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Sample records for chronic anal fissure

  1. Anal Fissure

    PubMed Central

    Beaty, Jennifer Sam; Shashidharan, M.

    2016-01-01

    Anal fissure (fissure-in-ano) is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents. When nonoperative management fails, surgical treatment with lateral internal sphincterotomy has a high success rate. In this chapter, we will review the symptoms, pathophysiology, and management of anal fissures. PMID:26929749

  2. Anal fissure

    MedlinePlus

    ... bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: Botox injections into the muscle in the anus (anal sphincter) ...

  3. [Perianal fistula and anal fissure].

    PubMed

    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.

  4. Comparative study of glyceryl trinitrate ointment versus surgical management of chronic anal fissure.

    PubMed

    Tauro, Leo Francis; Shindhe, Vittal V; Aithala, P Sathyamoorthy; Martis, John J S; Shenoy, H Divakar

    2011-08-01

    Chronic Anal Fissure (CAF) is common perineal condition and well-known painful entity. Standard surgical treatment even though available, may require long hospital stay and sometimes have worrying complications like anal incontinence. So non-surgical treatment, Glyceryl Trinitrate has been shown to be an effective for chronic anal fissure. It decreases anal tone and ultimately heals the anal fissure. The present study is the attempt to know the efficacy of 0.2% Glyceryl Trinitrate ointment in the treatment of chronic anal fissure and to compare the effectiveness of 0.2% Glyceryl Trinitrate ointment (GTN) versus fissurectomy with lateral internal sphincterotomy (LIS) and fissurectomy with posterior internal sphincterotomy (PIS) in the management of chronic anal fissure. This is a prospective comparative study of management of chronic anal fissure done in our hospital during the period of one and half year from October 2005 to March 2007. Thirty patients treated with 0.2% Glyceryl Trinitrate ointment and 30 patients treated with fissurectomy and lateral internal sphincterotomy and 30 patients treated with posterior internal sphincterotomy, for chronic anal fissure were selected for study. A single brand of 0.2% Glyceryl Trinitrate ointment (Nitrogesic) used for trial arm. Dose of administration was 1.5 cm to 2 cm in the anal canal with device provided by manufacturers of the proprietary preparation and applied twice a daily for 12 weeks. Patients were followed up for 12 weeks and thereafter evaluated for relief of symptoms in all three groups. Observations were recorded at 2 weeks; 6 weeks and 12 weeks of follow up period, regarding symptoms like pain and bleeding during defecation, healing of CAF and also for side effects like headache in GTN group and flatus, fecal incontinence in surgical groups. Data collected in proforma and analyzed. Study revealed CAF was more in male 59 patients (66%) than the female 31 patients (34%), the ratio being 1: 0.52. The

  5. Anal fissure - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100154.htm Anal fissure - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  6. [Surgical therapy of chronic anal fissure--do additional proctologic operations impair continence?].

    PubMed

    Pfeifer, J; Berger, A; Uranüs, S

    1994-07-01

    78 patients with chronic anal fissures have been mainly operated on by lateral internal sphincterotomy (LATS). Continence have been evaluated by questionnaire at least 9 months postoperatively. Patient without any additional proctological operation had minor disturbances of continence in 17%. Patient with additional operations had disturbances of continence in 30%. Especially the subgroup of patients with LATS and haemorrhoidectomy had bad results. In this group only 45% were fully continent.

  7. Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia

    PubMed Central

    Jacob, Tarun; Benjamin, Santosh; Kirishnan, Sumonth

    2017-01-01

    Introduction Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF). However, LAS is often done under spinal or general anaesthesia incurring huge treatment costs and hospital stay. Aim To study if LAS can be treated with Local Anaesthesia (LA) thereby, reducing the costs and the anaesthetic risk to patients with no significant change in the surgical ease or clinical outcome. Materials and Methods A total of 79 patients with chronic fissure underwent randomized allocation to two treatment arms – The first to undergo LAS under LA and the second under Spinal Anaesthesia (SA). The primary outcome variables studied were complications like post-operative pain, infections, healing rate of fissure and incontinence rates. Secondary outcome variables studied were cost, hospital stay and need for additional anaesthetic. Results A total of 79 patients underwent LAS procedure. A total of 42 patients had LA and 39 patients had SA. There was no statistically significant difference in the healing rate, pain, infection and incontinence rates between the two groups. Moreover, the LA group incurred lower cost, reduced hospital stay and reduced risk of anaesthesia. Conclusions LAS can be satisfactorily performed under local anaesthesia with no increased risk of pain or complications, and is best suited for resource-poor surgical settings.

  8. Quality of life in patients with chronic anal fissure after topical treatment with diltiazem

    PubMed Central

    Tsunoda, Akira; Kashiwagura, Yasuharu; Hirose, Ken-ichi; Sasaki, Tadanori; Kano, Nobuyasu

    2012-01-01

    AIM: To assess the physical and mental health of fissure patients before and after topical treatment with diltiazem. METHODS: Consecutive patients were enrolled prospectively into the study. Quality of life was measured with the short-forum 36 health survey (SF-36) before and after 6-wk treatment with diltiazem. Patients scored symptoms of pain, bleeding, and irritation using numeral rating scales at the initial and follow-up visits. Fissure healing was assessed and side effects were noted. RESULTS: Fissures healed in 21 of 30 (70%) patients. There were significant reductions in the scores of pain, bleeding, and irritation after 1 wk of treatment, respectively. Four patients experienced perianal itching and one patient reported headache. When measured at baseline, pain and irritation showed a negative impact on two of the eight subscales on the SF-36, respectively (bodily pain and social functioning for pain; vitality and mental health for irritation). Repeating the SF-36 showed an improvement in bodily pain (P = 0.001). Patients whose fissures healed reported an improvement in bodily pain, health-perception, vitality, and mental health (P < 0.05). CONCLUSION: Successful treatment of chronic anal fissure with topical diltiazem leads to improvement in health-related quality of life. PMID:23494072

