41/70 in group II (P=0.019; Fisher’s exact test and 30.2% (13/43 in group I versus 14.5% (7/48 in group II (P=0.0047; Fisher’s exact test. Conclusion. The maintenance therapy with PHGG in patients with healed CAF after chemical sphincterotomy by topical application of GTN 0.4% ointment seems associated with a significant reduction of recurrence rate and with a significant increase of success rate at 12-month followup.

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

    Directory of Open Access Journals (Sweden)

    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

  3. Open lateral internal anal sphincterotomy under local anesthesia as the gold standard in the treatment of chronic anal fissures: A prospective clinical and manometric study Esfinterotomía lateral interna abierta con anestesia local como gold standard en el tratamiento de la fisura anal crónica: Estudio prospectivo clínico y manométrico a largo plazo

    Directory of Open Access Journals (Sweden)

    A. Sánchez Romero

    2004-12-01

    Full Text Available Background: chronic anal fissure is one of the most frequent proctological disorders in Western populations. Open lateral internal sphincterotomy is one of the therapeutic options accepted as the treatment of choice for chronic anal fissure, since it reduces the hypertonia of the internal anal sphincter (the main etiopathogenic mechanism of fissures, decreases anal pain, and allows the fissure to heal. Material and methods: we carried out a prospective study of 120 patients operated on for chronic anal fissure with open sphincterotomy under local anesthesia at our Proctology Outpatient Unit from 1998 to 2001. No preoperative studies, bowel preparation, or antibiotic prophylaxis were carried out. All patients were followed up after 1 week, 2 months, 6 months, and 1 year, and underwent an anal manometry before and after surgery. Results: early complications: 3 hematoma-ecchymosis of the wound (2.5%, 3 self-limited hemorrhage events (2.5%. No hemorrhoidal thrombosis, fistulas, or perianal abscesses occurred. Fissures recurred in nine patients (7.5% within one year. The initial rate of incontinence of 7.5% at two months dropped down to 5% at six months. The mean resting pressure (MRP in incontinent patients was lower than in continent patients (55±7 mmHg versus 80.7 ± 21 mmHg. The difference in mean squeeze pressure (MSP between incontinent patients and continent patients was not statistically significant. Conclusions: open sphincterotomy under local anesthesia has a long-term rate of healing and a morbidity rate similar to other techniques. It may therefore be considered an effective treatment for chronic anal fissure.Introducción: la fisura anal crónica sigue siendo uno de los problemas proctológicos más frecuentes e incapacitantes en la población occidental actual. La esfinterotomía lateral interna abierta es una de las opciones terapéuticas descritas y aceptadas como tratamiento de elección de la fisura anal crónica, ya que reduce la

  4. CLINICAL OBSERVATION ON TREATMENT OF ANAL FISSURE BY APPLYING SPHINCTEROTOMY WITH ACUPOTOM

    Institute of Scientific and Technical Information of China (English)

    段海涛; 沈瑞子; 阳建明; 温伟平; 邱仁斌

    2003-01-01

    Objective: To observe the therapeutic effect end features of acupotomy in the treatment of anal fis-sure. Methods: Seventy-six cases with anal fissure were randomly divided into two groups, namely, acupotomy groupin which 37 patients were treated by anal internal sphincterotomy with acupotomy, and conventional anal sphincteroto-my group (conventional group, n=39) that was treated by conventional amputation of the anal sphincter. Results: Af-ter treatment, twenty-six over 37 cases in acupotomy group recovered completely and the other 9 cases were improvedclinically, with the total effective rate being 94.59%. In conventional group, 27 over 39 cases recovered completelyand the other 11 cases were improved clinically. The total effective rate was 97.44%. There was no significant differ-ence in the curative rate between two groups. However, compared with those of conventional group, patients inacupotomy group had significantly less bleeding, earlier healing of fissure and less pain. Conclusion: The results sug-gest that acupotomy treatment of anal fissure with anal sphincterotomy is a better therapeutic technique with advantagesof easier manipulation, earlier healing and milder wound, less infectious complications end pain.

  5. Study of efficacy and safety of a new local cream ("healer" in the treatment of chronic anal fissure: a prospective, randomized, single-blind, comparative study Estudo da eficácia e segurança de novo creme cicatrizante para o tratamento da fissura anal crônica: estudo prospectivo, randomizado, simples-cego e comparativo

    Directory of Open Access Journals (Sweden)

    Mostafa Yakoot

    2009-09-01

    Full Text Available OBJECTIVES: To determine the efficacy and safety of "healer" cream as monotherapy in the treatment of acute and chronic anal fissure. STUDY DESIGN: A prospective, randomized, single blinded, comparative trial. METHODS: Sixty patients suffering from anal fissure were included in the study. Patients were randomly divided into three groups: group A: treated with "healer" local cream application 3 times daily; group B: treated with nitroglycerine 0.25% local cream 3 times daily; group C: treated with a lidocaine 2% cream applied locally 3 times daily. All the followings were followed up and compared between groups. (1 Visual pain analogue score after defecation; (2 severity of straining and discomfort during defecation; (3 frequency of ulcer healed at 30 days; (4 any side effects or complications. RESULTS: The pain scoring after defecation was significantly reduced in the three treatment groups. The group treated with "healer" isosorbide-di-nitrate showed the greatest reduction of the visual pain analogue score median from 9 before treatment to 3 & 1 after 10 and 20 days respectively, while the median visual pain analogue score in group B treated with nitroglycerine cream was 9 reduced to 4 & 2 after 10 and 20 days respectively, and the median visual pain analogue score in lidocaine group only dropped from 9 to 6 and 4, respectively. The reduction of both pain scoring and defecation scoring with "healer" was statistically significantly greater than the other two treatments by Kruskal-Wallis test, POBJETIVOS: Determinar a eficácia e segurança de "creme cicatrizante" (dinitrato de isosorbida 1%; lidocaína 2%; rutosídios 5% em base de creme anti-séptico como monoterapia no tratamento da fissura anal aguda ou crônica. METODOLOGIA: Estudo prospectivo, randomizado, simples-cego, comparativo. Foram incluídos 60 pacientes com fissura anal. Foram divididos randomicamente em três grupos: grupo A: tratados com "creme cicatrizante", grupo B: tratados

  6. Anal Fissures

    Science.gov (United States)

    ... fruits, vegetables, and whole grains to your daily plate to get enough fiber. Drink plenty of fluids ... can help soothe the area. Instead of toilet paper, use alcohol-free baby wipes that are gentler ...

  7. Anal Fissure

    Science.gov (United States)

    ... Assessment and Safety Committee Initiatives Past Presidents Healthcare Economics Committee 2017 Tripartite Meeting Search form Search Login Join Now Find a Surgeon You are here Patients / Educational ...

  8. KRONİK ANAL FİSSÜR OLGULARINDA CERRAHİ TEDAVİ

    OpenAIRE

    ERSAN, Yılmaz; YAVUZ, Nihat; KUŞASLAN, Ramazan; ÇİÇEK, YUSUF; ERGÜNEY, Sabri

    2014-01-01

    Background.- Chronic anal fissure (Chronic fissure in ano) is a longitudinal or pear-shaped defect of the anal canal mucosa extending usually from the dentate line to the external verge of the anal canal. Circular fibers of the internal anal sphincter are visible on the floor of the fissure and secondary changes; such as a sentinel tag, hypertrophied anal papilla and a degree of anal stenosis frequently accompany chronic fissures. A fissure in ano may occur at any age, but is most common betw...

  9. Avaliação manométrica anal pré e pós tratamento da fissura anal crônica com nifedipina tópica 0,2% The role of nifedipine 0,2% in cronic anal fissure-manometric study pre and post treatment

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2007-06-01

    Full Text Available No tratamento da fissura anal, novas drogas têm sido utilizadas, dentre elas os bloqueadores de canais de cálcio. O objetivo desta pesquisa foi à avaliação manométrica de pacientes com fissura anal crônica após tratamento com nifedipina tópica 0,2%, correlacionando com a cicatrização e a dor. Trata-se de estudo prospectivo realizado em pacientes atendidos no ambulatório de Coloproctologia do Hospital Universitário de Taubaté. Os pacientes foram submetidos ao exame manométrico antes e após 30 dias da utilização de nifedipina tópica gel 0,2% três vezes ao dia no ânus e margem anal. Para a análise estatística foi utilizado o teste de Mann-Whitney considerando significante, se pIn the treatment of the anal fissure, calcium channel blockers are among the new drugs which have been used. The objective of this research was the manometric evaluation of patients with chronic anal fissure after topic treatment with 0.2% nifedipine and correlation with the healing and pain. This is a prospective study of patients from Coloproctology Clinic of the University of Taubaté Hospital. The patients had been submitted to a manometric examination before and after 30 days of the use of topic 0.2% nifedipine gel three times a day in the anus and anal edge. For the statistics analysis Mann-Whitney test was applied to a significance of p= 0,05. Ten patients did not exihibit manometric alteration associated with nifedipina treatment, however 50% of them reported improvement of the symptoms and 40% depicted healing of the fissure. The results demonstrated that nifedipine was effective and safe for anal fissure treatment and considering the functional point of view it did not cause injuries as well. The manometric evaluation did not demonstrate alterations in the anal pressure; however, it was observed that 50% of the patients had improvement in pain and 40% in healing.

  10. Topical glyceryl trinitrate in the treatment of anal fissure Utilidad del gliceril trinitrato en el tratamiento tópico de la fisura anal

    Directory of Open Access Journals (Sweden)

    F. Novell

    2004-04-01

    Full Text Available Aim: the aim of this study was to assess the effectiveness of topical glyceryl trinitrate (GTN in the treatment of anal fissure. Patients: eighty consecutive patients were randomized to receive 0.2% GTN gel twice a day during a minimum of 6 weeks. Of these 80 patients 34 were males and 46 female, with ages be-tween 20 and 78 years. All patients underwent a work-up that included gender, age, symptom duration, site, previous treatment attempts, pain score, associated diseases, and maximum anal resting pressure. These patients were followed at regular intervals of 4, 8, and 12 weeks to assess symptom outcome, rate of healing, adverse effects, and recurrence rate. Results: pain scores were significantly reduced during the treatment period in 65% of cases. After 4 weeks, 55% of patients had healed, and 78% after 9 weeks. In 18 patients (22%, anal fissures did not heal even with 6 additional weeks of treatment, and 12 of them (15% underwent lateral sphincterotomy. Sixty one percent of patients had flushing and 15% severe headaches. Conclusion: the results of this study have demonstrated the significant benefit of topical GTN when administered to patients suffering from anal fissures.Objetivo: el objetivo de este estudio era la valoración de la aplicación tópica de gliceril trinitrato en el tratamiento de las fisuras anales. Pacientes: un total de 80 consecutivos pacientes eran randomizados recibiendo gliceril trinitrato al 0,2% gel dos veces al día, durante un mínimo de 6 semanas. De los 80 pacientes, 34 eran varones y 46 mujeres, con edad comprendida entre 20 y 78 años. En los pacientes se controlaba sexo, edad, duración de síntomas, duración de tratamiento, localización, patología previa asociada, y valoración del dolor. Seguimiento a 4, 8 y 12 semanas, para controlar la sintomatología, el grado de curación, los efectos adversos y la relación de recidiva. Resultados: la disminución del dolor fue significativa en el 65% de los casos y

  11. 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.

  12. The safety and efficacy of a mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissure: a pilot study.

    Science.gov (United States)

    Al-Waili, Noori S; Saloom, Khelod S; Al-Waili, Thia N; Al-Waili, Ali N

    2006-02-02

    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.

  13. Methylene blue injection in treatment of postoperative pain of anal fissure%亚甲蓝注射治疗肛裂术后疼痛体会

    Institute of Scientific and Technical Information of China (English)

    谷凯

    2013-01-01

    目的:观察亚甲蓝注射肛裂术后止痛的疗效。方法:将60例肛裂术后患者随机分为治疗组和对照组,治疗组术后用亚甲蓝稀释液注射,对照组不用亚甲蓝。结果:治疗组效果优于对照组(p<0.05)。结论:亚甲蓝可有效降低肛裂术后的疼痛,值得临床推广。%Objective:To observe the methylene blue injection the anal fissure postoperative analgesic efficacy .Methods:60 cases of a-nal fissure patients were randomly divided into treatment group and control group , treatment group after using methylene blue dilution liq-uid injection , control group without methylene blue .Results:Methylene blue could effectively reduce postoperative pain of anal fissure ( P<0.05 ) , worthy of clinical application .

  14. The effect of lateral internal sphincterotomy on resting anal sphincter pressures

    OpenAIRE

    Peker, Kemal; YILMAZ, İsmayil; DEMİRYILMAZ, İsmail; İNAL, Abdullah; Işik, Arda

    2014-01-01

    Anal fissures are one of the most common proctologic disorders. This study aimed to investigate alterations in anal sphincteric resting pressures after lateral internal sphincterotomy, which was performed for chronic anal fissure treatment. Materials and methods: Fifty-six (68.3%) male and 26 (31.7%) female patients were included in this study. Patients complicated with fistula-in-ano, abscess, cancer, inflammatory bowel disease, dermatitis, poor general condition, allergy to any of the stan...

  15. Fissured Tongue

    Science.gov (United States)

    ... 2020 Annual Meeting Orlando, FL Our Partners Fissured Tongue The term fissured tongue describes the finding of multiple small furrows or grooves on the dorsal (top) surface of the tongue. These fissures can be shallow or deep, single ...

  16. Are we following an algorithm for managing chronic anal fissure? A completed audit cycle

    Directory of Open Access Journals (Sweden)

    Nicholas Farkas

    2016-02-01

    Conclusions: Topical creams were the most successful treatments (50%; n = 9/18 in ACPGBI-compliant strategies. Importantly, these data suggests that compliance with the ACPGBI algorithm leads to healing without surgery in 83.3% (n = 15/18 of patients, compared to 26.1% (n = 6/23 with non-compliant methods (P = 0.0004. This highlights the benefit of early conservative and medical management of CAF, before attempting surgery.

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

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    2010-01-01

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

  18. 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

  19. Clinical Observation of Partial Internal Sphincterotomy Combined with Chinese Herbs in Anal Fissure%内括约肌部分切断术联合中药治疗肛裂疗效观察

    Institute of Scientific and Technical Information of China (English)

    方赤波; 林东华; 邓振辉; 叶惠花; 罗凯凡; 张惠芝

    2013-01-01

    目的:探讨肛门内括约肌部分切断术联合中药对肛裂的治疗效果。方法:肛裂患者80例,观察组(40例)予肛裂切除术与肛门内括约肌部分切断术,术后予中药治疗,对照组(40例)予肛裂切除术,术后常规处理,对比两组疗效。结果:两组患者全部治愈,均未发生肛门失禁等严重并发症,伤口愈合时间无显著差异(P>0.05);观察组术后VAS疼痛指数及止痛药用量均显著优于对照组(P0.05);the VAS pain index and painkillers dose in the observation group was significantly better than the control group (P<0.01). Conclusion:Partial internal sphincterotomy combined with Chinese herbs has curative effect in anal fissure.

  20. Late results of mucosal proctectomy and colo-anal sleeve anastomosis for chronic irradiation rectal injury

    Energy Technology Data Exchange (ETDEWEB)

    Browning, G.G.P.; Varma, J.S.; Smith, A.N.; Small, W.P.; Duncan, W.

    1987-01-01

    Ten patients with severe chronic irradiation injury to the rectum were treated by mucosal proctectomy and colo-anal sleeve anastomosis. The indications were: recurrent rectal bleeding (five), stricture (three), fistula (one) and intractable pain (one). Overall follow-up has ranged from 8 to 77 months (mean 40 months). In the present survivors (n=7) the follow-up ranges from 18 to 77 months (mean 52 months). Six patients have been followed up for more than 3 years and four for more than 5 years. There was no operative mortality. Three anastomotic strictures occurred but the protecting stoma could be closed in all but one patient. Continence was acceptable although urgency and frequency of defaecation were troublesome symptoms. The operation is recommended for life-threatening, haemorrhagic chronic irradiation injury to the rectum.

  1. Anal Health Care Basics.

    Science.gov (United States)

    Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.

  2. Anal Health Care Basics

    Science.gov (United States)

    Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

  3. Treatment of chronic bacterial prostatits with amikacin through anal submucosal injection

    Institute of Scientific and Technical Information of China (English)

    Wei-LieHU; Shi-ZhenZHONG; 等

    2002-01-01

    Abstract Aim:To assess the efficacy and safety of anal submucosal injection(ASI)of amikacin in chronic bacterial prostatitis(CBP).Methods:Fifty male outpatients with CBP were randomly diided into two groups.Thirty cases of ASI group were given amikacin 400mg daily by ASI for ten times and the other twenty cases of intramuscular injection(IM)group were given the same drug daily by IM,All patients were evaluated with NIH-Chronic prostatitis symptom index(NIH-CPSI),the bacteria culture of the expressed prostate secretion(EPS),proctoscopic examination,rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7and 90after cessation of therapy,Results:The cure rate ,apparent effective rate and effective rate of ASI group and IM group were 33.3%vs5%(P0.05).respectively.The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7days after cessation of therapy,both ASI and IMof amikacin could relieve symptoms within a short time,However,3months after cessation of therapy the score of NIH-CPSIin ASIgroup continued own in spite of no significant differences compared with 7days after cessation of theragy,but the score of IMgroup was rebound nearly colsed to level of pretreatment at23.8±8.5and significantly higher than that of ASI group.The amount of white blood cell(WBC)of EPS in ASIgroup increased slightly at7days after cessation of therapy without significant difference with pretreatment(P>0.050,but it significantly decreased at 3months after cessation of therapy,the amount of WBCof EPS in ASIgroup was lower than that of IM group at 3months after cessation of therapy(P<0.05).Proctoscopic examination of anal canal were normal after ASI therapy and the rectum biopsy showed no obvious histopathologic abnormality at the site of injection except mild focal submucosal infiltration of lymphocytes and plasma cells at 7days after cessation of therapy which disappeared on 3months after cessation of therapy.All patients had no evident

  4. Clinical outcome of ileal pouch-anal anastomosis for chronic ulcerative colitis in China

    Institute of Scientific and Technical Information of China (English)

    Liu Gang; Han Hongqiu; Liu Tong; Fu Qiang; Lyu Yongcheng

    2014-01-01

    Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing,while little information on surgical treatment has been reported.This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for CUC in China.Methods Ninety-five consecutive patients,who suffered CUC and had surgical indications,were carefully selected.All patients underwent IPAA.Data on patient characteristics,surgical indications,surgical details,postoperative complications,functional outcome,and quality of life were collected.Results The mean patient age at the time of the operation was 32 years.Twenty-nine (31%) patients underwent an emergency operation,and 66 (69%) underwent elective procedures.Four patients with severe dysplasia underwent operations,but no carcinoma was histologically confirmed.A two-stage operation was performed in 87 (92%) patients,and a hand-sewn technique was applied in 88 (93%) patients.Sixteen patients (17.0%) experienced early complications,and there was a significant difference between the emergency surgery group and the elective group (31.0% vs.10.6%,respectively; P <0.01).Five (5.3%) patients developed pouchitis as a late complication.The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight.According to the Kirwan grading scale,87 (91.8%) patients showed satisfactory anal continence function.The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P <0.01) according to the Cleveland Global Quality of Life index.Conclusions IPAA is an effective and safe surgical procedure for patients with CUC in China.However,some characteristics,such as the low incidence of pouchitis,require further study.

  5. Botulinum Toxin Type A Internal Intramuscular Combined with Mini-incision Drainage in Treating Stage Ⅱ and Ⅲ Anal Fissure%A型肉毒素内括约肌注联合小切口切扩引流术治疗ⅡⅢ期肛裂的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨绍明

    2014-01-01

    目的:观察A型肉毒素内括约肌注联合小切口切扩引流术治疗Ⅱ、Ⅲ期肛裂的疗效及安全性。方法:选取90例Ⅱ、Ⅲ期肛裂患者按照随机数字表法随机分为治疗组60例与对照组30例,治疗组给予A型肉毒素内括约肌注联合小切口切扩引流术,对照组给予传统肛裂切除术联合肛管内括约肌切断术,比较两组患者疗效指标及并发症情况。结果:治疗组治愈率(95.0%)明显高于对照组(83.3%),手术时间及切口愈合时间明显短于对照组(P<0.05),愈合后瘢痕面积明显小于对照组(P<0.05),术后并发症发生率(1.6%)远低于对照组(13.2%),术后24h疼痛评分也明显低于对照组( P<0.05)。结论:A型肉毒素内括约肌注联合小切口切扩引流术治疗Ⅱ、Ⅲ期肛裂较传统手术效果理想,且具有术后恢复快、疼痛轻、并发症少等优点。%Objective:To observe the efficacy and safety of botulinum toxin type A internal intramuscu-lar combined with mini-incision drainage in treating stage Ⅱ and Ⅲ anal fissure .Method:90 cases with stage ⅡandⅢanal fissure were selected and divided into two groups randomLy , the treatment group for 60 cases and the control group for 30 cases.The treatment group was treated with botulinum toxin type A internal intramuscular combined with mini-incision drainage ,and the control group was treated with traditional exci-sion of anal fissure and anal canal sphincter amputation .The efficacy and complications of two groups were compared.Result:The cure rate of the treatment group(95.0%)was evidently higher than that of the control group (83.3%), the operation time and incision healing time of the treatment group was evidently shorter than that of the control group ( P<0.05) , and the scar area after healing was evidently smaller than that of the control group(P<0.05), the incidence rate of complications after

  6. 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

  7. 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.

  8. Defensive anality and anal narcissism.

    Science.gov (United States)

    Shengold, L

    1985-01-01

    This paper aims at demonstrating a currently beleaguered assumption: the central importance, the continuing vitality, and the appropriate complexity of Freud's theory of the drives and of his idea of the primacy of the body ego. It is not enough to consider man a thinking machine or a social being; his animal nature must be given a central place in psychology. The paper postulates that 'anal or sphincter defensiveness' is one of the precursors of the repression barrier. Anality has been comparatively neglected in recent psychoanalytic literature, and so has its explorer, Karl Abraham. The paper's thesis is that there is a special defensive importance to anal erogeneity and libido, and to those aspects of ego and superego that are functionally operative (as the 'sadistic-anal organization' (Freud, 1917)) during the so-called 'sadistic-anal' developmental phase. Any of the psychic danger situations can evoke regression to manifestations of 'anal narcissim'--an attempt to master overwhelming feeling by a kind of emotional sphincter action, narrowing down the world to the controllable and the predictable. The basic assumption here is Fliess's idea that the attainment of anal sphincter control functions--with, as-it-were, 'psychic resonance'--as a means to master primal (murderous, cannibalistic) affect. For optimal psychic development, a proper balance must be attained between anal control of, and anal expression of, instinctual derivatives--especially of affect laden with aggression.

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

    Directory of Open Access Journals (Sweden)

    C. Ciriza de los Ríos

    2010-12-01

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

  10. The Physiology, Pharmacology and Therapeutic Manipulation of the Internal Anal Sphincter

    Directory of Open Access Journals (Sweden)

    Oliver M Jones

    2002-01-01

    Full Text Available Recent research into the physiology and pharmacology of the internal anal sphincter has elucidated the importance of this structure in health and disease. Its pharmacological manipulation for therapeutic gain has focused mainly on agents to reduce internal anal sphincter tone, a ‘chemical sphincterotomy’ that might heal chronic anal fissure. However, drugs to increase sphincter tone, and augment intermittent and appropriate relaxation are also being evaluated. The initial results with this medical approach to anorectal disease have often been disappointing, failing to match the results achievable with surgery, and many of these drugs have a high rate of side effects in the short term. However, clinical trials have yet to establish the optimum doses, dose intervals and routes of administration for many of these therapies. Furthermore, it is uncertain whether this medical approach should be applied to all patients or just to an as yet undefined subgroup. Certainly, even in the current environment of uncertainty, there is little reason not to try medical manipulation of the internal sphincter as first-line treatment. Surgery remains an option for treatment failures; patients responding to pharmacological manipulation of the internal anal sphincter are spared the long term risks of continence that are inherent in many surgical procedures on the anorectum.

  11. Intractable colitis associated with chronic granulomatous disease in a young girl.

    Science.gov (United States)

    Yaman, Aytaç; Kuloğlu, Zarife; Doğu, Figen; İkincioğulları, Aydan; Ensari, Arzu; Çiftçi, Ergin; Kansu, Aydan

    2015-01-01

    Chronic granulomatous disease (CGD) is an autosomal recessive or X-linked disorder caused by NADPH oxidase deficiency leading to an impaired ability of reactive superoxide anion and metabolite formation and recurring severe bacterial and fungal infections, with a high mortality rate. Diarrhea, colitis, ileus, perirectal abscess formation and anal fissures are reported gastrointestinal findings in these patients. We report a case of intractable colitis associated with CGD in a young girl.

  12. 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....

  13. Variations of Lung Fissures: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Ambali Manoj P

    2014-01-01

    Full Text Available Background: The presence of fissures in the normal lungs enhances uniform expansion and hence facilitates more air intake. Accessory and incomplete fissures of varying depth can be seen in unusual locations of the lung, delimiting abnormal lobes which correspond to the normal bronchopulmonary segments. The knowledge of anatomical variations of lung fissures is essential for clinicians, surgeons, and for radiologist for recognizing various images of related abnormalities because an accessory or anomalous fissure can be mistaken for a lung lesion or an atypical appearance of pleural effusion. Aims and Objectives: The aim of the present study is to observe the variations of lung fissures in Indian population. Fifty pairs (right- 50; left- 50 of lungs were used for this study. Each lung was studied carefully for number of fissures whether complete or incomplete or absent. Presences of accessory fissures were noted. Results: We observed complete absence of fissures in two right and left lungs. Accessory fissures were present in 38% right lungs and 32% in left lungs. Conclusion: Incidence of absence of oblique fissure and accessory fissure was greater in our present work when compared our results with other authors. Considering this we feel that more elaborative study should be done on this topic which will throw more light on this.

  14. Anal Abscess/Fistula

    Science.gov (United States)

    ... to determine if antibiotics are indicated. TREATMENT OF ANAL FISTULA Currently, there is no medical treatment available for ... surgery is almost always necessary to cure an anal fistula. If the fistula is straightforward (involving minimal sphincter ...

  15. Fissure seal or fluoride varnish?

    Science.gov (United States)

    Deery, Christopher

    2016-09-01

    Data sourcesCochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Register and the World Health Organization (WHO) Clinical Trials Registry PlatformStudy selectionRandomised controlled trials (RCTs) with at least 12 months follow-up, in which fissure sealants, or fissure sealants together with fluoride varnishes, were compared with fluoride varnishes alone for preventing caries in occlusal surfaces of permanent teeth of children and adolescents.Data extraction and synthesisTwo reviewers independently screened search results, extracted data and assessed risk of bias of included studies. Studies were grouped and analysed on the basis of sealant material type (resin-based sealant and glass ionomer-based sealant, glass ionomer and resin-modified glass ionomer) and different follow-up periods. Odds ratio were calculated for caries or no caries on occlusal surfaces of permanent molar teeth. Mean differences were calculated for continuous outcomes and data. Evidence quality was assessed using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods.ResultsEight RCTs involving a total of 1747 children aged five to ten years of age were included. Three trials compared resin-based fissure sealant versus fluoride varnish. Results from two studies (358 children) after two years were combined. Sealants prevented more caries, pooled odds ratio (OR) = 0.69 (95%CI; 0.50 to 0.94). One trial with follow-up at four and nine years found that the caries-preventive benefit for sealants was maintained, with 26% of sealed teeth and 55.8% of varnished teeth having developed caries at nine years. Evidence for glass-ionomer sealants was of low quality. One split-mouth trial analysing 92 children at two-year follow-up found a significant difference in favour of resin-based fissure sealant together with fluoride varnish compared with fluoride varnish only (OR

  16. 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.)

  17. EVALUATION OF ANAL DISEASE COMPLEX IN SURGICAL OPD IN TAGORE MEDICAL COLLEGE AND HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sasivannan

    2014-05-01

    Full Text Available Anal disease complex consists of anal symptoms of the patient and the findings by the surgeon. Every individual in his lifetime would have had anal discomfort ranging from pain to bleeding per anus but statistics of anal disease complex in less available. The drawback regarding anal disease is, patient presents with more than one symptom and more than one finding co- exist and the patient gets treated for his complaints from family physician up to super specialist. AIM OF THE STUDY: To find out the commonest presentation and the commonest findings by the surgeon. MATERIAL AND METHOD: In this retrospective study we analyzed 200 of our patients presented to surgical OPD with anal symptoms. RESULT: From our study we found out the commonest symptom presentation was Painful defecation with bleeding per anus and the commonest finding was Fissure in ano.

  18. Modeling plaque fissuring and dissection during balloon angioplasty intervention.

    Science.gov (United States)

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

    Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage.

  19. HRCT evaluation of the accessory fissures of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Yildiz, Altan E-mail: ayildiz@mersin.edu.tr; Goelpinar, Fulya; Calikoglu, Mukadder; Duce, Meltem Nass; Oezer, Caner; Apaydin, F. Demir

    2004-03-01

    Introduction: The purpose of this study was to classify the accessory fissures of the lung and to assess their frequency by using high-resolution CT. Methods and patients: HRCT scans of 115 patients were prospectively reviewed. 1 mm thin sections were obtained at 10 mm intervals with a scan time of 1.9 s. The fissure and its relationship to the segmental bronchovascular structures were then evaluated on transverse sections. Results: Forty-four accessory fissures were detected in 35 of 115 patients. The most common accessory fissure was the inferior accessory fissure (12%). The second most common accessory fissure was the left minor fissure (8%). The right superior accessory fissure (5%), the accessory fissure between the medial and lateral segments of the right middle lobe (5%), and the accessory fissure between the superior and inferior segments of the lingula (5%) were seen in equal frequencies. Also, intersegmental accessory fissures, namely the fissure between the anterobasal and laterobasal of both the right (1%) and the left (2%) lower lobes were detected. We found only one subsegmental accessory fissure. Discussion and conclusion: The inferior accessory fissure and the left minor fissure were the most common accessory fissures in our study.

  20. Anal abscess and fistula.

    Science.gov (United States)

    Sneider, Erica B; Maykel, Justin A

    2013-12-01

    Benign anorectal diseases, such as anal abscesses and fistula, are commonly seen by primary care physicians, gastroenterologists, emergency physicians, general surgeons, and colorectal surgeons. It is important to have a thorough understanding of the complexity of these 2 disease processes so as to provide appropriate and timely treatment. We review the pathophysiology, presentation, diagnosis, and treatment options for both anal abscesses and fistulas.

  1. Effect of Psychological Nursing Intervention on the Symptom Alleviation Rate of Negative Emotion and Pain of Patients with Disease of Anal Fissure%心理护理干预对肛裂患者负性情绪及疼痛缓解率的影响

    Institute of Scientific and Technical Information of China (English)

    叶琴

    2015-01-01

    目的:探讨心理护理干预对肛裂患者忧郁、焦虑及疼痛缓解率的影响。方法将120例肛裂患者随机分为观察组和对照组各60例,对照组给予常规护理,观察组在此基础上给予心理护理干预。比较两组治疗前后负性情绪及疼痛变化。结果两组干预后SAS、SDS评分低于干预前(P<0.01),观察组干预后SAS、SDS评分低于对照组干预后(P<0.05),观察组疼痛总有效率高于对照组(P<0.05)。结论心理护理干预可有效缓解肛裂患者因恐惧、焦虑情绪导致的心理负面反应,减轻患者的疼痛感。%ObjectiveTo explore the effect of psychological nursing intervention on the symptom alleviation rate of depression, anxiety and pain of patients with disease of anal ifssure.Methods120 patients with anal ifssure diseases were randomly divided into the patients in the observation group and control group(60 cases in each group).The patients in the control group were given routine nursing care and the patients in the observation group were given extra psychological nursing intervention. The changes of negative emotion and pain of the patients were compared between the two groups before and after treatment.ResultsThe scores of SAS and SDS were lower after the intervention than those before the intervention in the two groups(P<0.01);the scores of SAS and SDS were lower in the observation group than the control group after the intervention(P<0.05);the total alleviation rate of pain of the patients was higher in observation group than the control group(P<0.05).ConclusionThe psychological nursing intervention can effectively alleviate the negative psychological response due to fear and anxiety in patients with gastrointestinal diseases so as to reduce the pain of the patients.

  2. Odontalgia atípica crónica por leve fisura de la corona de un diente, no apreciable con radiografía Chronic atypical odontalgia due to a minor fissure in the tooth crown, not visible in a radiograph

    Directory of Open Access Journals (Sweden)

    JM González-González

    2003-12-01

    Full Text Available Las odontalgias atípicas crónicas obligan en muchos casos al paciente a ir saltando por consultas de diferentes especialistas, sin encontrar la causa, ni el tratamiento apropiado a su padecimiento. Presentamos tres casos clínicos en los cuales queda demostrada como causa de una odontalgia atípica crónica una fisura de la corona del diente. Pensamos que dicha fisura, cuando se prolonga en profundidad, puede afectar a dentina o pulpa y ser el motivo de ese dolor atípico durante incluso años, terminando en más de un caso en fractura del diente. Proponemos un diagnóstico temprano de este tipo de etiología, realización de una endodoncia y colocación de una funda metal-porcelana de protección.In many cases chronic atypical odontalgia make patients visit several different specialists' surgeries, being unable to find the reason or the suitable treatment for the pain. We present three clinical cases in which a fissure in the tooth crown is proved to be the cause of the chronic atypical odontalgia. We think that when this fissure deepens it can affect dentin or pulp and thus not only cause this atypical pain for years but also result in tooth fracture in more than one case. We propose an early diagnosis of this type of etiology, the performance of an endodontic treatment and the placement of a protective metal-porcelain cap.

  3. Anal cancer; Cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Fesneau, M.; Champeaux-Orange, E. [Service de radiotherapie, Centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hopital Bretonneau, 37 - Tours (France); Champeaux-Orange, E. [Service d' oncologie-radiotherapie, Centre hospitalier regional d' Orleans, 45 - Orleans (France); Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 75 - Paris (France)

    2010-07-01

    Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, para-rectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report. (authors)

  4. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, Thomas; Bower, Mark

    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...

  5. ACCESSORY FISSURE OF RIGHT LUNG: A REPORT OF TWO CASES

    Directory of Open Access Journals (Sweden)

    Sarita Behera

    2014-06-01

    Full Text Available Right lung is divided into upper (superior, middle and lower (Inferior lobes by an oblique and a horizontal fissure.Oblique fissure passes spirally from posterior border to inferior border deep into the lung separating the lower lobe from upper and middle lobes. A short horizontal fissure passes horizontally forwards from the oblique fissure at midaxillary line to meet the anterior border at 4th costochondral junction. This separates the upper lobe from the middle lobe. During routine dissection in 2010-11 undergraduate batch, we came across two cases of right lungs where an accessory fissure was extending horizontally backwards from the oblique fissure at mid axillary line towards the vertebral part of medial surface. In the 1st case, this accessory fissure was not meeting the normal horizontal fissure where as in the 2nd case it was meeting. This accessory fissure separates the lower lobe into a superior and an inferior segment. Knowledge of different types of accessory fissures is important because it may mislead the radiological findings, may act as a barrier to spread of infection creating a sharply marginated pneumonia which can wrongly be interpretated as atelectasis or consolidation. Identification of completeness of fissure is important prior to lobectomy, because individuals with incomplete fissures are more prone to develop postoperative air leak. Considering the clinical importance of such anomalies, anatomical knowledge and prior awareness of accessory fissures in the lungs may be important for clinicians and radiologists.

  6. Obstetric anal sphincter injuries

    Directory of Open Access Journals (Sweden)

    Remon Keriakos

    2015-10-01

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

  7. Obstetric anal sphincter injuries

    Institute of Scientific and Technical Information of China (English)

    Remon Keriakos; Deepa Gopinath

    2015-01-01

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

  8. Cryptoglandular anal fistula.

    Science.gov (United States)

    de Parades, V; Zeitoun, J-D; Atienza, P

    2010-08-01

    Fistula arising from the glands of the anal crypts is the most common form of anoperineal sepsis. It is characterized by a primary internal orifice in the anal canal, a fistulous tract, and an abscess and/or secondary perineal orifice with purulent discharge. Antibiotics are not curative. The treatment of an abscess is urgent and consists, whenever possible, of incision and drainage under local anesthesia. Definitive treatment of the fistulous tract can await a second stage. The primary aim is to control infection without sacrificing anal continence. Fistulotomy is the basis for all treatments but the specific technique depends on the height of the fistula in relation to the sphincteric mechanism. Overall results of fistulotomy are excellent but there is some risk of anal incontinence. This explains the growing interest in sphincter sparing techniques such as the mucosal advancement flap, the injection of fibrin glue, and the plug procedure. However, results of these procedures are not yet good enough and leave much room for improvement.

  9. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  10. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Science.gov (United States)

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-06-04

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management.

  11. 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.

  12. [Cryptoglandular anal fistulas].

    Science.gov (United States)

    de Parades, Vincent; Zeitoun, Jean-David; Bauer, Pierre; Atienza, Patrick

    2008-10-31

    Cryptoglandular anal fistulae are the most frequently occurring form of perianal sepsis. Characteristically they have an endoanal primary opening, a fistula track and an abscess and/or an external purulent opening. Antibiotic therapy is not of use in initial management except in special cases. Treatment of an abscess, if present, is required urgently and when possible, consists of its incision under local anaesthesia. Treating the fistula track occurs afterwards and aims to dry up the purulent discharge and avoid recurrence of the abscess by means of surgical fistulotomy. These techniques are very effective in terms of eradication of the problem but there is sometimes a risk of anal incontinence. This explains the increasing interest in sphincter preserving techniques using the advancement of a covering flap of rectal mucosa and the injection of fibrin glue.

  13. Anal squamous intraepithelial neoplasia.

    Science.gov (United States)

    Bejarano, Pablo A; Boutros, Marylise; Berho, Mariana

    2013-12-01

    Diagnosis, follow up, and treatment of anal intraepithelial neoplasia are complex and not standardized. This may be partly caused by poor communication of biopsy and cytology findings between pathologists and clinicians as a result of a disparate and confusing terminology used to classify these lesions. This article focuses on general aspects of epidemiology and on clarifying the current terminology of intraepithelial squamous neoplasia, its relationship with human papilloma virus infection, and the current methods that exist to diagnose and treat this condition.

  14. Earth Fissures in Su-Xi-Chang Region, Jiangsu, China

    Science.gov (United States)

    Wang, Guang-ya; You, Greg; Zhu, Jin-qi; Yu, Jun; Li, Wei

    2016-11-01

    The earth fissures in the Su-Xi-Chang area are caused by differential land subsidence due to long-term excessive groundwater withdrawal and controlled by the bedrock ridge or cliff underlying. There have been more than 15 earth fissures in the area since 1989. The field investigations have lasted for more than 20 years. The earth fissures generally have a main fissure and a number of secondary ones parallel to the main one. The main fissure (crack) has a scarp, is steeply dipping, and can be more than 2000 m long. Geophysical surveys (2D or 3D seismic investigation, controlled source audio frequency magnetotelluric sounding, and electric sounding) combined with geological drilling are effective for the investigation of earth fissures. Geodetic leveling is effective to monitor the ground deformation across the earth fissure, so is the extensometer for the opening of the fissure. The activities of earth fissures are directly related to different stages of land subsidence and controlled by geological abnormalities. Most earth fissures in the area are still active.

  15. Mineralization of human premolar occlusal fissures: a quantitative histochemical microanalysis

    OpenAIRE

    Campos, Antonio; Rodriguez, I. A.; Sanchez-Quevedo, M.C.; García, J. M.; Nieto-Albano, O.H.; Gómez de Ferraris, M. E.

    2000-01-01

    The mechanisms of cariogenesis in occlusal fissures remain elusive because of limited information about fissure structure and wall mineralization. The purpose of the present study was to determine the correlation between morphological patterns in occlusal fissures in human premolars and quantitative histochemical patterns of mineralization in the walls of these formations. We used scanning electron microscopy and quantitative X-ray microanalysis with the peak-t...

  16. DAMAGE MODEL OF CONTROL FISSURE IN PERILOUS ROCK

    Institute of Scientific and Technical Information of China (English)

    CHEN Hong-kai; TANG Hong-mei; YE Si-qiao

    2006-01-01

    Hitherto, perilous rock is the weakest topic in disasters studies. Specially,damage of control fissure under loads is one key technique in study of develop mechanism of perilous rock. Damage division of end area of control fissure was defined by authors,then calculation methods of timed-Poisson's ratio and timed-Young's modulus were established in damage mechanics theory. Further, the authors set up damage constitutive equation of control fissure, which founds important basis to numerical simulation for control fissure to develop.

  17. Anal anatomy and normal histology.

    Science.gov (United States)

    Pandey, Priti

    2012-12-01

    The focus of this article is the anatomy and histology of the anal canal, and its clinical relevance to anal cancers. The article also highlights the recent histological and anatomical changes to the traditional terminology of the anal canal. The terminology has been adopted by the American Joint Committee on Cancer, separating the anal region into the anal canal, the perianal region and the skin. This paper describes the gross anatomy of the anal canal, along with its associated blood supply, venous and lymphatic drainage, and nerve supply. The new terminology referred to in this article may assist clinicians and health care providers to identify lesions more precisely through naked eye observation and without the need for instrumentation. Knowledge of the regional anatomy of the anus will also assist in management decisions.