  9. Myoxinol (Hydrolyzed Hibiscus esculentus Extract) in the Cure of Chronic Anal Fissure: Early Clinical and Functional Outcomes

    PubMed Central

    Renzi, Adolfo; Di Sarno, Giandomenico; D'Aniello, Francesco; Ziccardi, Stefania; Paladino, Fiorella

    2015-01-01

    Objective. This study was designed to evaluate the early results of the topical application of Hydrolyzed Hibiscus esculentus Extract 3% ointment (Myoxinol 3%), a novel local product with Botox-like activity, in the conservative treatment of chronic anal fissure (CAF). Methods. Among all patients with CAF observed during the study period, 31 subjects met the inclusion criteria and underwent medical therapy with Myoxinol 3% ointment every 12 hours for 6 weeks. Two patients were lost to follow-up. Clinical and manometric follow-up was carried out eight weeks after treatment. Results. At follow-up the success rate was 72.4% (21/29); median VAS score and mean anal resting pressure were significantly lower if compared with respective baseline data. The only one adverse effect of the topical application of Myoxinol 3% ointment was perianal itch, which was reported by 3,4% (1/29) of the patients available for the analysis. However, in this case this symptom did not cause interruption of the treatment. Conclusions. The topical application of Myoxinol 3% ointment in the cure of CAF shows encouraging early results. Further researches with a larger series and a longer follow-up are needed to confirm these data. PMID:25861259

  10. Nitroglycerin 0.4% ointment vs placebo in the treatment of pain resulting from chronic anal fissure: a randomized, double-blind, placebo-controlled study

    PubMed Central

    2013-01-01

    Background Complications of chronic anal fissure (CAF) treatments are prompting interest in lower-risk therapies. This study was conducted to compare nitroglycerin (NTG) 0.4% ointment with placebo for pain associated with CAF. Methods In this randomized, double-blind, placebo-controlled trial, patients with one CAF and moderate-to-severe pain (≥50 mm on a 100 mm visual analog scale [VAS]) received 375 mg NTG 0.4% (1.5 mg active ingredient) or 375 mg placebo ointment applied anally every 12 hours for 21 days. The primary end point was change from baseline VAS score in 24-hour pain averaged over days 14–18. Review of data from patients who withdrew early was blinded to treatment. To control for the confounding effects of analgesics, all patients received 650 mg acetaminophen for headache prophylaxis before each application. Results A total of 247 patients were enrolled (NTG, n = 123; placebo, n = 124). The prespecified baseline observation carried forward (BOCF) analysis found no significant difference between groups; however, a last observation carried forward (LOCF) analysis showed a significant advantage for NTG. A post hoc analysis (LOCF/BOCF hybrid) demonstrated a significant adjusted mean difference of −7.0 mm in favor of NTG 0.4% (95% CI −13.6, –0.4; P = .038). Headache was the most common adverse event in the NTG (69.9%) and placebo (47.6%) groups. Conclusions This was the first placebo-controlled study that also controlled for the confounding effects of analgesics used to treat NTG-induced headache. In patients with moderate-to-severe CAF pain, NTG 0.4% ointment effectively reduced CAF pain compared with placebo. Trial registration ClinicalTrials.gov, NCT00522041 PMID:23815124

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

    PubMed Central

    Izzo, Giuseppe; Di Martino, Natale; Renzi, Adolfo

    2014-01-01

    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. PMID:25089280

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

    PubMed Central

    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 fissure aged 18 to 60 years managed in our clinics were included in this study. The patients were randomly divided into two groups. Sixty-five patients received topical nifedipine (TN) and the same number received oral nifedipine (ON). Results: Ulcer healing occurred in 43 (73.33%) of topical nifedipine group compared to 29 (49.5%) patients in oral nifedipine, which was significantly different (P < 0.05). Side effects such as headache and flushing in oral nifedipine group were more prevalent than topical nifedipine, which was statistically different. Recurrence rates were the same after six months of follow-up. Conclusions: Although oral nifedipine can reduce symptom and signs of anal fissure, topical nifedipine has a superior role for anal fissure treatment with higher healing rate and lower side effects. PMID:25389477

  13. Hemorrhoids and anal fissures in inflammatory bowel disease.

    PubMed

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

    2015-12-01

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

  14. A rare case of myeloid sarcoma presenting as anal fissure

    PubMed Central

    VECCHIO, R.; INTAGLIATA, E.; FIUMARA, P.F.; VILLARI, L.; MARCHESE, S.; CACCIOLA, E.

    2015-01-01

    Myeloid sarcoma is a tumor composed of myeloblasts occurring at an extramedullary site. It may develop in patients with acute myeloid leukemia, myeloproliferative or myelodysplastic syndrome, sometimes preceding onset of the systemic disease. Frequent sites of myeloid sarcoma are bones or various soft tissues. Gastrointestinal involvement is very rare. We report a unique case of myeloid sarcoma presenting as a painful anal fissure, in a patient with a history of acute myeloid leukemia. The diagnosis was achieved by a surgical excisional biopsy and immunoistochemical staining. PMID:26712260

  15. Health-related quality of life in patients with anal fissure: effect of type D personality

    PubMed Central

    Yilmaz, Edip Erdal; Canan, Fatih; Yildirim, Osman; Cetin, Mehmet Mustafa

    2014-01-01

    Introduction Health-related quality of life (HRQL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition. Aim To assess the prevalence of type D personality in patients with anal fissure and to investigate whether the presence of a type D personality would affect HRQL in patients with anal fissure. Material and methods One hundred outpatients with anal fissure with no psychiatric comorbidity were consecutively enrolled, along with 100 healthy controls. Type D Scale (DS14) and General Health Survey Short Form-36 (SF-36) were used in the collection of data. Results Patients with anal fissure scored lower on physical roles and bodily pain dimensions of SF-36 than healthy subjects (p < 0.05). Thirty-three patients with anal fissure (33%) and 16 controls (16%) had scored above the cut-off score of the DS14 (p < 0.05). Patients with a type D personality were found to score lower on bodily pain and social roles domains of HRQL than patients without a type D personality. Conclusions Type D personality was associated with increased perceived bodily pain and social roles in patients with anal fissure. Type D personality construct may be an important consideration when assessing HRQL outcomes. A multidimensional approach may be valuable in the assessment of patients presenting with anal fissure, because a subgroup with type-D personality might benefit from psychological therapies. PMID:25061489

  16. Anal Fissures

    MedlinePlus

    ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ...

  17. Anal Fissure

    MedlinePlus

    ... and Conditions Find A Surgeon Patients ASCRS Non-Discrimination Statement Privacy Policy Research Foundation of the ASCRS Non-Discrimination Statement About Us ASCRS News Video Disclaimer Social ...

  18. Maintenance therapy with unprocessed bran in the prevention of acute anal fissure recurrence.

    PubMed Central

    Jensen, S L

    1987-01-01

    The effect of unprocessed bran in a dose of 5 g three times daily and a dose of 2.5 g three times daily for one year on the recurrence rate of anal fissures was studied in a double-blind, placebo-controlled trial in 90 patients with recently healed acute posterior anal fissures. Fifteen patients (16.6%) were withdrawn before the code was broken due to failure to follow the trial protocol for various reasons. Significantly fewer recurrences occurred in patients receiving bran 5 g three times daily (recurrence rate 16%, 95% confidence limits, 4.54 to 36.08) when compared with patients receiving bran 2.5 g three times daily (60%; 38.67 to 78.87) (P less than 0.01) and with patients receiving placebo three times daily (68%; 46.50 to 85.05) (P less than 0.01). No significant difference in recurrences was found between patients on bran 2.5 g and those on placebo. PMID:3039130

  19. [Epidemiology of anal lesions (fissure and thrombosed external hemorroid) during pregnancy and post-partum].

    PubMed

    Abramowitz, L; Batallan, A

    2003-06-01

    Thrombosed external hemorrhoids (TEH) and anal fissure (AF) are 2 frequent sources of anal pains during childbirth. We are going to define their incidences as available in publications and in our experience in Bichat hospital. Then we will define their risk factors. According to Martin's and Corby's studies, AF was observed in 10% of the delivered women. In Bichat hospital we performed a proctological assessment to 165 pregnant women during the last third of pregnancy and within the 2 months following delivery. We observed 2 AF (1,2%) during the first period and 25 (15,2%) during the second. Rouillon et al. reported an incidence of TEH in 12,2% (20/164), while Pradel and al. reported 34% (18/52) of it. In Bichat hospital, 13 women (7,9%) were presenting with TEH during the last third of pregnancy and 33 (20%) in post-partum period. Two studies looked for a statistical correlation between AF and obstetrical, foetal or maternal factors. Corby et al. only pointed the role of constipation. In our study, terminal constipation was the most important risk factor for AF with 5.7 (2.7-12), odds ratio (95% confidence intervals). Rouillon et al. observed more TEH among women with a prolonged first stage labor and a big baby. In our study, a big baby and mother little lips tears were observed more often among women with TEH (P <0,05). Also, we observed only one TEH among the 25 women with caesarean section (4%). Finally, observation that TEH arise immediately after delivery is another argument to support the role of traumatic delivery. We also demonstrated the role of terminal constipation as risk factor for TEH after delivery. To conclude, 1/3 of pregnant women develop AF or TEH after delivery. These 2 pathologies are strongly correlated to terminal constipation. TEH seems equally furthered by traumatic delivery.

  20. Hemorrhoids, anal fissure, and carcinoma of the colon, rectum, and anus during pregnancy.

    PubMed

    Medich, D S; Fazio, V W

    1995-02-01

    The pregnant patient afflicted with a variety of colorectal conditions merits special consideration for reasons related to the safety and timeliness of operation while preserving fetal viability and fertility. The literature is scanty with respect to hemorrhoids, fissures, and colorectal and anal carcinoma. Therefore, the patient has to have a forthright discussion with her physician(s) about the pros and cons of operative and nonoperative approaches, which can result in either therapeutic abortion and timely surgery versus preserving the fetus and taking on the unknown factor of whether delay in treatment will cause an adverse outcome. This underscores the need for a frank discussion with the patient with regard to anticipated outcomes. In benign conditions, there is more latitude to adopt a conservative approach, as the patient's ability to tolerate the symptoms of her condition would dictate the need for definitive operative therapy. In the patient with malignancy, delaying surgical or radiation therapy carries an unknown risk to the patient. Here, the patient's personal views regarding abortion and future fertility dictate the timing of definitive treatment.