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

    Directory of Open Access Journals (Sweden)

    Uzum Ayse

    2011-08-01

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

  19. Non‑Azygos Accessory Fissure in Right Upper Lobe Associated with Superior and Inferior Accessory Fissures in Right Lower Lobe

    Directory of Open Access Journals (Sweden)

    Thomas Jose Eluvathingal Muttikkal

    2012-01-01

    Full Text Available Accessory fissures in the lungs are common congenital variations, usually detected as incidental findings in radiographs or CT scan. Accessory fissures can act as an anatomic barrier to the spread of inflammatory or neoplastic disease, as well as due to the variant anatomy, mimic lesions. It is important to recognize the presence of accessory fissures, as they affect surgical planning of pulmonary lobectomy and segmentectomy. Accessory fissure in the right upper lobe other than due to the anomalous course of azygos vein is very rare. We report a case of non-azygos accessory fissure, between the apical and the anterior segments of right upper lobe, along with superior and inferior accessory fissures in the right lower lobe.

  20. FISSURES AND LOBES OF LUNGS: A MORPHOLOGICAL AND ANATOMICAL STUDY

    Directory of Open Access Journals (Sweden)

    Radha K

    2015-06-01

    Full Text Available Background and Aims: The fissures of the lungs serve as boundaries for the lobes of the lungs. They also acts as barriers to avoid the spread of pathologies .The proposed aim of the study was to study the fissures and lobes of the lungs and their variations and to compare them with previous studies and to find their clinical implications. Methods: Thirty pairs of lungs were used for the study, obtained from formalin-fixed cadavers of south-indian origin. The lung specimens were observed for the patterns of lobes and fissures, variations were noted and specimens were photographed. Results: Five right lungs showed absence of horizontal fissure. Out of thirty, twelve right sided lungs showed incomplete fissures.On the left side, seven specimens showed incomplete oblique fissure. In addition, two right-sided specimens and four left sided specimens showed presence accessory fissure. Conclusion: The results and their comparison with the previous works show that there is a wide range of difference in occurrence of major, minor and accessory fissures between and among different populations. Knowledge of such variations is mandatory for surgeons in pre-operative planning for performing pulmonary lobectomies and for radiologists for interpreting X-rays and CT scans

  1. [The anal fistula disease and abscess].

    Science.gov (United States)

    Strittmatter, Bernhard

    2004-01-01

    There are two forms of anal fistulas arising from its pathogenesis: the acute stage is the abscess, whereas the chronic stage is the fistula in ano. The classification of the fistula in ano is named after Parks. Pathogenesis and classification are explained. For complete cure, every abscess needs precise examination to be able to show the course and shape of the fistula. The surgical procedure depends on the fistula tract. Most fistulas can be operated by means of a fistulotomy or fistulectomy. Recovery depends on locating the total fistula tract.

  2. [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.

  3. Laser fluorescence detection of demineralization in artificial occlusal fissures.

    Science.gov (United States)

    Ferreira Zandoná, A G; Analoui, M; Schemehorn, B R; Eckert, G J; Stookey, G K

    1998-01-01

    Laser fluorescence (LF) has been used previously to detect early smooth-surface lesions. Although its use for detection of occlusal demineralization has been implicated, it has not been demonstrated. The aim of this study was to determine whether LF could detect demineralization in the base of artificial fissures. To employ LF for detection of occlusal demineralization an apparatus was devised to direct laser light into fissures and simultaneously detect fluorescence from the base of the fissures. Three groups (n = 40/group) of differing fissure types were prepared (straight wall, converging and diverging wall) with either a sound or lesioned base. One half of each group was examined with LF and dye-enhanced LF (DELF); the other half was examined with LF, exposed to plaque, examined with LF and DELF, air-polished and examined with DELF. All images were scored twice as either (1) carious; (2) sound, or (3) undetermined, by a group of 3 examiners. For fissures without plaque, the average sensitivity was higher for DELF (0.76) than for LF (0.54) (p DELF (0.64) than for LF (0.29) (p DELF (0.91) compared to LF (0.43); however, specificity was lower for DELF (0.05) compared to LF (0.55). When the fissures were air-polished and then examined with DELF, sensitivity averaged 0.82 (p DELF was a better diagnostic tool than LF for detection of demineralization in artificial fissures.

  4. 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.

  5. 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.

  6. Randomized trial on fluorides and sealants for fissure caries prevention

    OpenAIRE

    Lin, HC; Liu, BY; Lo, ECM; Chu, CH

    2012-01-01

    To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine ...

  7. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

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

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional...... outcomes, but the success rate varies. The endorectal advancement flap is considered to be the gold standard. Ligation of the intersphincteric fistula tract is promising. Proctectomy or proctocolectomy in combination with transposition flaps may be necessary. A success rate of 66-70% has been reported....

  8. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-07

    Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practise. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcome, which is quite inevitable following conventional surgical treatment. For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function. Among them, the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula. Another technique, the anal fistula plug, derived from porcine small intestinal submucosa, is safe but modestly effective in long-term follow-up, with success rates varying from 24%-88%. The failure rate may be due to its extrusion from the fistula tract. To obviate that, a new designed plug (GORE BioA®) was introduced, but long term data regarding its efficacy are scant. Fibrin glue showed poor and variable healing rate (14%-74%). FiLaC and video-assisted anal fistula treatment procedures, respectively using laser and electrode energy, are expensive and yet to be thoroughly assessed in clinical practise. Recently, a therapy using autologous adipose-derived stem cells has been described. Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae, and studies remain in progress. The aim of this present article is to review the pertinent literature, describing the advantages and limitations of

  9. Incomplete and accessory fissures of the lung evaluated by high-resolution computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Heřmanová, Zuzana, E-mail: zuzana.hermanova2@fnol.cz; Čtvrtlík, Filip, E-mail: filip.ctvrtlik@fnol.cz; Heřman, Miroslav, E-mail: herman@fnol.cz

    2014-03-15

    Purpose: The aim of our study was to assess incomplete and accessory interlobar fissures using volumetric thin-section high-resolution computed tomography (HRCT). Materials and methods: Retrospective assessment of HRCT examinations of 250 patients was performed. We assessed the localization, extension, and type of the incompleteness of fissures as well as the presence and localization of accessory fissures. We searched for possible correlation among the localization of interlobar fissures, the presence of incompleteness, and accessory fissures. Results: On the left side, an incomplete oblique fissure was found in 24%. The discontinuity was present in the parahilar region and the area of the incompleteness was most frequently between 21% and 40%. The right oblique fissure was incomplete in 35%, mostly parahilarly, with the most frequent discontinuity below 20%. An incomplete horizontal fissure was found in 74%. Accessory fissures were identified in 16% of patients, with the same frequency on both sides. The most frequent finding was accessory horizontal fissure with 8.0% on the left side, superior accessory fissure (7.2%) and inferior accessory fissure (5.2%) on the right side. No correlation was found among the localization of interlobar fissures, the presence of incompleteness, and accessory fissures. Conclusion: Incomplete and accessory fissures are frequent anatomic variations of interlobar fissures.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  11. 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

  12. Hardness testing of some fissure-sealing materials.

    Science.gov (United States)

    Ulvestad, H

    1977-11-01

    The mechanical properties of fissure-sealing materials are of significant importance for their durability, i.e. their wear resistance. One of the methods of evaluating a material's resistance to attrition is to apply a hardness test. In the present investigation, the surface hardness of some fissure-sealing materials was tested. Sealants made from diluted composite materials and with inclusion of inorganic filler particles appeared to have a considerable higher surface hardness than the other sealing materials tested.

  13. Predominant cultivable microflora of human dental fissure plaque.

    OpenAIRE

    Theilade, E; Fejerskov, O; Karring, T; Theilade, J

    1982-01-01

    Plaque developed in 10 occlusal fissures from unerupted third molars during implantation for 200 to 270 days in lower molars of dental students was studied. To characterize the predominant cultivable flora, 592 isolates (51 to 67 from each fissure) were subcultured from anaerobic roll tubes. Twenty-eight of the isolates were lost. Streptococci constituted 8 to 86% (median, 45%) of the isolates, Streptococcus mutans constituted 0 to 86% (median, 25%) and S. sanguis constituted 0 to 15% (median...

  14. New Techniques for Treating an Anal Fistula

    OpenAIRE

    Song, Kee Ho

    2012-01-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is exp...

  15. 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

  16. A conceptual model of the hydrological influence of fissures on landslide activity

    Directory of Open Access Journals (Sweden)

    D. M. Krzeminska

    2012-06-01

    Full Text Available Hydrological processes control the behaviour of many unstable slopes, and their importance for landslide activity is generally accepted. The presence of fissures influences the storage capacity of a soil and affects the infiltration processes of rainfall. The effectiveness of the fissure network depends upon fissure size, their spatial distribution, and connectivity. Moreover, fissure connectivity is a dynamic characteristic, depending on the degree of saturation of the medium.

    This research aims to investigate the influence of the fissure network on hydrological responses of a landslide. Special attention is given to spatial and temporal variations in fissure connectivity, which makes fissures act both as preferential flow paths for deep infiltration (disconnected fissures and as lateral groundwater drains (connected fissures. To this end, the hydrological processes that control the exchange of water between the fissure network and the matrix have been included in a spatially distributed hydrological and slope stability model. The ensuing feedbacks in landslide hydrology were explored by running the model with one year of meteorological forcing. The effect of dynamic fissure connectivity was evaluated by comparing simulations with static fissure patterns to simulations in which these patterns change as a function of soil saturation. The results highlight that fissure connectivity and fissure permeability control the water distribution within landslides. Making the fissure connectivity function of soil moisture results in composite behaviour spanning the above end members and introduces stronger seasonality of the hydrological responses.

  17. Management of anal squamous intraepithelial lesions.

    Science.gov (United States)

    Pineda, Carlos E; Welton, Mark L

    2009-05-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is unknown, there is significant evidence that untreated HSIL progresses to squamous cell carcinoma in 11% of patients and in up to 50% of patients with extensive disease and immunosuppression. Anal cytology and reflex HPV DNA testing are used to screen for disease, particularly among patients with the aforementioned risk factors. Evaluation of the patient should include physical examination and high-resolution anoscopy (HRA) to evaluate for disease above and below the dentate line. Intervention is warranted and this can be achieved in many ways. The treatment option associated with the best outcomes is ablation directed with HRA, which can be performed in the office or in the operating room with minimal morbidity. This strategy is effective in patients with both low-volume and high-volume disease and is associated with a malignant progression rate of 0.4% in patients with treated HSIL.

  18. 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.

  19. Anal fistula. Past and present.

    Science.gov (United States)

    Zubaidi, Ahmad M

    2014-09-01

    Anal fistula is a common benign condition that typically describes a miscommunication between the anorectum and the perianal skin, which may present de novo, or develop after acute anorectal abscess. Athough anal fistulae are benign, the condition can still negatively influence a patient's quality of life by causing minor pain, social hygienic embarrassment, and in severe cases, frank sepsis. Despite its long history and prevalence, anal fistula management remains one of the most challenging and controversial topics in colorectal surgery today. The end goals of treatment include draining the local infection, eradicating the fistulous tract, and minimizing recurrence and incontinence rates. The goal of this review is to ensure surgeons and physicians are aware of the different imaging and treatment choices available, and to report expected outcomes of the various surgical modalities so they may select the most suitable treatment. 

  20. Identification of pulmonary fissures using a piecewise plane fitting algorithm.

    Science.gov (United States)

    Gu, Suicheng; Wilson, David; Wang, Zhimin; Bigbee, William L; Siegfried, Jill; Gur, David; Pu, Jiantao

    2012-10-01

    We describe an automated computerized scheme to identify pulmonary fissures depicted in chest computed tomography (CT) examinations from a novel perspective. Whereas CT images can be regarded as a cloud of points, the underlying idea is to search for surface-like structures in the three-dimensional (3D) Euclidean space by using an efficient plane fitting algorithm. The proposed plane fitting operation is performed in a number of small spherical lung sub-volumes to detect small planar patches. Using a simple clustering criterion based on their spatial coherence and surface area, the identified planar patches, assumed to represent fissures, are classified into different types of fissures, namely left oblique, right oblique and right horizontal fissures. The performance of the developed scheme was assessed by comparing with a manually created "reference standard" and the results obtained by a previously developed approach on a dataset of 30 lung CT examinations. The experiments show that the average discrepancy is around 1.0mm in comparison with the reference standard, while the corresponding maximum discrepancy is 20.5mm. In addition, 94% of the fissure voxels identified by the computerized scheme are within 3mm of the fissures in the reference standard. As compared to a previously developed approach, we also found that the newly developed scheme had a smaller discrepancy with the standard reference. In efficiency, it takes approximately 8 min to identify the fissures in a chest CT examination on a typical PC. The developed scheme demonstrates a reasonable performance in terms of accuracy, robustness, and computational efficiency.

  1. CLINICAL EVALUATION OF AYURVEDIC COMPOUND AND MANUAL DILATATION OF ANUS IN THE MANAGEMENT OF PARIKARTIKA (FISSURE-IN ANO: AN OPEN PERSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Panigrahi Hemanta

    2012-12-01

    Full Text Available Parikartika (Anal fissure is the most common cause of anal pain. The aim of this prospective study was to assess the effectiveness of Ayurvedic compound along with manual dilatation of Anus and Jatyadi tail in anal fissure. 40 patients were included in this study and the therapeutic outcome and side effects were recorded. Recurrence of symptoms occurred in two healed patients in four months. Remission of the disease was found in 80% of cases which is statistically significant. Partial remission in 12.5% and no remission was found in 7.5% of cases. The appetite was markedly improved, which was either nil or, reduced before treatment. The mean was 0.4 as compared to 2.375 before treatment with SD 0.5905 and P is significant <0.001. Complete healing of the fissure occurred in 95% of the subjects by the end of 30 days (P<0.0001, statistically highly significant. The pain score in the subjects dropped from 3.325 (mean to 0.35 (mean in 30days time with SD 0.4830, SEM dropped from 0.1154 to 0.07638 with P value < 0.001 which is statistically significant. Ninty nine percent of the subjects experienced a significant fall in the bleeding by the end of 30 days. There was also a significant reduction in the discharge with mean dropped from 3.375 to 0.2 and SD 0.4051, P value <0.0001.Perianal pruritis was also significantly reduced with mean dropped from 3.175 to 0.35 before and after treatment respectively with SD 0.4830, SEM0.07638, and P value <0.001.

  2. Research on positioning of Xi'an ground fissures with InSAR quality map

    Science.gov (United States)

    Xu, Li; Zhao, Chao-ying

    2011-02-01

    Xi'an ground fissure is a typical geo-hazard with nearly half a century history, which have been caused serious damages to roads, building and other civil facilities. Based on the theory of deformation de-correlation of the active ground fissures, this manuscript mainly investigated the positioning method of active ground fissures by analyzing the pseudo-coherence map of adaptively filtered differential interferogram. We took two ERS1 SAR data during 1992-1993 as an example to investigate the active fissures position during this period. Consequently, high consistency between newly detected fissures and the ground fissure map from engineering geological investigation can be achieved.

  3. Cochlear implant electrode array misplaced in Hyrtl's fissure.

    Science.gov (United States)

    Mouzali, Amina; Ouennoughi, Kheiredidine; Haraoubia, Mohamed-Salah; Zemirli, Omar; Triglia, Jean Michel

    2011-11-01

    Hyrtl's fissure is a cleft that is present in the developing fetal petrous temporal bone and extends from the area inferior to the round window to the meninges of the posterior fossa. Persistent Hyrtl's fissure, due to incomplete ossification, is considered a rare temporal bone malformation, and is a known cause of perilabyrinthine cerebrospinal fluid fistula. Very few cases are reported as being at risk of complication of cochlear implant surgery. Here we report the case of an 8-year-old boy with misplacement of an electrode array in Hyrtl's fissure. The diagnosis was made postoperatively, since cochlear implant failure was suspected from non-auditory responses. Computed tomography (CT) revealed the extracochlear location of the electrode array. We emphasize the role of presurgical imaging CT and magnetic resonance imaging in detecting temporal bone abnormalities, and we discuss the value of intraoperative auditory nerve response telemetry and postoperative radiological evaluation in diagnosing cochlear implant misplacement.

  4. Perioperative Identification of an Accessory Fissure of the Right Lung

    Directory of Open Access Journals (Sweden)

    Yannick Taverne

    2015-01-01

    Full Text Available Anatomical variations of lungs are common in clinical practice; however, they are sometimes overlooked in routine imaging. Surgical anatomy of the lung is complex and many variations are known to occur. A defective pulmonary development gives rise to variations in lobes and fissures. Morphological presentation is of clinical importance and profound knowledge of the organogenesis and functional anatomy is imperative for the interpretation and evaluation of lung pathophysiology and subsequent surgical intervention. However, appreciating them on radiographs and CT scans is difficult and they are therefore often either not identified or completely misinterpreted. As presented in this case report, an accessory fissure separating the superior segment of the right lower lobe from its native lobe was seen perioperatively and could only retrospectively be defined on X-rays and CT scan. It is imperative to keep in mind that accessory fissures can be missed on imaging studies and thus can make the surgical procedure more challenging.

  5. Marginal Microleakage of Conventional Fissure Sealants and Self-Adhering Flowable Composite as Fissure Sealant in Permanent Teeth

    Directory of Open Access Journals (Sweden)

    Sara Rahimian-Imam

    2015-11-01

    Full Text Available Objectives: Application of sealants is a safe and effective way to prevent occlusal caries in the posterior teeth. A successful sealant therapy depends on good isolation. Decreased steps of adhesive application may enable proper isolation and use of self-adhering flowable composites for sealant therapy. This study sought to compare the marginal microleakage of fissure sealants and self-adhering flowable composites in permanent teeth.Materials and Methods: This in vitro, experimental study was conducted on 60 extracted human premolar teeth. The teeth were divided randomly into two groups of 30. In the first group, fissure sealant (Clinpro, 3M ESPE, USA was placed on the teeth. In the second group, self-adhering flowable composite (Vertise Flow, Kerr, USA was applied as the sealant. Then, both groups were immersed in 0.5% fuchsin dye solution for 24 hours. Sectioned samples were observed with a stereomicroscope for the extent of dye penetration. Data were analyzed using SPSS 21 and the Mann-Whitney test (P<0.05.Results: Microleakage in the fissure sealant group was significantly higher than that in the self-adhering flowable composite group (P<0.001.Conclusion: Microleakage was less using self-adhering flowable composite compared to conventional fissure sealant; therefore, self-adhering flowable composite can be used as a suitable fissure sealant in permanent teeth.

  6. Experimental model of anal fistula in rats

    OpenAIRE

    Arakaki, Mariana Sousa; Santos,Carlos Henrique Marques dos; Falcão, Gustavo Ribeiro; Cassino,Pedro Carvalho; Nakamura, Ricardo Kenithi; Gomes,Nathália Favero; Santos,Ricardo Gasparin Coutinho dos

    2013-01-01

    INTRODUCTION: the management of anal fistula remains debatable. The lack of a standard treatment free of complications stimulates the development of new options. OBJECTIVE: to develop an experimental model of anal fistula in rats. METHODS: to surgically create an anal fistula in 10 rats with Seton introduced through the anal sphincter musculature. The animals were euthanized for histological fistula tract assessment. RESULTS: all ten specimens histologically assessed had a lumen and surroundi...

  7. Engineering a robotic approach to mapping exposed volcanic fissures

    Science.gov (United States)

    Parcheta, C. E.; Parness, A.; Mitchell, K. L.

    2014-12-01

    Field geology provides a framework for advanced computer models and theoretical calculations of volcanic systems. Some field terrains, though, are poorly preserved or accessible, making documentation, quantification, and investigation impossible. Over 200 volcanologists at the 2012 Kona Chapman Conference on volcanology agreed that and important step forward in the field over the next 100 years should address the realistic size and shape of volcanic conduits. The 1969 Mauna Ulu eruption of Kīlauea provides a unique opportunity to document volcanic fissure conduits, thus, we have an ideal location to begin addressing this topic and provide data on these geometries. Exposed fissures can be mapped with robotics using machine vision. In order to test the hypothesis that fissures have irregularities with depth that will influence their fluid dynamical behavior, we must first map the fissure vents and shallow conduit to deci- or centimeter scale. We have designed, constructed, and field-tested the first version of a robotic device that will image an exposed volcanic fissure in three dimensions. The design phase included three steps: 1) create the payload harness and protective shell to prevent damage to the electronics and robot, 2) construct a circuit board to have the electronics communicate with a surface-based computer, and 3) prototype wheel shapes that can handle a variety of volcanic rock textures. The robot's mechanical parts were built using 3d printing, milling, casting and laser cutting techniques, and the electronics were assembled from off the shelf components. The testing phase took place at Mauna Ulu, Kīlauea, Hawai'i, from May 5 - 9, 2014. Many valuable design lessons were learned during the week, and the first ever 3D map from inside a volcanic fissure were successfully collected. Three vents had between 25% and 95% of their internal surfaces imaged. A fourth location, a non-eruptive crack (possibly a fault line) had two transects imaging the textures

  8. Diffuse large B cell lymphoma presenting as a peri-anal abscess

    OpenAIRE

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-01-01

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a ...

  9. Method to calculate fatigue fracture life of control fissure in perilous rock

    Institute of Scientific and Technical Information of China (English)

    CHEN Hong-kai; TANG Hong-mei

    2007-01-01

    Rupture and safety of perilous rock are dominated by control fissure behind perilous rock block. Based on model-Ⅰ and model-Ⅱ stress strength factors of control fissure under acting of weight of perilous rock, water pressure in control fissure and earthquake forces, method to calculate critical linking length of control fissure is established. Take water pressure in control fissure as a variable periodic load, and abide by P-M criterion, when control fissure is filled with water, establish the method to calculate fatigue fracture life of control fissure in critical status by contributing value of stress strength factor stemming from water pressure of control fissure in Paris's fatigue equation. Further, parameters(C and m)of sandstone with quartz and feldspar in the area of the Three Gorges Reservoir of China are obtained by fatigue fracture testing.

  10. Image Spectrum of Anal Ultrasound in Patients with Peri Anal Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Kim, Young Jun; ParK, Hee Sun; Jung, Sung Il; Park, Sang Woo; Choi, Young Chil; Shin, Hyun Joon; Park, Uug Chae [Konkuk University School of Medicine, Seoul (Korea, Republic of); Jin, Yong Hyun [Sung Ae General Hospital, Seoul (Korea, Republic of)

    2009-12-15

    Endoanal ultrasonography has recently emerged as a popular diagnostic modality for mapping and imaging the anal sphincter. This procedure can be performed as an outpatient procedure: it is relatively quick and virtually painless. The imaging typically is performed in a proximal to distal manner with defining a variety of levels of the anal canal as it progresses. Anal ultrasound can provide a detailed image of the anal sphincter musculature. The internal anal sphincter appears endosonographically as a hypoechoic circular band that is most prominently seen at the level of the mid-anal canal. The external anal sphincter appears as a thicker circular mixed echogenic band outside of the hypoechoic internal sphincter. Anal ultrasound can be used to evaluate patients with anal fistulas with or without abscess. Imaging is performed and the fistulous tracts or abscesses are identified by hypoechogenicity within the external sphincter muscle or the ischiorectal fossa. Its ability to clearly image the anal sphincters has allowed its use for the evaluation of anal fistulas. Moreover, anal ultrasound has emerged as the technique of choice for imaging the anal sphincters and for evaluating incontinence. Each of the individual physiologic tests offers valuable information that is relevant to the continence mechanism, and the ultrasound yields results that are complementary to other tests. Ultrasound serves as a surveillance tool to monitor the results after sphincterplasty. We illustrate the endo-anal sonographic features of various anal diseases and the ultrasound-anatomic correlation for the anus

  11. The usefulness of transrectal endosonography in differentiating an anal abscess from a rectal carcinoma: a case report:

    OpenAIRE

    Kolodziejczak, Malgorzata; Sudoł-Szopińska, Iwona

    2005-01-01

    Background. The high anal abscess might have not a typical, chronic clinical course, and its diagnosis may be difficult. Case report. The authors describe a case of a patient with the initial diagnosis of rectal cancer. Because of non-specific clinical symptoms suggesting a high anal abscess with atypical , chronic course of the disease, additional investigations were suggested. The final diagnosis was high, submucous-intersphincetric abscess. Conclusions. In the described case the most impor...

  12. Flow characteristics and sealing ability of fissure sealants.

    Science.gov (United States)

    Barnes, D M; Kihn, P; von Fraunhofer, J A; Elsabach, A

    2000-01-01

    This study evaluated the relationship between fissure sealant viscosity, leakage prevention and the incidence of void formation of five commercially available pit-and-fissure sealants. Seventy-two intact, caries free human pre-molars and molars were divided into six test groups of 12 teeth each. All teeth were cleaned with a flour of pumice prophylaxis followed by etching for 60 seconds with 37% H3PO4, rinsing for 30 seconds and drying with oil-free air. Five commercial, light-cured fissure sealants and an unfilled version of one sealant were applied following manufacturers' instructions. Teeth were thermal cycled for 5000 cycles from 5-50 degrees C with a one-minute dwell time at each temperature. Silver nitrate staining followed by mesiodistal sectioning was performed. Leakage and void formation were evaluated at X50 optical magnification. Viscosity was assessed by syringing the fissure sealants into short pipettes, allowing free flow for 30 seconds and then light curing for one minute. The length of unfilled capillary was measured with a Vernier gauge. All experimental data was subjected to a one-way ANOVA, and where differences were detected, they were identified by a post hoc Tukey hsd test at a priori alpha = 0.05. Based on the conditions of the study, viscosity and flow characteristics had no effect on sealing ability or void formation.

  13. 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.

  14. Cellular resolution optical access to brain regions in fissures: imaging medial prefrontal cortex and grid cells in entorhinal cortex.

    Science.gov (United States)

    Low, Ryan J; Gu, Yi; Tank, David W

    2014-12-30

    In vivo two-photon microscopy provides the foundation for an array of powerful techniques for optically measuring and perturbing neural circuits. However, challenging tissue properties and geometry have prevented high-resolution optical access to regions situated within deep fissures. These regions include the medial prefrontal and medial entorhinal cortex (mPFC and MEC), which are of broad scientific and clinical interest. Here, we present a method for in vivo, subcellular resolution optical access to the mPFC and MEC using microprisms inserted into the fissures. We chronically imaged the mPFC and MEC in mice running on a spherical treadmill, using two-photon laser-scanning microscopy and genetically encoded calcium indicators to measure network activity. In the MEC, we imaged grid cells, a widely studied cell type essential to memory and spatial information processing. These cells exhibited spatially modulated activity during navigation in a virtual reality environment. This method should be extendable to other brain regions situated within deep fissures, and opens up these regions for study at cellular resolution in behaving animals using a rapidly expanding palette of optical tools for perturbing and measuring network structure and function.

  15. 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...... uncomplicated vaginal delivery or caesarean section. RESULTS: There were 93 437 vaginal deliveries. ASR occurred in 5.5% (n = 2851) of the nulliparous and 1.5% (n = 608) of the multiparous women. Recurrent ASR occurred in 8% (n = 49) of whom 50% reported symptoms of AI. We found no difference in the occurrence...... of AI between women with recurrent ASR, and those who delivered vaginally without repeat ASR (p = 0.37; OR = 2.0) or by caesarean section (p = 0.77; OR = 1.3). CONCLUSION: Women with a past history of ASR have an 8% risk of recurrence. AI affects half of the women with recurrent ASR. Larger studies...

  16. Perianal mucinous adenocarcinoma associated with chronic anaI fistula: case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, ChuI Hi; Yang, Dal Mo; Kim, Jee Eun; Choi, Soo Jin [Gil Medical Center, Incheon (Korea, Republic of)

    2004-09-01

    Perianal mucinous adenocarcinoma is a rare disease. We report here on the CT findings in a case of perianal mucinous adenocarcinoma associated with chronic anal fistula. The CT revealed a low attenuated lesion surrounding the subcutaneous area of chronic anal fistula, anal canal and perirectal area.

  17. Anal fistula: intraoperative difficulties and unexpected findings.

    Science.gov (United States)

    Abou-Zeid, Ahmed A

    2011-07-28

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. Despite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical examination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the operation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected findings that can be encountered during anal fistula surgery and how to overcome them.

  18. Anal fistula: Intraoperative difficulties and unexpected findings

    Institute of Scientific and Technical Information of China (English)

    Ahmed A Abou-Zeid

    2011-01-01

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. De-spite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical ex-amination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the oper-ation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected find-ings that can be encountered during anal fistula sur-gery and how to overcome them.

  19. Structural analysis of the eruptive fissures at Mount Etna (Italy

    Directory of Open Access Journals (Sweden)

    Francesco Mazzarini

    2011-12-01

    Full Text Available Mount Etna produces frequent eruptions from its summit craters and from fissures on its flanks. The flank fissures trend approximately radially to the summit, and are mainly concentrated in three rift zones that are located on the NE, S and W flanks. Many flank eruptions result from lateral magma transfer from the central conduit into fractures intersecting the flanks, although some eruptions are fed through newly formed conduits that are not directly linked to the central conduit. We analyzed the structural features of eruptions from 1900 to the present, one of the most active periods in the documented eruptive history of Etna, which comprised 35 summit and 33 flank events. Except for a small eruption on the W flank in 1974, all of the flank eruptions in this interval occurred on or near the NE and S rifts. Eruptions in the NE sector were generally shorter, but their fissure systems developed more rapidly and were longer than those in the S sector. In contrast, summit eruptions had longer mean durations, but generally lower effusion rates (excluding paroxysmal events characterized by very high effusion rates that lasted only a few hours. This database was examined considering the main parameters (frequency and strike of the eruptive fissures that were active over the last ~2 ka. The distribution in time and space of summit and flank eruptions appears to be closely linked to the dynamics of the unstable E to S flank sector of Etna, which is undergoing periodic displacements induced by subvolcanic magma accumulation and gravitational pull. In this framework, magma accumulation below Etna exerts pressure against the unbuttressed E and S flanks, which have moved away from the rest of the volcano. This has caused an extension to the detachment zones, and has facilitated magma transfer from the central conduit into the flanks.

  20. Consistency of DIAGNOdent instruments for clinical assessment of fissure caries.

    Science.gov (United States)

    Astvaldsdóttir, Alfheidur; Holbrook, W Peter; Tranaeus, Sofia

    2004-08-01

    DIAGNOdent (KaVo, Biberach, Germany) has shown high diagnostic accuracy and intra-operator agreement for caries detection, both in vitro and in vivo. The aims of this study were to compare DIAGNOdent with visual examination (VI) and bitewing radiographs (BW) for clinical assessment of occlusal fissures, and to evaluate inter-device consistency of clinical recording using four different DIAGNOdent instruments; secondly, to correlate DIAGNOdent readings with microbial culture of the measured site. The subjects were young adults, the material comprising 34 occlusal fissures, scheduled for restorative treatment at the Dental School Clinic of the University of Iceland. Two examiners conducted visual and radiographic assessments. One examiner measured each site with four DIAGNOdent instruments in random order. The fissure was then opened and lesion depth was classified on a 4-point scale. Bacterial samples were taken from the fissure before and after opening. Intra-operator agreement was high (r = 0.85-0.98). Inter-device correlation for the four DIAGNOdent instruments was significant in all cases (r = 0.81-0.92). However, a common cut-off point could not be determined. There was weak but significant correlation between DIAGNOdent readings and all three classes of lesion depth. Level of infection showed very weak correlation with the DIAGNOdent readings. It was concluded that DIAGNOdent is more reliable in detecting dentinal caries if a proper cut-off point is used than in indicating actual lesion depth. Readings from the different instruments were not directly comparable, however, owing to the lack of a common cut-off point.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Marginal Microleakage of Conventional Fissure Sealants and Self-Adhering Flowable Composite as Fissure Sealant in Permanent Teeth

    OpenAIRE

    Sara Rahimian-Imam; Nahid Ramazani; Mohammad Reza Fayazi

    2015-01-01

    Objectives: Application of sealants is a safe and effective way to prevent occlusal caries in the posterior teeth. A successful sealant therapy depends on good isolation. Decreased steps of adhesive application may enable proper isolation and use of self-adhering flowable composites for sealant therapy. This study sought to compare the marginal microleakage of fissure sealants and self-adhering flowable composites in permanent teeth.Materials and Methods: This in vitro, experimental study was...

  6. 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.

  7. 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...

  8. 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

  9. Nocturnal faecal soiling and anal masturbation.

    OpenAIRE

    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.

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

    OpenAIRE

    Shahram Paydar; Ahmad Izadpanah; Leila Ghahramani; Seyed Vahid Hosseini; Alimohammad Bananzadeh; Salar Rahimikazerooni; Faranak Bahrami

    2015-01-01

    Background: On an average 30-50% of patients who undergo incision and drainage (I and D) of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal ...

  11. O Proceso analítico

    OpenAIRE

    Yebra Biurrun, María del Carmen

    2013-01-01

    Esta unidade didáctica enfócase de maneira que permita proporcionar unha visión global da Química Analítica e a súa terminoloxía básica, mostrando a importancia da Química Analítica para a resolución de problemas de diversos ámbitos. Este enfoque faise sobre o esquema do proceso analítico como medio de resolución dunha determinada problemática analítica real. Deste xeito, partindo dun esquema sinxelo, explícase o obxectivo e as distintas etapas do proceso analítico: definición do problema...

  12. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  13. 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.

  14. Viscoelastic assessment of anal canal function using acoustic reflectometry

    DEFF Research Database (Denmark)

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

    2012-01-01

    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.......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....

  15. Natural Fissures of Lung- Anatomical Basis of Surgical Techniques and Imaging

    Directory of Open Access Journals (Sweden)

    Sumita Dutta

    2013-04-01

    Full Text Available Background The fissures in lung enhances uniform expansion.These fissures may be complete, incomplete or absent.A detailed knowledge of variations of classical and accessory fissures is necessary for proper radiological interpretation.It is a guide to cardiothoracic surgeons performing segmental lung resections, lobectomies to have an uncomplicated perioperative outcome. So,the cadaveric study was done to note the morphological variation of the fissures of lung in eastern Indian population and compare it with previous studies. Methods 102 lungs obtained during dissection of formalin fixed cadavers in Calcutta National Medical College,Kolkata and preserved in 10% formalin were thoroughly studied to note every morphological details of fissures present in the lungs. Results 44% of left lungs had classically complete oblique fissure compared to 26.92% on the right. No oblique fissure could be detected in 8% lungs of left and 11.54% of right side. Horizontal fissure was completely absent in 34.6%. Various degree of parenchymal fusion was more common on the right side.None of the oblique fissures had uniform depth. Conclusion Comparison with other studies shows wide regional variations in morphological patterns of lung fissures,implying environmental and genetic factors in its development .Present study unfolds that parenchymal fusion of various extent is a very common entity of oblique fissure of lung. So more lung parenchyma has to be dissected to reach the bronchi and pulmonary arteries during partial lung resection which naturally might lead to peroperative hemorrhage and more postoperative complications.This knowledge of anatomy of fissures of lung may also help clarifying confusing radiographic findings. [Natl J Med Res 2013; 3(2.000: 117-121

  16. Surface anatomy of the pulmonary fissures determined by high-resolution computed tomography.

    Science.gov (United States)

    Heřmanová, Zuzana; Ctvrtlík, Filip; Heřman, Miroslav

    2012-10-01

    The aim of our study was to describe the surface anatomy of the interlobar fissures using volumetric thin-section high-resolution computed tomography (HRCT). Retrospective assessment of HRCT examinations of 250 patients was performed. The localization of the oblique fissures was marked at three sites: posteriorly at its most superior medial limit, laterally in the midaxillary line, and inferiorly at the junction of the middle and lateral thirds of the hemithorax; posteriorly and laterally, this was to the nearest rib whilst inferiorly the position was described in relation to the diaphragm or chest wall. The localization of the horizontal fissure was marked anteriorly in relation to the nearest rib (or costal cartilage) and posteriorly where it intersected with the oblique fissure (superior, middle, or inferior third). Shapes of the fissures and differences between inspiration and expiration were also documented. Descriptive statistics were used to report the most frequent positions. The most frequent localization of the oblique fissure on the left side was posteriorly at the fourth rib (45%), laterally at the sixth rib (52%), and inferiorly in the anterior third of the hemidiaphragm (60%). The right oblique fissure was located posteriorly at the fifth rib (50%), laterally at the sixth rib (50%), and inferiorly in the anterior third of the hemidiaphragm (71%). The horizontal fissure most commonly originated in the middle third of the oblique fissure (61%) and met the anterior thoracic wall at the level of the fourth rib (51%). The most frequent shape of the left oblique fissure was linear (78%), whereas S-shaped and linear configurations (28% each) were most frequent on the right. No difference was found in the surface markings of the fissures between inspiration and expiration in 90% of cases. The considerable individual variation in the position and shape of the interlobar fissures helps to explain the variable descriptions of their surface anatomy in the

  17. Clinical efficacy of combined therapy for perianal eczema caused by anal diseases in 160 cases

    Directory of Open Access Journals (Sweden)

    Zhi-Chao LIU

    2007-01-01

    Full Text Available Perianal eczema is a kind of inflammatory dermatosis on the perianal skin and mucosa. The aim of the study was to evaluate the clinical efficacy of the combined therapy of medicine and operation for the perianal eczema caused by the anal diseases such as hemorrhoids, fissures and fistulas. One hundred and sixty patients with perianal eczema were involved in this study. They were randomly divided into four groups and treated by different therapies for four weeks respectively. Group A (40 patients was only treated with medicine, Group B (40 patients only with operation, Group C (40 patients firstly with medicine and then with operation and Group D (40 patients firstly with operation and then with medicine. The efficacy was determined as reduction of lesion size relative to initial size. The cure rate was 22.50%, 32.50%, 57.50% and 45.00% in Group A, B, C and D, respectively. The effective rate was 40.00%, 52.50%, 85.00% and 75.00%, respectively. The efficacy was significantly different (H=20.8689, g = 3, P value =0.0001. The results of group comparison showed that there were significant difference between Group C and Group A, Group C and Group B, Group D and Group A (all P values, < 0.05. It was concluded that the combined therapy of medicine and operation is optimal choice for the perianal eczema caused by the anal diseases such as hemorrhoids, fissures, and fistula. It highly improves the cure rate and efficacy rate.

  18. New techniques for treating an anal fistula.

    Science.gov (United States)

    Song, Kee Ho

    2012-02-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is expected to provide a collagen scaffold to promote tissue in growth and fistula healing. Another addition to the sphincter-preserving options is the ligation of intersphincteric fistula tract procedure. This technique is based on the concept of secure closure of the internal opening and concomitant removal of infected cryptoglandular tissue in the intersphincteric plane. Recently, cell therapy for an anal fistula has been described. Adipose-derived stem cells have two biologic properties, namely, ability to suppress inflammation and differentiation potential. These properties are useful for the regeneration or the repair of damaged tissues. This article discusses the rationales for, the estimated efficacies of, and the limitations of new sphincter-preserving techniques for the treatment of anal fistulae.

  19. Anal cancer and intraepithelial neoplasia screening: Areview

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. Anumber of risk-stratification strategies as well as screeningtechniques have been suggested, and currently littleconsensus exists among national societies. Much ofthe current clinical rationale for the prevention of analcancer derives from the similar tumor biology of cervicalcancer and the successful use of routine screening toidentify cervical cancer and its precursors early in thedisease process. It is thought that such a strategy ofidentifying early anal intraepithelial neoplasia will reducethe incidence of invasive anal cancer. The low prevalenceof anal cancer in the general population prevents theuse of routine screening. However, routine screeningof selected populations has been shown to be a morepromising strategy. Potential screening modalities includedigital anorectal exam, anal Papanicolaou testing, humanpapilloma virus co-testing, and high-resolution anoscopy.Additional research associating high-grade dysplasiatreatment with anal cancer prevention as well as directcomparisons of screening regimens is necessary todevelop further anal cancer screening recommendations.

  20. Experimental investigation and numerical simulation on the effect of fissure water pressure in vertical sliding surface

    Institute of Scientific and Technical Information of China (English)

    ZHANG; Lei; LI; Shihai; LIAN; Zhenzhong; WANG; Yuannian

    2005-01-01

    This paper studies the effect of fissure water pressure in different fractures on the critical angle of landslide by laboratory investigation and numerical simulation in order to understand the mechanisms of fissure water pressure on landslide stability. Laboratory observations show that the effect of fissure water pressure on the critical angle of landslide is little when the distance between water-holding fracture and slope toe is three times greater than the depth of fissure water. These experimental results are also simulated by a three-dimensional face-to-face contact discrete element method. This method has included the fissure water pressure and can accurately calculate the critical angle of jointed slope when fissure water pressure in vertical sliding surface exists.Numerical results are in good agreement with experimental observations. It is revealed that the location of water-holding structural surface is important to landslide stability. The ratio of the distance between water-holding fissure and slope toe to the depth of fissure water is a key parameter to justify the effect of fissure water pressure on the critical angle of landslide.

  1. The 1981 eruptive fissure on Mt. Etna: considerations on its exploration and genesis

    Directory of Open Access Journals (Sweden)

    Angelo Leotta

    1998-01-01

    Full Text Available This paper is targeted to an analysis of features common to various fissure caves on Mt. Etna, Sicily. The Authors report the preliminary results of the exploration carried out in the 1981 eruptive fissure, the technical problems met during the exploration, the flow trends and the different courses of the molten material inside the fissure, the particular morphologies. A genetic model is proposed, different from those characterising the lava tube cave genesis, and links are suggested between the various fissures and the main tectonic stress systems operating on Mt. Etna, as well as the morpho-structural conditions of the volcanic edifice of Mt. Etna.

  2. The fissural complex of the lung: anatomy and variations on thin-section CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Kim, Pyo Nyun; Kim, Il Young; Bae, Won Kyung; Lee, Byoung Ho [College of Medicine, Soonchunhyang University, Cheonan (Korea, Republic of)

    1994-03-15

    To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. This section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consecutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CT scans were analyzed. Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level, the minor and major fissure intersected each other in only 27 subjects (54%). The highest point of intersection was variable. There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CT scans.

  3. Anal erogeneity: the goose and the rat.

    Science.gov (United States)

    Shengold, L

    1982-01-01

    A case is presented in which the patient's traumatically derived intense anal erogeneity (associated with traumatic anxiety as well as with castration anxiety) inhibited his phallic sensations and potency and also his power to sustain productive thought. His passive cravings were disguised and reacted against in his compulsive-exhibitionistically phallic role of a Don Juan. He described at least two levels of anal feelings: a dangerous but exciting, tolerable or even pleasurable tension associated with the imago of the goose; and an unbearable, terrifying overcharged level embodied in the imago of the rat. (He had read of, and had felt himself identified with, Freud's Rat Man.) Contrasts are presented with François Rabelais' account of the instinctual development and anal training of Gargantua, in which the connotations of the goose lead to a happy anal, phallic and intellectual control. Generalizations are ventured about the crucial attainment of command over the anal sphincter for the taming of 'primal affect'(Fliess). With early psychopathology there is a defensive overcathexis of anal control (and of anal mechanisms and character traits) to try to contain over-stimulation. In contrast true anal mastery contributes to the acquisition of optimal genital feelings and functioning and to the capacity for sustaining integrative thinking so necessary for 'owning' one's affects and impulses, and therefore for a feeling of identity. Finally, some remarks of Freud on Rabelais are reviewed in relation to levels of urethral erogeneity, seen as developmental way stations between the anal and the phallic, and partaking of both.

  4. Tratamento dos datos analíticos

    OpenAIRE

    Yebra Biurrun, María del Carmen

    2008-01-01

    Esta unidade didáctica é a primeira toma de contacto do alumnado co estudo do tratamento dos datos analíticos e a comprobación da súa calidade. Este estudo poderase completar máis adiante dentro do programa desta materia cando se presente o resto dos parámetros de calidade dos métodos analíticos. A importancia deste tema radica en que unha vez obtidos os datos analíticos, o primeiro aspecto que se ten que considerar é a verificación da calidade dos mesmos en termos de exactitude e precisió...

  5. A Comparison of Different Methods for Fissure Caries Detection

    Directory of Open Access Journals (Sweden)

    Peycheva K.

    2016-03-01

    Full Text Available The aim of the study is to compare the diagnostic capabilities of three different diagnostic methods: Quantitative Laser Fluorescence (QLF − DIAGNOdent Classic (DD, Light-Induced Fluorescence (LIF − SoproLife daylight and blue fluorescence, and their relevance to ICDAS II system in detection of fissure caries lesions in permanent molars. Permanent molars (n = 45 are divided in two groups: 1 third molars, n = 35; 2 first and second molars, n = 10. They are examined by 2 examiners with and without magnification x5 using ICDAS II, SoproLife “day light” and “blue light” (405nm, LIF, DIAGNOdent Classic − emitting laser light on 655nm, QLF. The results are proven with histological bucco-lingual or mesio-distal sections through the body of the lesion with diamond blade rinsed with water. Photos of all occlusal surfaces of the molars are taken before and after the sections. The lowest overdiagnosis rate is found with SoproLife camera. When visual examination is applied overdiagnoses are fewer than with DD. DD is not capable to differentiate white and brown spots from a caries lesion. Soprolife is not capable to differentiate brown spots from a caries lesion. The most accurate method in this in vitro study for diagnosis of fissure caries is LIF (SoproLife − 75.6% of the teeth are correctly diagnosed, followed by ICDAS (57.8% and QLF (DIAGNOdent (40%.

  6. Anal Cancer: What Happens After Treatment?

    Science.gov (United States)

    ... see the section Understanding Recurrence . For patients with colostomies Most people treated for anal cancer don’t ... APR, you will need to have a permanent colostomy. If you have a colostomy, follow-up is ...

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

    Directory of Open Access Journals (Sweden)

    Shahram Paydar

    2015-01-01

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

  8. VAAFT - Videoassisted anal fistula treatment: a new approach for anal fistula

    OpenAIRE

    Mendes,Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; Sapucaia,Ricardo Aguiar; LIMA, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    INTRODUCTION: Anal fistula is an epithelised path between the rectum or anal canal and the perianal region. The use of laparoscopic surgery with a minimally invasive procedure has led to the development of video-assisted surgical treatment of anal fistula.OBJECTIVE: To describe the surgical technique VAAFT as a new approach to fistula.CONCLUSION: This is a safe and reproducible procedure. It enables the study of the entire fistula, obtaining the identification of accessory paths, cavitations ...

  9. 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 adolescent...

  10. Fissure eruptions at Mount Vesuvius (Italy): Insights on the shallow propagation of dikes at volcanoes

    Science.gov (United States)

    Acocella, Valerio; Porreca, Massimiliano; Neri, Marco; Mattei, Massimo; Funiciello, Renato

    2006-08-01

    Fissure eruptions may provide important information on the shallow propagation of dikes at volcanoes. Somma-Vesuvius (Italy) consists of the active Vesuvius cone, bordered to the north by the remnants of the older Somma edifice. Historical chronicles are considered to define the development of the 37 fissure eruptions between A.D. 1631 and 1944. The 1631 fissure, which reopened the magmatic conduit, migrated upward and was the only one triggered by the subvertical propagation of a dike. The other 25 fissure eruptions migrated downward, when the conduit was open, through the lateral propagation of radial dikes. We suggest two scenarios for the development of the fissures. When the summit conduit is closed, the fissures are fed by vertically propagating dikes. When the summit conduit is open, the fissures are fed by laterally propagating dikes along the volcano slopes. Consistent behaviors are found at other composite volcanoes, suggesting a general application to our model, independent of the tectonic setting and composition of magma. At Vesuvius, the historical data set and our scenarios are used to predict the consequences of the emplacement of fissures after the opening of the conduit. The results suggest that, even though the probability of opening of vents within the inhabited south and west slopes is negligible, the possibility that these are reached by a lava flow remains significant.

  11. 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.

  12. 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.

  13. 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 μm2 and Estelite Flow Quick High Flow exhibited 3206 ± 2445.1 μm2of 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. PMID:27651887

  14. Pleistocene microvertebrates from fissure-fillings in Thailand

    Science.gov (United States)

    Chaimanee, Yaowalak; Jaeger, Jean-Jacques; Suteethorn, Varavudh

    Microvertebrates (and among them specially, rodents) have contributed to the elaboration of precise biochronological time scales and to the reconstitution of Pleistocene paleoenvironments in several parts of the world (North America, Africa, Europe and Japan). They have been demonstrated to be highly sensitive to climatic changes since they are very sensitive to vegetation changes. Up to now, no data is available for Southeast Asia and very few information is available concerning the nature of climatic changes which affected that part of the tropical world during the Pleistocene. In the past few years, we have discovered several fissure fillings in Thailand yielding numerous remains of microvertebrates which have been extracted by dissolution in acetic acid solution. These deposits are the result of the feeding activity of predators, like owls or diurnal raptors, whose pellets are accumulated in caves or fissures. Eleven localities, located in Central (2), Eastern (1), Western (2) and Peninsular Thailand (6) have been investigated so far. Several rodent species, belonging to 9 genera of Murinae (rats and mice) and 9 genera of Sciuridae (squirrels) have been identified in these localities. The most important differences with the extant representatives often concern the size of the teeth of these fossil species. The meaning of these size differences is not yet clearly understood since they can be attributed either to significant time differences between localities (microevolution) or as the result of size variations related to climatic changes (clinical variations). More data will have to be collected to calibrate the temporal frame. Already, important modification of the geographic distribution of some species have been discovered which testify that during the Pleistocene, significative climatic changes have affected Southeast Asia. For example, Exilisciurus, a squirrel which is presently restricted to Borneo has been recognized in Peninsular Thailand. Also, Iomys

  15. 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.

  16. 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)

  17. [Colo-anal anastomosis. Our experience].

    Science.gov (United States)

    Morlino, A; Tramutola, G; Rossi, M T; Scutari, F

    2009-03-01

    The aim of study is to report the results of our experience about ultra-low rectum carcinomas treated with anterior resection and colo-anal anastomosis. The surgery still represents the treatment of choice for the cancer of the rectum. The problems concern the conservation of the sphincter functions (anal and urethral), and sexual function and the reduction of the locoregional recurrences. From 2005 to 2007, 33 patients underwent surgery for low and ultralow rectal carcinoma (30 treated with neoadjuvant radio-chemotherapy, and 3 only with surgery). In 16 of these we have performed a colo-anal anastomosis, in 11 an ultralow colorectal anastomosis and in 7 a Miles resection. We report our updated results.

  18. A conceptual model of the hydrological influence of fissures on landslide activity

    Directory of Open Access Journals (Sweden)

    D. M. Krzeminska

    2011-12-01

    Full Text Available Hydrological processes control the behaviour of many unstable slopes and their importance for landslide activity is generally accepted. In slow-moving landslides differential displacement complicates the hydrological regime due to continuous opening and closing of the fissures and cracks, creating dynamic preferential flow path systems. The consequences of the appearance and destruction of these preferential flow paths is thus closely related to the formation of critical pore pressure and the resulting movement and persistence of fissure systems. This interaction may account for the seasonal nature of the slow-moving landslide activity, including the often observed shifts and delays.

    This research aims to investigate this interaction between slope stability and spatial and temporal variations in fissure patterns, which makes fissures act both as preferential flow paths for infiltration and as lateral groundwater drains. To this end, the hydrological processes that control exchange of water between the fissure network and the matrix has been included in a spatially distributed hydrological and slope stability model. The ensuing feedbacks in landslide activity were explored by running the model with the meteorological forcing of one year until a dynamic steady-state was achieved. The effect of fissure dynamics was evaluated by comparing simulations with static fissure patterns to those in which these patterns deform as function of the local stability.

  19. Homogenization of geological fissured systems with curved non-periodic cracks

    Directory of Open Access Journals (Sweden)

    Fernando A. Morales

    2014-09-01

    Full Text Available We analyze the steady fluid flow in a porous medium containing a network of thin fissures of width $\\mathcal{O}(\\epsilon$, generated by the rigid translation of continuous piecewise $C^{1}$ functions in a fixed direction. The phenomenon is modeled in mixed variational formulation, using the stationary Darcy's law and coefficients of low resistance $\\mathcal{O}(\\epsilon$ on the network. The singularities are removed by asymptotic analysis as $\\epsilon \\to 0$ which yields an analogous system hosting only tangential flow in the fissures. Finally the fissures are collapsed into two dimensional manifolds.

  20. The Problem of Occlusal Surface Pit and Fissure Dental Caries in Naval Recruits.

    Science.gov (United States)

    1980-06-01

    been little attention devoted to oclusal surface pit and fissure dental caries. There is so= evidence that tooth morphology is related to susceptibility...AD-A0CM 755 NAVAL DENTAL RESEARCH INST GREAT LAKES IL F/S 6/5 THE PROBLEM OF OCCLUSAL SURFACE PIT AND FISSURE DENTAL CARIES I--ETC(U) JUN 80 M R...THE PROBLEM OF OCCLUSAL SURFACE PIT AND FISSURE DENTAL CARIES IN NAVAL RECRUITS M. R. WIRTHLIN 1. L. SHKLAIR R. G. WALTER J. C. CECIL 0 M. E. COHEN

  1. Cassini VIMS Spectra of the Thermal Emission from Hot Spots Along Enceladus South Pole Fissures

    Science.gov (United States)

    Goguen, Jay D.; Buratti, Bonnie J.; Cassini VIMS Team

    2016-10-01

    Most of the south pole fissure region has not been directly illuminated by sunlight since the sub-solar point moved into the northern hemisphere in 2009, thereby eliminating the background of reflected sunlight at VIMS wavelengths and making the fissure thermal emission readily measureable. Since then, VIMS has measured spectra of at least 11 hot spots along the fissures. Most of these measurements were acquired in ride-along mode with CIRS as the prime instrument. During at least 2 encounters, VIMS and CIRS acquired simultaneous or near-simultaneous spectra of the same fissure location. VIMS spectra include multiple hot spots along Damascus, Baghdad, Cairo, and a likely hot spot on Alexandria.All of the VIMS spectra examined to date are consistent with this scenario of a self-regulating fissure maximum T~200 K with brighter VIMS emissions corresponding to fissures up to ~20 m wide. Emission from the warm fissure interior walls dominate the VIMS spectra with <15% contributed by conductive heating of the adjacent terrain at VIMS wavelengths.CIRS spectra report slightly cooler T's due to CIRS increased sensitivity to lower T emission at longer wavelengths and averaging over contributions from both the hottest and cooler areas. Combined analysis of the CIRS and VIMS spectra spanning 3 to 500 micron wavelengths promises to reveal the distribution of [T, area] near the fissures that cannot be spatially resolved. This [T, area] distribution holds the key to understanding how heat is transferred to the surface within a few 100 m of the fissures.The VIMS-detected emission is concentrated in localized hot spots along the fissures and does not seem to be distributed continuously along them. CIRS spectra suggest a more continuous distribution of the emission along the fissure length. Jets locations also are distributed along the fissure length and it appears that the VIMS-detected hot spots in general correlate with jet locations, but not all of the jet locations have been

  2. Application of Seismic Anisotropy Caused by Fissures in Coal Seams to the Detection of Coal-bed Methane Reservoirs

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Coal-bed methane is accumulated in micro-fissures and cracks in coal seams. The coal seam is the source terrace and reservoir bed of the coal-bed methane (Qian et al., 1996). Anisotropy of coal seams is caused by the existence of fissures. Based on the theory of S wave splitting: an S wave will be divided into two S waves with nearly orthogonal polarization directions when passing through anisotropic media, i.e. the fast S wave with its direction of propagation parallel to that of the fissure and slow S wave with the direction of propagation perpendicular to that of the fissure.This paper gives the results of laboratory research and field test on the S wave splitting caused by coal-seam fissures. The results show that it is feasible to detect fissures in coal seams by applying the converted S wave and finally gives the development zone and development direction of these fissures.

  3. Anal adenocarcinoma complicating chronic Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Ioannis Papaconstantinou

    2015-01-01

    Conclusion: Albeit a rare complication, clinicians should maintain a high degree of vigilance about the possible development of adenocarcinoma in patients with long-standing perianal Crohn’s disease. Thus, these patients should be kept under regular surveillance with examination under anaesthesia and biopsies or curettage of the tracts.

  4. 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...... and January 2010. KRAS mutations were detected using Therascreen(®)KRAS real-time PCR assay (Qiagen) and V600E or V600D/K BRAF mutations were uncovered using Pyrosequencing. The frequency of KRAS and BRAF mutations was low; KRAS mutations were detected in 1.6% and BRAF mutations in 4.7% of the biopsies....... No impact of KRAS or BRAF status on survival was found. In conclusion, both KRAS and BRAF mutations are rare in anal cancer. The low frequency of KRAS mutations support protocols exploring EGFR-targeted therapy in patients with metastatic anal cancer, while treatment with BRAF inhibitors might be relevant...

  5. [Diagnostics and conservative treatment of anal incontinence].

    Science.gov (United States)

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

    Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

  6. Do We Know What Causes Anal Cancer?

    Science.gov (United States)

    ... cells are more likely to become cancerous. Lowered immunity When the body is less able to fight off infections, viruses like HPV can become more active, which might trigger the development of anal cancer. HIV, the virus that causes AIDS, weakens the ...

  7. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be ...

  8. 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

  9. Mechanical benefits of conservative restoration for dental fissure caries.

    Science.gov (United States)

    Zhang, Zhongpu; Zheng, Keke; Li, Eric; Li, Wei; Li, Qing; Swain, Michael V

    2016-01-01

    The principle of minimal intervention dentistry (MID) is to limit removal of carious tooth tissue while maximizing its repair and survival potential. The objective of this study is to explore the fracture resistance of a permanent molar tooth with a fissure carious lesion along with three clinical restoration procedures, namely one traditional and two conservative approaches, based upon MID. The traditional restoration employs extensive surgical removal of enamel and dentine about the cavity to eliminate potential risk of further caries development, while conservative method #1 removes significantly less enamel and infected dentine, and conservative method #2 only restores the overhanging enamel above the cavity and leaves the infected and affected dentine as it was. An extended finite element method (XFEM) is adopted here to analyze the fracture behaviors of both two-dimensional (2D) and three-dimensional (3D) modeling of these four different scenarios. It was found that the two conservative methods exhibited better fracture resistance than the traditional restorative method. Although conservative method #2 has less fracture resistance than method #1, it had significantly superior fracture resistance compared to other restorations. More important, after cavity sealing it may potentially enhance the opportunity for remineralization and improved loading bearing capacity and fracture resistance.

  10. 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.

  11. 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......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 fissured structure of the clay. This article presents oedometer tests performed on Søvind Marl, a plastic Eocene clay, with a high presence of fissures and slickensides. Four incremental loading oedometer tests and four continuous loading oedometer tests were performed in order to determine...

  12. Relationship of Resistivity with Water Content and Fissures of Unsaturated Expansive Soils

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The development of fissures in expansive soils has a great effect on the stability of slope.Of the three phases of soils, the gas phase and solid phase are relatively insulated, so the average resistivity of soils can be calculated from the resistivity of the liquid phase.On this basis, the two-part model of resistivity changing with the water saturation of the expansive soil can be deduced.A 2-D resistance grid model is established based on simulating the resistance of vertically developed fissures.Variation in measured resistance of vertically developed fissures at different positions can be calculated from this model.Fissure development can be inversely determined from the variation in the measured resistance.Finally, the model is verified by an indoor resistivity test for remolded soil samples, indicating that the test result agrees well with that of the model established.

  13. Introducing the operation method for curing anal fistula by laser

    Science.gov (United States)

    Ji, Bingzhi

    1993-03-01

    The key to the treatment of anal fistula lies in scavenging the infected anal gland thoroughly, which is the source of anal fistula infection. The fistula tract at the internal orifice of the anal fistula is cut 1 cm using laser with the infectious source completely degenerated and the wound gassified and scanned. The residual distal fistula softens and disappears upon the action of organic fibrinolysin.

  14. Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques

    OpenAIRE

    Chu, C. H.; Lo, E. C. M.; You, D. S. H.

    2010-01-01

    We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device (DIAGNOdent). A total of 144 and second molars with macroscopically intact occlusal surfaces in 41 Chinese young adults were examined visually, by bitewing radiography, and by DIAGNOdent. Visual examination after pit and fissure opening was used as the reference standard. The sensitivity and specificity of detecting caries that had ex...

  15. Effect of LED curing on the marginal leakage of a pit and fissure sealant

    OpenAIRE

    Pineda Mejia, Martha Elena; Magister en Estomatología. Profesor Principal. UNMSM. Dpto. Estomatología Rehabilitadora. Facultad Odontología. UNMSM.; Gloria Zevallos, Waldo; Dpto. Estomatología Rehabilitadora. Facultad Odontología. UNMSM.; Abuhadba Hoyos, Tulio; Dpto. Estomatología Rehabilitadora. Facultad Odontología. UNMSM.

    2014-01-01

    The purpose of this study was to evaluate in vitro the curing effect of a light-emitting diode LED unit and conventional halogen light on the marginal leakage of a pit and fissure sealant. We used 40 caries-free permanent premolars recently extracted, which were randomly divided into two groups (n = 20), sealed with a resin based fissure sealant, Helioseal F (Ivoclar Vivadent), according to the manufacturer patterns, then photopolymerized using either L.E.D. light or conventional halogen ligh...

  16. 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.

  17. In vitro Microleakage Comparison of Two Fissure Sealants and two Flowable Composite Resins

    Directory of Open Access Journals (Sweden)

    Ahmadi M.

    2012-02-01

    Full Text Available Statement of Problem: Nowadays, fissure sealants are commonly used for sealing the occlusal pit and fissures. However, flowable composites which are more resistance to wear and have a lower amount of shrinkage might be a good substitute for sealants.Purpose: The aim of this study was to compare the amount of micro-leakage between two types of fissure sealants, clinpro and embrace, and two kinds of flowable composites, Filtek flow and Flows-Rite.Materials and Method: 60 intact extracted maxillary permolars were selected and divided into 4 groups. In each group, occlusal fissures of the samples were sealed with fissures sealants (clinpro or Embrace or flowable composites (Filtek flow or Flows-Rite. The apex and furcation of all the teeth were sealed by sealing wax and then the root and crown of the samples were covered by two layers of nail varnish to 1 mm next to the sealant margin. The teeth were immersed in 0.5% fuchsine for 24 hours; then, the teeth were washed and cut off parallel to the linear axis. The microleakage of the samples was studied under the stereomicroscope with a magnification of 16x. Finally, data were analyzed using the Kruskal-Wallis test.Results: There was no significant difference between the amount of microleakage of fissure sealants (clinpro and embrace and flowable composites (filtek flow and Flows-Rite. Conclusion: Under the circumstances of this study and with respect to the clinical situation, it seems that both flowable composite and fissure sealants are suitable materials for pit and fissure sealing.

  18. Anal human papillomavirus DNA in women at a colposcopy clinic.

    NARCIS (Netherlands)

    Hauwers, K.W.M. d'

    2012-01-01

    OBJECTIVES: To describe the type-specific prevalence of anal and cervical human papillomavirus (HPV) infections and the cytology in HIV-negative women without a history of cervical cancer, attending a colposcopy clinic. To examine if an HPV positive anal smear is related to anal pathology and conseq

  19. Update on Anal Fistulae: Surgical Perspectives for the Gastroenterologist

    Directory of Open Access Journals (Sweden)

    Helena Tabry

    2011-01-01

    Full Text Available Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.

  20. Anal fistulas : New perspectives on treatment and pathogenesis

    NARCIS (Netherlands)

    R.S. van Onkelen (Robbert)

    2015-01-01

    markdownabstractAbstract The objective of modern anal fistula treatment is healing of the fistula without diminished fecal continence. Sphincter saving techniques have been developed for anal fistulas, for which fistulotomy is not suitable. Treatment of these anal fistulas remains challenging and

  1. Conversion degree, microhardness, microleakage and fluoride release of different fissure sealants.

    Science.gov (United States)

    Kuşgöz, Adem; Tüzüner, Tamer; Ulker, Mustafa; Kemer, Bariş; Saray, Onur

    2010-11-01

    The purpose of this study was to determine the degree of conversion (DC), microhardness, microleakage and fluoride release of a nano-filled resin based fissure sealant (Grandio Seal, GS) and compare it with an un-filled resin based fissure sealant (Clinpro, CL) and a glass-ionomer based fissure sealant (Fuji Triage, FT). Disk shaped specimens were prepared from tested fissure sealants to determine the DC, Vicker hardness (VHN) and fluoride release (FR). The DC and VHN of each material was evaluated after 24 h. The cumulative fluoride concentrations were evaluated at 1 h, 6 h, 12 h, 1, 7, 15 and 30 days. For microleakage evaluation, fissure sealants were applied to the etched and dried enamel surfaces of sound third molar teeth according to the manufacturer's instructions (n=10). After the thermocycling and mechanical loading procedures, microleakage assessments were carried out. Data were analyzed using one-way ANOVA followed by a post hoc Tukey test, the Kruskal Wallis and Mann-Whitney U test (p GS (55.02%) > CL (%51.10) (p FT > CL (p<0.05). FT exhibited significantly higher microleakage scores compared to the CL and GS sealants (p<0.05). The FR of FT was significantly greater than CL and GS (p<0.05). Nano-filled resin based sealant can be used as an alternative to other fissure sealant materials because of its superior hardness results and feasible sealing ability.

  2. The use of holmium-yttrium aluminum garnet laser as pit and fissure cleaner

    Directory of Open Access Journals (Sweden)

    Armasastra Bahar

    2009-09-01

    Full Text Available Background: The prevention and management of pit and fissure caries has become relatively more important in recent times. There is a need for an effective preventive measure against pit and fissure caries. Purpose: The purpose of this study was to investigate the effect of laser beam as a cleaning method of pits and fissures. Methods: Ho-YAG laser which has a wavelength of 2.1 µm was used in this experiment. The specimens were extracted human teeth. The effect of three cleaning methods was examined comparatively by scoring the cleaned area of fissure, namely laser irradiation with Ho-YAG laser, chemico-mechanical with combination of 10% NaOCl and ultrasonic scaler and mechanical with ultrasonic scaler. Vertico-bucco-lingual serial ground sections of each tooth were observed under light microscopy. Scoring the depth of cleaned area was performed by comparing the depth of fissure. result: Progressive result was obtained on the cleaning effect of three methods laser irradiation methods which was the most effective compared to other methods but statistically was not significant. Cleaned area of laser irradiation method was 48.91%, chemico-mechanical method was 41.77% and mechanical method was 36.78%. Conclusion: Holmium -yttrium aluminum garner laser is a relatively new method for pit and fissure cleaning even though the effectivity is not yet maximal. More research is needed to maximize the use of this laser.

  3. A study on using texture analysis methods for identifying lobar fissure regions in isotropic CT images.

    Science.gov (United States)

    Wei, Q; Hu, Y

    2009-01-01

    The major hurdle for segmenting lung lobes in computed tomographic (CT) images is to identify fissure regions, which encase lobar fissures. Accurate identification of these regions is difficult due to the variable shape and appearance of the fissures, along with the low contrast and high noise associated with CT images. This paper studies the effectiveness of two texture analysis methods - the gray level co-occurrence matrix (GLCM) and the gray level run length matrix (GLRLM) - in identifying fissure regions from isotropic CT image stacks. To classify GLCM and GLRLM texture features, we applied a feed-forward back-propagation neural network and achieved the best classification accuracy utilizing 16 quantized levels for computing the GLCM and GLRLM texture features and 64 neurons in the input/hidden layers of the neural network. Tested on isotropic CT image stacks of 24 patients with the pathologic lungs, we obtained accuracies of 86% and 87% for identifying fissure regions using the GLCM and GLRLM methods, respectively. These accuracies compare favorably with surgeons/radiologists' accuracy of 80% for identifying fissure regions in clinical settings. This shows promising potential for segmenting lung lobes using the GLCM and GLRLM methods.

  4. 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.

  5. Effect of Saliva Contamination on Microleakage of a Fissure Selant with or without Bonding Agent

    Directory of Open Access Journals (Sweden)

    A Abarghooyi

    2012-10-01

    Full Text Available Introduction: Contamination of etched enamel to saliva before placement of sealant prevents the appropriate bonding and results in microleakage. Using bondings is effective for decreasing the microleakage. This experimental study aimed to evaluate the effect of bonding agent on microleakage of a fissure sealant before or after contamination to saliva. Methods: In this experimental study 40 sound premolar teeth were randomly divided into four groups. The prophylaxis was done and the teeth were etched with 37% phosphoric acid gel, then they were washed and dried. In the first group, Seal-Rite fissure sealant and Dentastic (Pulpdent, USA without saliva contamination, and in the second group sealant with bonding agent after saliva contamination for 10s, were applied and cured for 40s. In the third group, fissure sealant without bonding agent or saliva contamination, and in the fourth group fissure sealant without bonding application was applied after contamination with saliva and then was cured. After thermocycling, the teeth were placed in 50% silver nitrate for 2 hours. The buccolingual sections were applied and microleakage evaluation was made by stereomicroscope at 4X magnifications and results were evaluated with mann-whiteny test. Results: The fissure sealant group without bonding agent showed the most microleakage after contamination to saliva and use of sealant with bonding agent significantly showed decrease of microleakage. Conclusion: Use of bonding agent under fissure sealant in saliva-contamination status is beneficial for decreasing microleakage.

  6. Risk Factors for Anal HPV Infection and Anal Precancer in HIV-Infected Men Who Have Sex With Men

    OpenAIRE

    Schwartz, Lauren M.; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; Fetterman, Barbara; Tokugawa, Diane; Lorey, Thomas S.; Sahasrabuddhe, Vikrant V.; Luhn, Patricia; Gage, Julia C; Darragh, Teresa M.; Wentzensen, Nicolas

    2013-01-01

    Background. Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM.

  7. Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Primiparous women have an increased risk of obstetric anal sphincter injury; because most of these patients deliver again, there are major concerns about mode of delivery: the risk of recurrent obstetric anal sphincter injury and the risk of long-term symptoms of anal incontinence...

  8. Case report of an anal adenocarcinoma arising from a perineal lump

    Directory of Open Access Journals (Sweden)

    Dedrick Kok-Hong Chan

    2016-03-01

    Full Text Available Anal adenocarcinoma is a rare condition and can arise in chronic inflammatory states such as in Crohn's disease, or in a chronic fistula-in-ano. We report our diagnosis and management of a patient who presented with a large perineal lump with a long-standing history of perianal fistulous disease. This was initially evaluated with a Magnetic Resonance Imaging, and the diagnosis was confirmed with biopsy. Multimodality treatment with chemoradiotherapy and surgery should be offered to achieve the best outcomes.

  9. [Pay attention to the imaging diagnosis of complex anal fistula].

    Science.gov (United States)

    Zhou, Zhiyang

    2015-12-01

    The diagnosis and treatment of complex anal fistula has been a significant challenge. Unwise incision and excessive exploration will lead to the secondary branch, sinus and perforation. A simple fistula may become a surgical problem and result in disastrous consequences. Preoperative accurate diagnosis of anal fistula, including in the internal opening, primary track and location of the fistula, extensions and abscess, is important for anal fistula treatment. In the diagnosis of anal fistula, imaging examination, especially MRI plays a crucial role. Localization and demarcation of anal fistula and the relationship with sphincter are important. MRI has been an indispensable confirmatory imaging examination.

  10. Controversies in the management of anal high-grade squamous intraepithelial lesions.

    Science.gov (United States)

    Pineda, C E; Welton, M L

    2008-10-01

    Anal squamous dysplasia is recognized as a spectrum of disease that ranges from low-grade intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) to invasive anal squamous cell carcinoma (SCC). Recent reports have shown a significant increase in both the incidence and prevalence of both HSIL and anal SCC, particularly in immunocompromised patients and in men who have sex with men. These lesions are associated with chronic infection with the human papillomavirus. The natural history is unknown, yet reports of untreated patients have shown progression rates of up to 50% in high risk patients. There are controversies as to the optimal management of patients with HSIL. However, there is evidence that screening of high-risk patients with anal cytology is useful in identifying those that require further evaluation. Examination of the anorectal region is enhanced with the use of high resolution anoscopy. Treatment modalities vary in terms of morbidity and success rates. Wide local excision is associated with significant morbidity. Newer therapies such as topical immunomodulation, photodynamic therapy and therapeutic vaccines have been proposed, but long-term follow-up is unavailable. High resolution anoscopy can be used in the office or in the operating room to direct therapy. Using a comprehensive approach of cytology and office-based and/or operating room procedures directed with high resolution anoscopy results in clearance of HSIL in up to 80% of patients, malignant progression in 1%, and less morbidity than wide local excision.

  11. Treatment of anal fistula and abscess.

    Science.gov (United States)

    Pigot, F

    2015-04-01

    The glands of Hermann and Desfosses, located in the thickness of the anal canal, drain into the canal at the dentate line. Infection of these anal glands is responsible for the formation of abscesses and/or fistulas. When this presents as an abscess, emergency drainage of the infected cavity is required. At the stage of fistula, treatment has two sometimes conflicting objectives: effective drainage and preservation of continence. These two opposing constraints explain the existence of two therapeutic concepts. On one hand the laying-open of the fistulous tract (fistulotomy) in one or several operative sessions remains the treatment of choice because of its high cure rates. On the other hand surgical closure with tract ligation or obturation with biological components preserves sphincter function but suffers from a higher failure rate.

  12. 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

  13. [Combined radio- and chemotherapy of anal cancer].

    Science.gov (United States)

    Dobrowsky, W

    1986-05-30

    The treatment regime in anal carcinoma is changing from being a mainly surgical problem. Combined radio-chemotherapy is of increasing interest as treatment of choice. The new treatment modality, including chemotherapy with Mitomycin C and 5-fluorouracil combined with percutaneous and interstitial radiotherapy is presented. The treatment regimes performed at the University Department for Radiotherapy and Radiobiology Vienna is discussed with regard to tolerance, side effects and local control.

  14. 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.

  15. In vitro evaluation of shear bond strength and microleakage of different pit and fissure sealants

    Science.gov (United States)

    Babaji, Prashant; Vaid, Shivali; Deep, S.; Mishra, Samvit; Srivastava, Madhulika; Manjooran, Thomas

    2016-01-01

    Aim and Objectives: Fissure caries is most common in children due to deep pit and fissures. Pit and fissure areas on the occlusal surface of the teeth make them susceptible to dental caries, which need to be prevented or restored. Fissures sealant reduces the risk of occlusal caries. The present study was done to evaluate microleakage and shear bond strength of various fissure sealants. Materials and Methods: Thirty-six extracted molars were randomly allocated equally (n = 12) into three groups with three different sealants to evaluate shear bond strength and microleakage at sealant space. The shear bond strengths was evaluated with one-way analysis of variance and microleakage by Kruskal-Wallis nonparametric test using the Statistical Package for the Social Sciences version 18.0 (Chicago: SPSS Inc, 2009). Results: Tetric flow (16.8 MPa) recorded the highest shear bond strength and the difference was statistically significant with enamel loc (12.8 MPa). There was no statistically significant difference in relation to microleakage (P > 0.05) in the tested groups. Conclusions: Tetric flow recorded the highest shear bond strength and the difference was statistically significant with enamel loc. However, there was no statistically significant difference among the groups regarding microleakage. PMID:27652241

  16. 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.

  17. Cáncer anal en la era del VIH: papel de la citología anal Anal cancer in the HIV era

    Directory of Open Access Journals (Sweden)

    Juan Carlos Cataño Correa

    2004-09-01

    Full Text Available El cáncer anal solía ser una neoplasia infrecuente que afectaba principalmente a mujeres y personas mayores de 65 años, pero recientemente su incidencia ha venido en aumento debido a la pandemia de VIH, fenómeno que tiende a empeorar porque la terapia antirretroviral altamente activa (HAART, por su sigla en inglés no solo alarga la vida de los pacientes, sino que al mismo tiempo hace posible una prolongada evolución de las lesiones precancerosas que conducen a cáncer anal; además, está plenamente demostrado que la HAART no evita la evolución de las lesiones intraepiteliales escamosas hacia cáncer anal. La citología anal ha demostrado ser una prueba de tamización poblacional útil y costoefectiva para el diagnóstico de las lesiones precancerosas producidas por Papilomavirus humano en el canal anal de hombres homosexuales y bisexuales, principalmente de aquellos positivos para VIH. Esta revisión tiene como objetivo llamar la atención sobre la creciente incidencia de cáncer anal en la población de pacientes VIH positivos, y sobre la utilidad del diagnóstico temprano utilizando la citología anal en este grupo de pacientes de riesgo. Anal cancer used to be an uncommon neoplasia that affected mainly women and people aged over 65 years, but recently its incidence has been growing, mostly due to the HIV pandemic, and it will become worse because highly active antiretroviral therapy (HAART at the same time that lengthens life expectancy in HIV positive subjects, will increase the possibility to develop anal cancer; it has already been demonstrated that HAART does not prevent the evolution of intraepithelial squamous lesions to anal cancer. Anal cytology has demonstrated to be an useful and cost-effective screening tool for detection of precancerous lesions associated with human Papillomavirus (HPV infection in the anal canal of homosexual and bisexual men, specially in those that are HIV positive. This article is an update of the

  18. Numerical simulation and damage analysis of fissure field evolution law in a single coal seam mining

    Institute of Scientific and Technical Information of China (English)

    Feng; Gao; Xingguang; Liu; Chaofeng; Ge; Hongmei; Cheng

    2012-01-01

    Based on the different deformation and failure laws of coal and rock materials under tensile or compressive loads,the damage variable was defined to divide three phases from the damage and rupture point of view in order to reveal the fissured field evolution characteristics and spatial distribution of coal and rock in the single coal seam mining with low permeability and rich methane.According to the corresponding damage constitutive equations,the secondary development of the finite element program was completed.The fissures field evolution law of a coal mine with single coal seam mining was calculated and analyzed by this new program and the distribution areas and failure degree of the surrounding coal and rock structures with damage,fissure or rupture are given on the condition of mining.This paper provides a scientific basis for quantitative research and evaluation of the safe simultaneous production of coal and gas.

  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. Etude du comportement dynamique des structures à barres comportant des fissures

    OpenAIRE

    Slimani, Mohammed

    2014-01-01

    dans ce travail, des modèles mathématiques ont été développées pour pouvoir faire l’analyse statique et aussi dynamique d’une structure fissurée. Ces modèles présentent la fissure par un ressort à raideur non linéaire existant au niveau des barres définies en éléments finis. La modélisation de la fissure est réalisée à partir de trois approches différentes qui sont celles de Nandwann et Maiti, de Kurtosis et aussi de Okamura. Pour cette étude, un programme a été développé à l’a...

  2. An experimental study on fracture mechanical behavior of rock-like materials containing two unparallel fissures under uniaxial compression

    Institute of Scientific and Technical Information of China (English)

    Yan-Hua Huang; Sheng-Qi Yang; Wen-Ling Tian; Wei Zeng; Li-Yuan Yu

    2016-01-01

    Strength and deformability characteristics of rock with pre-existing fissures are governed by cracking behavior. To further research the effects of pre-existing fis-sures on the mechanical properties and crack coalescence process, a series of uniaxial compression tests were car-ried out for rock-like material with two unparallel fissures. In the present study, cement, quartz sand, and water were used to fabricate a kind of brittle rock-like material cylindri-cal model specimen. The mechanical properties of rock-like material specimen used in this research were all in good agreement with the brittle rock materials. Two unparallel fissures (a horizontal fissure and an inclined fissure) were cre-ated by inserting steel during molding the model specimen. Then all the pre-fissured rock-like specimens were tested under uniaxial compression by a rock mechanics servo-controlled testing system. The peak strength and Young’s modulus of pre-fissured specimen all first decreased and then increased when the fissure angle increased from 0◦ to 75◦. In order to investigate the crack initiation, propagation and coalescence process, photographic monitoring was adopted to capture images during the entire deformation process. Moreover, acoustic emission (AE) monitoring technique was also used to obtain the AE evolution characteristic of pre-fissured specimen. The relationship between axial stress, AE events, and the crack coalescence process was set up:when a new crack was initiated or a crack coalescence occurred, the corresponding axial stress dropped in the axial stress–time curve and a big AE event could be observed simultaneously. Finally, the mechanism of crack propagation under micro-scopic observation was discussed. These experimental results are expected to increase the understanding of the strength fail-ure behavior and the cracking mechanism of rock containing unparallel fissures.

  3. 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...

  4. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should...... be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor...

  5. A robotic approach to mapping post-eruptive volcanic fissure conduits

    Science.gov (United States)

    Parcheta, Carolyn E.; Pavlov, Catherine A.; Wiltsie, Nicholas; Carpenter, Kalind C.; Nash, Jeremy; Parness, Aaron; Mitchell, Karl L.

    2016-06-01

    VolcanoBot was developed to map volcanic vents and their underlying conduit systems, which are rarely preserved and generally inaccessible to human exploration. It uses a PrimeSense Carmine 1.09 sensor for mapping and carries an IR temperature sensor, analog distance sensor, and an inertial measurement unit (IMU) inside a protective shell. The first field test succeeded in collecting valuable scientific data but revealed several needed improvements, including more rugged cable connections and mechanical couplers, increased ground clearance, and higher-torque motors for uphill mobility. The second field test significantly improved on all of these aspects but it traded electrical ruggedness for reduced data collection speed. Data collected by the VolcanoBots, while intermittent, yield the first insights into the cm-scale geometry of volcanic fissures at depths of up to 25 m. VolcanoBot was deployed at the 1969 Mauna Ulu fissure system on Kīlauea volcano in Hawai'i. It collected first-of-its-kind data from inside the fissure system. We hypothesized that 1) fissure sinuosity should decrease with depth, 2) irregularity should be persistent with depth, 3) any blockages in the conduit should occur at the narrowest points, and 4) the fissure should narrow with depth until it is too narrow for VolcanoBot to pass or is plugged with solidified lava. Our field campaigns did not span enough lateral or vertical area to test sinuosity. The preliminary data indicate that 1) there were many irregularities along fissures at depth, 2) blockages occurred, but not at obviously narrow locations, and 3) the conduit width remained a consistent 0.4-0.5 m for most of the upper 10 m that we analyzed.