  1. Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: A randomized clinical trial study

    PubMed Central

    Salari, Masoumeh; Salari, Roshanak; Dadgarmoghadam, Maliheh; Khadem-Rezaiyan, Majid; Hosseini, Mousalreza

    2016-01-01

    Background Acute anal fissure as a common disease in society has several etiologies and manifestations such as severe anal pain and bleeding. Nitroglycerin ointment 0.2% is the most common topical treatment used. The most common side effect of nitroglycerin is headache, which is annoying for patients and often leads to discontinuation of the drug. Objective Comparison of egg yolk as a natural substance with analgesic and anti-inflammatory properties and minimal side effects with nitroglycerin ointment in the treatment of acute anal fissure. Methods This randomized clinical trial was carried out during a 10-day period in the Gastroenterology clinic of Ghaem Hospital, Mashhad, Iran (year 2015). 126 patients who filled the inclusion criteria were enrolled. The patients were randomly divided into two groups. Nitroglycerin ointment (0.2%) was applied by patients in the first group, twice daily for 10 days. For the second group, one egg yolk once a day was administered rectally up to 10 days. The pain and bleeding severity were recorded every two days up to 10 days after finishing the treatment course, based on visual scale Results The results showed that egg yolk caused a significant reduction in pain and bleeding compared with nitroglycerin (p<0.05). At the beginning of the study, the difference in pain intensity between the two groups was not statistically significant (p-value = 0.25). However, it became significant in the following days. Changes in the frequency of rectorrhagia were also significant in both groups, showing a major decrease in the number of rectorrhagia cases (p<0.001). Conclusion Egg yolk is more efficient than nitroglycerin in the treatment of acute anal fissure. In addition, lack of any side effects results in the completion of the treatment course by the patients. Trial Registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015050718915N3. Funding This work was supported by a

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

    PubMed

    Derakhshan, Ali Reza

    2016-06-08

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

  3. Anal Health Care Basics

    PubMed Central

    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

  4. Anal Health Care Basics.

    PubMed

    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.

  5. Resting anal pressure, not outlet obstruction or transit, predicts healthcare utilization in chronic constipation: a retrospective cohort analysis

    PubMed Central

    Staller, Kyle; Barshop, Kenneth; Kuo, Braden; Ananthakrishnan, Ashwin N

    2015-01-01

    Background Chronic constipation is common and exerts a considerable burden on health-related quality of life and healthcare resource utilization. Anorectal manometry (ARM) and colonic transit testing have allowed classification of subtypes of constipation, raising promise of targeted treatments. There has been limited study of the correlation between physiological parameters and healthcare utilization. Methods All patients undergoing ARM and colonic transit testing for chronic constipation at two tertiary care centers from 2000 to 2014 were included in this retrospective study. Our primary outcomes included number of constipation-related and gastroenterology visits per year. Multivariate linear regression adjusting for confounders defined independent effect of measures of colonic and anorectal function on healthcare utilization. Key Results Our study included 612 patients with chronic constipation. More than 50% (n=333) of patients had outlet obstruction by means of balloon expulsion testing and 43.5% (n=266) had slow colonic transit. On unadjusted analysis, outlet obstruction (1.98 vs. 1.68), slow transit (2.40 vs 2.07) and high resting anal pressure (2.16 vs. 1.76) were all associated with greater constipation-related visits/year compared to patients without each of those parameters (P<0.05 for all). Outlet obstruction and high resting anal pressure were also associated with greater number of gastroenterology visits/year. After multivariate adjustment, high resting anal pressure was the only independent predictor of increased constipation-related visits/year (P=0.02) and gastroenterology visits/year (P=0.04). Conclusions and Inferences Among patients with chronic constipation, high resting anal pressure, rather than outlet obstruction or slow transit, predicts healthcare resource utilization. PMID:26172284

  6. Anal cancer

    MedlinePlus

    Cancer - anus; Squamous cell carcinoma - anal; HPV - anal cancer ... cancer and the human papillomavirus or HPV infection. HPV is a sexually transmitted virus that has been linked to other cancers as well. Other major risk factors include: HIV ...

  7. Robust pulmonary lobe segmentation against incomplete fissures

    NASA Astrophysics Data System (ADS)

    Gu, Suicheng; Zheng, Qingfeng; Siegfried, Jill; Pu, Jiantao

    2012-03-01

    As important anatomical landmarks of the human lung, accurate lobe segmentation may be useful for characterizing specific lung diseases (e.g., inflammatory, granulomatous, and neoplastic diseases). A number of investigations showed that pulmonary fissures were often incomplete in image depiction, thereby leading to the computerized identification of individual lobes a challenging task. Our purpose is to develop a fully automated algorithm for accurate identification of individual lobes regardless of the integrity of pulmonary fissures. The underlying idea of the developed lobe segmentation scheme is to use piecewise planes to approximate the detected fissures. After a rotation and a global smoothing, a number of small planes were fitted using local fissures points. The local surfaces are finally combined for lobe segmentation using a quadratic B-spline weighting strategy to assure that the segmentation is smooth. The performance of the developed scheme was assessed by comparing with a manually created reference standard on a dataset of 30 lung CT examinations. These examinations covered a number of lung diseases and were selected from a large chronic obstructive pulmonary disease (COPD) dataset. The results indicate that our scheme of lobe segmentation is efficient and accurate against incomplete fissures.