  6. Anal intraepithelial neoplasia: A review of diagnosis and management

    Science.gov (United States)

    Roberts, Joseph R; Siekas, Lacey L; Kaz, Andrew M

    2017-01-01

    Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal mucosa that is a precursor to anal cancer. Although anal cancer is relatively uncommon, rates of this malignancy are steadily rising in the United States, and among certain high risk populations the incidence of anal cancer may exceed that of colon cancer. Risk factors for AIN and anal cancer consist of clinical factors and behaviors that are associated with the acquisition and persistence of human papilloma virus (HPV) infection. The strongest HPV-associated risk factors are HIV infection, receptive anal intercourse, and high risk sexual behavior. A history of HPV-mediated genital cancer, which suggests infection with an oncogenic HPV strain, is another risk factor for AIN/anal cancer. Because progression of AIN to anal cancer is known to occur in some individuals over several years, screening for AIN and early anal cancer, as well as treatment of advanced AIN lesions, is reasonable in certain high-risk populations. Although randomized controlled trials evaluating screening and treatment outcomes are lacking, experts support routine screening for AIN in high risk populations. Screening is performed using anal cytological exams, similar to those performed in cervical cancer screening programs, along with direct tissue evaluation and biopsy via high resolution anoscopy. AIN can be treated using topical therapies such as imiquimod, 5-flurouracil, and trichloroacetic acid, as well as ablative therapies such as electrocautery and laser therapy. Reductions in AIN and anal cancer rates have been shown in studies where high-risk populations were vaccinated against the oncogenic strains of HPV. Currently, the CDC recommends both high-risk and average-risk populations be vaccinated against HPV infection using the quadrivalent or nonavalent vaccines. It is important for clinicians to be familiar with AIN and the role of HPV vaccination, particularly in high risk populations. PMID:28255426

  7. Update on anal fistulae: Surgical perspectives for the gastroenterologist

    OpenAIRE

    Helena Tabry; Farrands, Paul A

    2011-01-01

    Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgic...

  8. Squamous cell carcinoma of the anal sacs in three dogs.

    Science.gov (United States)

    Mellett, S; Verganti, S; Murphy, S; Bowlt, K

    2015-03-01

    Anal sac squamous cell carcinoma is rare in dogs. Five cases have been previously reported, treatment of which involved surgery alone. This report describes three further cases of canine anal sac squamous cell carcinoma which underwent medical (meloxicam) management alone, resulting in survival of up to seven months. No metastases were identified. Squamous cell carcinoma, although extremely uncommon, should be considered as a possible differential diagnosis when a dog is presented for investigation of an anal sac mass.

  9. [Saccular aneurysm of the azygos vein in a patient with azygos accessory fissure].

    Science.gov (United States)

    Córdoba Rovira, S M; Guedea Martin, A; Salvador Adell, I; Elias Artiga, J

    2015-01-01

    The saccular aneurysm of the azygos vein is an extremely rare condition, which when located in the path of an accesory pulmonary fissure, becomes a diagnostic challenge because it can be mistaken for tumors arising from the accesory pleura, like solitary fibrous tumor of the pleura or mesothelioma. The diagnosis should ideally be done by non-invasive methods such as CT or MR angiographic technique in multiple phases, thus avoiding unnecessary surgical intervention. This case is exceptional because, to our knowledge, it is the first to report both concomitant clinical situations, an aneurysm of the azygos vein in the pathway of its accessory fissure.

  10. Elektromagnetická analýza

    OpenAIRE

    Kolofík, Josef

    2012-01-01

    Tato práce se zabývá problematikou elektromagnetické analýzy a aplikací elektromagnetického postranního kanálu. První a druhá část práce popisují základy kryptografie, funkci kryptografického modulu a útoky vedené postranními kanály. Třetí část práce rozebírá možnosti elektromagnetické analýzy, konstrukci sondy, popis laboratorního pracoviště, elektromagnetickou emisi PIC16F84A, algoritmus AES a přípravu na laboratorní měření. Čtvrtá část práce popisuje konkrétní laboratorní měření a extrakci...

  11. 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.

  12. Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma.

    OpenAIRE

    Frisch, M; Glimelius, B; van den Brule, A. J.; Wohlfahrt, J; Meijer, C. J.; Walboomers, J M; Adami, H. O.; Melbye, M.

    1998-01-01

    A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 populatio...

  13. 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

  14. 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 ...

  15. 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, the know......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......, the knowledge of these highly clays is very limited. The thesis consists of three parts based on five scientific papers and a monograph covering a range of different geotechnical tests and properties. The first part describes the geotechnical description and properties of Søvind Marl in order to get a general...... knowledge of the material and an idea of potential challenges. The second part deals with the preconsolidation and stiffness of Søvind Marl. This study herein evaluates the preconsolidation stresses and clarifies and discusses potential difficulties. During continuous loading oedometer tests, the earth...

  16. 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

    2012-01-01

    Aim: 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. Materials and Methods: 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). Results and Conclusions: 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. PMID:22557813

  17. Impact of extended radiant exposure time on polymerization depth of fluoride-containing fissure sealer materials.

    Science.gov (United States)

    Borges, Boniek C D; Souza-Junior, Eduardo J; Catelan, Anderson; Ambrosano, Gláucia M B; Paulillo, Luís A M S; Aguiar, Flávio H B

    2011-01-01

    Physical properties such as surface hardness of dental materials are directly linked to their clinical behavior. The aim of this study was to investigate the influence of extended curing time on the polymerization depth offluoride-containing materials used as pit and fissure sealants. Conventional and extended exposure times (20 and 60 seconds) were used to photoactivate a gold-standard pit and fissure sealant (Fluroshield, Dentsply) and a flowable composite (PermaFlo, Ultradent). Twenty square-shaped samples (n=5) were prepared using a LED device (Bluephase 16i, Ivoclar). The Knoop Hardness Number (KHN) was calculated for the top and bottom surface of each sample 24 hours after polymerization. Bottom/top hardness ratio (B/T KHN) was than calculated. Averages were analyzed by two-way ANOVA and Tukey test (alpha=0.05). The flowable composite had higher KHN than conventional pit and fissure sealant for all experimental conditions (p<0.05). The 60-second photoactivation time increased KHN at the bottom surface and B/T KHN only of composite specimens. The flowable composite had better physical properties than the pit and fissure sealant, and they were improved by extended curing time.

  18. Coal and rock fissure evolution and distribution characteristics of multi-seam mining

    Institute of Scientific and Technical Information of China (English)

    Zhang Dongming; Qi Xiaohan; Yin Guangzhi; Zheng Binbin

    2013-01-01

    Henan Pingdingshan No.10 mine is prone to both coal and gas outbursts. The E9-10 coal seam is the main coal-producing seam but has poor quality ventilation, thus making it relatively difficult for gas extraction. The F15 coal seam, at its lower section, is not prone to coal and gas outbursts. The average seam separa-tion distance of 150 m is greater than the upper limit for underside protective seam mining. Based on borehole imaging technology for field exploration of coal and rock fracture characteristics and discrete element numerical simulation, we have studied the evolution laws and distribution characteristics of the coal and rock fissure field between these two coal seams. By analysis of the influential effect of group F coal mining on the E9-10 coal seam, we have shown that a number of small fissures also develop in the area some 150 m above the overlying strata. The width and number of the fissures also increase with the extent of mining activity. Most of the fissures develop at a low angle or even parallel to the strata. The results show that the mining of the F15 coal seam has the effect of improving the permeability of the E9-10 coal seam.

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

    Directory of Open Access Journals (Sweden)

    Kristlee Sabrin Fernandes

    2012-01-01

    Full Text Available Aim: 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. Materials and Methods: 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. Results and Conclusions: 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.

  20. Long-term performance of resin based fissure sealants placed in a general dental practice.

    NARCIS (Netherlands)

    Hevinga, M.; Opdam, N.J.M.; Bronkhorst, E.M.; Truin, G.J.; Huysmans, M.C.D.N.J.M.

    2010-01-01

    OBJECTIVES: The aim of the present retrospective study was to evaluate the long-term performance of resin based fissure sealants applied in a general dental practice. METHODS: Regularly attending patients visiting the practice between July 2006 until November 2007 and who had received sealants befor

  1. 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.…

  2. Response of rock-fissure seepage to snowmelt in Mount Taihang slope-catchment, North China.

    Science.gov (United States)

    Cao, Jiansheng; Liu, Changming; Zhang, Wanjun

    2013-01-01

    The complex physiographic and hydrogeological systems of mountain terrains facilitate intense rock-fissure seepages and multi-functional ecological interactions. As mountain eco-hydrological terrains are the common water sources of river basins across the globe, it is critical to build sufficient understanding into the hydrological processes in this unique ecosystem. This study analyzes infiltration and soil/rock-fissure seepage processes from a 65 mm snowfall/melt in November 2009 in the typical granitic gneiss slope catchment in the Taihang Mountains. The snowfall, snowmelt and melt-water processes are monitored using soil-water time-domain reflectometry (TDR) probes and tipping bucket flowmeters. The results suggest that snowmelt infiltration significantly influences soil/rock water seepage in the 0-100 cm soil depth of the slope-catchment. It is not only air temperature that influences snowmelt, but also snowmelt infiltration and rock-fissure seepage. Diurnal variations in rock-fissure seepage are in close correlation with air temperature (R(2) > 0.7). Temperature also varies with soil/rock water viscosity, which element in turn influences soil/rock water flow. Invariably, water dynamics in the study area is not only a critical water supply element for domestic, industrial and agricultural uses, but also for food security and social stability.

  3. Painless ulcers and fissures of toes: Hereditary sensory neuropathy, not leprosy

    Directory of Open Access Journals (Sweden)

    Angoori Gnaneshwar Rao

    2016-01-01

    Full Text Available Hereditary sensory neuropathies (HSN are rare genetically determined neuropathies. They often manifest as painless injuries in children. We present HSN in a 5-year-old boy who presented with recurrent fissuring and ulceration involving both great toes.

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

    Science.gov (United States)

    Dong, Yan; Zhang, Ling; Sun, Xiang; Liu, Zhengya; Guo, Huihui; Huang, Li; Chen, Jihua

    2016-01-01

    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 integrity of S

  5. 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

  6. 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...... contractions and to react in stress conditions with fast increase in tension....

  7. Obstetrical anal sphincter injuries and outcome of primary repair

    Directory of Open Access Journals (Sweden)

    Gauri J. Desai

    2016-10-01

    Conclusions: Nulliparity, instrumental delivery, increasing birth weight were high risk factors for obstetrical anal sphincter injuries. Obstetrician needs to be more careful while delivering a patient with multiple risk factors for OASIs. Primary suturing of anal sphincter injury with good post-operative care has a favorable outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3568-3571

  8. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy

    Science.gov (United States)

    Mandaliya, Rohan; DiMarino, Anthony J.; Moleski, Stephanie; Rattan, Satish; Cohen, Sidney

    2015-01-01

    Background Despite the surge of new medical and surgical approaches to treat fecal incontinence, the types of sphincter abnormalities in patients with incontinence have not been well characterized. We aimed to categorize anal sphincter dysfunction using anorectal manometry in patients with fecal incontinence as a potential guide for improved treatment. Methods A retrospective review of 162 consecutive patients with fecal incontinence referred for anorectal manometry was performed. Resting anal pressure and maximal squeeze pressure were considered as measures of internal anal sphincter and external anal sphincter function respectively. Results Mean age of the patients was 63 years (13-89); females (81.5%) and males (18.5%). 74% of the patients had sphincter dysfunction on anorectal manometry. Internal anal sphincter dysfunction was present in 62% patients vs. external anal sphincter dysfunction present in 44% patients. 80% females had abnormal manometry vs. 44% in males (P<0.0001). Internal anal sphincter dysfunction was present in 68% females vs. 37% in males (P=0.0026). Conclusions Overall, abnormal anorectal manometry studies revealed that internal anal sphincter dysfunction is the most common finding, alone or in combination with external anal sphincter dysfunction. We suggest that anorectal manometry may be important to delineate anal sphincter function prior to using newer therapeutic mechanical devices. Future studies using pharmacological agents to increase internal anal sphincter tone may be of clinical importance. Finally, the classification of fecal incontinence based on the type of sphincter dysfunction may be an improved guide in the selection of newer agents in treating fecal incontinence. PMID:26423466

  9. Treatment of non-IBD anal fistula.

    Science.gov (United States)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter; Buntzen, Steen; Thorlacius-Ussing, Ole; Andersen, Jens; Krupa, Marek; Qvist, Niels

    2015-05-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor the right operation to the individual patient. The given levels of evidence and grades of recommendations are according to the Oxford Centre for Evidence-based Medicine (www.cemb.net).

  10. Sumario analítico / Analytic Summary

    Directory of Open Access Journals (Sweden)

    José URRUTIKOETXEA LIZARRAGA

    2010-02-01

    Full Text Available Los estudios sobre demografía histórica en el marco de la historiografía vasca han experimentado algunos cambios notables en los últimos decenios. Hacer un balance de los mismos, por un lado, y profundizar en el análisis de espacios y de ámbitos hasta hace poco tiempo desconocidos o marginados en este territorio histórico, por otro, son los retos que se plantean en este artículo. Las herramientas analíticas y metodológicas empleadas permiten al autor concluir sobre el vigor y los déficits de la demografía histórica vasca, las líneas centrales de investigación y los nuevos temas de análisis.

  11. 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

  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. An evaluation of nanocomposites as pit and fissure sealants in child patients

    Directory of Open Access Journals (Sweden)

    S Singh

    2011-01-01

    Full Text Available Background: Dental caries affects populations of all ages in all the regions of the world, with the child patient being at the highest risk. Fifty percent of the permanent molars are decayed by the age of 12, due to lack of information about protection and occlusal morphology. Pit and fissure sealing undoubtedly plays a fundamental role in preventing occlusal caries. The most common approach to assess the sealing ability of pit and fissure sealants of tooth/restoration is the measurement of dye penetration along the interface. Aims and Objectives: The present study aims to evaluate the microleakage and penetration depth of three different types of dental materials, namely (A Conventional pit and fissure sealant, (B Flowable composite, (C Flowable nanocomposite. Study Design: This in-vitro comparative study comprised of extracted human posterior teeth mounted as blocks. Materials and Methods: In the present study, microleakage and penetration depths of conventional sealants/flowable composite and nanocomposite were measured with the help of a dye under stereomicroscope. Statistical Analysis: A student′t′ test and Analysis of variance (ANOVA tests were performed to compare the mean microleakage and penetration depth. Results: Microleakage was found to be highest for the flowable composites, and least for the conventional sealant. The nanocomposite values were intermediate. Penetration depth was highest for nanocomposite and least for flowable composite. Conclusions: According to the results, the nanocomposite was found to be an excellent dental material for penetration in deep pits and fissures, though it exhibits mild microleakage. Hence, it can be recommended for use in pediatric dental patients, as a pit and fissure sealing agent.

  14. Treating anal fistula with the anal fistula plug: case series report of 12 patients

    OpenAIRE

    Saba, Reza Bagherzadeh; Tizmaghz, Adnan; Ajeka, Somar; Karami, Mehdi

    2016-01-01

    Introduction Recurrent and complex high fistulas remain a surgical challenge. This paper reports our experience with the anal fistula plug in patients with complex fistulas. Methods Data were collected prospectively and analyzed from consecutive patients undergoing insertion of a fistula plug from January 2011 through April 2014 at Hazrat-e-Rasoul Hospital in Tehran. We ensured that sepsis had been eradicated in all patients prior to placement of the plug. During surgery, a conical shaped col...

  15. 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.

  16. 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......-associated histological types levelled out or even declined during the 30 years of observation. In women, the increase in HPV-associated cancers was more pronounced among those under 60 years of age. Our findings indicate that vaccines against HPV might play an important role in the prevention of anal cancer and its...... cases of AIN2/3 during the study period. The average annual percentage change of 5% between 1998 and 2008 represents a steep increase in the incidence of AIN in both genders. Furthermore, the incidence rate of HPV-associated anal cancers increased significantly, whereas that of non-HPV...

  17. Strategická analýza Citibank a. s.

    OpenAIRE

    Boháčová, Michaela

    2007-01-01

    Bakalářská práce si za svůj cíl vytyčila problematiku strategické analýzy, která je důležitou součástí tvorby strategie. Výstupem strategické analýzy je SWOT analýza. Na závěr práce jsou uvedeny a zhodnoceny používané strategie, které utváří rámec hospodaření Citibank a. s. Stručný obsah: 1. Strategická analýza 1.1. Externí analýza 1.2. Interní analýza 1.3. SWOT analýza 2. Vize a poslání Citibank 3. Zhodnocení zvolené strategie 3.1. Konkurenční strategie 3.2. Investiční strategie 3.3. Strateg...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-09-01

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

  19. Conservative treatment of the anal carcinoma. Retrospective results - radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  20. [Conservative treatment of anal cancer. Retrospective results--radiotherapy].

    Science.gov (United States)

    Dobrowsky, W

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected: 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  1. Anal transition zone in the surgical management of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jennifer Holder-Murray; Alessandro Fichera

    2009-01-01

    Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis;these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.

  2. DO CHANGES IN ANAL SPHINCTER ANATOMY CORRELATE WITH ANAL FUNCTION IN WOMEN WITH A HISTORY OF VAGINAL DELIVERY?

    Directory of Open Access Journals (Sweden)

    Sthela Maria MURAD-REGADAS

    2014-09-01

    Full Text Available Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner’s score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS, the anterior and posterior internal anal sphincter (IAS, the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal.

  3. Radiotherapy of epidermoid anal canal cancer.

    Science.gov (United States)

    Dobrowsky, W

    1989-01-01

    Forty-eight patients with anal canal cancers were treated with surgery and irradiation or irradiation alone during the period 1970-1982. All cases were treated by external megavoltage equipment. The overall 5-year survival was 50%, and the local recurrence rate 33%. According to the therapy, four major groups were analysed: radical surgery followed by post-operative irradiation (5-year survival 43%, local recurrence rate 38%), incomplete major surgery and post-operative irradiation with very inferior prognosis (none of the patients surviving beyond 52 months). Two groups of patients had sphincter-saving procedures: local surgery followed by irradiation (5-year survival 78%, local recurrence rate 22%) and primary irradiation (5-year survival 57%, local recurrence rate 14%). Lymph node positive patients showed a median survival of 24.5 months against 52 months in N0 cases (5-year survival 21% against 50%). Side-effects of radiotherapy were transient and mild, and no late severe sequelae were seen. The data indicate that post-operative external radiotherapy seems insufficient and unable to decrease the local recurrence rate, especially when surgery is incomplete. Both spincter-saving surgery and radiotherapy, as well as primary irradiation, are effective treatment modalities. These data are analysed and future aspects considering combined radiochemotherapy are discussed.

  4. Technická analýza

    OpenAIRE

    Kosek, Lukáš

    2014-01-01

    Diplomová práce se zabývá problematikou technické analýza a jejího využití při tvorbě automatických obchodních systémů. V teoretické části práce jsou vysvětleny základní principy fungování měnového trhu (Forex) a technických identifikátorů. Výstupem práce je portfolio strategií, které je aplikováno na měnové páry Euro/Americký dolar a Britská libra/Americký dolar. Obchodní strategie jsou navrhnuté v programu Adaptrade Builder pomocí genetických algoritmů a následně otestované v obchodní platf...

  5. EVALUATION OF DIAGNODENT FOR THE DIAGNOSIS OF FISSURAL CARIES. A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Luiza Ungureanu

    2011-12-01

    Full Text Available Diagnosis of fissural caries, especially in young permanent teeth, is quite difficult to establish, its sometimes aleatory character possibly leading to incorrect therapeutical decisions. The aim of the study is to evaluate laser fluorescence (LF represented by Diagnodent as a diagnosis means, comparatively with the exams involving inspection and probing (VI, the validation test of which is the exploratory drilling. Method: 72 occlusal surfaces of the permanent molars of 10-15 year-old children have been examined, the diagnosis being established by two methods; after validation of the diagnosis through exploratory drilling, specific treatments were performed, exemplified by self-evident clinical cases. Results: The obtained values are: VI sensitivity 68.1%, LF 83.3%, specificity VI 77.7%, LF 50%, comparable with the results of other studies. Conclusions: Due to its increased sensitivity, Diagnodent completes the examination through inspection and probing, for the establishment of a correct diagnosis and treatment of fissural caries.

  6. [Treatment of anorectal diseases].

    Science.gov (United States)

    Herold, A

    2007-02-14

    HAEMORRHOIDAL DISEASE: Stage orientated treatment of haemorrhoidal disease using conservative and operative measures provides high healing rates with low complication- and recurrence rates. ANAL FISSURE: Muscle relaxing ointments (Nitrates, Ca-channel-blocker) are the treatment of choice for chronic anal fissure. In cases of insufficiency fissurectomy provides high healing rates. ABSCESS AND ANAL FISTULA: Anal fistulae are treated with respect of their involvement of the anal sphincters. Distal fistulae are completely excised reaching high healing rates, proximal fistulae are treated using local flap procedures with healing rates reaching 50 to 80%. ANAL INCONTINENCE: Treatment of anal incontinence is depending on the severity and on the etiology of the disease. The following procedures are used: conservative: improving consistency, physical exercises, electrostimulation Biofeedback-Training surgical: Sphincterreconstruction, Pre-anal Repair, Post-anal Repair, Total Pelvic Floor Repair, Dynamic Graciloplasty, Artificial Anal Sphincter, Sacralnervestimulation, Stoma

  7. Quality Assessment of Information About Pit and Fissure Sealants in Persian Websites in 2012

    Directory of Open Access Journals (Sweden)

    Firoozeh Nilchian Nilchian

    2016-08-01

    Full Text Available Objectives: Despite the increasing use of Internet, there is no supervision over the accuracy and quality of the information provided in the web. To deal with this problem, health specialists should take part in planning, publishing and supervision of online health-related information. The aim of this study was to evaluate the quality of information related to pit and fissure sealants in Persian websites.Materials and Methods: In this cross-sectional study, Persian websites providing information about fissure sealants were found using Google search engine. The searched keywords according to the MeSH database were "patient education" and "fissure sealant". After applying the exclusion criteria, 37 websites out of 500 initial links remained in the study. These websites were evaluated based on a researcher-made checklist. The validity and reliability of the checklist were evaluated and confirmed. Descriptive analysis was applied to report the results of our study using SPSS version 11.5.Results: The average score for the quality of information was 22.46 out of 38. The minimum scores were 16 and 30 and belonged to Pezeshkanemrooz.com and Asa85.blogfa.com, respectively. The results showed that 62.2% of the answers were scored 2-4 and 37.8% were scored 1; therefore, the overall quality of the published content was rated to be moderate for 62.2% and low for 37.8% of the websites.Conclusions: Overall, the quality of information related to fissure sealant provided in Persian websites was good; however, the information given was mostly incomplete and could be improved. The main problems were doubtful credibility and outdated information.

  8. Intraventricular racemose type neurocysticercosis with anterior interhemispheric fissure cyst: A rare case report

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta

    2015-01-01

    Full Text Available Racemose type of neurocysticercosis (NCC is a rare form of parasitic infestation of central nervous system. Most commonly it is found in fourth ventricle and cisterns. On reviewing the PubMed and Google databases, we found that this would be the first reported case of racemose type NCC in occipital horn of lateral ventricle with obstructive hydrocephalus, along with an incidental interhemispheric fissure arachnoid cyst.

  9. 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.

  10. Reflexo pudendo-anal em mulheres normais Pudendo-anal reflex in normal women

    Directory of Open Access Journals (Sweden)

    Geraldo de Aguiar Cavalcanti

    2004-09-01

    Full Text Available São descritas observações do registro do reflexo pudendo-anal em mulheres sem queixas de incontinência urinária. Foram estudadas 31 voluntárias adultas, com estimulação elétrica bilateral e independente do clitóris e registros de superfície em ambos os lados do músculo esfíncter externo do ânus (EEA. As respostas foram obtidas com pulsos duplos de 0,2 ms de duração e intervalos de 5 ms, aplicados a uma freqüência menor que 0,5 Hz. Foram medidas as latências iniciais das respostas. Não foram evidenciadas diferenças entre as respostas obtidas de cada lado do EEA e nem entre os lados, com relação aos estímulos. Uma das voluntárias não apresentou respostas após estimulação de um dos lados. Não foram observadas diferenças relacionadas a paridade total e nem com a presença de partos vaginais. A idade e o índice de massa corpórea não se correlacionaram com as respostas. Em 12% das respostas, a medida das latências foi dificultada pela baixa relação sinal-ruído.The pudendo-anal reflex was studied in a sample of 31 normal women. Responses were obtained after bilateral independent stimulation of the clitoris, with surface recordings from both sides of the external anal sphincter. Reponses were elicited with double-pulses of 0,2 ms duration with a interstimulus interval of 5 ms, frequency of stimulation was lower than 0,5 Hz. A minimal of four responses were recorded after supramaximal stimulation. In one volunteer no response was recorded after unilateral stimulation. Latencies of the responses from the right and left sides of the anal sfincter after right and left stimulation were 36.35±6.37, 36.28±6.23, 35.88±4.68, 36.44±4.45ms, respectively. No relation was detected between latencies and age, body mass index and parity (considering either total parity or vaginal delivery only. In 12% of the recordings uncertainty was introduced in the latency measurements related to a poor signal-noise ratio.

  11. 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.

  12. Relationship between DIAGNOdent values and sealant penetration depth on occlusal fissures.

    Science.gov (United States)

    Rodrigues, Jonas A; Diniz, Michele B; Hug, Isabel; Cordeiro, Rita C L; Lussi, Adrian

    2010-12-01

    The aim of this in vitro study was to evaluate the relationship between laser fluorescence values and sealant penetration depth on occlusal fissures. One hundred and sixty-six permanent molars were selected and divided into four groups, which were each treated using a different sealant (two clear and two opaque). The teeth were independently measured twice by two experienced dentists using two laser fluorescence devices-DIAGNOdent (LF and LFpen)-before and after sealing, and then thermoclycled. After measuring, the teeth were histologically prepared and assessed for caries extension. Digital photographs of the cut sealed sites were assessed, and the sealant penetration depth was measured. All 166 sites were measured by one of the examiners taking as limits the outer and inner surface of the sealant into the fissure. For each device (LF and LFpen) and each group, the difference between the values at baseline and after sealing was plotted against the sealant penetration depth and scatter plots were provided. It could be observed that most of the points were concentrated around the zero line, for both LF and LFpen in the four groups. In conclusion, there is no relation between changes in DIAGNOdent values and increasing of depth sealant penetration within the occlusal fissures.

  13. 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.

  14. Også gravide skal rektaleksploreres ved anale symptomer

    DEFF Research Database (Denmark)

    Højgaard, Helle Manfeld; Rahr, Hans

    2012-01-01

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

  15. Sphincter preservation in anal cancer: A brief review

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2013-01-01

    Full Text Available Management of anal cancer is a challenge. The goal of treatment is to eradicate tumor without sacrificing the anal sphincters. The idea of organ preservation emerged following the discovery of a high complete response rate from preoperative combined chemoradiation (CRT prior to abdominoperineal resection.CRT is widely accepted as the standard therapy for treating anal squamous cell cancer. The combination of external beam radiotherapy with interstitial brachytherapy increases the dose to the tumor volume and decreases dose to normal tissues. The current goal is to avoid colostomy, and surgery has become a salvage or secondary therapy. In this article, we review the non-surgical management of anal cancer with special emphasis on CRT, role of intensity modulated radiation therapy and brachytherapy.

  16. Softwarová podpora analýzy rizik

    OpenAIRE

    Psota, Michal

    2013-01-01

    Tato práce se zabývá teoretickým popisem možností řízení rizik především v oblasti informačních technologií a popisuje metody sloužící k analýze rizik. Rozebrané metody jsou analýza stromu událostí, analýza stromu poruch, FMEA, HAZOP a Markovova analýza. Praktická část práce zahrnuje návrh a implementaci aplikace, která vizualizuje rozhodovací stromy a určuje pravděpodobnosti jednotlivých prvků. This thesis focuses on the theoretical description of risk management options related to inform...

  17. Tubulovillous adenoma of anal canal: A case report

    Institute of Scientific and Technical Information of China (English)

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  18. 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.

  19. Anal sphincter EMG in the diagnosis of parkinsonian syndromes

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Marcel Koenigkam-Santos

    2013-02-01

    Full Text Available 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.

  2. 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)

  3. Is routine endoanal ultrasound useful in anal fistulas?

    Directory of Open Access Journals (Sweden)

    I. Pascual Migueláñez

    Full Text Available Objective: to evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening, and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique. Patients: endoanal ultrasound was performed in 103 patients with anal or perianal suppuration. Twenty patients were excluded: 9 had the external opening closed, and 11 had cryptoglandular abscesses. All ultrasound scans were performed by the same explorer using a B&K Diagnostic Ultrasound System with a 7 MHz endoprobe. The examination was based on the identification of the three anal planes, then hydrogen peroxide was infused and the procedure was repeated. Results: out of 83 patients included, 11 had a perianal sinus and 72 an anal fistula. In all fistulas the main tract was found: 24 were inter-sphinteric (33.33%, 33 trans-sphincteric (45.83%, 3 supra-sphincteric (4.17%, and 12 extra-sphincteric (16.67%. An internal opening was identified in 69 (95.83%. Conclusions: endoanal ultrasound with hydrogen peroxide enhancement is an effective examination to visualize fistulous tracts and internal openings. We think it is highly useful for anal or perianal suppuration to identify abscesses, to recognize a perianal sinus, to check the sphincteric condition, and to plan subsequent surgery.

  4. [Epithelium and anal glands in rectal pouches and fistula. Histologic studies of swine with congenital anal atresia].

    Science.gov (United States)

    Lambrecht, W; Kluth, D; Lierse, W

    1989-02-01

    The epithelial coating of the rectal pouch and fistula was studied morphologically in 33 newborn piglets with high and low forms of anal atresia and was found to be similar to the epithelial coating of the anal canal in normal piglets: the typical epithelium of the rectum changed its character into transitional epithelium at the region of the internal sphincter which surrounded the fistulae in all animals. In the caudal part of the fistula the transitional epithelium was followed by squamous epithelium. Only in male piglets with deformities and recto-urethral fistulae no squamous epithelium was found. In these cases transitional epithelium covered all parts of the fistula and the region of the internal sphincter. Anal glands were found in all animals, with or without anorectal malformations. They always invaded the internal sphincter. According to our morphological studies the fistula in anorectal malformations represents an ectopic anal canal.

  5. Coseismic Pit Crater, Normal Fault, and Extensional Fissure Formation in Unconsolidated Sediment and Basalt in Northern Iceland

    Science.gov (United States)

    Ferrill, D. A.; Wyrick, D. Y.; Smart, K. J.

    2008-12-01

    Two rifting-related seismic events in 1975 and 1978 along the Mid-Atlantic Ridge near the northern coast of Iceland produced an array of surface deformation features in Holocene basalt flows and overlying unconsolidated sediments. New field mapping and aerial photograph interpretation is coupled with analysis of maps of seismic activity and level-line survey results to constrain the timing, style, and magnitude of this deformation. Fault scarps and fissures in basalts can be traced laterally down a gentle northward dip projecting into unconsolidated braided stream deposits, providing an impressive view of the deformation style in the two contrasting mechanical layers. We report on detailed field mapping of two of these laterally traceable structures conducted in the summer of 2008 and analysis of a suite of aerial photographs from 1958 to 1998. Map-scale structures in the basalts with little or no sedimentary cover include (i) fault scarps, (ii) fissures, and (iii) locally-developed gentle dip away from the related normal fault. Dilation of faults and extension fractures in the basalt has led to rock toppling and rock fall causing widening of fissures. Wedging of toppled rock blocks at the tops of fissures has locally produced keystone arches and bridges across the tops of open fissures. Different stages in the progression of fissure formation and collapse, including (i) fissure, (ii) widened fissure with cavern, (iii) localized collapse pit, and (iv) elongate collapsed fissure, can be observed over along-strike distances of 10's of meters. Where unconsolidated sand and gravel deposits >3 m thick cover the basalts (200 m to the north along strike) structural geomorphologic features are dominated by (i) grabens, (ii) pit craters, and (iii) elongate troughs. Graben-bounding normal faults cutting the sedimentary cover in many cases have displacements >1 m. Pit craters have cone to bowl shapes, commonly occur within grabens, and have depths up to 2.8 m. The mapped

  6. The Effectiveness of Fissure Sealant Therapy Placed by Professional Complementary to Dentistry Compared with Dentists

    Directory of Open Access Journals (Sweden)

    F Nilchian

    2005-10-01

    Full Text Available Background: Dental caries is a process that may take place on any tooth surface in the oral cavity where a microbial biofilm (dental plaque is allowed to develop over a period. From the public health perspective, the prevention of caries is still a major challenge. The development of dental caries within the mouth follows a fixed hierarchy indicating that tooth surfaces vary in caries susceptibility. The most susceptible surfaces are the buccal pits and occlusal-fissured surfaces of the first molar teeth. Since the 1960`s many trials have investigated the effectiveness of using sealants on pit and fissure surfaces. However, the cost effectiveness of sealants is an important issue considered by many studies noted that cost-effectiveness of sealants would be enhanced by using trained auxiliaries to apply them. The changes in dentistry and oral health reveal a need to review the roles of dental auxiliaries in order to deliver quality care cost-effectively. There were number of studies conducted on the effectiveness of dental auxiliaries around the world. According to the purpose of this project, studies evaluated the effectiveness of Professional complementary to dentistry (PCDs and different type of dental auxiliaries in carrying out complete restorations and in the preventive therapies, fissure sealants, traumatic restorative treatment were evaluated in literature review. The aim of the present study is to review the literature and assess whether PCDs can perform pit and fissure sealants as effectively as dentist through investigation of the caries preventive effect of sealant placed by dentist relative to sealant placed by PCDs. Method: Electronic databases were searched till January 2005. The databases which were used are: Medline via Ovid, Cochrane databases of systematic review , DARE (Database of Abstracts of Reviews of Effectiveness, CCTR (Clinical Controlled Trials Register Cochrane Library, Dissertation Abstracts International database

  7. 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

  8. Current treatment options for management of anal intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Weis SE

    2013-06-01

    Full Text Available Stephen E Weis1,2 1Division of Dermatology, Department of Internal Medicine, University of North Texas Health Science Center at Fort Worth, 2Preventive Medicine Clinic, Tarrant County Public Health, Fort Worth, TX, USA Abstract: Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN, the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5

  9. All's Well That Ends Well: Shakespeare's treatment of anal fistula.

    Science.gov (United States)

    Cosman, B C

    1998-07-01

    Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's play All's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. Shakespeare's use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio's Decameron and from its possible historical antecedent, the fistula of Charles V of France. This difference makes sense given the conventions of Elizabethan comedy, which included anal humor. It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging of All's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.

  10. [A case of primary carcinoma associated with anal fistula].

    Science.gov (United States)

    Nushijima, Youichirou; Nakano, Katsutoshi; Sugimoto, Keishi; Nakaguchi, Kazunori; Kan, Kazuomi; Maruyama, Hirohide; Doi, Sadayuki; Okamura, Shu; Murata, Kohei

    2014-11-01

    A 47-year-old man with no history of anal fistula was admitted to our hospital with a complaint of perianal pain. Computed tomography (CT) imaging revealed perianal abscess. Incision and drainage were performed under spinal anesthesia. Ten months after drainage, magnetic resonance imaging revealed anal fistula on the left side of the anus. Subsequently, core-out and seton procedures were performed for ischiorectalis type III anal fistula. Pathological examination of the resected specimen of anal fistula revealed a moderately differentiated adenocarcinoma, leading to the diagnosis of carcinoma associated with anal fistula. No distant metastases or enlarged lymph nodes were observed on positron emission tomography (PET)/CT. We performed abdominoperineal resection with wide resection of ischiorectalis fat tissue. The pathology results were tub2, A, ly0, v0, n0, PM0, DM0, RM0, H0, P0, M0, Stage II. Negative pressure wound therapy was performed for perineum deficiency, after which rapid wound healing was observed. Left inguinal lymph node recurrence was detected 8 months after surgery, for which radiotherapy was administered. Distant metastasis was detected 11 months after surgery. The patient died 21 months after surgery.

  11. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Arain Shehla

    2005-01-01

    Full Text Available Abstract Background Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs. This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. Methods The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. Results Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK, atypical parakeratotic cells (APK, and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. Conclusions In this study liquid based anal smears had a high sensitivity (98% for detection of ASIL but a low specificity (50% for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46–56% of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  12. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions.

    Science.gov (United States)

    Arain, Shehla; Walts, Ann E; Thomas, Premi; Bose, Shikha

    2005-02-16

    BACKGROUND: Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs). This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. METHODS: The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. RESULTS: Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK), atypical parakeratotic cells (APK), and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. CONCLUSIONS: In this study liquid based anal smears had a high sensitivity (98%) for detection of ASIL but a low specificity (50%) for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46-56%) of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  13. KEBERHASILAN PENETRASI BAHAN PIT & FISSURE SEALANT KE DALAM FISURA MENGGUNAKAN SYRINGE BLUE MICRO TIPS DAN SYRINGE WHITE MINI BRUSH TIPS (LAPORAN PENELITIAN)

    OpenAIRE

    2015-01-01

    The aim of this study was to know the success and differences of pit & fissure sealant materal penetration of composite resin type (UltraSeal XT Plus) into fissure by using syringe blue micro tips and syringe white mini brush tips in fissure closure efforts for caries prevention of permanent teeth. The study was conducted to 30 maxillary first premolar, using syring blue micro tips, and 30 maxilary first premolar using syringw white mini brush tips. The samples, then, were made smears and...

  14. Fissure distribution at Mauna Loa (Hawaii) as an example to understand shallow magma transfer at volcanoes

    Science.gov (United States)

    La Marra, Daniele; Acocella, Valerio; Trusdell, Frank

    2016-04-01

    Mauna Loa (Hawaii) is the largest active shield volcano on the Island of Hawai'i, covering more than half of it and rising to 4,169 meters above sea level. The volcano hosts the Moku'aweoweo summit caldera, from which two elongated rift zones depart: the Northeast Rift Zone (NERZ) and the Southwest Rift Zone (SWRZ). Most of Mauna Loa's eruptions begin with lava fountains from a series of fissure vents in the summit region and then often migrate to vents down either rift zone. Mauna Loa volcano shows a distinctive feature, being characterized by minor radial eruptive fissures (not related to the two main rifts) on the NW flank only. This study tries to explain such a selective distribution of vents, and thus of shallow magma transfer. To this aim, we run numerical models with different amount of opening of the two rift zones of Mauna Loa, as well as different amount of slip on its SE flank. Our results suggest that the selective occurrence of the radial fissures may be explained by the competition between two processes: a) rift intrusion (especially along the NERZ), promoting the development of radial dikes along the NW flank; b) flank slip, inhibiting the development of the radial dikes on the SE flank. The opening of the two non-parallel main rift zones of Mauna Loa promotes the local extension necessary to develop the radial dikes on the NW flank. A general model for the development of a third branch of radial rift, which may be also applied to Mt. Etna and some volcanoes on the Canary Islands, is proposed.

  15. Deformation properties of highly plastic fissured Palaeogene clay - Lack of stress memory?

    DEFF Research Database (Denmark)

    Krogsbøll, Anette; Hededal, Ole; Foged, Niels Nielsen

    2012-01-01

    are evaluated based on the degree of debonding caused by natural processes insitu as compared to processes induced during severe loading and unloading in laboratory. A long term oedometer test on Lillebælt Clay with a series of loading and unloading cycles was carried out. The test results are used to evaluate...... of fissuring or debonding. Based on a large amount of high quality tests on Palaeogene clay partly encountered at Fehmarn Belt the typical deformational behaviour during unloading and swelling is discussed and evaluated with focus on stress states. K0-OCR relations are established and the relations...

  16. Manometric asymmetry of the anal sphincter: anatomic evidence and clinical application

    Institute of Scientific and Technical Information of China (English)

    XIAO Yuan-hong; LIU Gui-lin

    2005-01-01

    Background Manometric pressure asymmetry of the anal sphincter exists in the anal canal. There are reports about the anatomy of the anal sphincter, but the relationship between the configuration and the pressure asymmetry of the anal sphincter is not clear. This study is to investigate the anatomic evidence and clinical application of anal sphincter pressure asymmetry. Methods PC polygram HR at the state of relaxing and squeezing was used in 27 normal children and 12 abnormal ones with fecal incontinence.Results In normal children, longitudinal pressure gradients existed at eight channels in the anal canal, and the maximal pressure 1 cm from the anal verge. Longitudinal pressure asymmetry changes of eight channels also existed in the anal canal, from 3 cm to 2 cm to 1 cm from the anal verge. The high pressure distribution changed from the posterior to the anterior anal canal. Anteriorly, 1 cm from the anal verge, the maximal pressure was formed in the anal canal. However, neither longitudinal pressure gradients nor longitudinal pressure asymmetry changes were seen in patients with fecal incontinence. Conclusion The configuration and function of the striated muscle complex possibly contribute to the formation of the pressure asymmetry of the anal sphincter, which is essential to anal control.

  17. Influences of soil hydraulic and mechanical parameters on land subsidence and ground fissures caused by groundwater exploitation

    Institute of Scientific and Technical Information of China (English)

    陈兴贤; 骆祖江; 周世玲

    2014-01-01

    In order to study the influences of hydraulic and mechanical parameters on land subsidence and ground fissure caused by groundwater exploitation, based on the Biot’s consolidation theory and combined with the nonlinear rheological theory of soil, the constitutive relation in Biot’s consolidation theory is extended to include the viscoelastic plasticity, and the dynamic relationship among the porosity, the hydraulic conductivity, the parameters of soil deformation and effective stress is also considered, a three-dimensional full coupling mathematical model is established and applied to the study of land subsidence and ground fissures of Cangzhou in Hebei Province, through the analysis of parameter sensitivity, the influences of soil hydraulic and mechanical parame-ters on land subsidence and ground fissure are revealed. It is shown that the elastic modulus E , the Poisson ratio, the specific yield m and the soil cohesion c have a great influence on the land subsidence and the ground fissures. In addition, the vertical hydraulic conductivity zk and the horizontal hydraulic conductivity ks also have a great influence on the land subsidence and the ground fissures.

  18. [Management of complications in anal and transanal tumor surgery].

    Science.gov (United States)

    Sailer, M; Eisoldt, S; Möllmann, C

    2015-08-01

    Anal and transanal tumor operations are safe and are associated with a very low morbidity. Perianal and anal lesions as well as low rectal tumors can be excised by direct exposure using an anal retractor. For lesions situated in the middle or upper third of the rectum, special instrumentation, such as transanal endoscopic microsurgery (TEM) and transanal endoscopic operation (TEO) should be used to avoid unnecessary R1 resections. Fatal complications are extremely rare and most complications, such as urinary retention or temporary subfebrile temperatures, are minor. Suture line dehiscences are usually clinically unremarkable. Major complications comprise significant hemorrhage and opening of the peritoneal cavity. The latter must be recognized intraoperatively and can usually be managed by primary suturing. Infections, abscess formation, rectovaginal fistula, injury of the prostate or even urethra are extremely rare complications.

  19. Treatment of peri-anal fistula in Crohn's disease.

    Science.gov (United States)

    Sica, Giuseppe S; Di Carlo, Sara; Tema, Giorgia; Montagnese, Fabrizio; Del Vecchio Blanco, Giovanna; Fiaschetti, Valeria; Maggi, Giulia; Biancone, Livia

    2014-10-07

    Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.

  20. Squamous cell carcinoma of the anal sac in five dogs.

    Science.gov (United States)

    Esplin, D G; Wilson, S R; Hullinger, G A

    2003-05-01

    Tumors of the perianal area of dogs are common and include multiple tumor types. Whereas perianal adenomas occur often, adenocarcinomas of the apocrine glands of the anal sac occur less frequently. A review of the literature revealed no reports of squamous cell carcinomas arising from the epithelial lining of the anal sac. Squamous cell carcinomas originating from the lining of the anal sac were diagnosed in five dogs. Microscopically, the tumors consisted of variably sized invasive nests and cords of epithelial cells displaying squamous differentiation. Four of the five dogs were euthanatized because of problems associated with local infiltration by the tumors. In the fifth dog, there was no evidence of tumor 7 months after surgical removal, but further follow up was not available.

  1. Why do we have so much trouble treating anal fistula?

    Institute of Scientific and Technical Information of China (English)

    Haig Dudukgian; Herand Abcarian

    2011-01-01

    Anal fistula is among the most common illnesses af-fecting man. Medical literature dating back to 400 BC has discussed this problem. Various causative factors have been proposed throughout the centuries, but it appears that the majority of fistulas unrelated to spe-cific causes (e.g. Tuberculosis, Crohn's disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces. The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases. The problem with this single, yet effective, treatment plan is that depending on the thickness of sphincter muscle the fistula trans-gresses, the patient will have varying degrees of fecal incontinence from minor to total. In an attempt to pre-serve continence, various procedures have been pro-posed to deal with the fistulas. These include: (1) sim-ple drainage (Seton); (2) closure of fistula tract using fibrin sealant or anal fistula plug; (3) closure of prima-ry opening using endorectal or dermal flaps, and more recently; and (4) ligation of intersphincteric fistula tract (LIFT). In most complex cases (i.e. Crohn's disease), a proximal fecal diversion offers a measure of symptom-atic relief. The fact remains that an "ideal" procedure for anal fistula remains elusive. The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations. In essence, the price of preservation of continence at all cost is multi-ple and often different operations, prolonged disability and disappointment for the patient and the surgeon. Nevertheless, the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist. Conversely, an expert colorectal surgeon must be familiar with many different opera-tions in order to selectively tailor an operation to the individual patient.

  2. Fistulotomy or seton in anal fistula: a decisional algorithm.

    Science.gov (United States)

    Cariati, Andrea

    2013-09-01

    Fistula in ano is a common proctological disease. Several authors stated that internal and external anal sphincters preservation is in the interest of continence maintenance. The aim of the present study is to report our experience using a decisional algorithm on sphincter saving procedures that achieved us to obtain good results with low rate of complications. From 2008 to 2011, 206 patients underwent surgical treatment for anal fistula; 28 patients underwent perianal abscess drainage plus seton placement of trans-sphincteric or supra-sphincteric fistula (13.6 %), 41 patients underwent fistulotomy for submucosal or low inter-sphincteric or low trans-sphincteric anal fistula (19.9 %) and 137 patients underwent partial fistulectomy or partial fistulotomy (from cutaneous plan to external sphincter muscle plan) and cutting seton placement without internal sphincterotomy for trans-sphincteric anal fistula (66.50 %). Healing rates have been of 100 % and healing times ranged from 1 to 6 months in 97 % of patients treated by setons. Transient fecal soiling was reported by 19 patients affected by trans-sphincteric fistula (11.5 %) for 4-6 months and then disappeared or evolved in a milder form of flatus occasional incontinence. No major incontinence has been reported also after fistulotomy. Fistula recurred in five cases of trans-sphincteric fistula treated by seton placement (one with abscess) (1/28) (3.5 %) and four with trans-sphincteric fistula (4/137) (3 %). Our algorithm permitted us to reduce to 20 % sphincter cutting procedures without reporting postoperative major anal incontinence; it seems to open an interesting way in the treatment of anal fistula.

  3. Why do we have so much trouble treating anal fistula?

    Science.gov (United States)

    Dudukgian, Haig; Abcarian, Herand

    2011-07-28

    Anal fistula is among the most common illnesses affecting man. Medical literature dating back to 400 BC has discussed this problem. Various causative factors have been proposed throughout the centuries, but it appears that the majority of fistulas unrelated to specific causes (e.g. Tuberculosis, Crohn's disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces. The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases. The problem with this single, yet effective, treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses, the patient will have varying degrees of fecal incontinence from minor to total. In an attempt to preserve continence, various procedures have been proposed to deal with the fistulas. These include: (1) simple drainage (Seton); (2) closure of fistula tract using fibrin sealant or anal fistula plug; (3) closure of primary opening using endorectal or dermal flaps, and more recently; and (4) ligation of intersphincteric fistula tract (LIFT). In most complex cases (i.e. Crohn's disease), a proximal fecal diversion offers a measure of symptomatic relief. The fact remains that an "ideal" procedure for anal fistula remains elusive. The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations. In essence, the price of preservation of continence at all cost is multiple and often different operations, prolonged disability and disappointment for the patient and the surgeon. Nevertheless, the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist. Conversely, an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.

  4. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  5. Correlação entre a incompetência esfincteriana anal e a prática de sexo anal em homossexuais do sexo masculino Correlation between anal sphincter incompetence and anal sex practice in male homosexual

    OpenAIRE

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

    2010-01-01

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

  6. The anal personality: self-disclosure, negativism, self-esteem, and superego severity.

    Science.gov (United States)

    Fischer, R E; Juni, S

    1982-02-01

    Psychoanalytic implications of anal characterology were operationalized, and an experimental situation devised to test hypotheses of various aspects of interpersonal behavior. Subjects selected for the study had been found to score either high or low on Kline's (Ai3) Anality Scale. Self-disclosure and disclosure reciprocity were shown to be negative functions of anality: productivity and superego measures were also shown to be functions of anality. Self-esteem and socio-economic status did not relate to anality levels, while the hypothesis linking anality with negativism was only partially confirmed. Implications for psychoanalytic and social psychology research are discussed.

  7. Understanding the link between circumferential dikes and eruptive fissures around calderas based on numerical and analog models

    Science.gov (United States)

    Corbi, Fabio; Rivalta, Eleonora; Pinel, Virginie; Maccaferri, Francesco; Acocella, Valerio

    2016-06-01

    Active calderas are seldom associated with circumferential eruptive fissures, but eroded magmatic complexes reveal widespread circumferential dikes. This suggests that, while the conditions to emplace circumferential dikes are easily met, mechanisms must prevent them from reaching the surface. We explain this discrepancy with experiments of air injection into gelatin shaped as a volcano with caldera. Analog dikes show variable deflection, depending on the competition between overpressure, Pe, and topographic unloading, Pl; when Pl/Pe = 4.8-5.3, the dikes propagate orthogonal to the least compressive stress. Due to the unloading, they become circumferential and stall below the caldera rim; buoyancy is fundamental for the further rise and circumferential fissure development. Numerical models quantitatively constrain the stress orientation within the gelatin, explaining the observed circumferential dikes. Our results explain how dikes propagate below the rim of felsic and mafic calderas, but only in the latter they are prone to feed circumferential fissures.

  8. Le Fort I osteotomy to enucleation of grand proportions fissural cyst-presentation of case report.

    Science.gov (United States)

    Cavalcante, Rafael Correia; Durski, Fernanda; Deliberador, Tatiana Miranda; Giovanini, Allan Fernando; Rebellato, Nelson Luís Barbosa; da Costa, Delson João; Klüppel, Leandro Eduardo; Scariot, Rafaela

    2016-01-01

    Fissural cysts (FC) are caused by entraped epithelium between nasal and maxilar processes. They are commonly treated with surgical enucleation precedded or not by marsupialization depending on the cyst size. Biopsy of lesion is recommended due to confirm radiographic evaluation. It is rare to observe Le Fort I surgical approach to this type of injury. This study reports the case of an uncommon grand proportions fissural cyst in a female patient, 53, that was referred to the Oral and Maxillofacial Surgery Departament of Hospital XV presenting volume increase in maxilla associated with numbness of palate. Radiograph examination showed an intimate relationship between incisors apexes and FC. Expansion of both buccal and palate cortical was then confirmed as well as its unusual size, approximately 25 millimeters. Due to the abnormal size of lesion and possible impairment of upper incisors, LeFort I osteotomy associated with downfracture to cystic enucleation was the chosen treatment. After enucleation, the remaining space was filled with BIOSs and bioguide (lyophilized bone and collagen membrane). Patients' twelve months follow-up demonstrate no relapses and maintenance of teeth involved.

  9. The Effects of Opaque and Clear Pit and Fissure Sealants on Infrared Laser Fluorescence Measurements

    Science.gov (United States)

    Bahrololoomi, Z.; Khodabakhsh, M.; Khaksar, Y.

    2014-01-01

    Statement of the Problem: The purpose of placing sealants is to inhibit caries by physical closure of the pits and fissures of teeth. A device named DIAGNOdent is useful in detecting occlusal caries by employing laser fluorescence (LF). However, there are contradictory results in the influence of sealants on LF measurements. Purpose: The aim of this study is to investigate the effects of two different types of fissure sealants on LF measurements. Materials and Method: In this in vitro study, 86 extracted permanent third molars were divided randomly into two groups and clear or opaque sealant was applied on the occlusal surfaces. Two examiners performed pre- and post-seal fluorescence measurements twice with one week interval by employing DIAGNOdent device. Finally, measured values were evaluated through the statistical paired t-test by means of SPSS 17 software. Results: The mean value of LF measurements increased significantly due to the application of clear sealant (p= 0.001) while the statistical changes in this measurement was negligible after applying opaque sealant (p= 0.311). Conclusion: Clear sealants increase the LF measured values but opaque sealants cause almost no changes. Therefore, DIAGNOdent device is not reliable for detecting caries beneath the clear sealant. PMID:24883342

  10. The Effects of Opaque and Clear Pit and Fissure Sealants on Infrared Laser Fluorescence Measurements

    Directory of Open Access Journals (Sweden)

    Bahrololoomi Z.

    2013-10-01

    Full Text Available Statement of the Problem: The purpose of placing sealants is to inhibit caries by physical closure of the pits and fissures of teeth. A device named DIAGNOdent is useful in detecting occlusal caries by employing laser fluorescence (LF. However, there are contradictory results in the influence of sealants on LF measurements. Purpose: The aim of this study is to investigate the effects of two different types of fissure sealants on LF measurements. Materials and Method: In this in vitro study, 86 extracted permanent third molars were divided randomly into two groups and clear or opaque sealant was applied on the occlusal surfaces. Two examiners performed pre and post-seal fluorescence measurements twice with one week interval by employing DIAGNOdent device. Finally, measured values were evaluated through the statistical paired t-test by means of SPSS 17 software. Results: The mean value of LF measurements increased significantly due to the application of clear sealant (p= 0.001 while the statistical changes in this measurement is negligible after applying opaque sealant (p= 0.311. Conclusion: Clear sealants increase the LF measured values but opaque sealants cause almost no changes. Therefore DIAGNOdent device is not reliable for detecting caries beneath the clear sealant.

  11. Effects of aging on surface properties and adhesion of Streptococcus mutans on various fissure sealants.

    Science.gov (United States)

    Bürgers, Ralf; Cariaga, Tashiana; Müller, Rainer; Rosentritt, Martin; Reischl, Udo; Handel, Gerhard; Hahnel, Sebastian

    2009-12-01

    The aim of the present study was the quantification of Streptococcus mutans adhesion on ten widely used pit and fissure sealant materials and the correlation of these findings to surface roughness (R(a)) and surface free energy (SFE). Additionally, changes in streptococcal adhesion and surface parameters after water immersion and artificial aging have been investigated. Circular specimens of ten fissure sealants (seven resin-based composites, two glass ionomers, and one compomer) were made and polished. Surface roughness was determined by perthometer and SFE by goniometer measurements. Sealant materials were incubated with S. mutans suspension (2.5 h, 37 degrees C), and adhering bacteria were quantified by using a biofluorescence assay in combination with an automated plate reader. Surface properties and S. mutans adhesion were measured prior to and after water immersion after 1 and 6 months and after additional thermocycling (5,000 cycles; 5 degrees C/55 degrees C). The tested sealants showed significant differences in S. mutans adhesion prior to and after the applied aging procedures. Aging resulted in slight increases (mostly <0.2 microm) in surface roughness, as well as in significant decreases in SFE and in significantly lower quantities of adhering bacteria. Ketac Bond and UltraSeal XT plus revealed the lowest adhesion potential after artificial aging. In general, the amount of adhering S. mutans was reduced after aging, which may be related to the decline in SFEs.

  12. Deep Orbital Dermoid Cyst Bulging into the Superior Orbital Fissure: Clinical Presentation and Management

    Science.gov (United States)

    Kumar, Ravinder; Vyas, Kapil; Jaiswal, Gagan; Bhargava, Abhishek; Kundu, Jyoti

    2017-01-01

    Purpose: To present a case of deep orbital dermoid cyst with emphasis on clinical presentation, imaging spectrum, differential diagnosis and management. Case Report: A 28-year-old female was referred to our hospital with chief complaint of drooping of right eyelid and progressive headache. Ocular motility, visual acuity and fundus examination were normal. computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-defined, intraosseous deep orbital dermoid cyst (5.9 mm × 12.5 mm) located near the apex of right orbit, extending from greater wing of sphenoid into the superior orbital fissure. Due to occulomotor nerve (superior and inferior divisions) compression which passes through the superior orbital fissure, ipsilateral headache and ptosis occurred. Complete surgical excision of cyst was performed using noninvasive extracranial lateral orbitotomy approach. After removal of the cyst, curette and cutting drill were used to thoroughly remove any residual cystic content. Histopathological analysis confirmed the diagnosis. The healing was uneventful postoperatively. Conclusion: CT and MRI are easy, reliable, safe and effective imaging methods for establishing the diagnosis of orbital dermoid cyst. Size, location and manifestations are the most important determinants of the disease management. Complete surgical excision without rupture of the cyst is the treatment of choice. PMID:28299014

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

    Directory of Open Access Journals (Sweden)

    Fischer AK

    2016-10-01

    associated neoplasia in immunosuppressed patients might represent a fast-tracked process of the long-term course of precancerous or cancerous lesions in immunocompetent hosts. This might implicate, that there is a need to re-evaluate current screening guidelines for anal cancer in patients with chronic inflammatory bowel disease under immunosuppressive therapy.

  14. L576P KIT mutation in anal melanomas correlates with KIT protein expression and is sensitive to specific kinase inhibition.

    Science.gov (United States)

    Antonescu, Cristina R; Busam, Klaus J; Francone, Todd D; Wong, Grace C; Guo, Tianhua; Agaram, Narasimhan P; Besmer, Peter; Jungbluth, Achim; Gimbel, Mark; Chen, Chin-Tung; Veach, Darren; Clarkson, Bayard D; Paty, Philip B; Weiser, Martin R

    2007-07-15

    Activating mutations in either BRAF or NRAS are seen in a significant number of malignant melanomas, but their incidence appears to be dependent to ultraviolet light exposure. Thus, BRAF mutations have the highest incidence in non-chronic sun damaged (CSD), and are uncommon in acral, mucosal and CSD melanomas. More recently, activating KIT mutations have been described in rare cases of metastatic melanoma, without further reference to their clinical phenotypes. This finding is intriguing since KIT expression is downregulated in most melanomas progressing to more aggressive lesions. In this study, we investigated a group of anal melanomas for the presence of BRAF, NRAS, KIT and PDGFRA mutations. A heterozygous KIT exon 11 L576P substitution was identified in 3 of 20 cases tested. The 3 KIT mutation-carrying tumors were strongly immunopositive for KIT protein. No KIT mutations were identified in tumors with less than 4+ KIT immunostaining. NRAS mutation was identified in one tumor. No BRAF or PDGFRA mutations were identified in either KIT positive or negative anal melanomas. In vitro drug testing of stable transformant Ba/F3 KIT(L576P) mutant cells showed sensitivity for dasatinib (previously known as BMS-354825), a dual SRC/ABL kinase inhibitor, and imatinib. However, compared to an imatinib-sensitive KIT mutant, dasatinib was potent at lower doses than imatinib in the KIT(L576P) mutant. These results suggest that a subset of anal melanomas show activating KIT mutations, which are susceptible for therapy with specific kinase inhibitors.

  15. Radio(chemo)therapy of the anal carcinoma. A retrospective study; Radio(chemo)therapie des Analkarzinoms. Eine retrospektive Studie

    Energy Technology Data Exchange (ETDEWEB)

    Sauer, Thomas Albert

    2013-07-17

    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.

  16. 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.

  17. Aspectos funcionales de la psicoterapia analítico funcional.

    OpenAIRE

    2003-01-01

    Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  18. Analýza vybrané firmy

    OpenAIRE

    ZAVORALOVÁ, Eva

    2012-01-01

    Diplomová práce je zaměřena na analýzu realitní společnosti M&M reality holding, a.s.. V rámci mapování společnosti se zaměřuji na rozbor oborového okolí pomocí PEST analýzy, Porterův model pěti konkurenčních sil, SWOT analýzu a finanční analýzu. V závěru práce navrhuji doporučení, která by měla vést ke zlepšení současné situace. The master´s thesis is focused on the analysis of real estate company M&M reality holding, a.s.. The mapping of the analysis focuses on the professional environme...

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

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

  20. Usefulness and limitations of CT examinations for deep anal fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shinichiro; Matsumoto, Akihiko (Yokohama City Univ. (Japan). Faculty of Medicine); Kono, Kazuo (and others)

    1990-05-01

    Preoperative CT examination was performed on 30 cases of deep anal fistula and one case with an anal fistular carcinoma, and its usefulness and the limit of applicability were investigated. The deep anal fistula was recognized as a funicular or tumorous shadow on CT image. The differentiation of tumorous shadow and carcinoma was performed by biopsy under CT observation. While, there were also unidentifiable cases including three out of eight cases (37.5%) in II HC type and one out of 11 cases (9.1%) in II HC and III B types. Particularly, patients with a rectostenosis as the madn lesion could not be identified on CT images. The benefits of CT examination in deep anal fistula were compared with transrectal ultrasonography to establish a procedure for image diagnosis. Transrectal ultrasonography is performed as a routine test and CT examination is added when a lesion waving diameter of more than one cm is observed. Furthermore, active biopsy for patients with suspected carcinoma is planned under CT observation. (author).

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

    Directory of Open Access Journals (Sweden)

    Jain Prashant

    2008-01-01

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

  2. Aspectos funcionales de la psicoterapia analítico funcional.

    Directory of Open Access Journals (Sweden)

    Javier Virués Ortega

    2003-01-01

    Full Text Available Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  3. Organisation og tidlige operationsresultater efter ileo-pouch-anal-anastomose

    DEFF Research Database (Denmark)

    Ljungmann, Ken; Bendixen, Anette; Laurberg, Søren;

    2008-01-01

    INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has become the operation of choice for patients with ulcerative colitis and familial polyposis. However, the procedure is complex with a long learning curve, and carries a risk of both early and late complications...

  4. 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

  5. [Anal abscess with a tuberculous origin: report of two cases and review of the literature].

    Science.gov (United States)

    Romelaer, Charlotte; Abramowitz, Laurent

    2007-01-01

    Gastrointestinal tuberculosis represents 1% of extrapulmonary tuberculoses and only sporadic cases of anal tuberculosis have been reported in the literature. We report two cases of tuberculous anal abscess and a review of the literature for diagnosis and treatment.

  6. 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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  8. 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...

  9. Levator Syndrome

    Science.gov (United States)

    ... Overview of the Anus and Rectum Anal Fissure Anal Itching Anorectal Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids ... Overview of the Anus and Rectum Anal Fissure Anal Itching Anorectal Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids ...

  10. KEBERHASILAN PENETRASI BAHAN PIT & FISSURE SEALANT KE DALAM FISURA MENGGUNAKAN SYRINGE BLUE MICRO TIPS DAN SYRINGE WHITE MINI BRUSH TIPS (LAPORAN PENELITIAN

    Directory of Open Access Journals (Sweden)

    Avy Permata Sari

    2015-07-01

    Full Text Available The aim of this study was to know the success and differences of pit & fissure sealant materal penetration of composite resin type (UltraSeal XT Plus into fissure by using syringe blue micro tips and syringe white mini brush tips in fissure closure efforts for caries prevention of permanent teeth. The study was conducted to 30 maxillary first premolar, using syring blue micro tips, and 30 maxilary first premolar using syringw white mini brush tips. The samples, then, were made smears and observed by optic microscope with 300 times magnification. The result of this stuy showed that mean of pit & fissure sealant material penetration of composite resin type into fissure by using blue micro tips was (67.93 ± 13.09%. By using syringe white mini brush tips was (92.96 ± 6.18%. With t-test, it showed a significant difference (t = 9.84, p<0,01.

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

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    2005-01-01

    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 ma

  12. 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...

  13. 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

  14. 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.

  15. Removal of organic debris with Er:YAG laser irradiation and microleakage of fissures sealants in vitro.

    Science.gov (United States)

    Hossain, Mozammal; Yamada, Yoshishige; Masuda-Murakami, Yoshiko; Nakamura, Yukio

    2012-09-01

    The current study was conducted to improve fissure sealing by pre-treatment with Er:YAG laser irradiation in order to remove organic debris. The surface morphology, surface roughness of fissure cavities, and the degree of microleakage after laser treatment were compared with those after bristle brush treatment in vitro. Sixty extracted human teeth were used in this study. The teeth were randomly divided into two groups of 30 each. Artificial fissures were prepared in all teeth into which artificial organic debris was placed. The debris in 30 teeth of one group was removed by means of Er:YAG laser system and the remaining 30 teeth were cleaned using a bristle brush with prophylaxis paste. Surface morphology and surface roughness of were analyzed in ten samples from each group by color laser three-dimensional (3D) microscopy and by scanning electron microscopic examination. The remaining samples were then filled with sealant and subjected to a microleakage test under thermocycling. Statistical analysis was performed using the Mann-Whitney U test; a value of p Er:YAG laser treatment, whereas some fissures were not cleaned by bristle brush. However, microleakage test of both laser and etched brush methods showed similar results. Laser technique might facilitate good adaptation of resin sealant to enamel, because of an increase in surface roughness and favorable surface characteristics.

  16. Three-Dimensional Numerical Simulation on Triaxial Failure Mechanical Behavior of Rock-Like Specimen Containing Two Unparallel Fissures

    Science.gov (United States)

    Huang, Yan-Hua; Yang, Sheng-Qi; Zhao, Jian

    2016-12-01

    A three-dimensional particle flow code (PFC3D) was used for a systematic numerical simulation of the strength failure and cracking behavior of rock-like material specimens containing two unparallel fissures under conventional triaxial compression. The micro-parameters of the parallel bond model were first calibrated using the laboratory results of intact specimens and then validated from the experimental results of pre-fissured specimens under triaxial compression. Numerically simulated stress-strain curves, strength and deformation parameters and macro-failure modes of pre-fissured specimens were all in good agreement with the experimental results. The relationship between stress and the micro-crack numbers was summarized. Crack initiation, propagation and coalescence process of pre-fissured specimens were analyzed in detail. Finally, horizontal and vertical cross sections of numerical specimens were derived from PFC3D. A detailed analysis to reveal the internal damage behavior of rock under triaxial compression was carried out. The experimental and simulated results are expected to improve the understanding of the strength failure and cracking behavior of fractured rock under triaxial compression.

  17. Evaluation of palpebral fissure and orbital volume after bimatoprost 0.03% orbital injections. Experimental study in rats

    Directory of Open Access Journals (Sweden)

    Nilson Lopes da Fonseca Junior

    2014-12-01

    Full Text Available Objective: To evaluate in experimental animals the changes of the palpebral fissure and the orbital volume after orbital injection of bimatoprost 0.03%. Methods: Two main groups of Wistar rats were analyzed, one after orbital injection of bimatoprost 0.03% and another, a control group, after orbital injection of saline solution. The calculation of the palpebral fissure was done on images by means of computer processing, using the program Image J. After taking photographs, the animals were submitted to bilateral orbital exenteration and the volume was calculated in all the animals by the water displacement method (Archimedes’ Principle. Results: While comparing the measurements of the palpebral fissure and the orbital volume among animals given an injection with bimatoprost 0.03% and the control group it was found that there were no statistically significant differences. Conclusions: In this study there were no statistically significant differences in the measurement of the vertical palpebral fissure and the orbital volume among animals given the orbital injection of bimatoprost 0.03% and the animals of the control group.

  18. Fissuration en relaxation des aciers inoxydables austénitiques au voisinage des soudures

    Science.gov (United States)

    Auzoux, Q.; Allais, L.; Gourgues, A. F.; Pineau, A.

    2003-03-01

    Des fissures intergranulaires peuvent se développer au voisinage des soudures des aciers inoxydables austénitiques lorsqu'ils sont réchauffés dans le domaine de température compris entre 500^{circ}C et 700^{circ}C. A ces températures, les contraintes résiduelles post-soudage se relaxent par déformation viscoplastique. Il peut arriver que ces zones proches de la soudure soient tellement fragiles, qu'elles ne puissent accommoder cette faible déformation. Afin de préciser quelles peuvent être les modifications microstructurales qui conduisent à une telle fragilisation, on a examiné les microstructures de ces zones et révélé ainsi un écrouissage résiduel, responsable d'une forte élévation de la dureté. On a pu reproduire par hypertrempe puis laminage entre 400^{circ}C et 600^{circ}C une microstructure similaire. Des essais mécaniques (traction, fluage, relaxation, sur éprouvettes lisses et pré-fissurées) ont été réalisés à 550^{circ}C et à 600^{circ}C sur ces zones affectées simulées et sur un état de référence hypertrempé. Ils ont montré que l'écrouissage diminuait la ductilité dans le domaine de rupture intergranulaire, sans modifier qualitativement le mécanisme d'endommagement. Pendant la pré-déformation les incompatibilités de déformation entre grains conduiraient à l'existence de contraintes locales élevées qui favoriseraient la germination des cavités intergranulaires.

  19. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  1. 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.   ...

  2. Analysis of the Cuban journal Bibliotecas: Anales de Investigacion

    OpenAIRE

    2016-01-01

    The objective of this article is to describe the academic impact, the editorial process quality, and the editorial and visibility strategies of Bibliotecas. Anales de Investigacion (BAI), a scientific Cuban journal edited by National Library of Cuba Jose Marti. The academic impact is determined through a citation analysis, which considers Google Scholar database as reference source. The bibliometric indicators applied are: citation per year, citation vs. self-citation, citable journals vs. no...

  3. Carcinoma of the anal sac glands in ranch mink.

    Science.gov (United States)

    Hadlow, W J

    1985-05-01

    During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

  4. Obstetrics anal sphincter injury and repair technique: a review.

    Science.gov (United States)

    Temtanakitpaisan, Teerayut; Bunyacejchevin, Suvit; Koyama, Masayasu

    2015-03-01

    The Urogynecology Committee of the Asia and Oceania Federation of Obstetrics and Gynaecology (AOFOG) has held seminars and workshops on various urogynecological problems in each country in the Asia-Oceania area in order to encourage young obstetricians and gynecologists. In 2013, we organized the operative seminar for obstetrical anal sphincter injuries (OASIS) in which we prepared porcine models to educate young physicians in a hands-on workshop at the 23rd Asian and Oceanic Congress of Obstetrics and Gynaecology in Bangkok, Thailand. Laceration of the anal sphincter mostly occurs during vaginal delivery and it can develop into anal sphincter deficiency, which causes fecal incontinence, if an appropriate suture is not performed. OASIS has become an important issue, especially in developing countries. The prevalence of OASIS of more than the third degree is around 5% in primary parous women and the frequency is higher when detected by ultrasonographic evaluation. Several risk factors, such as macrosomia, instrumental labor, perineal episiotomy and high maternal age, have been recognized. In a society where pregnant women are getting older, OASIS is becoming a more serious issue. An intrapartum primary appropriate stitch is important, but the 1-year outcome of a delayed operation after 2 weeks postpartum is similar. A randomized controlled study showed that overlapping suture of the external sphincter is better than that of end-to-end surgical repair. The Urogynecology Committee of the AOFOG would like to continue with educative programs about the appropriate therapy for OASIS.

  5. Fractal dimension and image statistics of anal intraepithelial neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ahammer, H., E-mail: helmut.ahammer@medunigraz.a [Institute of Biophysics, Center of Physiological Medicine, Medical University of Graz, Harrachgasse 21, A-8010 Graz (Austria); Kroepfl, J.M. [Human Performance Research Graz (HPR Graz), Karl-Franzens and Medical University of Graz, Max-Mell Allee 11, A-8010 Graz (Austria); Hackl, Ch. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Sedivy, R. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria)

    2011-01-15

    Research Highlights: Human papillomaviruses cause anal intraepithelial neoplasia (AIN). Digital image processing was carried out to classify the grades of AIN quantitatively. The fractal dimension as well as grey value statistics was calculated. Higher grades of AIN yielded higher values of the fractal dimension. An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  6. 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

  7. Câncer ano-reto-cólico - aspectos atuais: I - câncer anal Anal canal and colorectal cancer - current features: I - anal canal cancer

    Directory of Open Access Journals (Sweden)

    Júlio César M. Santos Jr.

    2007-06-01

    Full Text Available A inclusão do tema - câncer anal - nessa revisão, apesar de sua relativa raridade, responde, em parte, ao propósito de chamar atenção para o significativo aumento dessa lesão e sua estreita relação com doenças sexualmente transmissíveis, principalmente causadas pelo vírus do papiloma humano (HPV; seus aspectos nosológicos, sua epidemiologia, sua etiologia multifatorial, seus fatores de riscos, sua prevenção e, em parte, para revelar a definição atual do tratamento.The inclusion of the theme - anal cancer - in this revision, in spite of its relative rarity, it answers, partly, to the purpose of calling attention for the significant increase of that lesion and its narrow relationship with sexually transmissible diseases mainly caused by the human papilloma virus (HPV; its nosologic aspects, epidemiology, etiology, and the multifactorial nature of risk that is associated to the disease, its prevention, and, partly, to reveal the current definition of the treatment.

  8. NUMERICAL ANALYSIS OF DISLOCATION OF GROUND FISSURE ON THE METRO TUNNEL PARALLELING TO THE GROUND FISSURE'S STRIKE%地铁隧道受平行向地裂缝错动影响数值分析

    Institute of Scientific and Technical Information of China (English)

    吴明; 彭建兵; 贺凯; 孟舒然

    2015-01-01

    The Xi′an metro line 3 paralleling to the strike of f7ground fissure,pass through locally hanging wall of the f7ground fissure.Based on the maximum activity values forecasted by the level monitoring datum,the influence of dislocation of ground fissure on metro tunnel was researched which parallel to the f7ground fissures strike, utilizing the numerical method.The dislocation of ground fissure occurs in characteristic loess soil strata which are compose of loess soil,paleosol and silty clay.By gradually changing the distance between the out layer of metro tunnel liner and the f7ground fissure,the deformation and stress of the metro tunnel liner was computed under six calculation conditions.The results show that the tunnel liner is safe and has safety margin to some extent when the distance is 30meters between the out layer of metro tunnel liner and the f7ground fissure.%西安地铁3号线局部地段通过 f7地裂缝上盘,并且和 f7地裂缝近似平行。基于 f7地裂缝长期水准监测预测的未来最大活动量值,采用数值方法,研究了西安典型的黄土、古土壤和粉质黏土地层下地铁隧道受平行向地裂缝活动的影响。通过逐渐变化地铁隧道衬砌外皮同地裂缝间的距离,计算了6种工况下地铁隧道衬砌的变形和内力。计算结果表明:当地铁隧道衬砌外皮距离地裂缝30m 时,隧道衬砌是安全,并有一定的安全储备。

  9. Mechanical Behavior of Brittle Rock-Like Specimens with Pre-existing Fissures Under Uniaxial Loading: Experimental Studies and Particle Mechanics Approach

    Science.gov (United States)

    Cao, Ri-hong; Cao, Ping; Lin, Hang; Pu, Cheng-zhi; Ou, Ke

    2016-03-01

    Joints and fissures with similar orientation or characteristics are common in natural rocks; the inclination and density of the fissures affect the mechanical properties and failure mechanism of the rock mass. However, the strength, crack coalescence pattern, and failure mode of rock specimens containing multi-fissures have not been studied comprehensively. In this paper, combining similar material testing and discrete element numerical method (PFC2D), the peak strength and failure characteristics of rock-like materials with multi-fissures are explored. Rock-like specimens were made of cement and sand and pre-existing fissures created by inserting steel shims into cement mortar paste and removing them during curing. The peak strength of multi-fissure specimens depends on the fissure angle α (which is measured counterclockwise from horizontal) and fissure number ( N f). Under uniaxial compressional loading, the peak strength increased with increasing α. The material strength was lowest for α = 25°, and highest for α = 90°. The influence of N f on the peak strength depended on α. For α = 25° and 45°, N f had a strong effect on the peak strength, while for higher α values, especially for the 90° sample, there were no obvious changes in peak strength with different N f. Under uniaxial compression, the coalescence modes between the fissures can be classified into three categories: S-mode, T-mode, and M-mode. Moreover, the failure mode can be classified into four categories: mixed failure, shear failure, stepped path failure, and intact failure. The failure mode of the specimen depends on α and N f. The peak strength and failure modes in the numerically simulated and experimental results are in good agreement.

  10. Straight ileo-anal anastomosis with myectomy as an alternative to ileal pouch-anal anastomosis in restorative proctocolectomy.

    Science.gov (United States)

    Landi, E; Landa, L; Fianchini, A; Marmorale, C; Piloni, V

    1994-04-01

    Restorative proctocolectomy with various types of reservoir is widely used in the elective surgery of ulcerative colitis and familial adenomatous polyposis. Both, advantages and disadvantages of this procedure are well known and documented. Straight ileo-anal anastomosis (IAA) yields unsatisfactory clinical results due to the lack of storage capacity of the distal ileum and the frequency of bowel movements related to high pressure ileal waves. In an attempt to create an alternative to the above procedures, we have performed a straight ileo-anal anastomosis with two rectangular (10 cm x 1 cm) myectomies down to 2 cm, above the anastomotic line. The two myectomies are spaced at 120 degrees to each other and to the mesenteric border of the ileal loop. The rationale of this approach is to reduce the peristaltic drive of the ileum by weakening the muscular wall. This study presents the results in three patients operated on with this new method in the last year.

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

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

  12. Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair.

    Science.gov (United States)

    Harvey, Marie-Andrée; Pierce, Marianne; Alter, Jens-Erik W; Chou, Queena; Diamond, Phaedra; Epp, Annette; Geoffrion, Roxana; Harvey, Marie-Andrée; Larochelle, Annick; Maslow, Kenny; Neustaedter, Grace; Pascali, Dante; Pierce, Marianne; Schulz, Jane; Wilkie, David; Sultan, Abdul; Thakar, Ranee

    2015-12-01

    Objectif : Analyser les données probantes traitant des lésions obstétricales du sphincter anal (LOSA) en ce qui concerne leur diagnostic, les techniques visant leur réparation et les résultats de l’intervention. Formuler des recommandations permettant d’éclairer les conseils offerts aux patientes ayant connu des LOSA en ce qui a trait à la voie d’accouchement à privilégier dans le cadre des grossesses subséquentes. Options : Les fournisseurs de soins obstétricaux qui comptent des patientes ayant connu des LOSA disposent de l’option de réparer le sphincter anal en faisant appel à la méthode de suture « bout à bout » (end-to-end) ou à la méthode « en paletot » (overlapping). Ils pourraient également être appelés à conseiller des femmes ayant déjà connu des LOSA en ce qui a trait à la voie d’accouchement à privilégier pour les grossesses subséquentes. Issues : Le critère d’évaluation était la continence anale à la suite d’une réparation primaire de LOSA et à la suite d’un accouchement subséquent. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans Medline, EMBASE et The Cochrane Library en mai 2011 au moyen d’un vocabulaire contrôlé (p. ex. anal canal, obstetrics, obstetric labour complication, pregnancy complication, treatment outcome, surgery, quality of life) et de mots clés (p. ex. obstetrical anal sphincter injur*, anus sphincter, anus injury, delivery, obstetrical care, surgery, suturing method, overlap, end-to-end, feces incontinence) appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs. Aucune restriction n’a été imposée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en septembre 2014. La littérature grise (non

  13. Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma

    OpenAIRE

    Weledji, Elroy P; Elong, Adolphe; Verla, Vincent

    2014-01-01

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the...

  14. Subsurface Gas Flow and Ice Grain Acceleration within Enceladus and Europa Fissures: 2D DSMC Models

    Science.gov (United States)

    Tucker, O. J.; Combi, M. R.; Tenishev, V.

    2014-12-01

    The ejection of material from geysers is a ubiquitous occurrence on outer solar system bodies. Water vapor plumes have been observed emanating from the southern hemispheres of Enceladus and Europa (Hansen et al. 2011, Roth et al. 2014), and N2plumes carrying ice and ark particles on Triton (Soderblom et al. 2009). The gas and ice grain distributions in the Enceladus plume depend on the subsurface gas properties and the geometry of the fissures e.g., (Schmidt et al. 2008, Ingersoll et al. 2010). Of course the fissures can have complex geometries due to tidal stresses, melting, freezing etc., but directly sampled and inferred gas and grain properties for the plume (source rate, bulk velocity, terminal grain velocity) can be used to provide a basis to constrain characteristic dimensions of vent width and depth. We used a 2-dimensional Direct Simulation Monte Carlo (DSMC) technique to model venting from both axi-symmetric canyons with widths ~2 km and narrow jets with widths ~15-40 m. For all of our vent geometries, considered the water vapor source rates (1027­ - 1028 s-1) and bulk gas velocities (~330 - 670 m/s) obtained at the surface were consistent with inferred values obtained by fits of the data for the plume densities (1026 - 1028 s-1, 250 - 1000 m/s) respectively. However, when using the resulting DSMC gas distribution for the canyon geometries to integrate the trajectories of ice grains we found it insufficient to accelerate submicron ice grains to Enceladus' escape speed. On the other hand, the gas distributions in the jet like vents accelerated grains > 10 μm significantly above Enceladus' escape speed. It has been suggested that micron-sized grains are ejected from the vents with speeds comparable to the Enceladus escape speed. Here we report on these results including comparisons to results obtained from 1D models as well as discuss the implications of our plume model results. We also show preliminary results for similar considerations applied to Europa

  15. 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 %.

  16. The epidemiology of anal human papillomavirus infection among women and men having sex with women.

    Science.gov (United States)

    Nyitray, Alan G

    2012-12-01

    The goal of this review is to summarise epidemiological data that support an understanding of the natural history of anal human papillomavirus (HPV) among women and men having sex with women (MSW). HPV is a common infection of the anal canal among women and MSW. Although there have been a limited number of studies to date, both oncogenic and nononcogenic HPV genotypes commonly occur among these populations even when individuals do not report receptive anal sex. Genotype distribution is quite diverse, with recent studies typically detecting more than two dozen genotypes in the anal canal in samples of women and MSW. Factors most consistently associated with HPV in the anal canal among both women and MSW are lifetime number of sexual partners and detection of HPV at the genitals. The common finding of genotypic concordance between the genitals and anal canal in women and MSW, and the infectious nature of HPV, in addition to a limited number of studies offering empirical evidence of anal-to-genital self-inoculation and evidence of HPV hand carriage, may help explain the detection of HPV in the anal canal outside the context of receptive anal sex. HPV vaccination has been shown to reduce anal HPV infection among women and is also a promising prevention strategy among MSW.

  17. Conceptualizations of heterosexual anal sex and HIV risk in five East African communities.

    Science.gov (United States)

    Duby, Zoe; Colvin, Christopher

    2014-01-01

    Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

  18. A novel artificial anal sphincter system based on transcutaneous energy transmission

    Institute of Scientific and Technical Information of China (English)

    Zan Peng; Yan Guozheng; Liu Hua

    2008-01-01

    For controlling anal incontinence, a new artificial anal sphincter system (AASS) with sensor feedback based on transcutaneous energy transmission is developed. The device mainly comprises an artificial anal sphincter (AAS), a wireless power supply subsystem, and a communication subsystem. The artificial anal sphincter comprises a front cuff and a sensor cuff placed around the rectum, a reservoir sited in abdominal cavity and a micropump controlling inflation and deflation of the front cuff. There are two pressure sensors in the artificial anal sphincter. One can measure the pressure in the front cuff to clamp the rectum, the other in the sensor cuff can measure the pressure of the rectum. Wireless power supply subsystem includes a resonance transmit coil to transmit an alternating magnetic field and a secondary coil to receive the power. Wireless communication subsystem can transmit the pressure information of the artificial anal sphincter to the monitor, or send the control commands to the artificial anal sphincter. A prototype is designed and the basic function of the artificial anal sphincter system has been tested through experiments. The results demonstrate that the artificial anal sphincter system can control anal incontinence effectively.