  8. Squamous cell carcinoma arising in a chronic osteomyelitic sinus tract in the peri-anal region involving pelvis: a rare occurrence.

    PubMed

    Karumbaiah, K P; Shruthi, M S; Ragavendran, V; Kariappa, T M

    2014-01-01

    Squamous cell carcinoma is a rare, but well documented complication of chronic osteomyelitis. Squamous cell carcinoma arising in a sinus tract following chronic osteomyelitis of the pelvic bone is a very rare occurrence. The patient presented with multiple draining sinuses and an ulcerative growth at the mouth of one of the sinuses in the peri-anal region. X-ray findings and sinogram showed de- struction of part of pubic bone. Biopsy from the growth confirmed a well differentiated squamous cell carcinoma. Therefore it is imperative that these lesions be biopsied for accurate diagnosis, adequate therapy and follow-up.

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

    PubMed

    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.

  10. Growing Hemorrhagic Choroidal Fissure Cyst

    PubMed Central

    Gelal, Fazıl; Gurkan, Gokhan; Feran, Hamit

    2016-01-01

    Choroidal fissure cysts are often incidentally discovered. They are usually asymptomatic. The authors report a case of growing and hemorrhagic choroidal fissure cyst which was treated surgically. A 22-year-old female presented with headache. Cranial MRI showed a left-sided choroidal fissure cyst. Follow-up MRI showed that the size of the cyst had increased gradually. Twenty months later, the patient was admitted to our emergency department with severe headache. MRI and CT showed an intracystic hematoma. Although such cysts usually have a benign course without symptoms and progression, they may rarely present with intracystic hemorrhage, enlargement of the cyst and increasing symptomatology. PMID:26962426

  11. Hyrtl fissure: a historical thriller.

    PubMed

    Mudry, Albert

    2009-06-01

    Hyrtl fissure is an anatomic landmark allowing a transient embryonic communication between the subarachnoid space and the middle ear. It is an eponym characterized by the absence of a known original description. The aim of this study was to try to find and explain the origin of the use of this eponym. Numerous references and original publications were studied to finally demonstrate that Joseph Hyrtl was not able to describe this fissure in the mid-19th century.

  12. Shallow Subsurface Structures of Volcanic Fissures

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

    Volcanic fissure vents are a difficult geologic feature to quantify. They are often too thin to document in detail with seismology or remote geophysical methods. Additionally, lava flows, lava drain back, or collapsed rampart blocks typically conceal a fissure's surface expression. For exposed fissures, quantifying the surface (let along sub0surface) geometric expression can become an overwhelming and time-consuming task given the non-uniform distribution of wall irregularities, drain back textures, and the larger scale sinuosity of the whole fissure system. We developed (and previously presented) VolcanoBot to acquire robust characteristic data of fissure geometries by going inside accessible fissures after an eruption ends and the fissure cools off to <50 C. Data from VolcanoBot documents the fissure conduit geometry with a near-IR structured light sensor, and reproduces the 3d structures to cm-scale accuracy. Here we present a comparison of shallow subsurface structures (<30 m depth) within the Mauna Ulu fissure system and their counterpart features at the vent-to-ground-surface interface. While we have not mapped enough length of the fissure to document sinuosity at depth, we see a self-similar pattern of irregularities on the fissure walls throughout the entire shallow subsurface, implying a fracture mechanical origin similar to faults. These irregularities are, on average, 1 m across and protrude 30 cm into the drained fissure. This is significantly larger than the 10% wall roughness addressed in the engineering literature on fluid dynamics, and implies that magma fluid dynamics during fissure eruptions are probably not as passive nor as simple as previously thought. In some locations, it is possible to match piercing points across the fissure walls, where the dike broke the wall rock in order to propagate upwards, yet in other locations there are erosional cavities, again, implying complex fluid dynamics in the shallow sub-surface during fissure eruptions.

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

    USGS Publications Warehouse

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

    2016-01-01

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

  14. Fissure seal or fluoride varnish?

    PubMed

    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

  15. Sylvian Fissure Dermoid Cyst - A Rare case

    PubMed Central

    Anand, Deepak; Soin, Divya; Garg, Ravinder

    2014-01-01

    Intracranial dermoid cysts are rare tumours which usually occur in the midline. Sylvian fissure is a very unusual site for this lesion. This case presents a patient with unruptured dermoid cyst in the left sylvian fissure who was operated successfully without any residual deficit. PMID:25386502

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

    PubMed

    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.

  17. Anal abscess and fistula.

    PubMed

    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.

  18. Thoracoscopic anterior ‘fissure first’ technique for left lung cancer with an incomplete fissure

    PubMed Central

    Samejima, Joji; Matsuura, Yosuke; Nakao, Masayuki; Uehara, Hirofumi; Nakagawa, Ken; Masuda, Munetaka; Okumura, Sakae

    2016-01-01

    Background Dealing with incomplete lung fissures during thoracoscopic surgery is difficult. Our objective was to evaluate the efficacy and safety of a thoracoscopic anterior ‘fissure first’ technique for dealing with incomplete left lung fissures. Methods One hundred and seventy patients underwent left upper lobectomy or left lower lobectomy between April 2008 and July 2014. Of these, 34 patients underwent surgery using a thoracoscopic anterior ‘fissure first’ technique for incomplete fissures (group A) and 136 underwent surgery using a conventional thoracoscopic method for unfused fissures (group B). A four-port complete thoracoscopic approach was used in all patients. After completion of the fissure, hilar lymphadenectomy was performed in the conventional manner. Results There were no significant differences between the two groups in operating time, blood loss, or duration of chest tube drainage. Patients in group A required more staple cartridges than those in group B (mean number of cartridges, 2.4 vs. 1.1; P<0.01). The two groups did not significantly differ with regard to the prevalence of air leaks (12% vs. 4%; P=0.11), either prolonged or delayed. Conclusions We found that a thoracoscopic anterior ‘fissure first’ technique for left lung cancer with an incomplete fissure enabled hilar lymphadenectomy to be performed in the conventional manner without any increase in the prevalence of air leaks, operating time, or duration of chest tube drainage. This technique should be considered for use in left upper lobectomy or left lower lobectomy in patients with an incomplete fissure. PMID:28066589

  19. Enceladus Near-Fissure Surface Temperatures

    NASA Astrophysics Data System (ADS)

    Howell, Robert R.; Goguen, J. D.; Spencer, J. R.

    2013-10-01

    Recently reported Cassini VIMS observations of thermal emission from the Enceladus south-pole fissures (Goguen et al. 2013) when combined with previous longer wavelength Cassini CIRS observations (Spencer et al. 2006) allow us to better constrain the highest temperatures present, but also require more detailed modeling of the processes which control those highest temperatures. The simplest interpretation of the VIMS observations is that the 3-5 µm thermal radiation comes from the walls within a fissure, rather than the adjacent surface. But as part of investigating that latter alternative it became clear that very high sublimation rates are implied by some predicted surface temperatures. Abramov and Spencer (2009) produced models of the expected surface temperature distribution, assuming conduction of heat through the ice, balanced by thermal radiation at the surface. However as temperature is raised, at 186K sublimation cooling equals radiation, and because it depends exponentially on temperature, it quickly dominates. We have found that including the surface sublimation cooling suppresses the higher temperatures. Regardless of the fissure temperature, surface temperatures above 200K can only be maintained by conduction within a few tens of centimeters of the assumed fissure wall. The high sublimation erosion rates (0.25 m/yr at 180K, rising to over 100 m/yr at 220K) imply that the fixed boundaries we have previously assumed are unrealistic. If these surface temperatures are maintained then either a sublimation lag of non-ice components will accumulate, inhibiting sublimation, or the geometry of the fissure vent will rapidly change. However the rate of change will be limited by the available heat provided by conduction. We are now developing numerical models with moving boundary conditions to explore the time evolution. The simplest result may be that the lip of the fissure erodes back till it no longer remains in thermal contact with the rising vapor which

  20. Pathology of Anal Cancer.

    PubMed

    Hoff, Paulo M; Coudry, Renata; Moniz, Camila Motta Venchiarutti

    2017-01-01

    Anal canal cancer is rather an uncommon disease but its incidence is increasing. Squamous cell carcinoma (SCC) is the most frequent primary anal neoplasm and can encompass a variety of morphologies. HPV infection has a key role in precancerous lesions and cancer development by the production of E6 and E7 oncoproteins. Anal squamous precancerous lesions are now classified according to the same criteria and terminology as their cervical counterparts. The p16 expression by immunohistochemistry is a surrogate marker for human papilloma virus (HPV). Many other tumor types can arise in the anal canal, including adenocarcinomas, neuroendocrine tumors, malignant melanomas, lymphomas and various types of mesenchymal tumors. For differential diagnosis, immunostaining markers such as CK5/6 and p63 can be used to distinguish SCC and CK7 for adenocarcinoma. Other classical panels can also be applied as in other locations. Currently, there are no biomarkers able to predict prognosis or response to treatment in clinical practice.

  1. Identification of the pleural fissures with computed tomography

    SciTech Connect

    Marks, B.W.; Kuhns, L.R.

    1982-04-01

    The pleural fissures can be identified as avascular planes within the pulmonary parenchyma on CT scans. A retrospective analysis of 23 consecutive scans was conducted to consider identification of fissures. On 21% of the axial images, a ''ground glass'' band was identified within the avascular plane, probably due to partial volume averaging of the pleural fissure with the adjacent lung. The pleural fissures could be identified in 84% of cases.

  2. [Acute anal pain].

    PubMed

    Pittet, O; Demartines, N; Hahnloser, D

    2014-03-05

    Anal pain is a common reason for consultation, whose etiology is varied and should not be limited to the hemorrhoidal disease. The purpose of this article is to conduct a review of the literature on anorectal pathologies most frequently encountered and make recommendations regarding their management.

  3. Cryptoglandular anal fistula.

    PubMed

    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.

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

    PubMed

    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.

  5. Hydraulic fracturing in tight, fissured media

    SciTech Connect

    Warpinski, N.R. )

    1991-02-01

    Large volumes of natural gas are found in tight, fissured reservoirs. Hydraulic fracturing can enhance recovery, but many complications, such as pressure-sensitive or accelerated leakoff, damage, and complex fracturing, arise during treatment of such reservoirs. This paper reports that special procedures generally should be considered during breakdown and fracturing of these reservoirs. In addition, the use of alternative stimulation strategies may be beneficial.