  19. 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.

  20. 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.

  1. Progression of anal high-grade squamous intraepithelial lesions to invasive anal cancer among HIV-infected men who have sex with men.

    Science.gov (United States)

    Berry, J Michael; Jay, Naomi; Cranston, Ross D; Darragh, Teresa M; Holly, Elizabeth A; Welton, Mark L; Palefsky, Joel M

    2014-03-01

    The incidence of anal cancer is elevated in human immunodeficiency virus (HIV)-infected men-who-have-sex-with-men (MSM) compared to the general population. Anal high-grade squamous intraepithelial lesions (HSIL) are common in HIV-infected MSM and the presumed precursors to anal squamous cell cancer; however, direct progression of HSIL to anal cancer has not been previously demonstrated. The medical records were reviewed of 138 HIV-infected MSM followed up at the University of California, San Francisco, who developed anal canal or perianal squamous cancer between 1997 and 2011. Men were followed up regularly with digital anorectal examination (DARE), high-resolution anoscopy (HRA) and HRA-guided biopsy. Although treatment for HSIL and follow-up were recommended, not all were treated and some were lost to follow-up. Prevalent cancer was found in 66 men. Seventy-two HIV-infected MSM developed anal cancer while under observation. In 27 men, anal cancer developed at a previously biopsied site of HSIL. An additional 45 men were not analyzed in this analysis due to inadequate documentation of HSIL in relation to cancer location. Of the 27 men with documented progression to cancer at the site of biopsy-proven HSIL, 20 men progressed from prevalent HSIL identified when first examined and seven men from incident HSIL. Prevalent HSIL progressed to cancer over an average of 57 months compared to 64 months for incident HSIL. Most men were asymptomatic, and cancers were detected by DARE. Anal HSIL has clear potential to progress to anal cancer in HIV-infected MSM. Early diagnosis is facilitated by careful follow-up. Carefully controlled studies evaluating efficacy of screening for and treatment of HSIL to prevent anal cancer are needed.

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

    Science.gov (United States)

    Knaus, Tracey A.; Tager-Flusberg, Helen; Foundas, Anne L.

    2012-01-01

    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. PMID:22713374

  3. In vitro study of microleakage of different techniques of surface preparation used in pits and fissures

    Directory of Open Access Journals (Sweden)

    Shahrzad Javadi Nejad

    2012-01-01

    Full Text Available Objective : The purpose of this in vitro study was to evaluate the effect of different techniques of surface preparation on the microleakage of a sealant applied with traditional acid etching and self-etched bonding agent. Study Design : A total of 60 extracted third molars were randomly assigned into six groups (n = 10/each. The occlusal surfaces were sealed with a sealant (Clinpro after one of the following pretreatments: (1 phosphoric acid etching; (2 Prompt L-Pop; (3 laser + etching; (4 laser + Prompt L-Pop; (5 air abrasion + etching; (6 air abrasion + Prompt L-Pop. The specimens were immersed in a 0.5% basic fuchsin solution. Buccolingual cuts parallel to the long axis of the tooth were made. The surfaces were scored 0--2 for extent of microleakage using a microscope and the data were analyzed statistically. Results : The poorest results were obtained with laser + Prompt L-Pop which showed a greater number of specimens with microleakage (80%. Air abrasion surface preparation + phosphoric acid etching showed less microleakage than the other groups (40%. Kruskal--Wallis and t-tests revealed no significant difference in microleakage between six groups. Conclusion : The self-etching adhesive studied seems an attractive alternative to the acid-etch technique for sealant application in young children where simplifications in the clinical procedure are warranted. No significant difference was noted between the different types of enamel preparation before fissure sealant.

  4. 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.

  5. Estudo microanatômico da fissura coroidéia na abordagem dos ventrículos e cisternas cerebrais Microanatomical study of the choroidal fissure in ventricular and cisternal approaches

    Directory of Open Access Journals (Sweden)

    Gustavo R. Isolan

    2005-09-01

    Full Text Available A fissura coroidéia é uma estreita fenda situada na parte medial dos ventrículos laterais, em formato de "C", entre o fórnix e o tálamo e onde o plexo coróide se adere. O fato de não haver tecido nervoso entre o epêndima e a pia-máter ao longo deste acidente anatômico torna-o uma importante via no acesso aos ventrículos e cisternas cerebrais. Foram estudados cinco cérebros, injetando-se artérias e veias com material siliconado colorido e cinco cérebros sem realce colorido dos vasos, num total de 20 hemisférios cerebrais. Foram analisadas e revisadas as relações neurais, arteriais e venosas, bem como as abordagens cirúrgicas em cada parte da fissura coroidéia. Concluiu-se que o conhecimento prévio detalhado desta microanatomia é fundamental para os neurocirurgiões que vão abordar lesões nos ventrículos e cisternas cerebrais, pois se obtém uma noção tridimensional que será indispensável durante o ato cirúrgico.The choroidal fissure is a narrow cleft in the medial part of the lateral ventricle, in a C-shaped arc, between the fornix and the thalamus, where the choroidal plexus join. Due to absence nervous tissue between ependima and pia-mater along this invagination, it is an important route in brain ventricles and cisterns. Five brains were studied by injecting colored silicone arteries and veins and five brains without colored silicone, in a total number of 20 brain hemispheres. It was analized and revised the neural, arterial and venous relationships and surgical approaches in all parts of the choroidal fissure. In conclusion, the previous knowledge detailed this microanatomy is primordial for neurosurgeons that will approach brain ventricular and cisternal lesions because the neurosurgeons gain a tridimensional notion that will be indispensable during surgery.

  6. Fluid flow on 3D triangulated fissures: conservative piece-wise constant velocity fields and associated transport processes

    CERN Document Server

    Morales, Fernando A

    2016-01-01

    For a fissured medium with uncertainty in the knowledge of fractures' geometry, a conservative tangential flow field is constructed, which is consistent with the physics of stationary fluid flow in porous media and an interpolated geometry of the cracks. The flow field permits computing preferential fluid flow directions of the medium, rates of mechanical energy dissipations and a stochastic matrix modeling stream lines and fluid mass transportation, for the analysis of solute/contaminant mass advection-diffusion as well as drainage times.

  7. Probable recent water/lava source fissures in the Cerberus Plains: stratigraphic and crater count age constraints

    Science.gov (United States)

    Thomas, R.

    2012-09-01

    The Cerberus Plains have received increasing attention in recent years due to evidence from highresolution imagery that they are some of the youngest surfaces on Mars. The plains are incised by large outflow channels, possibly as recently as 20Ma in the case of Athabasca Valles [2]. These channels are generally thought to be water-carved [1,3], though it is possible they were incised by turbulent lava [8]. As recently as 10Ma or less [5] both the channels and the plains around them are proposed to have been draped with lava [7]. Thus the recent activity forming the Cerberus Plains probably required large volumes of both water and lava. The problem which arises is a source. Cerberus Fossae have been suggested as the source of the Athabasca Valles outflows [3,6], but topographic and stratigraphic issues have arisen which make this unlikely: for example, a streamlined island spans the fossa where water and/or lava is said to have originated [4]. No other specific sources have been identified. As plains volcanism often obscures its fissures, sources should be searched for in features elevated above the plain. New HiRISE images have shown just such a feature: a wrinkle ridge south of Cerberus Fossae incised by a series of fissures. Every fissure has associated channels and deposits indicating outflow onto the plains surrounding the ridge. Until now, the stratigraphic history of these features was poorly known, with Tanaka et al.'s [9] geological map considering the area only on the broadest scale. This study produces small-scale geomorphological maps to establish the stratigraphic relationships between the fissure-sourced outflows and the plains surrounding the ridge to test the hypothesis that they were the source of the plains material. Crater counting is also conducted to supplement stratigraphic observations and give tentative ages.

  8. Papilomavirus humano e o câncer anal

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2006-06-01

    Full Text Available O Papilomavirus humano (HPV é uma das causas mais comuns de doença sexualmente transmissível, podendo provocar os condilomas acuminados que são considerados fatores de risco para displasia e neoplasia. Embora os HPV de alto risco sejam causa necessária para o câncer cervical, eventos genéticos adicionais são indispensáveis para transformação maligna da maioria dos carcinomas anais e de outros sítios. Os trabalhos da literatura especializada ainda não conseguiram demonstrar se esse vírus é o fato determinante ou associado ao carcinoma anal. É preciso que mais pesquisas sejam feitas para resolver esse dilema. De qualquer forma, sugerimos que o controle das lesões clínicas e das sub-clínicas provocadas pelo HPV possa evitar a eventual progressão para carcinoma invasivo.Human Papillomavirus (HPV is one of the commonest sexually transmitted diseases agents. It can provoke condylomata acuminata, considered at risk to dysplasia and neoplasia. Although, high-risk HPVs are necessary to cervical cancer, additional genetic events are essential to malign transormation of most of anal carcinoma. Specialized studies did not explain already if this vírus is the cause or the associated factor to anal carcinoma. More research is needed to solve this doubt. Anyway, we suggest that clinic and sub-clinic lesions control could avoid the eventual evolution to invasive carcinoma.

  9. The architecture and shallow conduits of Laki-type pyroclastic cones: insights into a basaltic fissure eruption

    Science.gov (United States)

    Reynolds, P.; Brown, R. J.; Thordarson, T.; Llewellin, E. W.

    2016-05-01

    Pyroclastic cones built along basaltic fissures provide important volcanological information, but it is often difficult to examine the early-erupted products due to burial by later products. Furthermore, it is rare to see the link between the feeder dyke and overlying cone fully exposed. In this study, we detail the architecture of a hybrid spatter cone, scoria half-cone and feeder dyke that has been dissected to below the pre-eruption surface by glacial floods. The cones were constructed during the 6-8 ka Rauðuborgir-Kvensöðul fissure eruption in North Iceland during Hawaiian- and Strombolian-style activities. Widening of their feeder dyke in the shallow sub-surface to produce an upward flaring morphology was accommodated by country rock removal and elastic host rock deformation. Ballistic calculations and stratigraphic relationships indicate that the scoria half-cone was constructed early in the eruption from the deposits of a lava fountain ~100 m high. A decline in fountain height and the generation of abundant welded deposits resulted in the formation of a nested spatter cone within the scoria half-cone. The cones are similar in structure and size to the hybrid scoria and spatter cones produced during the 15-km3 1783 Laki eruption and serve as a valuable window into the construction of pyroclastic edifices during basaltic fissure eruptions.

  10. Amoebic anal fistula: new insight into an old disease.

    Science.gov (United States)

    Agrawal, Vivek; Garg, Pankaj Kumar; Jain, Bhupendra Kumar; Mishra, Kiran; Mohanty, Debajyoti

    2014-04-01

    A 67-year-old gentleman underwent fistulectomy for low trans-sphincteric anal fistula along with curettage for an associated abscess extending proximally for half a centimeter into the intersphincteric plane. The roof of the cavity became clearly visible after satisfactory culmination of the surgical procedure. Histopathological examination of the fistulous tract and the curetted granulation tissue revealed presence of multiple trophozoites of Entamoeba histolytica exhibiting erythrophagocytosis in the background of mixed inflammatory infiltrate. This case report provides the outlook that yields the novel insight into the possible role of Entamoeba histolytica in the pathogenesis and persistence of the fistulous tract.

  11. Role of intracellular calcium in contraction of internal anal sphincter

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    @@ INTRODUCTION Internal anal sphincter (IAS) is a continuation of the smooth circular muscle layer thickened at the rectum, innervated by vegetative nerve. IAS is a special smooth muscle, which is different from colonic smooth muscle in physiology and pharmaology[1]. It was found that contraction of gastric smooth muscle depends on the influx of extracellular calcium and release of intracellular calcium[2]. In present study, we observed and compared the effects of extra- and intracellular calcium on the contraction of IAS and colonic smooth muscle.

  12. Learning discriminative classification models for grading anal intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Kainz Philipp

    2016-09-01

    Full Text Available Grading intraepithelial neoplasia is crucial to derive an accurate estimate of pre-cancerous stages and is currently performed by pathologists assessing histopathological images. Inter- and intra-observer variability can significantly be reduced, when reliable, quantitative image analysis is introduced into diagnostic processes. On a challenging dataset, we evaluated the potential of learning a classifier to grade anal intraepitelial neoplasia. Support vector machines were trained on images represented by fractal and statistical features. We show that pursuing a learning-based grading strategy yields highly reliable results. Compared to existing methods, the proposed method outperformed them by a significant margin.

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

    OpenAIRE

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

    2012-01-01

    Objective: 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). Materials and Methods: The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targe...

  14. Video-assisted anal fistula treatment: technical considerations and preliminary results of the first brazilian experience

    OpenAIRE

    Mendes,Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; Sapucaia,Ricardo Aguiar; LIMA, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    Backgroung : Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim : To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique : A Karl Storz video equipment was used. Main steps included the ...

  15. Morphologic Study of Superior Temporal Sulcus-Amygdaloid Body and Lateral Fissure-Amygdaloid Body Surgical Approach by Using Magnetic Resonance Imaging Volume Rendering.

    Science.gov (United States)

    Qu, Yuan; Ren, Bichen; Chang, Xiaoyu; Zhang, Jinnan; Li, Youqiong; Duan, Haobo; Cheng, Kailiang; Wang, Jincheng

    2016-01-01

    In this research, 83 patients were measured by magnetic resonance imaging volume rendering technique. The authors acquired the curve length of the superior temporal sulcus and the lateral fissure on the cerebral hemisphere, the shortest distance from the superior temporal sulcus and the lateral fissure to the center of amygdaloid body separately, the vertical diameter, the transversal diameter, and the anteroposterior diameter of the amygdaloid body and the 2 approach angles between the median sagittal plane and the shortest segment from the superior temporal sulcus to the center of amygdaloid body and the shortest segment from lateral fissure to the center of the amygdaloid body. At the same time, we preliminarily oriented the 2 points of the superior temporal sulcus and the lateral fissure, which are closest to the center of amygdaloid body, aimed at finding out the best entrance points of surgical approach through the superior temporal sulcus and the lateral fissure to the amygdaloid body and reducing the damage to the nerve fibers or blood vessels during the operation. The results indicate that the point at the front side 1/4 of the superior temporal sulcus may be the ideal surgical approach entrance point and the point at the front side 1/3 of the lateral fissure. There is no difference between 2 cerebral hemispheres (P < 0.05).

  16. PROGRESS IN GROUND FISSURES AND ITS HAZARD RESEARCH%地裂缝及其灾害研究的新进展

    Institute of Scientific and Technical Information of China (English)

    王景明; 刘科; 王春梅

    2001-01-01

    已查明我国26个省市出现具一定规模的地裂缝1 003处,6 000多条。其中80%是构造地裂缝,它们是地壳浅表层破裂。区域地裂缝与强震区分布一致,活跃期也相吻合,它们是同一构造应力场作用的不同构造现象,区域地裂缝释放地壳应变能远超过同期强震能量释放的总和。作为动力源的地裂缝活动使同期地质体发生位移产生形变场和应力场,并通过地基使建筑物结构等失稳失效破坏成灾,估算全国地裂缝造成的损失为91.2亿元,其中华北区损失占70%。地裂缝已构成一个新的独立的灾种。%It generally discusses the main progress in ground fissures studyingin in our country's.Investigation showes that:there are 1 003 places (more than 6 000 strips) where ground fissures are on a certain extent scale and knockout in 26 provinces and cities in China.Among which tectonic ground fissures occupies about 80%.The ground fissures of wriggle fault occupies 15%~20.8% and that of territorial slight cracking occupies 79.2%~85% among tectonic ground fissures.Tectonic ground fissures are territorial superficial crack of lithosphere.They are domino effect of wriggle crack in rock and soil.   According to the pattern of distribution,the degree of development,the type of cause of formation and tectonic background,it can be marked off four distributed regions of ground fissures such as the NANHUA,the big North of China,the Northeast and the West.In every place the degree of development of ground fissures is corresponding to the degree of lithosphere motion at the location.In the big North of China,the earth is basically steady once,and the length of the ground fissures with earthquake and without earthquake separately add up to 321 km and 497 km.In the West,the lithosphere is relatively unsteady,and that separately add up to 2 696 km and 2.5 km.In the Nanhua and the Northeast,lithosphere is relatively steady,and the non

  17. Surgical treatment of anal stenosis: assessment of 77 anoplasties Tratamento cirúrgico da estenose anal: resultados de 77 anoplastias

    Directory of Open Access Journals (Sweden)

    Angelita Habr-Gama

    2005-02-01

    Full Text Available PURPOSE: Anal stenosis is a rare, incapacitating, and challenging condition, occurring mainly after hemorrhoidectomy, for which several surgical techniques have been devised. The purpose of this study was to describe early and late (1 year results of 77 anoplasty operations performed in the Colorectal Unit of our institution. METHODS: From 1977 to 2002, 77 patients with moderate to severe anal stenosis underwent surgery using two sliding graft techniques: 58 underwent Sarner's operation and 19 underwent Musiari's technique. Bilateral flaps were used in 7 patients. RESULTS: Early morbidity was due to pruritus occurring in 2 patients, urinary infection in 1, and temporary incontinence in 1 patient. One patient needed early reoperation following suture line dehiscence. Late results (1 year were classified as good in 67 cases (87%. There was no reoperation due to recurrence of stenosis. CONCLUSION: The ease of performance, good functional results, and lack of severe complications show that Sarner's and Musiari's flap advancement techniques are effective and safe methods for surgical correction of anal stenosis, particularly when cutaneous fibrosis plays a major role in its etiology.OBJETIVO: A estenose anal é uma condição rara, incapacitante e desafiadora que ocorre principalmente após hemorroidectomia, para a qual diversas técnicas cirúrgicas reparadoras foram desenvolvidas. O objetivo deste estudo é descrever os resultados precoces e tardios (um ano de 77 anoplastias realizadas no Serviço de Cirurgia Colorretal. MÉTODOS: No período de 1977 a 2002, 77 pacientes com estenose anal moderada ou grave foram operados, utilizando-se duas técnicas diferentes de avanço de retalho: 58 foram submetidos à técnica de Sarner e 18 submetidos à Técnica de Musiari. Avanços bilaterais foram utilizados em sete pacientes. RESULTADOS: As complicações precoces foram: prurido em dois pacientes, infecção urinária em um paciente e incontinência fecal

  18. Anal Pap Screening for HIV-infected Men Who Have Sex With Men: Practice Improvement.

    Science.gov (United States)

    Welbeck, Monique

    2016-01-01

    HIV-infected men who have sex with men (MSM) have the highest rates of anal dysplasia and anal cancer when compared to HIV-uninfected MSM and when compared to HIV-infected heterosexual men and women. Despite significantly increasing rates of anal dysplasia and anal cancer in HIV-infected MSM, in many settings, no standard protocol is in place to screen for anal dysplasia in this high-risk group. A practice improvement project was conducted at a primary care health center to educate the HIV health care team about anal Pap screening in an effort to increase provider knowledge and rates of anal Pap screening performed as part of primary comprehensive care for HIV-infected MSM. Increased health care provider knowledge of anal Pap screening within this setting resulted in increased anal Pap screening for HIV-infected MSM. Routine screening leads to improved surveillance and treatment of precancerous lesions, decreasing morbidity and mortality in HIV-infected MSM.

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

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    healthy women received 30 RBDs in the rectum and the anal canal at intensities corresponding to sensory and unpleasantness thresholds, and response was recorded as cortical evoked potentials (CEPs) in 64-channels. The anal canal stimulations at unpleasantness level were repeated after 4 min to test...... showed reproducibility with ICCs for all bands >0.8 and corresponding CVs potentials evoked from the anal canal are challenged by latency jitter likely related to variability in muscle tone due to the distensions. Using single-sweep analysis, anal CEPs proved...

  20. [Choice of surgical procedure and management of postoperative incision for anal fistula].

    Science.gov (United States)

    Chen, Chaowen; Peng, Bo

    2015-12-01

    Anal fistula is a common disease in general surgery. It is difficult to heal without intervention and surgical treatment is the major treatment. Method of surgical treatment and management of postoperative incision are based on features and classifications of anal fistula. Choosing the appropriate approach in accordance with specific conditions of patients can obtain effective healing and proper protection against anal sphincter, along with the improvement of life quality. Comprehensive evaluation on methods of surgical treatment and managements of postoperative incision for anal fistula is presented in this paper.

  1. A New Method to Treat High Anal Fistula - Bidirectional Isobaric Drainage

    DEFF Research Database (Denmark)

    Zheng, Linghua; Wang, Yanmei; Zhao, Jingbo

    2016-01-01

    Background and aim: Traditionally, the principle of the treatment for anal fistula is "open fistula, fistulotomy ". Fistulotomy is the standard treatment for simple and low fistulas. However for the high fistula, the anorectal ring will be disconnected by fistulotomy. A better treatment should...... postoperative pain and protect anal function. In the patients of Experimental group, the appearance was kept well and had good anal closure (Figure 1 A-D). However, in the patients of Control group, the appearance was changed and the anal closure was not well (Figure 1 E-H). Conclusions and perspectives...

  2. The hero, the anima and the claustrum: anality and idealization.

    Science.gov (United States)

    Meredith-Owen, William

    2012-04-01

    Joe Redfearn's (1979) classic paper 'The captive, the treasure, the hero and the anal stage of development' is recognized as seminal to the development of Jungian thought about anality, particularly its integration with mainstream (Freudian, Kleinian) psychoanalytic perspectives. This paper develops such an approach through drawing on contributions from Meltzer, Green, Bion, Chasseguet-Smirgel and Kernberg. More specifically, it is argued that over-investment in hero and anima archetypal configurations may represent an attempt to replace the resource of the internal parental couple that, at the level of unconscious phantasy, has been destroyed by the aggrieved child's attack on the primal scene. Unless this usually dissociated sadism can be integrated, the creative epistemophilic instinct may remain blunted, giving rise, through projective identification, to the adoption of a pseudo-adult identity based on appropriation or assertion. This in turn may lead to manic attempts to reach authentic ('animating') experience through the (often erotized) excitement of heroic endeavour. Consideration of both Redfearn's and the author's own clinical material demonstrates how close attention to process as well as content is fundamental to revealing and addressing such likely-to-be dissociated scenarios.

  3. Radiofrequency fistulotomy: a better alternative for treating low anal fistula

    Directory of Open Access Journals (Sweden)

    Pravin Jaiprakash Gupta

    Full Text Available CONTEXT: Wide varieties of approaches are employed in dealing with low anal fistula. However, the simple method of laying open the fistula tract (fistulotomy is still considered to be the favored one. MATERIALS AND METHODS: A modified approach to the procedure of fistulotomy is discussed. This study describes the procedure, which used a technique of radiofrequency surgery, and its outcome in 232 patients with low anal fistula. The patients were followed for a period of 15 months. RESULTS: The patients were discharged on the same day as the procedure. The mean period off work was four days. The average healing time recorded was 67 days. Four wound complications in the form of premature closure of the external wound were noted, which required trimming of the edges. Two of these wounds remained unhealed. The recurrence rate was 1.7%. CONCLUSION: In this era when the emphasis is on criteria like the minimization of hospital stay, reduction of postoperative pain, early resumption of work and low and comparable recurrence rates, there is a future for the procedure of radiofrequency fistulotomy.

  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. Characterisation and microleakage of a new hydrophilic fissure sealant - UltraSeal XT® hydro™

    Science.gov (United States)

    GÜÇLÜ, Zeynep A.; DÖNMEZ, Nazmiye; HURT, Andrew P.; COLEMAN, Nichola J.

    2016-01-01

    ABSTRACT Objectives The aim of this study was to characterise the new hydrophilic fissure sealant, UltraSeal XT® hydro™ (Ultradent Products, USA), and to investigate its in vitro resistance to microleakage after placement on conventionally acid etched and sequentially lased and acid etched molars. Material and Methods The sealant was characterised by Fourier transform infra-red spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX), and Vickers indentation test. Occlusal surfaces of extracted human molars were either conventionally acid etched (n=10), or sequentially acid etched and laser irradiated (n=10). UltraSeal XT® hydro™ was applied to both groups of teeth which were then subjected to 2,500 thermocycles between 5 and 55°C prior to microleakage assessment by fuchsin dye penetration. Results UltraSeal XT® hydro™ is an acrylate-based sealant that achieved a degree of conversion of 50.6±2.2% and a Vickers microhardness of 24.2±1.5 under standard light curing (1,000 mWcm-2 for 20 s). Fluoride ion release is negligible within a 14-day period. SEM and EDX analyses indicated that the sealant comprises irregular submicron and nano-sized silicon-, barium-, and aluminium-bearing filler phases embedded in a ductile matrix. Laser preconditioning was found to significantly reduce microleakage (Mann-Whitney U test, proughness on a 50 to 100 μm scale that caused the segregation and concentration of the filler particles at the enamel-sealant interface. Conclusion Laser preconditioning significantly decreased microleakage and increased enamel surface roughness, which caused zoning of the filler particles at the enamel-sealant interface. PMID:27556205

  6. Measurements of the gas emission from Holuhraun volcanic fissure eruption on Iceland, using Scanning DOAS instruments

    Science.gov (United States)

    Galle, Bo; Pfeffer, Melissa; Arellano, Santiago; Bergsson, Baldur; Conde, Vladimir; Barsotti, Sara; Stefansdottir, Gerdur; Ingvarsson, Thorgils; Bergsson, Bergur; Weber, Konradin

    2016-04-01

    On 31 August 2014 a volcanic fissure eruption started at Holuhraun on Iceland. The eruption lasted for 6 months and was by far the strongest source of sulfur dioxide in Europe over the last 230 years, with sustained emission rates exceeding 100 000 ton/day. This gas emission severely affected people within Iceland. Under the scope of the EU-project FUTUREVOLC, a project with 3.5 years duration, aiming at making Iceland a supersite for volcanological research as a European contribution to GEO, a version of the Scanning DOAS instrument that is adapted to high latitudes with low UV radiation and severe meteorological conditions was developed. Since the first day of the eruption several of these novel instruments were monitoring the SO2 emission from the eruption. A lot of work was needed to sustain this operation during the winter at a very remote site and under severe field conditions. At the same time the very high concentrations in the gas plume, in combination with bad meteorological conditions has required the development of novel methods to derive reliable flux estimates. A simple approach to make a first order correction for atmospheric scattering has been applied, as well as filtering of the dataset to remove the data most affected by scattering. Substantial work has also been made to obtain realistic information on plume height and wind speed. The data from these instruments are the only sustained ground-based measurements of this important gas emission event. In this presentation we will discuss the instrumental issues and evaluation procedures and present the latest version of the emission estimates made from our measurements.

  7. 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.

  8. Anal paracoccidioidomycosis: an unusual presentation of disseminated disease Paracoccidioidomicose anal: apresentação pouco comum de uma doença disseminada

    Directory of Open Access Journals (Sweden)

    René Aloisio da Costa Vieira

    2001-12-01

    Full Text Available We report a patient with an unusual anal ulceration. The biopsy of an anal lesion and subsequent studies revealed a disseminated form of paracoccidioidomycosis, observed in the lungs, small and large bowel. The anorectal disease frequently represents a secondary site of disease, and the patient must be better evaluated.Relatamos um paciente com uma lesão anal incomum. A biópsia da ulceração anal e estudos subsequentes, revelaram a forma disseminada da paracoccidioidomicose presente no pulmão, intestino delgado e grosso. A doença anorretal freqüentemente representa um sítio secundário da doença, devendo o paciente ser melhor avaliado.

  9. Increases in Oral and Anal Sexual Exposure among Youth Attending STD Clinics in Baltimore, Maryland.

    OpenAIRE

    Gindi, Renee M.; Ghanem, Khalil G.; ERBELDING, EMILY J.

    2007-01-01

    We examined reports of receptive oral or anal sex among clinic patients age 12−25 over time. Odds of reporting oral sex were approximately three times higher in 2004 than in 1994; odds of anal sex were twice as high. Providers should be aware of increased risk behavior among young people.

  10. Surgical treatment of locally advanced anal cancer after male-to-female sex reassignment surgery

    Institute of Scientific and Technical Information of China (English)

    Marco Caricato; Fabio Ausania; Giovanni Francesco Marangi; Ilaria Cipollone; Gerardo Flammia; Paolo Persichetti; Lucio Trodella; Roberto Coppola

    2009-01-01

    We present a case of a transsexual patient who underwent a partial pelvectomy and genital reconstruction for anal cancer after chemoradiation. This is the first case in literature reporting on the occurrence of anal cancer after male-to-female sex reassignment surgery. We describe the surgical approach presenting our technique to avoid postoperative complications and preserve the sexual reassignment.

  11. 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…

  12. 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

  13. Adenocarcinoma arising from an anal gland—Report of a case

    Science.gov (United States)

    Sakamoto, Takashi; Konishi, Fumio; Yoshida, Takayoshi; Yoshinaga, Yasuo; Izumo, Toshiyuki; Lefor, Alan

    2014-01-01

    INTRODUCTION Adenocarcinoma arising from an anal gland is extremely rare. Most anal canal cancers are squamous cell carcinoma, and adenocarcinoma is infrequently diagnosed. Diagnostic criteria and the standard treatment for adenocarcinoma of the anal canal have not been clearly defined, in part because of the rarity of this lesion. PRESENTATION OF CASE An 84-year-old man who presented with a piece of tissue prolapsing from the anus. An incisional biopsy showed adenocarcinoma, and an abdomino-perineal resection was then performed. Cytokeratin 7 (CK7), cytokeratin 19 (CK19) stained positive in the specimen, suggesting that the tumor developed from an anal gland. The patient was discharged after surgery without any complications. DISCUSSION Exact diagnostic criteria for adenocarcinoma of the anal canal have not been previously described. In the present case, CK7 and CK19 were stained, and the tumor showed positivity for both of these markers, which is compatible with the staining patterns of anal gland origin cancer. Radical resection is recommended rather than local resection, because of the tumor's high recurrence rate. Some authors recommend combined modality treatment with preoperative or postoperative chemoradiotherapy because of the high rate of distant recurrence. CONCLUSION The preoperative diagnosis of adenocarcinoma arising from an anal gland is not easily established. However, it may be possible to suspect an anal glandular adenocarcinoma based on a meticulous physical examination, appropriate diagnostic studies and pathological findings on biopsy. PMID:24705191

  14. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... Chronic myelogenous leukemia is grouped into phases: Chronic Accelerated Blast crisis The chronic phase can last for ...

  15. Hacia una pragmática analógica

    Directory of Open Access Journals (Sweden)

    Mauricio Beuchot

    2013-02-01

    Full Text Available En este artículo se intenta plantear la posibilidad de una pragmática analógica, es decir, que tome en cuenta la noción aristotélica de analogía. La analogía se coloca entre la univocidad y la equivocidad, siendo la primera el ideal de lo claro y lo distinto, perfectamente riguroso y exacto; en pragmática es la pretensión del sentido literal pleno. La equivocidad es lo ambiguo e inexacto; en pragmática es la pérdida total del sentido literal. En cambio, la analogía da el sentido de la mediación, tomando de la univocidad la tensión hacia la exactitud y de la equivocidad la apertura, aprovecha sus ventajas, sin caer en los vicios de esos extremos.

  16. Tepelná analýza Gunnovy diody

    OpenAIRE

    Chára, Pavel

    2010-01-01

    Cílem bakalářské práce byla tepelná analýza Gunnovy diody. Model Gunnovy diody zahrnující tepelné jevy byl analyzován programem COMSOL Multiphysics. Dalším úkolem bylo navrhnout pro diodu vhodný chladič a jeho správnou funkci ověřit simulacemi. The aim of bachelor’s project has been thermal analysis of Gunn diode. Gunn diode model involving thermal effects was analyzed in COMSOL Multiphysics. Another task was to design a suitable heat sink for diode and its proper function to verify simula...

  17. Komercbanku darbības analīze

    OpenAIRE

    Sileniece, Elīna

    2013-01-01

    Darba autors uzskata, ka bakalaura darba temats „Komercbanku darbības analīze” ir aktuāls, jo nereti bankas tiek salīdzinātas ar tautsaimniecības sirdi, kurām jānodrošina visa tautsaimniecība ar naudu. Lai tās pietiktu saimniecisko darījumu kārtošanai un ekonomikas augšupejai, un uzsākot uzņēmējdarbību - ir jāizvēlas banka. Temats ir aktuāls gan fiziskām, gan juridiskām personām. Jo katram ir dota iespēja pārvaldīt sev pieejamos naudas līdzekļus. Komercbanku darbības rezultāti atstāj iespa...

  18. [Obstetric damage to the perineum and the anal sphincters. Reconstruction surgery].

    Science.gov (United States)

    Kościński, Tomasz

    2014-08-01

    Damage to the perineum, vulva, anal sphincters, rectal wall and the fascial structures of the pelvic floor may be caused by obstetric trauma. Emergency surgical treatment aims at control of the bleeding, anatomical reconstruction of the disrupted tissues and minimization of the risk of infection. Suturing of the rectal wall and mucosa of the anal canal is followed by reconstruction of the perineal body internal and external anal sphincters, vulva and the perineum. Delayed surgery is undertaken after the complete healing of the obstetric tear. All cicatricial fibers must be saved to reinforce sphincters and perineal body muscles suturing. Anal levators and perineal transvers muscles suturing is used for the rectovaginal septum and pelvic floor reconstruction. Anal sphincters are reconstructed by the 'overlapping' technique. X en Z suturing is used for a perineal skin plasty.

  19. [Some critical issues in the diagnosis and treatment of complex anal fistula].

    Science.gov (United States)

    Ren, Donglin; Zhang, Heng

    2015-12-01

    In the past thirty years, colorectal surgeons have made great progress regarding the diagnosis and treatment of complex anal fistula, including the improvement of the accuracy of the preoperative evaluation of complex anal fistula, the improvement and standardization of the diagnosis and treatment of perianal fistulising Crohn's disease, the application of various "sphincter-sparing" procedures. However, complex anal fistula continues to prove a formidable challenge with a high recurrence rate and high incontinence rate. The variety of the surgical treatment also means that there is still no established "golden standard" with respect to that of the complex anal fistula. According to recent relevant literatures and personal experience, some critical issues in the diagnosis and treatment of complex anal fistula, including the approach to the accurate diagnosis, the value and significance of seton technique, the individual algorithm between the minimal invasive and extensive surgical treatments, the value of biopsy, are discussed in this article.

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

    Directory of Open Access Journals (Sweden)

    Saroj Tucker

    2012-01-01

    Full Text Available Objective: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.

  1. Individual, partner, and partnership level correlates of anal sex among youth in Baltimore City.

    Science.gov (United States)

    Hebert, Luciana E; Lilleston, Pamela S; Jennings, Jacky M; Sherman, Susan G

    2015-04-01

    Anal sex is an efficient mode of STI transmission and studies indicate that anal sex is common among heterosexuals, including adolescents. We examined the association between individual, partner, and sexual partnership-level characteristics with anal sex among a household survey of 263 individuals aged 15-24 years in Baltimore City, Maryland. We used weighted multiple logistic regression to examine correlates of anal sex in a heterosexual partnership by gender. Twenty-nine percent of males and 15% of females reported anal sex in a partnership in the past 6 months. For males, anal sex was associated with having two or more partners in the past 3 months (AOR = 13.93, 95% CI 3.87-50.12), having been tested for HIV (AOR = 0.30, 95% CI 0.12-0.72), and oral sex with a partner (AOR = 8.79, 95% CI 1.94-39.78). For females, anal sex was associated with reporting having a main partner (AOR = 6.74, 95% CI 1.74-23.65), partner meeting place (AOR = 3.03, 95% CI 1.04-8.82), partner history of STI (AOR = 0.20, 95% CI 0.05-0.85), and oral sex with a partner (AOR = 8.47, 95% CI 1.08-66.25). Anal sex was associated with inconsistent condom use for both males (OR = 5.77, 95% CI 1.68-19.79) and females (OR = 5.16, 95% CI 1.46-18.30). We conclude that anal sex is a prevalent risk behavior among heterosexual youth and is associated with a range of factors at the individual and partnership levels. These findings provide support for comprehensive sex education that includes information about anal sex; findings from this study can inform public health campaigns targeting youth at risk for STIs.

  2. [Prospective study of the function of the anal sphincter before and after hemorrhoidectomy].

    Science.gov (United States)

    Champigneulle, B; Dieterling, P; Bigard, M A; Gaucher, P

    1989-05-01

    A prospective study was carried out on the anorectal function in patients with hemorrhoids (group H, n = 25) versus normal controls (group T, n = 22) and on the effect at three months of hemorrhoidectomy on sphincter function and anal continence. Hemorrhoidectomy was performed by the same surgeon using the standard Milligan Morgan procedure in all cases. All patients and controls underwent an anal manometry, a measure of the length of the anal sphincter and a saline continence test. Anal resting pressure was higher in group H as compared to group T before hemorrhoidectomy (136 +/- 32 cm H2O vs 98 +/- 19 p less than 0.001). After hemorrhoidectomy, and resting pressure was significantly lower (141 +/- 21 cm H2O vs 106 +/- 25 p less than 0.01). Anal length was similar in group H and in group T (50.2 +/- 6.6 mm vs 45 +/- 5.5 NS) but decreased significantly after hemorrhoidectomy (41.9 +/- 7.6 vs 50.3 +/- 7.3 p less than 0.01). Ultraslow waves were more often observed in patients with piles (60 p. 100 vs 9 p. 100 of normal controls). After hemorrhoidectomy ultraslow waves were less commonly encountered (25 p. 100 p less than 0.05). Anal leakage during the saline continence test was observed in 12 and 82 p. 100 of patients before and after hemorrhoidectomy, respectively (p less than 0.001). No anal leakage was observed in the control groups. After hemorrhoidectomy the mean volume of anal leakage was of 190 ml. In 35 p. 100 of the patients, anal leakage occurred before the anal infusion of 500 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Are eruptions from linear fissures and caldera ring dykes more likely to produce pyroclastic flows?

    Science.gov (United States)

    Jessop, D. E.; Gilchrist, J.; Jellinek, A. M.; Roche, O.

    2016-11-01

    Turbulent volcanic jets are produced by highly-energetic explosive eruptions and may form buoyant plumes that rise many tens of kilometres into the atmosphere to form umbrella clouds or collapse to generate ground-hugging pyroclastic flows. Ash injected into the atmosphere can be transported for many hundreds of kilometres with the potential to affect climate, disrupt global air travel and cause respiratory health problems. Pyroclastic flows, by contrast, are potentially catastrophic to populations and infrastructure close to the volcano. Key to which of these two behaviours will occur is the extent to which the mechanical entrainment and mixing of ambient air into the jet by large (entraining) eddies forming the jet edge changes the density of the air-ash mixture: low entrainment rates lead to pyroclastic flows and high entrainment rates give rise to buoyant plumes. Recent experiments on particle-laden (multi-phase) volcanic jets from flared and straight-sided circular openings suggest that the likelihood for buoyant plumes will depend strongly on the shape and internal geometry of the vent region. This newly recognised sensitivity of the fate of volcanic jets to the structure of the vent is a consequence of a complex dynamic coupling between the jet and entrained solid particles, an effect that has generally been overlooked in previous studies. Building on this work, here we use an extensive series of experiments on multi-phase turbulent jets from analogue linear fissures and annular ring fractures to explore whether the restrictive vent geometry during cataclysmic caldera-forming (CCF) eruptions will ultimately lead a relatively greater frequency of pyroclastic flows than eruptions from circular vents on stratovolcanoes. Our results, understood through scaling analyses and a one-dimensional theoretical model, show that entrainment is enhanced where particle motions contribute angular momentum to entraining eddies. However, because the size of the entraining

  4. The cycle of instability: stress release and fissure flow as controls on gully head retreat

    Science.gov (United States)

    Collison, A. J. C.

    2001-01-01

    Gully head and wall retreat has commonly been attributed to fluvial scour and head collapse as a result of soil saturation, sapping or piping. The empirical evidence to substantiate these conceptual models is sparse, however, and often contradictory. This paper explores the hydrological and mechanical controls on gully head and wall stability by modelling the hydrology, stability and elastic deformation of a marl gully complex in Granada Province, south-east Spain. The hydrological and slope-stability simulations show that saturated conditions can be reached only where preferential fissure flow channels water from tension cracks into the base of the gully head, and that vertical or subvertical heads will be stable unless saturation is achieved. Owing to the high unsaturated strengths of marl measured in this research, failure in unsaturated conditions is possible only where the gully head wall is significantly undercut. Head retreat thus requires the formation of either a tension crack or an undercut hollow. Finite-element stress analysis of eroding slopes reveals a build up of shear stress at the gully head base, and a second stress anomaly just upslope of the head wall. Although tension cracks on gully heads have often been attributed to slope unloading, this research provides strong evidence that the so called sapping hollow commonly found in the gully headwall base is also a function of stress release. Although further research is needed, it seems possible that pop out failures in river channels may be caused by the same process. The hydrological analysis shows that, once a tension crack has developed, throughflow velocity in the gully headwall will increase by an order of magnitude, promoting piping and enlargement of this weakened area. It is, therefore, possible to envisage a cycle of gully expansion in which erosion, channel incision or human action unloads the slope below a gully head, leading to stress patterns that account for the tension crack and a

  5. Geophysical Exploration of Faults, Fissures, and Fractures at Four Sites in Mexicali, Baja California, Mexico

    Science.gov (United States)

    Lázaro-Mancilla, O.; Gonzalez-Fernandez, A.; Contreras-Corvera, A.; Stock, J. M.; Moreno-Ayala, D.; Ramirez-Hernandez, J.; Carreon-Diazconti, C.; Lopez, D. A. L.; Lopez, J. R.

    2014-12-01

    We conducted field geophysical measurements in areas in the City of Mexicali that are associated with geological faults, fissures, and fractures. The study sites are: 1) Instituto Tecnologico de Mexicali 2) The buried trace of the Michoacan de Ocampo fault in the urban zone 3) Rio Nuevo 4) A site reported by Frez (2013) with ground rupture SW of Cerro Prieto At Site 1, seismic reflection profiling used a cable with 24 geophones at 1 m spacing. The source was a 3.6 kg sledge hammer, with 3 impacts per shot point. 347 shot points at 2 m spacing provided 6 fold coverage along a straight line with minimal elevation changes. Sample rate was 2000/s, and record length 1 s; reflections were seen down to 0.3 s TWTT. Processing included: frequency filter, fk filter, predictive deconvolution, geometry, velocity analysis, NMO and stacking. Lateral changes in the seismic section are due to surface modification and/or the presence of faults.At site 2, we measured 222Radon in 36 locations along 17 profiles across the fault, using inherent alpha spectrometry with a Durridge RAD7 detector. Each site was measured at a depth of 60 cm, with 31 five-minute readings in a 3 hour period, interspersed with 10 minute of background purge and 3 five-minute background measurements. In a profile parallel to the fault, 78% of the readings were > 100 pCi/L, confirming the presence of the fault along the swath surveyed. At Site 3 we compiled observations of post-earthquake cracks, conducted reconnaissance, and measured some profiles using 100 MHz GPR. These observations showed that the cracks are associated with ground failure due to earthquake shaking. At Site 4 our new 222Radon gas measurements complemented a pre-existing profile that had high 222Radon values lacking a structural explanation. Related to this we found that this region has two NW-SE trending features: a magnetic anomaly low of 360 nT (Evans, Summer and Castillo, 1972) and a graben reported by the Mexican Geological Survey in 2003

  6. Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass.

    Science.gov (United States)

    Yang, S-Y; Kwon, J-S; Kim, K-N; Kim, K-M

    2016-05-01

    Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (Penamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting secondary caries at the margins.

  7. The fissured East Yorkshire Chalk, UK - a 'sustainable' aquifer under stress ?

    Science.gov (United States)

    Elliot, T.; Younger, P. L.; Chadha, D. S.

    2003-04-01

    The fissured Chalk is an important regional aquifer in East Yorkshire, UK, with a large potential for water supply to the Humberside region and especially the City of Hull. It has been exploited since the end of the 19th Century, but although there are more than a dozen long-established pumping wells in the Chalk these currently abstract only 7% of the total recharge the aquifer receives. The classical notion of ‘safe aquifer yield' equates the quantity of groundwater available for abstraction with the long-term natural recharge to the aquifer. An incautious hydrogeologist might be lead to conclude that this is a secure, under-developed resource. In this case study, the aquifer is shown to be already displaying early symptoms of hydrological stress (eg drought effects, overexploitation), and hydrogeochemical indicators point to further effects of anthropogenic pollution impacts in the unconfined aquifer and both recent and ancient saline intrusion in its semi-confined and confined zones. The hydrochemical evidence clearly reveals the importance both of recent aquifer management decisions and palaeohydrogeology in determining the distribution of water qualities within the aquifer. Waters encountered in the confined aquifer are identified as complex (and potentially dynamic) mixtures between recently recharged waters, modern seawater intrusion, and ancient seawater which entered the aquifer many millennia ago. Elliot, T. Younger, P.L. &Chadha, D.S. (1998) The future sustainability of groundwater resources in East Yorkshire - past and present perspectives. In H. Wheater and C. Kirby (Eds.) Hydrology in a Changing Environment, Vol. II, Proc. British Hydrological Society (BHS) International Conference, 6-10 July 1998, Exeter, UK. pp.21-31. Elliot, T., Chadha, D.S. &Younger, P.L. (2001) Water Quality Impacts and Palaeohydrogeology in the East Yorkshire Chalk Aquifer, UK. Quarterly Journal of Engineering Geology and Hydrogeology, 34(4): 385-398. Younger, P.L., Teutsch

  8. Crohn's-like complications in patients with ulcerative colitis after total proctocolectomy and ileal pouch-anal anastomosis.

    Science.gov (United States)

    Goldstein, N S; Sanford, W W; Bodzin, J H

    1997-11-01

    Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become an established surgical procedure for ulcerative colitis. Occasional patients who have undergone IPAA develop persistent or recurrent episodes of pouchitis (chronic pouchitis), from which a subset also develop gastrointestinal and systemic complications that are identical to those seen in Crohn's disease. These complications include enteric stenoses or fistulas in the pouch or pouch inlet segment, perianal fistulas or abscesses, pouch fistulas, arthritis, iridocyclitis, and pyoderma gangrenosum. The development of Crohn's-like gastrointestinal complications in a patient with chronic pouchitis frequently engenders concern that the pathologist misinterpreted the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease. We describe eight patients who developed chronic pouchitis and Crohn's-like complications after IPAA and total proctocolectomy. In each case, concern was voiced about misinterpretation of the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease after the development of the Crohn's-like complications. Preoperatively, all eight patients had characteristic clinical, radiographic, and pathologic features of ulcerative colitis. Review of the pathology specimens indicated that all eight had ulcerative colitis. Crohn's-like complications are most likely related to chronic pouchitis, which probably is a form of recrudescent ulcerative colitis within the novel environment of the pouch. A diagnosis of Crohn's disease after IPAA surgery should only be made when reexamination of the original proctocolectomy specimen shows typical pathologic features of Crohn's disease, Crohn's disease arises in parts of the gastrointestinal tract distant from the pouch, pouch biopsies contain active enteritis with granulomas, or excised pouches show the characteristic features of Crohn's disease, including granulomas. There were no histologic differences in the total

  9. 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 wi...

  10. Observation on the Therapeutic Efficacy of Nano Silver Antibacterial Gel for Hemorrhoids in the Treatment of Acute Anal Fissure%纳米银痔疮抗菌凝胶治疗急性肛裂疗效观察

    Institute of Scientific and Technical Information of China (English)

    谢敏; 商群献; 吴周选; 杨宇龙

    2011-01-01

    为研究纳米银痔疮抗菌凝胶治疗急性肛裂的有效性及安全性,对60例急性肛裂患者采用随机、对照方法进行研究.其中治疗组30例采用纳米银痔疮抗菌凝胶,对照组30例采用马应龙麝香痔疮膏治疗.结果显示,治疗组治愈率(86.67%)明显高于对照组(63.33%)(P0.05),两组均未出现全身不良反应.结果表明,纳米银痔疮抗菌凝胶治疗急性肛裂的临床效果显著,安全性高,无明显副作用.

  11. Anal sex, vaginal sex and HIV risk among female sex workers in Papua New Guinea.

    Science.gov (United States)

    Kelly-Hanku, Angela; Rawstorne, Patrick; Kupul, Martha; Worth, Heather; Shih, Patti; Man, Wing Young Nicola

    2014-03-01

    Female sex workers (FSW) are considered one of the key affected populations in Papua New Guinea at risk of acquiring HIV. An integrated bio-behavioral survey of sex workers in Port Moresby was conducted to determine the nature and extent of this risk. About half (51.1 %) of the 411 FSW who reported having any sexual intercourse with clients had engaged in both anal and vaginal intercourse with clients in the last 6 months. In spite of having poorer HIV knowledge (OR95 % CI = 0.14-0.34), FSW who had anal intercourse with clients were significantly more likely to have used a condom at the last vaginal intercourse with a client (OR95 % CI = 1.04-2.87). Similarly, FSW who had anal intercourse with regular and casual partners were significantly more likely to have used a condom at the last vaginal intercourse. Those who engaged in both anal and vaginal intercourse with clients had similar condom use for both vaginal and anal intercourse, with the majority (78.1 %) using a condom at the last occasion for both vaginal and anal intercourse. These FSW may have different risk and protective factors that affect their use of condom during sexual intercourse. Further research is needed to investigate this difference between those who practice anal intercourse and those who do not in order to provide evidence for better programming.

  12. 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.

  13. Anal cancer in Chinese: human papillomavirus infection and altered expression of p53

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    AIM To detect the presence of HPV DNA and study the alteration of p53 expression in anal cancers in Chinese.METHODS HPV DNA was amplified by PCR. The amplified HPV DNA was classified by DBH. HPV antigen and p53 expression were respectively detected by immunohistochemistry.RESULTS HPV DNA was amplified only in one case of squamous cell carcinoma of the 72 Chinese anal cancers and further classified as HPV type 16. Others were all HPV negative. HPV antigen and p53 expression were also detected in this case. Positive stainings with anti-p53 antibody were seen in 61.2% anal cancers. There were no statistically significant differences between anal squamous cell carcinomas and adenocarcinomas and between anal adenocarcinomas and rectal adenocarcinomas. p53 protein expression was observed in the basal cells of squamous epithelium of condyloma acuminatum and morphologically normal squamous epithelium in 2 cases invaded by anal adenocarcinoma.CONCLUSION HPV infection was not associated with these cases of anal cancer. p53 alteration was a common event. Positive p53 immunostaining can not be regarded as a marker for differentiating benign from malignant lesions.

  14. 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.

  15. A case of metastatic carcinoma of anal fistula caused by implantation from rectal cancer.

    Science.gov (United States)

    Takahashi, Rina; Ichikawa, Ryosuke; Ito, Singo; Mizukoshi, Kosuke; Ishiyama, Shun; Sgimoto, Kiichi; Kojima, Yutaka; Goto, Michitoshi; Tomiki, Yuichi; Yao, Takashi; Sakamoto, Kazuhiro

    2015-12-01

    This case involved an 80-year-old man who was seen for melena. Further testing revealed a tubular adenocarcinoma 50 mm in size in the rectum. In addition, an anal fistula was noted behind the anus along with induration. A biopsy of tissue from the external (secondary) opening of the fistula also revealed adenocarcinoma. Nodules suspected of being metastases were noted in both lung fields. The patient was diagnosed with rectal cancer, a cancer arising from an anal fistula, and a metastatic pulmonary tumor, and neoadjuvant chemotherapy was begun. A laparoscopic abdominoperineal resection was performed 34 days after 6 cycles of mFOLFOX-6 therapy. Based on pathology, the rectal cancer was diagnosed as moderately differentiated adenocarcinoma, and this adenocarcinoma had lymph node metastasis (yp T3N2aM1b). There was no communication between the rectal lesion and the anal fistula, and a moderately differentiated tubular adenocarcinoma resembling the rectal lesion was noted in the anal fistula. Immunohistochemical staining indicated that both the rectal lesion and anal fistula were cytokeratin 7 (CK7) (-) and cytokeratin 20 (CK20) (+), and the patient's condition was diagnosed as implantation of rectal cancer in an anal fistula.In instances where an anal fistula develops in colon cancer, cancer implantation in that fistula must also be taken into account, and further testing should be performed prior to surgery.

  16. Morphology of the epithelium of the lower rectum and the anal canal in the adult human.

    Science.gov (United States)

    Tanaka, Eiichi; Noguchi, Tsuyoshi; Nagai, Kaoruko; Akashi, Yuichi; Kawahara, Katsunobu; Shimada, Tatsuo

    2012-06-01

    The anal canal is an important body part clinically. However, there is no agreement about the epithelium of the anal canal, the anal transitional zone (ATZ) epithelium in particular. The aim of this study is to clarify the structure of the epithelium of the human lower rectum and anal canal. Intact rectum and anus obtained from patients who underwent surgery for rectal carcinoma were examined by light and scanning electron microscopy (LM and SEM). By LM, three types of epithelium were observed in the anal canal: simple columnar epithelium, stratified squamous epithelium, and stratified columnar epithelium. The lower rectum was composed of simple columnar epithelium. SEM findings showed stratified squamous epithelium that consisted of squamous cells with microridges, changing to simple columnar epithelium consisting of columnar cells with short microvilli at the anorectal line. LM and SEM observations in a one-to-one ratio revealed that the area of stratified columnar epithelium based on LM corresponded to the anal crypt and sinus. In conclusion, the epithelium of the human anal canal was fundamentally composed of simple columnar epithelium and stratified squamous epithelium. We found no evidence of the ATZ.

  17. Experimental and numerical study on loading rate effects of rock-like material specimens containing two unparallel fissures

    Institute of Scientific and Technical Information of China (English)

    黄彦华; 杨圣奇; 曾卫

    2016-01-01

    A series of laboratory experiments and PFC numerical simulations for rock-like material specimens containing two unparallel fissures were carried out. On the basis of experimental and numerical results, the stress−strain curves, mechanical properties, AE events, cracking behavior and energy characteristics were analyzed to reveal the macro-mechanical behavior and meso-mechanism of pre-fissured specimens under different loading rates. Investigated results show that:1) When the loading rate is relatively low, the stress−strain curves show a brittle response. When the loading rate is relatively high, the curve shows a more ductile response. Both of the peak strength and elastic mudulus increase with the increase of loading rate, which can be expressed as power functions. 2) Four crack types are identified, i.e., tensile crack, shear crack, far-field crack and surface spalling. Moreover, the tensile crack, far-field crack and surface spalling are under tensile mechanism, while the shear crack is under shear mechanism. 3) The drops of the stress−strain curves all correspond to the crack initiation or coalescence, which is also linked to a sudden increasing in the accumulated micro-crack curve. 4) Both of the maximum bond force and energy have the similar trend with the increase of loading rate to peak strength, which indicates that the trend of peak strength can be explained by the meso-mechanics and energy.

  18. Micro-leakage of a Fissure Sealant Cured Using Quartz-tungsten-halogen and Plasma Arc Light Curing Units.

    Science.gov (United States)

    Bahrololoomi, Zahra; Soleimani, Ali Asghar; Jafari, Najmeh; Varkesh, Bentolhoda

    2014-01-01

    Background and aims. Newer curing units such as plasma arc can polymerize the sealants in much shorter curing times. The aim of this study was to compare the effect of two different curing units on the micro-leakage of a fissure sealant material. Materials and methods. Sixty two extracted premolars without caries were randomly divided into two groups of 31 samples. Occlusal surfaces of all teeth were cleansed. Then, teeth surfaces were etched by 37% phosphoric acid. After rinsing and drying, occlusal surfaces of teeth were sealed by a fissure sealant. The sealant was then cured using either a halogen light curing unit or a plasma arc curing light. After sealing, the teeth were thermocycled for 500 cycles. The teeth were then sectioned and examined for micro-leakage. Statistical analyses were performed with Mann-Whitney test. Results. There was no significant difference between two groups regarding micro-leakage (P = 0.42). Conclusion. Results showed that there was no significant difference between two different curing units. Therefore, plasma arc unit might be a useful alternative for sealant polymerization.

  19. Native gold from volcanic gases at Tolbachik 1975-76 and 2012-13 Fissure Eruptions, Kamchatka

    Science.gov (United States)

    Chaplygin, Ilya; Yudovskaya, Marina; Vergasova, Lidiya; Mokhov, Andrey

    2015-12-01

    Aggregates and euhedral crystals of native gold were found in sublimates formed during New Tolbachik Fissure Eruption in 2012-2013 (NTFE). Gold-bearing sublimate samples were taken from a red-hot (690 °C) degassing fracture in the roof of an active lava tunnel 1.5 km from active Naboko cinder cone in May 2013. The gas condensate collected at 690 °C in this site contains 16 ppb Au, 190 ppb Ag and 1180 ppm Cu compared to 3 ppb Au, 39 ppb Ag and 9.7 ppm Cu in the condensate of pristine magmatic gas sampled at 1030 °C. The 690 °C volcanic gas is most likely a mix of magmatic gas and local snow buried under the lava flows as indicated by oxygen and hydrogen isotope compositions of the condensate. The lower-temperature gas enrichment in gold, copper and chlorine is resulted from evaporation of the 690 °C condensate during forced gas pumping at sampling. Native gold was also found in fumarolic encrustations collected from caverns in basalt lava flows with temperature up to 600 °C in June 2014, in a year after eruption finished. The native gold precipitation in newly formed Cu-rich sublimates together with the well known gold occurrences in cinder cones of 1975-1976 Large Tolbachik Fissure Eruption manifest a transport capability of oxidized volcanic gas.

  20. 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

  1. 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.

  2. A CLINICOPATHOLOGICAL CORRELATION OF COLORECTAL AND ANAL CANAL MALIGNANCY

    Directory of Open Access Journals (Sweden)

    Majethia Nikhil

    2015-07-01

    Full Text Available BACKGROUND: Colorectal carcinoma is considered a calamity for humanity, but it could have a long survival if it is diagnosed early. The epidemiology of this calamity is also interesting and has always been the subject of investigati on in the in the western world. AIMS: 1. To compare the findings in a series of 215 cases studied over a period of 6 years from 2008 to 2013 . 2. T o study the incidence of colorectal carcinoma in a population with respect to age, sex, religion and diet . 3. T o study the occurrence of the carcinoma in a different parts of the colon . 4. To study the different histological an d m orphological types of carcinoma of colon . 5. To study the stages of carcinoma at the time of presentation by American Joint Commission on Cancer (AJCC staging system . 6. To study the clinical presentation of colorectal carcinoma. SETTINGS: Lokmanya Til ak Municipal General Hospital, Sion, Mumbai . DESIGN: A retrospective observational study . METHODS AND MATERIAL: The malignant tumor of large bowel and anal canal received in the Surgical Pathology, Department of Pathology, Lokmanya Tilak Medical College an d General Hospital in Mumbai in the form of biopsy and resected speciemen were studied after microscopic confirmation of diagnosis over a period of 6 years from 2008 to 2013. A total number of cases studied are 215 cases excluding the superficial biopsy an d doubtful cases. RESULTS: Of total 46255 surgical specimen, 6911 were gastrointestinal specimen i.e. 14.9% of all specimens , and 4271 were colorectal specimen. Of 4271 gastrointestinal specimens 497 gastrointestinal malignancy while 215 had colorectal malignancy. The common age group affected is 51 - 60 years. Rectum (57.74% is the most common site of colorectal malignancy. Abdo minal pain (33.5% was the most common clinical feature. Ulceroinfilterative is the most common type of gross morphology of tumor in rectum. Hindu and non - vegetarian are most common risk factors

  3. 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

  4. Comparison of Clinical Success of Applying a Kind of Fissure Sealant on the Lower Permanent Molar Teeth in Dry and Wet Conditions

    Directory of Open Access Journals (Sweden)

    Tahereh Eskandarian

    2015-09-01

    Full Text Available Statement of the Problem: Fissure sealant therapy is among the most effective methods of preventing dental caries. However, it is lengthy and isolation of the teeth is difficult in this procedure especially in young children. Using new hydrophilic fissure sealant may reduce such problems. Purpose: This study aimed to evaluate the clinical success of a hydrophilic fissure sealant on the lower permanent mo-lar teeth in dry and wet conditions. Materials and Method: This clinical trial assessed 31 patients (mean age 8.13±1.77 years who needed fissure sealant therapy on their first or second mandibular permanent molar. Having performed dental prophylaxis, the teeth were etched and rinsed. Then one of the two was randomly selected and sealed with smartseal & loc in isolated and dry con-ditions; while, the other was wetted on the etched enamel by using a saliva-contaminated micro brush, and was then sealed with the same fissure as the first tooth. Six and 12 months later, two independent observers examined the clinical success of sealant through checking the marginal integrity, marginal discoloration, and anatomical form. Data were analyzed by using SPSS software, version 16. The bivariate Chi-square and Exact Fisher tests were used to compare the clinical success of the two treatment methods. Results: There was a high interpersonal reliability between the two examiners (K= 0.713. After 12 months, 90.3% clinical success was observed in dry conditions and 83.9% in wet conditions for smartseal & loc; however, the differ-ence was not statistically significant (p= 0.0707. Conclusion: According to the results of this study, it seems that using new hydrophilic fissure sealant can reduce tech-nical sensitivities and consequently decreases the apprehensions on saliva contamination of etched enamel during treatment procedures.

  5. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    OpenAIRE

    Luís Marcelo Alves Ramos

    2002-01-01

    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 psycholo...

  6. Long-term anorectal, urinary and sexual dysfunction causing distress after radiotherapy for anal cancer

    DEFF Research Database (Denmark)

    Sunesen, K G; Nørgaard, M; Lundby, L;

    2015-01-01

    AIM: The objective of primary radiotherapy for anal cancer is to remove cancer while maintaining anorectal function. However, little is known about anorectal function among long-term survivors without colostomy. Using a cross-sectional questionnaire study, we examined symptoms and distress related...... to the dysfunction of pelvic organs after radiotherapy for anal cancer. METHOD: A questionnaire regarding anorectal, urinary and sexual symptoms was sent to anal cancer patients without recurrence or colostomy, diagnosed during 1996-2003, and treated with curative intent (chemo)radiotherapy at three Danish centres...

  7. 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...

  8. 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.

  9. [Latex ligation in treatment of chronic hemorrhoids].

    Science.gov (United States)

    Ektov, V N; Somov, K A

    2015-01-01

    We analyzed the results of treatment of 432 patients with chronic hemorrhoids using different variants of latex ligation. New technique including ligation of mucosa and submucosa of low-ampullar rectum providing ligation of hemorrhoidalvessels, lifting and recto-anal repair is developed and suggested. This method is advisable to use in case of chronic internal hemorrhoids stages I and II. The authors recommend simultaneous combined ligation of mucosa of low-ampullar rectum and internal hemorrhoids for stages III and IV. Different variants of latex ligation with external hemorrhoids excision were used in 103 patients. Pointed variants of latex ligation preserve important advantages including mini-invasiveness, simplicity and wide availability, low cost. Good remote results were obtained after these procedures in 87.3% of observations. Suggested tactics extends use of latex ligation and increases its effectiveness in treatment of different stages and forms of chronic hemorrhoids.

  10. Chronic cholecystitis

    Science.gov (United States)

    Cholecystitis - chronic ... Most of the time, chronic cholecystitis is caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These ...

  11. 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. ...

  12. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  13. Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal

    Institute of Scientific and Technical Information of China (English)

    Marni Colvin; Aris Delis; Erika Bracamonte; Hugo Villar; Luis R Leon Jr

    2009-01-01

    Primary neoplasms arising in the anal canal are relatively unusual. In particular, adenomas and adenocarcinomas are distinctly rare entities in this region. We describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal malignancy. This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia. Examination revealed a blood-covered pedunculated mass with a long stalk protruding from the anus. The lesion was amputated at the bedside. Microscopic evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous adenoma. This was further evaluated under anesthesia and complete excision of distal anal tissue was performed. Our report is the first describing the possible malignant degeneration of a villous adenoma in the anal canal.

  14. Toward an understanding of the context of anal sex behavior in ethnic minority adolescent women.

    Science.gov (United States)

    Dimmitt Champion, Jane; Roye, Carol F

    2014-07-01

    Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits.

  15. 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.

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

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K;

    2014-01-01

    BACKGROUND: Neurophysiological evaluation of anorectal sensory function is hampered by a paucity of methods. Rapid balloon distension (RBD) has been introduced to describe the cerebral response to rectal distension, but it has not successfully been applied to the anal canal. METHODS: Nineteen...... healthy women received 30 RBDs in the rectum and the anal canal at intensities corresponding to sensory and unpleasantness thresholds, and response was recorded as cortical evoked potentials (CEPs) in 64-channels. The anal canal stimulations at unpleasantness level were repeated after 4 min to test...... the within-day reproducibility. CEPs were averaged, and to overcome latency variation related to jitter the spectral content of single sweeps was also computed. KEY RESULTS: Repeated stimulation of the anal canal generated CEPs with similar latencies but smaller amplitudes compared to those from the rectum...

  17. Anal human papillomavirus infection: prevalence, diagnosis and treatment of related lesions.

    Science.gov (United States)

    Benevolo, Maria; Donà, Maria Gabriella; Ravenda, Paola Simona; Chiocca, Susanna

    2016-01-01

    Human papillomavirus (HPV) infection is mostly asymptomatic, but may also have many diverse clinical signs encompassing benign ano-genital lesions, and carcinomas. Recently, interest has also particularly focused on anal cancer since, over the last decades, its incidence has been greatly increasing in developed countries, both in women and men and is drastically higher in specific risk groups, such as men who have sex with men (MSM) and HIV-1 infected individuals. Approximately 88% of anal cancer cases worldwide are associated with HPV infection. This review summarizes our current understanding of anal HPV infection, discussing its epidemiology and risk factors in various populations, and the state of the art in the detection of anal HPV infection and its related lesions through both cytology and histology. Finally, we discuss the clinical management and therapy for these lesions.

  18. Histochemical properties of sialic acids and antimicrobial substances in canine anal glands

    Directory of Open Access Journals (Sweden)

    T. Nara

    2011-09-01

    Full Text Available The functional properties of sialic acids appear to be manifold. Additionally, antimicrobial substances serve as a non-specific defense against microorganisms. In this study, therefore, the localization of sialic acids and antimicrobial substances in the anal glands of dog was studied by sialoglycoconjugate histochemistry and immunohistochemistry. The secretory epithelium, luminal secretions and excretory ducts exhibited high levels of sialoglycoconjugates that terminated in Siaα2-6Gal/GalNAc or Siaα2-3Gal1-4GlcNAc. Additionally, O-acetylated sialic acids were detectable in these glandular structures. Antimicrobial substances, such as lysozyme, immunoglobulin A (IgA, lactoferrin and the peptide group of β-defensins, were also demonstrated as products of the anal glands. The results obtained are discussed with regard to the functional significance of the anal glands. These secretory products may create a defensive barrier against microbial invasion at the anal mucosa.

  19. The nursing experience of anal ifstula%肛瘘的护理体会

    Institute of Scientific and Technical Information of China (English)

    苑爱玲; 王奂生; 郑璇

    2014-01-01

    目的:探讨肛瘘手术病人的护理。方法对98例肛瘘手术患者的护理进行分析和总结。结果98例肛瘘患者均治愈,无一例复发。结论肛瘘病人手术治疗后,通过合理的治疗和护理,取得了满意的疗效。%Objective To explore anal fistula operation nursing.Methods The nursing of 98 cases of anal fistula operation were analyzed and summarized.Results All the 98 patients with anal fistula were cured, none recrudesce.Conclusion Anal fistula patients after operation treatment, with the reasonable treatment and nursing, we has obtained the satisfactory curative effect.

  20. 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)

  1. Lack of correlation between p53 codon 72 polymorphism and anal cancer risk

    Institute of Scientific and Technical Information of China (English)

    Simone S Contu; Grasiela Agnes; Andrea P Damin; Paulo C Contu; Mário A Rosito; Claudio O Alexandre; Daniel C Damin

    2009-01-01

    AIM: To investigate the potential role of p53 codon 72 polymorphism as a risk factor for development of anal cancer.METHODS: Thirty-two patients with invasive anal carcinoma and 103 healthy blood donors were included in the study. p53 codon 72 polymorphism was analyzed in blood samples through polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing.RESULTS: The relative frequency of each allele was 0.60 for Arg and 0.40 for Pro in patients with anal cancer,and 0.61 for Arg and 0.39 for Pro in normal controls.No significant differences in distribution of the codon 72 genotypes between patients and controls were found.CONCLUSION: These results do not support a role for the p53 codon 72 polymorphism in anal carcinogenesis.

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

    DEFF Research Database (Denmark)

    Legarth, Rebecca Asbjørn; 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...... risk of anal carcinoma (IRR 7.4, 95% CI 1.4-38.3) compared to fathers of population controls. Mortality after diagnosis of anal carcinoma was increased in male HIV patients compared with the male control cohort (MRR 3.2, 95% CI 1.1-9.2). Conclusions: Danish HIV patients, especially MSM, have...

  3. Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis

    NARCIS (Netherlands)

    Ali, Usama Ahmed; Keus, Frederik; Heikens, Joost T.; Bemelman, Willem A.; Berdah, Stephane V.; Gooszen, H. G.; van Laarhoven, Cees J. H. M.

    2009-01-01

    Background Restorative proctocolectomy with ileo pouch anal anastomosis (IPAA) is the main surgical treatment for patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). With the advancements of minimal-invasive surgery this demanding operation is increasingly being performed

  4. Overview of the precursors and dynamics of the 2012-13 basaltic fissure eruption of Tolbachik Volcano, Kamchatka, Russia

    Science.gov (United States)

    Belousov, Alexander; Belousova, Marina; Edwards, Benjamin; Volynets, Anna; Melnikov, Dmitry

    2015-12-01

    We present a broad overview of the 2012-13 flank fissure eruption of Plosky Tolbachik Volcano in the central Kamchatka Peninsula. The eruption lasted more than nine months and produced approximately 0.55 km3 DRE (volume recalculated to a density of 2.8 g/cm3) of basaltic trachyandesite magma. The 2012-13 eruption of Tolbachik is one of the most voluminous historical eruptions of mafic magma at subduction related volcanoes globally, and it is the second largest at Kamchatka. The eruption was preceded by five months of elevated seismicity and ground inflation, both of which peaked a day before the eruption commenced on 27 November 2012. The batch of high-Al magma ascended from depths of 5-10 km; its apical part contained 54-55 wt.% SiO2, and the main body 52-53 wt.% SiO2. The eruption started by the opening of a 6 km-long radial fissure on the southwestern slope of the volcano that fed multi-vent phreatomagmatic and magmatic explosive activity, as well as intensive effusion of lava with an initial discharge of > 440 m3/s. After 10 days the eruption continued only at the lower part of the fissure, where explosive and effusive activity of Hawaiian-Strombolian type occurred from a lava pond in the crater of the main growing scoria cone. The discharge rate for the nine month long, effusion-dominated eruption gradually declined from 140 to 18 m3/s and formed a compound lava field with a total area of ~ 36 km2; the effusive activity evolved from high-discharge channel-fed 'a'a lavas to dominantly low-discharge tube-fed pahoehoe lavas. On 23 August, the effusion of lava ceased and the intra-crater lava pond drained. Weak Strombolian-type explosions continued for several more days on the crater bottom until the end of the eruption around 5 September 2013. Based on a broad array of new data collected during this eruption, we develop a model for the magma storage and transport system of Plosky Tolbachik that links the storage zones of the two main genetically related magma

  5. 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

  6. [Special surgical complications in chronic inflammatory bowel diseases].

    Science.gov (United States)

    Kroesen, A J

    2015-04-01

    After colorectal and anorectal interventions for chronic inflammatory bowel diseases, specific complications can occur.In Crohn's disease these complications mainly occur after proctocolectomy. Pelvic sepsis can be prevented by omentoplasty with fixation inside the pelvis. A persisting sepsis of the sacral cavity can be treated primarily by dissection of the anal sphincter which ensures better drainage. In cases of chronic sacral sepsis, transposition of the gracilis muscle is a further effective option. Early recurrence of a transsphincteric anal fistula should be treated by reinsertion of a silicon seton drainage.Complications after restorative proctocolectomy are frequent and manifold (35%). The main acute complications are anastomotic leakage and pelvic sepsis. Therapy consists of transperineal drainage of the abscess with simultaneous transanal drainage. Late complications due to technical and septic reasons are still a relevant problem even 36 years after introduction of this operative technique. A consistent approach with detailed diagnostic and surgical therapy results in a 75% rescue rate of ileoanal pouches.

  7. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  8. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  9. 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.

  10. [Application and development of suture-dragging therapy for anal fistula].

    Science.gov (United States)

    Wang, Chen; Yao, Yibo; Dong, Qingjun; Liang, Hongtao; Guo, Xiutian; Cao, Yongqing; Lu, Jingen

    2015-12-01

    Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.

  11. Anal malignant proliferative trichilemmoma: report of a rare case with review of literature

    OpenAIRE

    Cui, Ang; Mei, Zubing; Cui, Long

    2015-01-01

    Trichilemmoma is a rare type of benign cutaneous neoplasm, which derives from outer sheath of hair follicle. It barely develops malignant progression and has rarely been reported in anal cancer. In this article, we report a case of a 73-year-old woman who presented to the outer-patient department with complaints of a ruptured and longstanding anal phyma. All the appearances were atypical. Blood routine examination showed that neutrophilic granulocyte percentage was elevated and suggest it was...

  12. Reparation of Traumatic Injury of Anal Sphincter: Case Report and Review of Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Stošić Momčilo

    2014-06-01

    Full Text Available Anal sphincter injuries are rare and usually related to obstetric injuries. Other more frequent causes of a violent injury of the anal muscles (including the rectum are war injuries, violent civil injuries, iatrogenic injuries during surgeries, sexual injuries and accidental injuries. Accidental injuries are extremely rare and, searching Medline, Scopus and Medscape for the past five years, I have found only a few descriptions of such injuries. Almost all such articles are of “the case study type”.

  13. 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

  14. 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

  15. 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.

  16. Maternal Body Mass Index and Risk of Obstetric Anal Sphincter Injury

    Directory of Open Access Journals (Sweden)

    Marie Blomberg

    2014-01-01

    Full Text Available Objective. To estimate the association between maternal obesity and risk of three different degrees of severity of obstetric anal sphincter injury. Methods. The study population consisted of 436,482 primiparous women with singleton term vaginal cephalic births between 1998 and 2011 identified in the Swedish Medical Birth Registry. Women were grouped into six categories of BMI. BMI 18.5–24.9 was set as reference. Primary outcome was third-degree perineal laceration, partial or total, and fourth-degree perineal laceration. Adjustments were made for year of delivery, maternal age, fetal head position at delivery, infant birth weight and instrumental delivery. Results. The overall prevalence of third- or four-degree anal sphincter injury was 6.6% (partial anal sphincter injury 4.6%, total anal sphincter injury 1.2%, unclassified as either partial and total 0.2%, or fourth degree lacerations 0.6%. The risk for a partial, total, or a fourth-degree anal sphincter injury decreased with increasing maternal BMI most pronounced for total anal sphincter injury where the risk among morbidly obese women was half that of normal weight women, OR 0.47 95% CI 0.28–0.78. Conclusion. Obese women had a favourable outcome compared to normal weight women concerning serious pelvic floor damages at birth.

  17. Anal malignant proliferative trichilemmoma: report of a rare case with review of literature.

    Science.gov (United States)

    Cui, Ang; Mei, Zubing; Cui, Long

    2015-01-01

    Trichilemmoma is a rare type of benign cutaneous neoplasm, which derives from outer sheath of hair follicle. It barely develops malignant progression and has rarely been reported in anal cancer. In this article, we report a case of a 73-year-old woman who presented to the outer-patient department with complaints of a ruptured and longstanding anal phyma. All the appearances were atypical. Blood routine examination showed that neutrophilic granulocyte percentage was elevated and suggest it was a simple inflammation response. No evidence of malignancy was detected upon the laboratory examinations. Then we performed an abscess incision drainage for the patient. A few days later, the biopsy pathological report suggested the specimen is a malignant proliferative trichilemmoma. We decided to perform a wide local excision instead of an extended radical operation in order to preserve anus. After the surgery, we chose not to give chemoradio-treatment for fear of side effects and complications. Careful follow-up indicates that peri-anal malignant proliferative trichilemmoma may have a good prognosis and our treatment is a good choice for the patients with this tumor. Because of the low occurrence rate of anal cancer, especially malignant trichilemmoma, any clinical manifestation and experience are valuable. On one hand, our case may help to take the consideration of the diagnosis of malignant trichilemmoma in case of longtime-suffered peri-anal mass, on the other hand it propose a different treatment method from other anal cancers for clinical doctors.

  18. Treatment of Complete Anal Stricture after Diverting Colostomy for Fournier's Gangrene

    Science.gov (United States)

    Kubota, Tadao; Lefor, Alan Kawarai; Mizokami, Ken

    2017-01-01

    Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy. He needed temporary continuous renal replacement therapy and was discharged on postoperative day 39. After four months, severe anal stenosis was found on physical examination, and total colonoscopy showed a complete anal stricture. The patient was brought to the operating room and underwent colostomy closure and anoplasty. He recovered without any complications. Conclusion. We present a first patient with a complete anal stricture after diverting colostomy treated with anoplasty and stoma closure. This case reminds us of the assessment of distal bowel conduit and might suggest that anoplasty might be considered in the success of the colostomy closure. PMID:28255493

  19. Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

    Institute of Scientific and Technical Information of China (English)

    Marcel Cazemier; Richelle JF Felt-Bersma; Chris JJ Mulder

    2007-01-01

    AIM: To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation.METHODS: Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS: Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05). Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION: RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

  20. 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.

  1. 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.

  2. Ki-67 expression in anal intraepithelial neoplasia in AIDS

    Directory of Open Access Journals (Sweden)

    Edenilson Eduardo Calore

    2001-05-01

    Full Text Available CONTEXT: AIDS is one of the most important risk factors for progression and recurrence of anogenital condyloma. In a previous work, we observed that patients with warts and high-grade AIN (HAIN had recurrences more frequently than did patients with warts without AIN. The mechanisms of this increased incidence of high-grade lesions in AIDS are not known. OBJECTIVE: We studied the expression of the proliferative marker Ki-67 by immunohistochemical methods, in specimens of anal condyloma from HIV+ patients to clarify whether its expression can be associated to the grade of AIN. DESIGN: A retrospective study of hiltological specimens. SETTING: University referral unit. SAMPLE: 34 patients were divided into two groups: (1 condylomas with low grade AIN (LAIN, with 25 patients; and (2 condylomas with HAIN, with 9 patients. In this latter group we examined two areas: 2A (HAIN area and 2B (LAIN area. MAIN MEASUREMENTS: The immunohistochemical reaction for Ki-67 was done on histological sections. Slices were lightly stained with hematoxylin, to help us in Ki-67 positive cell counting. The percentage of Ki-67 marked nuclei was calculated. We applied one-way variance analysis for statistics. RESULTS: The mean number of Ki-67 positive cells in group 1 was 19.68 ± 10.99; in group 2 (area A it was 46.73 ± 10.409; and in area B it was 36.43 ± 14.731. There were statistical differences between groups 1 and 2A and between groups 1 and 2B. Ki-67 positive cells predominated in the lower layer in LAIN. Positive Ki-67 cells were found in all layers in group 2A, and in group 2B they predominated in the two lower or in all layers of the epithelium. CONCLUSIONS: Our results suggest that LAIN areas (using routine staining techniques in HAIN can have a biological behavior more similar to HAIN.

  3. Détection de fissures de surface de chaussées par techniques d'imagerie dans le visible

    OpenAIRE

    2003-01-01

    Nous proposons un aperçu des travaux de recherche conduits au sein du LCPC sur l'automatisation progressive de la détection des dégradations de surface de chaussées par techniques d'imagerie. Cette présentation se focalise sur la mise en évidence de la présence de fissures de surface de chaussées par des techniques de traitement d'images acquises dans le spectre visible. La banque d'images servant de support à la mise au point d'algorithmes de traitement est présentée. Un état de l'art est pr...

  4. Effect of topical applications of a novel chlorhexidine-thymol varnish formula on mutans streptococci and caries development in occlusal fissures of permanent molars

    DEFF Research Database (Denmark)

    Sköld-Larsson, Kerstin; Sollenius, Ola; Petersson, Lars G;

    2009-01-01

    to adhesive properties. The varnishes were applied in the fissures at baseline, and then every sixth week throughout the 48-week study period. Endpoints were MS colonization (CRT test) and occlusal laser fluorescence (LF, DIAGNOdent) recordings carried out regularly during follow-up. RESULTS: A significant...

  5. 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

  6. 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.

  7. An in vitro comparison between laser fluorescence and visual examination for detection of demineralization in occlusal pits and fissures.

    Science.gov (United States)

    Ferreira Zandoná, A G; Analoui, M; Beiswanger, B B; Isaacs, R L; Kafrawy, A H; Eckert, G J; Stookey, G K

    1998-01-01

    It has been demonstrated that when excited by laser light carious enamel appears dark compared to luminescent sound enamel. The aim of this study was to compare the sensitivity and specificity of visual exams (V), laser fluorescence (LF) and dye-enhanced LF (DELF) for detecting demineralization in occlusal pits and fissures. The actual presence of lesions was determined by subsequent confocal laser microscopy (CM), which was compared to histology (H). Independent clinical examiners visually graded three sites on occlusal surfaces of extracted, human premolars as sound or carious and also rated the color of each graded site as: 0 = same as surrounding enamel; 1 = white; 2 = light brown, or 3 = brown/dark brown. An argon laser was used to illuminate the teeth for LF and DELF; the images were captured with a CCD camera and then analyzed. DELF images were captured after the teeth had been exposed to 0.075% sodium fluorescein. Sections were then cut from each specimen and analyzed by CM and H for the presence or absence of caries. Results showed that DELF (0.72) was significantly more sensitive (pDELF 0.60). When color was used as an indication of caries in V (VC, sensitivity 0.47; specificity 0.70), V exams were not different from LF. The area under the ROC curve, using H as the gold standard and CM as the test, was 0.78. Results indicated that DELF was the best diagnostic tool and that VC and LF were equally effective as diagnostic methods, when color of fissures was included as an indication of demineralization in the visual exam.

  8. 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.