  6. Prevalence of and Risk Factors for Anal Human Papillomavirus Infection Among Young Healthy Women in Costa Rica

    PubMed Central

    Castro, Felipe A.; Quint, Wim; Gonzalez, Paula; Katki, Hormuzd A.; Herrero, Rolando; van Doorn, Leen-Jan; Schiffman, Mark; Struijk, Linda; Rodriguez, Ana Cecilia; DelVecchio, Corey; Lowy, Douglas R.; Porras, Carolina; Jimenez, Silvia; Schiller, John; Solomon, Diane; Wacholder, Sholom; Hildesheim, Allan; Kreimer, Aimée R.

    2012-01-01

    Background. Anal cancer is caused by human papillomavirus (HPV), yet little is known about anal HPV infection among healthy young women. Methods. A total of 2017 sexually active women in the control arm of an HPV-16/18 vaccine trial had a single anal specimen collected by a clinician at the 4-year study visit. Samples were tested for HPV by SPF10 PCR/DEIA/LiPA25, version 1. Results. A total of 4% of women had HPV-16, 22% had oncogenic HPV, and 31% had any HPV detected in an anal specimen. The prevalence of anal HPV was higher among women who reported anal intercourse, compared with those who did not (43.4% vs 28.4%; P < .001). Among women who reported anal intercourse, cervical HPV (adjusted odds ratio [aOR], 5.3 [95% confidence interval {CI}, 3.4–8.2]), number of sex partners (aOR, 2.2 [95% CI, 1.1–4.6] for ≥4 partners), and number of anal intercourse partners (aOR, 1.9 [95% CI, 1.1–3.3] for ≥2 partners) were independent risk factors for anal HPV detection. Among women who reported no anal intercourse, cervical HPV (aOR, 4.7 [95% CI, 3.7–5.9]), number of sex partners (aOR, 2.4 [95% CI, 1.7–3.4] for ≥4 partners), and report of anal fissures (aOR, 2.3 [95% CI, 1.1–4.8]) were associated with an increased odds of anal HPV detection. Conclusion. Anal HPV is common among young women, even those who report no anal sex, and was associated with cervical HPV infection. Anal fissures in women who report never having had anal intercourse may facilitate HPV exposure. Clinical Trials Registration. NCT00128661. PMID:22850119

  7. [Cryptoglandular anal fistulas].

    PubMed

    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.

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

    NASA Astrophysics Data System (ADS)

    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.

  9. Lung fissure detection in CT images using global minimal paths

    NASA Astrophysics Data System (ADS)

    Appia, Vikram; Patil, Uday; Das, Bipul

    2010-03-01

    Pulmonary fissures separate human lungs into five distinct regions called lobes. Detection of fissure is essential for localization of the lobar distribution of lung diseases, surgical planning and follow-up. Treatment planning also requires calculation of the lobe volume. This volume estimation mandates accurate segmentation of the fissures. Presence of other structures (like vessels) near the fissure, along with its high variational probability in terms of position, shape etc. makes the lobe segmentation a challenging task. Also, false incomplete fissures and occurrence of diseases add to the complications of fissure detection. In this paper, we propose a semi-automated fissure segmentation algorithm using a minimal path approach on CT images. An energy function is defined such that the path integral over the fissure is the global minimum. Based on a few user defined points on a single slice of the CT image, the proposed algorithm minimizes a 2D energy function on the sagital slice computed using (a) intensity (b) distance of the vasculature, (c) curvature in 2D, (d) continuity in 3D. The fissure is the infimum energy path between a representative point on the fissure and nearest lung boundary point in this energy domain. The algorithm has been tested on 10 CT volume datasets acquired from GE scanners at multiple clinical sites. The datasets span through different pathological conditions and varying imaging artifacts.

  10. Anal involvement in pemphigus vularis.

    PubMed

    Khezri, Somayeh; Mahmoudi, Hamid-Reza; Masoom, Seyedeh Nina; Daneshpazhooh, Maryam; Balighi, Kamran; Hosseini, S Hamed; Chams-Davatchi, Cheyda

    2013-01-01

    Background. Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucosa. Anal mucosa may be involved in PV, but the frequency and clinical profile are not fully ascertained. Objective. The aim was to investigate the involvement of the anal area in newly diagnosed PV patients. Patients and Methods. A total of 168 consecutive newly diagnosed PV patients were enrolled. Anal symptoms and signs, involvement of other body sites, and severity of disease were recorded. Results. A total of 47 out of 168 patients (27.9%) had involvement of the anal area. Anal involvement was significantly associated with PV lesions in ophthalmic (P = 0.03), nasal (P = 0.02), and genital mucosa (P < 0.001) but not the oral cavity (P = 0.24). There was a significant association between number of involved mucosal sites and anal involvement (P < 0.001). Anal involvement was associated with oral severity (P = 0.02). Constipation was the most frequent symptom (73.8%) followed by pain on defecation (50%). Seventeen patients (36%) were symptom-free. Erosion was the most frequent sign (91.5%). Conclusion. Anal involvement in PV seems to be more frequent than previously assumed. Routine anal examination is recommended even in asymptomatic patients as anal involvement appears to correlate with the severity of PV.

  11. [Fissure sealants--5 years of use].

    PubMed

    Azul, A M

    1990-01-01

    This study assesses the caries prevalence, retention and cost-effectiveness of a pit and fissure sealant in a children population with 622 cases, 5 years after a single application of an auto-polymerized sealant to permanent molars. The status of the sealant and the presence of caries or restaurations on the sealed teeth was assessed. In a self-controlled group of children, the prevalence of disease (caries and restaurations) was also assessed in non-sealed teeth, for comparison. The sealant application was compared with Class I-restauration with amalgam for cost-effectiveness analysis.