  9. 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

  10. Anal cushion lifting method is a novel radical management strategy for hemorrhoids that does not involve excision or cause postoperative anal complications

    Institute of Scientific and Technical Information of China (English)

    Gentaro; Ishiyama; Toshihiko; Nishidate; Yuji; Ishiyama; Akihiko; Nishio; Ken; Tarumi; Maiko; Kawamura; Kenji; Okita; Toru; Mizuguchi; Mineko; Fujimiya; Koichi; Hirata

    2015-01-01

    AIM: To describe the anal cushion lifting(ACL) method with preliminary clinical results. METHODS: Between January to September 2007, 127 patients who received ACL method for hemorrhoid was investigated with informed consent. In this study, three surgeons who specialized in anorectal surgery performed the procedures. Patients with grade two or more severe hemorrhoids according to Goligher’s classification were considered to be indicated for surgery. The patients were given the choice to undergo either the ACL method or theligation and excision method. ACL method is an original technique for managing hemorrhoids without excision. After dissecting the anal cushion from the internal sphincter muscle, the anal cushion was lifted to oral side and ligated at the proper position. Clinical characteristics and outcomes of patients were recorded including complications after surgery. RESULTS: A total of 127 patients were enrolled. Their median age was 42(19-84) years, and 74.8% were female. In addition, more than 99% of the patients had grade 3 or worse hemorrhoids. The median followup period was 26(0-88) mo, and the median operative time was 15(4-30) min. After surgery, analgesics were used for a median period of three days(0-21). Pain control was achieved using extra-oral analgesic drugs, although some patients required intravenous injections of analgesic drugs. The median duration of the patients’ postoperative hospital stay was 7(2-13) d. A total of 10 complications(7.9%) occurred. Bleeding was observed in one patient and was successfully controlled with manual compression. Urinary retention occurred in 6 patients, but it disappeared spontaneously in all cases. Recurrent hemorrhoids developed in 3 patients after 36, 47, and 61 mo, respectively. No anal stenosis or persistent anal pain occurred. CONCLUSION: We consider that the ACL method might be better than all other current methods for managing hemorrhoids.

  11. Perianal and Vulvar Extramammary Paget Disease: A Report of Six Cases and Mapping Biopsy of the Anal Canal

    Science.gov (United States)

    Kazama, Sinsuke; Yamada, Daisuke; Miyagawa, Takuya; Murono, Koji; Yasuda, Koji; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Kawai, Kazushige; Masui, Yuri; Nozawa, Hiroaki; Yamaguchi, Hironori; Ishihara, Soichiro; Kadono, Takafumi; Watanabe, Toshiaki

    2016-01-01

    Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients. Two patients were positive for Paget cells within the anal canal (one at the dentate line and the other at 0.5 cm above the dentate line), whereas in three patients, Paget cell were present only in the skin of the anal verge. Using 1 cm margin within the anal canal from the positive biopsy sites, we performed anal-preserving wide local excision (WLE), and negative resection margins within the anal canal were confirmed in all five patients. The remaining one patient with perianal EMPD did not undergo mapping biopsy of the anal canal because preoperative colonoscopy revealed that the Paget cells had spread into the lower rectum. Therefore, WLE with abdominoperineal resection was performed. During the median follow-up period of 37.3 months, no local recurrence was observed in all patients. Our small case series suggest the usefulness of mapping biopsy of the anal canal for the treatment of perianal and vulvar EMPD. PMID:27746643

  12. 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.

  13. Squamous cell carcinoma of the anal canal treated with chemoradiotherapy in a patient with HIV.

    Science.gov (United States)

    Sugimoto, Aya; Nakazuru, Shoichi; Sakakibara, Yuko; Nishio, Kumiko; Yamada, Takuya; Ishida, Hisashi; Yajima, Keishiro; Uehira, Tomoko; Mori, Kiyoshi; Mita, Eiji

    2016-01-01

    Since the introduction of combination antiretroviral therapy (ART), the life expectancy has increased for patients infected with human immunodeficiency virus (HIV). This has been associated with reductions in the incidences of some AIDS-defining malignancies, such as Kaposi sarcoma and non-Hodgkin lymphoma, but has coincided with an increased incidence of non-AIDS-defining malignancies, such as anal cancer. However, anal cancers are rare in patients with HIV in Japan. We report the case of an HIV-infected patient with anal cancer treated with chemoradiotherapy. A 37-year-old man receiving ART for HIV infection presented with a 1-month history of left inguinal lymphadenopathy and anal pain. Magnetic resonance imaging and computed tomography revealed a 56-mm mass, left inguinal lymphadenopathy, and left external iliac lymphadenopathy. The mass had infiltrated from the anal canal to the right levator ani and corpus spongiosum. Colonoscopy revealed a tumor with an ulcer in the anal canal. Histological examination of the tumor biopsy specimens confirmed the diagnosis of squamous cell carcinoma. The patient was diagnosed with anal cancer (T4N2M1 stage IV), and he received 5-fluorouracil (1000mg/m(2) on days 1-4 and 29-32) plus mitomycin C (10mg/m(2) on days 1 and 29) and concurrent radiotherapy (total dose, 59.4Gy in 33 fractions) along with ART. The treatment-related adverse events were grade 4 leukopenia and neutropenia, grade 3 thrombocytopenia, and grade 2 radiation dermatitis. Moreover, CD4 suppression was observed:the CD4 count decreased from 190 cells/μl before chemoradiotherapy to 138 cells/μl after 3 months, but increased to 210 cells/μl after 1 year. Because of the grade 4 leukopenia and neutropenia, the dose of 5-fluorouracil was reduced to 800mg/m(2) on days 29-32. A complete response was confirmed on magnetic resonance imaging, and colonoscopy confirmed the disappearance of the anal cancer. The patient is living with no signs of recurrence at 2 years

  14. Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma.

    Science.gov (United States)

    Weledji, Elroy P; Elong, Adolphe; Verla, Vincent

    2014-05-13

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the underlying complexity of obstetric injury. As prevention is not always possible, immediate recognition and adequate primary treatment is of importance.

  15. 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.

  16. Salinity responsive aquaporins in the anal papillae of the larval mosquito, Aedes aegypti.

    Science.gov (United States)

    Akhter, Hina; Misyura, Lidiya; Bui, Phuong; Donini, Andrew

    2017-01-01

    The larvae of the mosquito, Aedes aegypti normally inhabit freshwater (FW) where they face dilution of body fluids by osmotic influx of water. In response, the physiological actions of the anal papillae result in ion uptake while the Malpighian tubules and rectum work in concert to excrete excess water. In an apparent paradox, the anal papillae express aquaporins (AQPs) and are sites of water permeability which, if AQPs are expressed by the epithelium, apparently exaggerates the influx of water from their dilute environment. Recently, naturally breeding populations of A. aegypti were found in brackish water (BW), an environment which limits the osmotic gradient. Given that salinization of FW is an emerging environmental issue and that these larvae would presumably need to adjust to these changing conditions, this study investigates the expression of AQPs in the anal papillae and their response to rearing in hypo-osmotic and near isosmotic conditions. Transcripts of all six Aedes AQP homologs were detectable in the anal papillae and the transcript abundance of three AQP homologs in the papillae was different between rearing conditions. Using custom made antibodies, expression of two of these AQP homologs (AQP4 and AQP5) was localized to the syncytial epithelium of the anal papillae. Furthermore, the changes in transcript abundance of these two AQPs between the rearing conditions, were manifested at the protein level. Results suggest that AQP4 and AQP5 play an important physiological role in larval responses to changes in environmental salinity.

  17. Anal Cancer Screening in an Urban HIV Clinic: Provider Perceptions and Practice.

    Science.gov (United States)

    Sowah, Leonard Anang; Buchwald, Ulrike K; Riedel, David J; Gilliam, Bruce L; Khambaty, Mariam; Fantry, Lori; Spencer, Derek E; Weaver, Jeffery; Taylor, Gregory; Skoglund, Mary; Amoroso, Anthony; Redfield, Robert R

    2015-01-01

    In this article, we sought to understand the perceptions and practice of providers on anal cancer screening in HIV-infected patients. Providers in an academic outpatient HIV practice were surveyed. Data were analyzed to determine the acceptability and perceptions of providers on anal Papanicolaou tests. Survey response rate was 55.3% (60.7% among male and 47.4% among female providers). One-third of the providers had received screening requests from patients. Female providers had higher self-rated comfort with anal Papanicolaou tests, with a mean score of 7.1 (95% confidence interval [CI] 4.7-9.5) compared to 3.6 (95% CI 1.5-5.7) for male providers, P = .02. Sixty-seven percent of male providers and 37.5% of female providers would like to refer their patients for screening rather than perform the test themselves. Only 54.2% of our providers have ever performed anal cytology examination. Our survey revealed that not all providers were comfortable performing anal cancer screening for their patients.

  18. [A case report of metastatic anal fistula cancer treated with neoadjuvant chemotherapy].

    Science.gov (United States)

    Murata, Akihiro; Takatsuka, Satoshi; Shinkawa, Hiroji; Kaizaki, Ryoji; Hori, Takaaki; Ikehara, Teruyuki

    2014-11-01

    A 69-year-old man with perianal pain was diagnosed with an anal fistula and a rectal tumor by magnetic resonance imaging and pulmonary tuberculosis by computed tomography. A colonoscopy confirmed the presence of a circular mass in the rectum 6 cm from the anal verge. Histological examination revealed a moderately differentiated adenocarcinoma. Initially, seton drainage was used to improve the perianal pain. After 2 months of anti-tuberculosis therapy, the patient underwent low anterior resection for the rectal cancer. Six months after surgery, a perianal tumor was detected at the postoperative site of the anal fistula. Biopsy of the tumor revealed adenocarcinoma. Because the histological appearance of the second tumor was identical to the rectal cancer, it was diagnosed as a metastatic anal fistula cancer. The tumor shrunk after 3 courses of neoadjuvant chemotherapy with S-1 plus oxaliplatin (SOX) plus bevacizumab and there was no evidence of distant metastasis. Local resection of the anal fistula cancer was performed. Six months postoperatively, the patient is doing well and shows no sign of recurrence.

  19. Anal sex role, circumcision status, and HIV infection among men who have sex with men in Chongqing, China.

    Science.gov (United States)

    Zhou, Chao; Raymond, H Fisher; Ding, Xianbin; Lu, Rongrong; Xu, Jing; Wu, Guohui; Feng, Liangui; Fan, Song; Li, Xuefeng; McFarland, Willi; Xiao, Yan; Ruan, Yuhua; Shao, Yiming

    2013-10-01

    Men who have sex with men (MSM) in China face a rapidly expanding HIV epidemic. Anal sex role plays a significant role in HIV infection. Research has already begun in China investigating the potential for circumcision-based interventions to slow the rise of HIV among Chinese MSM. Using peer referral recruitment, we sampled 491 men who reported anal sex role preference. We analyzed preferred anal sex role, enacted sex role during recent sexual behavior, and circumcision status and HIV infection among MSM in one Chinese city. Men reported on their anal sex role preference and reported on up to three male sexual partners. Men were asked to report on whether they were "top" or "bottom" with each of the partners. Those that preferred being bottom and versatile were significantly younger than those who preferred being top. Men who preferred bottoming and those that preferred the versatile role were significantly more likely to be HIV-infected than those who preferred to be tops. There was no significant association between circumcision and HIV infection among men who maintained their preferred top role. In terms of anal sex role behavior, prevalence was not statistically different across anal sex roles. Circumcision conferred no additional protection to men who preferred and who engaged the top role during anal sex. HIV interventions will need to address anal sex roles in more sophisticated ways than perhaps originally thought. Simplistic assumptions that anal sex role is a fixed behavior undermines interventions such as circumcision among MSM.

  20. 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; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

    2016-01-01

    Background 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. Methods 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. Results 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). Conclusions 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

  1. Telescopic straight ileo-anal anastomosis in dogs Anastomose íleo-anal direta por telescopagem em cães

    Directory of Open Access Journals (Sweden)

    Renato Arioni Lupinacci

    2011-10-01

    Full Text Available PURPOSE: To study outcomes and functional results of a telescopic straight ileo-anal anastomosis. METHODS: Thirty-six mongrel dogs were submitted to total proctocolectomy and telescopic straight ileo-anal anastomosis (ileal mucosa-submucosa pulled-through the rectal cuff. They were divided in 3 groups, sacrificed after one, two or eight weeks after the initial procedure. Gross and microscopic (degree of cooptation and signs of ischemia aspects of the anastomosis, as well, the aspect of defecation were analyzed. RESULTS: On microscopy all anastomosis analysed showed a continuous epithelial line and were considered good. After two-months no signs of ischemia were identified. Defecation aspect has considerably changed during the study, so no dogs presented solid defecation within the first two weeks, whereas 80% of dogs presented solid stools after two months. CONCLUSION: Telescopic ileo-anal anastomosis is a safe alternative and may provide good functional results after some small period of time.OBJETIVO: Estudar os resultados cirúrgicos e funcionais de uma anastomose íleo-anal por telescopagem. MÉTODOS: Trinta e seis cães sem raça definida foram submetidos à procto-colectomia total e anastomose ileo-anal por telescopagem da mucosa-submucosa ao coto retal. Os animais foram divididos em três grupos cujos sacrifícios ocorreram 1, 2 e 8 semanas após o procedimento inicial. O aspecto da anastomose foi analisado no momento do sacrifício e microscopicamente (grau de coaptação e sinais de isquemia, bem como o aspecto da evacuação nos canis de cada cão. RESULTADOS: O estudo microscópico evidenciou continuidade do epitélio em todas as anastomoses. Nos cães sacrificados após dois meses não houve sinais de isquemia nas anastomoses. O aspecto das fezes alterou-se consideravelmente com o tempo, assim, enquanto nenhum cão apresentou fezes sólidas nas primeiras duas semanas, ao término do segundo mês 80% dos cães apresentavam fezes s

  2. [Chronicity, chronicization, systematization of delusions].

    Science.gov (United States)

    Trapet, P; Fernandez, C; Galtier, M C; Gisselmann, A

    1984-05-01

    Chronicity in psychopathology is indicative of a term, a decay. Chronicization only leads the way to this term. Here, chronicization is taken literally as an inscription in the time course of delusions. The mechanism of systematization seems to be a central mark in the approach to chronic delusions. It is not an alienation or an irreversible closing but an attempted accommodation with reality in the life of psychotic subjects, irrespective of the delusional structure. The role of therapy and drug treatment as a follow-up may in that case assume another meaning.

  3. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  4. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  5. 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.

  6. 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.

  7. Anal Squamous Intraepithelial Lesions and HPV Among Young Black Men Who Have Sex with Men

    Science.gov (United States)

    Keglovitz, Kristin; Lancki, Nicola; Walsh, Tim; Schneider, John A.

    2017-01-01

    Abstract Purpose: Limited data are available on anal squamous intraepithelial lesions (ASILs) and anal human papillomavirus (HPV) infection in young, Black populations. The purpose of this study was to examine the prevalence of and relationships between ASILs and high-risk HPV infection in a young (sex with men (MSM) population. Methods: Results of anal cytology and HPV DNA were gathered for 83 individuals. Results: Forty-two percent of individuals (35) had atypical squamous cells of undetermined significance and 33% (27) had low-grade squamous intraepithelial lesion by cytology. Only 9% tested positive for both high-risk HPV subtypes 16 and 18. Conclusion: Low rates of infection with both HPV types 16 and 18 may provide further evidence that we should continue to vaccinate young, Black MSM against HPV. PMID:27673362

  8. Validación de métodos analíticos no cuantitativos

    OpenAIRE

    Juan Francisco Sánchez R.; María Elena Tejeda R.; Wolfhard Koch; José Luis Alfredo Mora G; Rubén Marroquín S.; Vicente Hernández A.; Valentín Islas P.; Elizabeth Guadalupe Sánchez G.; Alfredo De León V.

    2010-01-01

    En las ciencias farmacéuticas es bien conocida la metodología para validar métodos analíticos cuantitativos, sin embargo no es muy abundante la información sobre la metodología a seguir para validar un método analítico cualitativo o no cuantitativo. En este artículo se describen los aspectos importantes sobre los métodos de análisis cualitativos, se definen los principales parámetros de calidad y se describe una metodología de trabajo, soportada matemáticamente, para validar un método analíti...

  9. Modesty and recognition--a qualitative study of the lived experience of recovery from anal cancer

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Hansen, Mette Juel; Grandjean, Birgitte

    2009-01-01

    survivors of anal cancer to resist and to manage potentially complex stressors encountered in the recovery from the disease. DESIGN: A qualitative, salutogenetic-oriented, phenomenological study was conducted based on audio-taped, semi-structured interviews. METHODS: Interviewee selection was carried out...... through purposeful sampling. Sixteen individuals (11 women and five men; average age 52 years), who had completed therapy for anal cancer (average 31 months ago), participated in the study. Transcripts from the audio-taped interviews were used for qualitative text condensation analysis, inspired by Giorgi......'s phenomenological methodology. FINDINGS: The analysis revealed two concepts, modesty and recognition, which describe the essence of the lived experience of anal cancer, and which each appear to be important resistance resources. While modesty is regarded as an enforced and necessary competence developed...

  10. Problemas de geometría analítica y diferencial

    OpenAIRE

    2012-01-01

    Este libro, Problemas de Geometría Analítica y Diferencial, junto con otros dos, Problemas de Matemáticas y Problemas de Geometría, están dedicados a la presentación y resolución de problemas que se planteaban hace unas décadas, en la preparación para ingreso en las carreras de ingeniería técnica superior. Incluye 907 problemas, de los que 707 se refieren a la geometría analítica y 200 a la geometría diferencial. Los correspondientes a la geometría analítica se reparten entre la geometría del...

  11. Bacteriological comparison of low anal fistula operated by ordinary methods and laser methods

    Science.gov (United States)

    Yang, Yuanrong; Xiong, Yigai

    1996-09-01

    Since 1989, 42 cases with low anal fistula were operated with laser and ordinary methods respectively. During the operation, secreted or charred tissues were extracted from the surface of the wound for bacteria culture. Experimental group (laser method): no bacteria were found in 24 cases operated by laser method. Control group (ordinary method): bacterial were found in 16 out of 18 cases operated by ordinary methods. The results of two different group showed that they had statistical difference for P anal fistula were operated by the laser, the neurotic carboatomic tissue can block blood vessel and prevent infection from spreading. The high temperature produced by the carboatomic action have enough ability to kill directly the bacteria living in the anal fistula.

  12. Poor Outcomes of Complicated Pouch-Related Fistulas after Ileal Pouch-Anal Anastomosis Surgery

    DEFF Research Database (Denmark)

    Kjaer, M D; Kjeldsen, J; Qvist, N

    2016-01-01

    BACKGROUND AND AIMS: Development of a pouch-related fistula tract is an uncommon but highly morbid complication to restorative proctocolectomy with ileal pouch-anal anastomosis. Pouch failure with permanent ileostomy is reported in 21%-30% of patients, yet the factors contributing to pouch excision...... with diagnosed pouch-related fistulas were registered with information related to fistula classification, treatments, and outcome. RESULTS AND CONCLUSION: The final analysis included 48 (10.7%) of the 447 total ileal pouch-anal anastomosis patients with complicated pouch-related fistulas. Pouch-vaginal fistulas......, pouch-perianal fistulas, and other pouch-related fistulas were observed in 19 (63%), 29 (60%), and 10 (21%) patients, respectively, corresponding to an accumulated risk of 8%, 6%, and 2%, respectively. Time from ileal pouch-anal anastomosis surgery to fistula presentation was 24 (0.2-212) months...

  13. [Laparoscopic abdominoperineal resection after preoperative chemoradiotherapy for advanced carcinoma associated with anal fistula].

    Science.gov (United States)

    Morikawa, Takashi; Yamashita, Kimihiro; Sumi, Yasuo; Kanemitsu, Kiyonori; Yamamoto, Masashi; Kanaji, Shingo; Imanishi, Tatsuya; Nakamura, Tetsu; Suzuki, Satoshi; Tanaka, Kenichi; Kakeji, Yoshihiro

    2014-11-01

    The patient was a 71-year-old man who was diagnosed with anal fistula 50 years previously. He complained of mucous and bloody stools. He was diagnosed with a carcinoma associated with anal fistula after biopsy. Image examination showed that the tumor was filled with mucinous substances and that it had invaded the levator ani muscle, with left external iliac and left inguinal lymph node metastases. Therefore, preoperative chemoradiotherapy for locally advanced cancer was administered. After chemoradiotherapy, the tumor and metastatic lymph nodes reduced in size. We performed laparoscopic abdominoperineal resection. Histopathologically, the tumor was revealed as a mucinous adenocarcinoma, but no cancer cells were present on the surgical margin. This case suggested that preoperative chemoradiotherapy could be effective for locally advanced carcinoma associated with anal fistula.

  14. 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

  15. 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

  16. Locality-dependent descending reflex motor activity in the anal canal-cholinergic and nitrergic contributions in the rat model

    Institute of Scientific and Technical Information of China (English)

    Radomir RADOMIROV; Christina IVANCHEVA; Dimitar ITZEV; Polina PETKOVA-KIROVA

    2009-01-01

    Aim: Since the distal part of the intestine is targeted by a wide range of pathogens, the motility of the recto-anal region has been the object of many experimental and clinical observations. In this study, we investigated descending motor responses in the anal canal as a measure of the activation of autonomic reflex pathways underlying evacuatory recto-anal activity. Methods: The partitioned organ bath method was used to register motor responses of the anal canal as induced by balloon distension of the rectum in isolated rat recto-anal preparations. Results: Distension-induced descending responses of the anal canal comprised contractions (with distension at a distance of 15 mm), initial contractions and secondary relaxations (at 10 mm) and short contractions followed by deep relaxations (at 3-5 mm). Decreas-ing the distance between the distension stimulus and the anal canal resulted in a decreased contraction response and increased relaxation. Tetrodotoxin (0.1 μmol/L) inhibited these responses. Atropine (0.3 μmol/L) decreased contraction and did not change the relaxation response. N~G-nitro-L-arginine (0.5 mmol/L) enhanced contraction in both the absence and presence of atropine. L-arginine (0.5 mmol/L) inhibited contraction and extended relaxation in atropine-pretreated preparations. The actions of N~G-nitro-L-arginine and L-arginine were more pronounced in the aboral direction. ChAT-positive nerve fibers were observed in myenteric ganglia of the rectum and the anal canal. The density of NADPH-diaphorase-positive neurons was higher in the anal canal region. Conclusion: Our results suggest that locality-dependent activation of the descending reflex neuromuscular communications underlie evacuatory activity in the recto-anal region. This activation response involves long excitatory cholinergic and non-cholinergic pathways along the rectum and short inhibitory nitrergic pathways located predominantly in the anal canal region.

  17. Elementos esenciales de una hermenéutica analógica

    OpenAIRE

    MAURICIO BEUCHOT

    2015-01-01

    Mi propósito en este trabajo es ofrecer un panorama de la hermenéutica analógica. Comienzo con un breve recorrido histórico de la hermenéutica y de la noción de analogía. Reúno después ambos conceptos y explico cómo la hermenéutica analógica puede evitar las fallas tanto del univocismo como del equivocismo en la interpretación.

  18. Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

    Directory of Open Access Journals (Sweden)

    Thaís Helena Benetti

    2011-03-01

    Full Text Available CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4% with a mean age of 47.5 years old (23-72 were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1 and distal (2 portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007, independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06. The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008, either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides

  19. Factors Associated With Emotional Satisfaction During First Anal Intercourse in a Sample of YMSM.

    Science.gov (United States)

    Arrington-Sanders, Renata; Rosenberger, Joshua G; Matson, Pamela; Novak, David S; Fortenberry, J Dennis

    2016-07-01

    We sought to determine, in a sample of 2,813 HIV seronegative young men who had sex with other men age 18-24, whether physical satisfaction would explain emotional satisfaction during first anal intercourse and whether emotional satisfaction would impact having sex with a partner a second time. Emotional satisfaction was explained mostly by physical satisfaction during the event, but partner type also had direct impact on emotional satisfaction. Our findings suggest that first anal intercourse experiences in young men are both emotionally and physically satisfying and may impact subsequent sexual behavior and partner decision-making.

  20. Modeling of human colonic blood flow for a novel artificial anal sphincter system

    Institute of Scientific and Technical Information of China (English)

    Peng ZAN; Guo-zheng YAN; Hua LIU

    2008-01-01

    A novel artificial anal sphincter system has been developed to simulate the normal physiology of the human anorectum. With the goal of engineering a safe and reliable device, the model of human colonic blood flow has been built and the relationship between the colonic blood flow rate and the operating occlusion pressure of the anorectum is achieved. The tissue ischemia is analyzed based on constitutive relations for human anorectum. The results suggest that at the planned operating occlusion pressure of less than 4 kPa the artificial anal sphincter should not risk the vaseularity of the human colon.

  1. El juego simbólico una alternativa en las dilataciones anales

    Directory of Open Access Journals (Sweden)

    Aguinaga B. Oscar William

    1993-04-01

    Full Text Available "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.

     

  2. 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.

  3. Aprendizaje de procesos analíticos mediante clases prácticas con laboratorios virtuales

    OpenAIRE

    Sierra Fernández, J.; J. Bosque Sendra; García Campaña, A.; Blanc García, R.; Del Iruela, M.; Gámiz Gracia, L.; Alés Barrero, F.

    2009-01-01

    Este trabajo forma parte de un proyecto de innovación docente financiado por la Universidad de Granada durante el curso 2008-09 y pretende que el alumnado del Departamento de Química Analítica de los primeros cursos de Química, Ingeniería Química, Ciencias Ambientales y Farmacia sea capaz de interrelacionar los aspectos teóricos y prácticos de diversos procesos analíticos mediante el uso de laboratorios virtuales en las sesiones prácticas. Con este fin, las clases prácticas son planificadas y...

  4. Meta-analitička obrada osnovnog kemijskog sastava mesa janjadi mediteranskih pasmina ovaca

    OpenAIRE

    Kaić, dr.sc. Ana; Mioč, prof.dr.sc. Boro; Potočnik, doc.dr.sc. Klemen

    2014-01-01

    U ovom istraživanju je utvrđen osnovni kemijski sastav janjećeg mesa mediteranskih pasmina ovaca primjenom meta-analize rezultata sedam znanstvenih istraživanja. Baza kodiranih podataka o kemijskom sastavu uključivala je janjad pasmina Tushin, Rasa Aragonesa, Churra Tensina, Grazalema Merino, Comisana i ličke pramenke. Statistička obrada kodiranih podataka provedena je softverskim programom CMA, dok su rezultati meta-analitičke obrade prikazani šumskim grafikonom pomoću softverskog program...

  5. Application of YAG laser technique in the treatment of anal fistula

    Science.gov (United States)

    Liu, Jian-xun; Zhang, Xinrong

    1993-03-01

    The method of treating anal fistula with YAG laser technique is described in this essay. One-hundred-twenty patients have been treated successfully with this method and no recurrence was found in our series. Anal fistula is a common disorder in the anus and rectum. The tunnel of fistula zigzags around the external or internal sphincters. If the drainage is poor, and the skin around the external opening grows rapidly, false healing may occur and cause recurrent abscess. In this case, a fistula can not be cured except by operation.

  6. Etude fondamentale de l'imbibition dans un réservoir fissuré Basic Research on Inbibition in a Fractured Reservoir

    OpenAIRE

    Iffly R.; Rousselet D.; Vermeulen J. L.

    2006-01-01

    L'efficacité du balayage d'un gisement fissuré par de l'eau d'injection dépend étroitement de l'importance et de la vitesse d'imbibition de l'eau par les blocs matriciels. De nombreuses expériences de laboratoire, réalisées sur des échantillons de roche et avec les fluides provenant d'un gisement exploité par Elf, ont permis de préciser l'influence, sur la récupération de l'huile, de la hauteur et de la perméabilité des blocs, ainsi que des conditions régnant à leurs limites (certaines fissur...

  7. Soil gas composition from the 2001-2002 fissure in the Lakki Plain (Nisyros Island, Greece): evidences for shallow hydrothermal fluid circulation

    Science.gov (United States)

    Venturi, Stefania; Tassi, Franco; Kanellopoulos, Christos; Vaselli, Orlando; Caponi, Chiara; Ricci, Andrea; Raspanti, Alessio; Gallorini, Andrea; Cabassi, Jacopo; Vougioukalakis, Georges

    2016-04-01

    Nisyros volcano (Aegean Sea, Greece) is currently classified in the "Very High Threat" category (Kinvig et al., 2010). Although the last volcanic activity, consisting of phreatic eruptions, occurred in the 19th century, Nisyros experienced an intense seismic activity during 1996-1998 accompanied by ground deformation and changes in the chemistry of fumarolic gases (Chiodini et al., 2002), pointing to a renewed unrest. Between November 2001 and December 2002, a NNE-oriented 600 m long fissure opened in the vegetated central part of the Lakki Plain. The fissure, 1-5 m wide and up to 15-20 m deep, showed neither vertical displacements nor gas release. No changes in the seismic and volcanic activity were observed during or after this event, which was interpreted as related to collapse of the upper caldera floor fine sediment cover (Elsevier, Amsterdam The Netherlands, 2005, pp. 161-163.

  8. 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

  9. Comparative study of fluoride released and recharged from conventional pit and fissure sealants versus surface prereacted glass ionomer technology

    Directory of Open Access Journals (Sweden)

    Elias Nahum Salmerón-Valdés

    2016-01-01

    Full Text Available Context: The fluoride release of sealants in vitro shows a marked decrease. Giomers are distinguishable from manufactured resin-based sealants and contain prereacted glass-ionomer particles (PRG. Aims: To compare the amounts of fluoride released from the main pit and fissure of a resin-based sealant with that from a Giomer and to assess the abilities of the sealant and the Giomer to recharge when exposed to regular use of fluoride rinse. Materials and Methods: The readings for the fluoride concentration were carried out for 60 days using a fluoride ion-specific electrode. After this period, the samples were recharged using a fluoride mouth rinse. The amount of fluoride released after this recharge was determined for 5 days. The data were analyzed using Student′s t- and analysis of variance tests. Results: In general, all materials presented higher fluoride release in the first 24 h; G1 and G4 showed a higher fluoride release in this period. On the other hand, G3 and G1 presented the most constant fluoride release until the 8 th day, wherein all the sealants considerably decreased in the amount of fluoride released. Conclusion: G1 and G3 released higher concentrations of fluoride, although no significant differences were found. Giomers recharged in the first 24 h after polymerization presented an improved and sustained fluoride release.

  10. Dental depth profilometric diagnosis of pit & fissure caries using frequency-domain infrared photothermal radiometry and modulated laser luminescence

    Science.gov (United States)

    Jeon, R. J.; Mandelis, A.; Sanchez, V.; Abrams, S. H.

    2005-06-01

    Non-intrusive, non-contacting frequency-domain photothermal radiometry (FD-PTR or PTR) and frequency-domain luminescence (FD-LUM or LUM) have been used with 659- nm and 830-nm laser sources to detect artificial and natural sub-surface defects in human teeth. Fifty-two human teeth were examined with simultaneous measurements of PTR and LUM and compared to conventional diagnostic methods including continuous (dc) luminescence (DIAGNOdent), visual inspection and radiographs by calculating sensitivities and specificities. With the combined criteria of four PTR and LUM signals (two amplitudes and two phases), it was found that the sensitivity of this method was much higher than any of the other methods used in this study, whereas the specificity was comparable to that of dc luminescence diagnostics. Therefore, PTR and LUM, used together as a combined technique, have the potential to be a reliable tool to diagnose early pit and fissure caries and could provide detailed information about deep lesions with its depth profilometric character. Also, from experiments with natural or artificial defects, some depth profilometric characteristics were confirmed.

  11. Evaluation of retention of pit and fissure sealants placed with and without air abrasion pretreatment in 6-8 year old children – An in vivo study

    Science.gov (United States)

    Goswami, Mridula

    2017-01-01

    Background The success of pit and fissure sealants is directly related to their retention. The purpose of this study was to assess and compare the retention of pit and fissure sealants placed using acid etch alone and a combination of air abrasion and acid etch techniques. Material and Methods 50 subjects aged 6-8 years were included in the study. Primary second molars and permanent first molars were sealed in all four quadrants using split mouth design. The right maxillary and mandibular molars (Group A) were treated by acid etching alone while the left maxillary and mandibular molars (Group B) were pretreated with air abrasion followed by acid etching before application of pit and fissure sealant. Retention of sealants was checked using Simonsen’s criteria of sealant retention after three and six months of sealant application. Results There was no significant difference in retention of sealants in Group A and Group B (p0.05). Maxillary molars showed superior retention compared to mandibular molars, which was statistically significant at both three and six months (p<0.05). Conclusions Combining air abrasion pretreatment with subsequent acid etching did not result in statistically significant difference in sealant retention compared to acid etching alone in both primary and permanent molars after 3 and 6 months follow up. An additional air abrasion pretreatment step can be avoided in pediatric patients when placing sealants and the procedure can be completed faster with better behavior management using acid etching alone. Key words:Pit and fissure sealant, acid etching, air abrasion. PMID:28210438

  12. Comparative evaluation of Shear bond strength of different Pit and fissure Sealants in Primary and Permanent teeth - An In-Vitro Study

    OpenAIRE

    Pushpalatha, H M; Ravichandra, K S; Srikanth, Koya; G. Divya; Done, Vasanthi; Krishna, K Bala; Patil, Vishwanath

    2014-01-01

    Background: Dental caries among children is one of the greatest challenges faced by dentists globally; especially that of susceptible surfaces like the Pit and fissures. Dental sealants have proved to be an effective way to prevent caries development. The Clinical success of any material depends upon its adhesion to tooth structure, resistance to wear and ability to withstand the masticatory or occlusal forces. Hence it is important to evaluate the shear bond strength ...

  13. Application of three-dimensional discrete element face-to-face contact model with fissure water pressure to stability analysis of landslide in Panluo iron mine

    Institute of Scientific and Technical Information of China (English)

    ZHANG; Lei; WEI; Zuoan; LIU; Xiaoyu; LI; Shihai

    2005-01-01

    Three-dimensional discrete element face-to-face contact model with fissure water pressure is established in this paper and the model is used to simulate three-stage process of landslide under fissure water pressure in the opencast mine, according to the actual state of landslide in Panluo iron mine where landslide happened in 1990 and was fathered in 1999. The calculation results show that fissure water pressure on the sliding surface is the main reason causing landslide and the local soft interlayer weakens the stability of slope. If the discrete element method adopts the same assumption as the limit equilibrium method, the results of two methods are in good agreement; while if the assumption is not adopted in the discrete element method, the critical φ numerically calculated is less than the one calculated by use of the limit equilibrium method for the sameC. Thus, from an engineering point of view, the result from the discrete element model simulation is safer and has more widely application since the discrete element model takes into account the effect of rock mass structures.

  14. Effectiveness of Ozone with or without the Additional Use of Remineralizing Solution on Non-Cavitated Fissure Carious Lesions in Permanent Molars

    Science.gov (United States)

    Atabek, Didem; Oztas, Nurhan

    2011-01-01

    Objectives: The aim of this study was to evaluate the efficiency of ozone alone and with a re-mineralizing solution following application on initial pit and fissure caries lesions in permanent molars. Methods: Forty children (9–12 years) having non-cavitated fissure caries lesions on bilateral 40 first permanent mandibular molar teeth were participated in the study. Patients were randomly allocated to 2 experimental groups consisting of 20 subjects. In the first group, ozone was applied once for 40 seconds to the assigned test teeth of each pair. In the second group, ozone was applied once for 40 seconds to the assigned test teeth of each pair with the use of re-mineralizing solution. Progression or improvement of the caries was assessed at baseline, immediately after treatment and at 1-,2-,3-, and 6 month follow-up by comparing the DIAGNOdent values, Clinical Severity Indexes, Oral Hygiene Scores. The results were analyzed statistically by using the Wilcoxon-Test for dependent samples in each group. When comparing different test groups (control and experimental groups) the Friedman S test followed by the Mann-Whitney U test was used. Results: A statistically significant difference was found between all of the control and experimental test lesions in each group (P.001). Conclusions: Ozone treatment either alone or combined with a re-mineralizing solution was found to be effective for remineralization of initial fissure caries lesions. PMID:22654551

  15. Comparison of the Effect of Topical Acidulated Phosphate Fluoride Application on Surface Roughness of Two Fissure Sealants and One Flowable Composite

    Directory of Open Access Journals (Sweden)

    Leila Pishevar

    Full Text Available Introduction: fluoride application and fissure sealant therapy have an important cariostatic effect in pediatric dentistry. Investigations are indicative for effects of topical fluoride specially APF (Acidulated Phosphate Fluoride gel on the restorative materials. The purpose of this study was to assess the effect of repeated application of APF (1. 23% gel on the surface roughness of two fissure sealants and one flowable composite. Materials & Methods: In this experimental study, 81 specimens of two fissure sealants and one flowable composite were prepared, using special polymer mold in three groups of 27 including: unfilled resin sealant (Fissurite F, Voco, filled resin sealant (Fissurit FX, Voco and one flowable composite (Arabesk Flow, Voco. Then, these three groups were divided into three sub groups of 9 as follows: Group 1, 4, 7 (control: No treatment. Group 2, 5, 8: Single application of APF gel. Group 3, 6, 9: Six times application of APF gel. The APF gel was applied on the surface of specimens each time for 4 minutes. Then, the specimens were stored in the distilled water. Finally, the surface roughness of the sealants was measured by Profilometer. The statistical analysis was performed by 2-Way ANOVA & One-Way ANOVA. Results: The results of the study showed a significant statistical different between the surface roughness according to the type of material (P0.05. Conclusion: All three materials were resistant to the destructive effects of APF gel and no significant surface roughness was detected on them.

  16. Etude expérimentale et numérique de la propagation d'une fissure par fatigue dans un fil d'acier tréfilé entaillé.

    OpenAIRE

    CHARTIER, Cédric

    2007-01-01

    L'objectif de ce stage est d'étudier la propagation d'une fissure au sein d'un fil d'acier et a pour objectif, d'une part, d'initier des fissures les plus représentatives et reproductibles possibles sur fil d'acier non corrodé et, d'autre part, d'étudier la propagation sous l'effet de la fatigue.

  17. Regioonide arengu jätkusuutlikkuse analüüsi informatsiooniline alus ja metoodika / Janno Reiljan

    Index Scriptorium Estoniae

    Reiljan, Janno, 1951-

    2005-01-01

    Regionaalse arengu jätkusuutlikkuse analüüsi metoodikast mitmemõõtmelise statistilise analüüsi meetodite alusel, mis võimaldaks sünteesida mahuka alginfo kompleksseteks regiooni arengu jätkusuutlikkuse indikaatoriteks ja modelleerida erinevaid valdkondi iseloomustavate näitajate omavahelisi seoseid

  18. 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.

  19. USE OF TRANSPERINEAL ULTRASONOGRAPHY TO STUDY THE EFFECT OF DELIVERY AND EPISIOTOMY ON ANAL SPHINCTER IN WOMEN

    Directory of Open Access Journals (Sweden)

    Rooplekha

    2014-06-01

    Full Text Available Parturition has profound effect on the pelvic floor muscles and is associated with mechanical or neurological injuries. In most women, this effect is transitory, however in a few, permanent damage occurs in the form of urinary or fecal incontinence, fistulae, and sexual problems. often very little attention is paid on to these problems postnataly and few women volunteer to inform about these. Therefore, the true incidence of the problem is unknown. We conducted a study to correlate the various risk factors with the degree of perianal injury caused by the mode of delivery and episiotomy on the anal sphincter. Until recently, defects of external anal sphincter (EAS were detected by electromyography and internal anal sphincter (IAS by measurement of low resting anal pressure. This study uses the transperineal ultrasonography (TPUS. TPUS assesses the anal sphincter under more physiological condition with no intra anal probe like anal endosonography so also demonstrate the internal anal cushion (mucosa & submucosa of the resting canal. TPUS gives accurate images of both sphincter muscles, leading to recognition of unsuspected defects of external & internal sphincter.

  20. Análise do filme lacrimal e sua relação com a largura da fenda palpebral e a exoftalmia na oftalmopatia de Graves Tear film analysis and its relation with palpebral fissure height and exophthalmos in Graves' ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Maria Vitoria Oliveira Moura Brasil

    2005-10-01

    54 eyes of 27 patients with Graves' ophthalmopathy, either in the inflammatory or in the chronic phase of the disease. The evaluation consisted of tear film qualitative analysis by rose bengal staining using the van Bijsterveld grading scale, tear film stability analysis by breakup time, measurement of palpebral fissure height and exophthalmometry. Qui square test was used to perform statistical analysis. RESULTS: Among 27 studied patients, 77.8% were females and 22.2% males. Mean age was 44.26 years (SD 12.67. Mean disease time was 5.85 years (SD 4.47 and mean ophthalmopathy time was 5.81 years (SD 5.37. Among 54 studied eyes, 37% had positive test by van Bijsterveld's grading scale, 33.3% tear film breakup time lower than 5 seconds, 57.4% palpebral fissure height greater than 11 mm and 55.6% exophthalmometry greater than 19 mm. When relating tear film breakup time lower than 5 seconds with palpebral fissure height greater than 11 mm we found an odds ratio of 11.2 (p=0.0008. The remaining relationships did not show statistical significance. CONCLUSIONS: Dry eye diagnosed by rose bengal staining and tear film breakup time occurs frequently in Graves' ophthalmopathy. Palpebral fissure height correlates with tear film breakup time in Graves' ophthalmopathy. Its increase may lead to tear film instability.