  12. Anal anatomy and normal histology.

    PubMed

    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.

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2016-01-01

    Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since been detected across North America and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction or prevalence studies of large or protected herds, where depopulation may be contraindicated. This study evaluated the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay of recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brushings collected antemortem. These findings were compared to results of immunohistochemistry (IHC) analysis of ante- and postmortem samples. RAMALT samples were collected from populations of farmed and free-ranging Rocky Mountain elk (Cervus elaphus nelsoni; n = 323), and nasal brush samples were collected from a subpopulation of these animals (n = 205). We hypothesized that the sensitivity of RT-QuIC would be comparable to that of IHC analysis of RAMALT and would correspond to that of IHC analysis of postmortem tissues. We found RAMALT sensitivity (77.3%) to be highly correlative between RT-QuIC and IHC analysis. Sensitivity was lower when testing nasal brushings (34%), though both RAMALT and nasal brush test sensitivities were dependent on both the PRNP genotype and disease progression determined by the obex score. These data suggest that RT-QuIC, like IHC analysis, is a relatively sensitive assay for detection of CWD prions in RAMALT biopsy specimens and, with further investigation, has potential for large-scale and rapid automated testing of antemortem samples for CWD. PMID:26888899

  15. A Geophysical Study of Fissures in Pahrump, Nevada

    NASA Astrophysics Data System (ADS)

    Hirsch, A. C.; McEwan, M. J.; Howley, R. A.; Mehling, J. B.; Snelson, C. M.; Drohan, P.

    2004-12-01

    Earth fissures are surface expressions of deep fracturing subsidence systems caused by groundwater withdrawl greater than aquifer recharge. This type of subsidence is most common in arid environments of the south western U.S. such as, Las Vegas, NV, Phoenix, AZ, and areas in New Mexico. In addition, fissures have recently been identified in the Pahrump Valley in southwestern Nevada just west of Las Vegas. The city of Pahrump has experienced an increase in population and economic growth. This growth has lead to a higher demand in the use of the areas natural resources. One major concern is groundwater pumping and over-watering of the land surface. Pahrump has experienced significant differential subsidence within the valley causing significant structural damage to infrastructure. This differential subsidence is most readily identified by its surface expression as fissures. Earth fissures are not only shallow surface features but can be 10's of meters deep and 100's of meters long. These ground failures can be exacerbated by faults at depth, shallow bedrock, and/or differential compaction. However, the most significant cause is from groundwater withdrawl. Several geophysical methods were performed on the fissures to better understand their subsurface expression, trend, and ultimately their affect on the city of Pahrump. Seismic refraction, reflection, ground penetrating radar (GPR), and gravity measurements were performed on the fissures and surrounding area including local faults. Our initial studies show the fissures propagating for long distances, in a variety of shapes, and trending in a north-south direction. Initial GPR studies show high fissure reflections at approximately 1 and 1.5 meters along with general slumping features below these reflections. Fissures are an unmitigatable problem. Our results will help identify fissures in the area that do not have a surface expression as well as mapping the current fissures and their extent. These results can be used

  16. Fine Mapping and Introgressing a Fissure Resistance Locus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rice (Oryza sativa L.) kernel fissuring is a major concern of both rice producers and millers. Fissures are small cracks in rice kernels that increase breakage among kernels when transported or milled, which decrease the value of processed rice. This study employed molecular gene tagging methods to ...

  17. Management of Complex Anal Fistulas

    PubMed Central

    Bubbers, Emily J.; Cologne, Kyle G.

    2016-01-01

    Complex anal fistulas require careful evaluation. Prior to any attempts at definitive repair, the anatomy must be well defined and the sepsis resolved. Several muscle-sparing approaches to anal fistula are appropriate, and are often catered to the patient based on their presentation and previous repairs. Emerging technologies show promise for fistula repair, but lack long-term data. PMID:26929751

  18. [The anal fistula disease and abscess].

    PubMed

    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.

  19. Tongue fissure extraction and classification using hyperspectral imaging technology.

    PubMed

    Li, Qingli; Wang, Yiting; Liu, Hongying; Sun, Zhen; Liu, Zhi

    2010-04-10

    Tongue fissures, an important feature on the tongue surface, may be pathologically related to some diseases. Most existing tongue fissure extraction methods use tongue images captured by traditional charge coupled device cameras. However, these conventional methods cannot be used for an accurate analysis of the tongue surface due to limited information from the images. To solve this, a hyperspectral tongue imager is used to capture tongue images instead of a digital camera. New algorithms for automatic tongue fissure extraction and classification, based on hyperspectral images, are presented. Both spectral and spatial information of the tongue surface is used to segment the tongue body and extract tongue fissures. Then a classification algorithm based on a hidden Markov model is used to classify tongue fissures into 12 typical categories. Results of the experiment show that the new method has good performance in terms of the classification rates of correctness.

  20. Total proctocolectomy and ileal - anal pouch

    MedlinePlus

    Restorative proctocolectomy; Ileal-anal resection; Ileal-anal pouch; J-pouch; S-pouch; Pelvic pouch; Ileal-anal pouch; Ileal ... RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, ...

  1. [Surgical treatment of anal fistula].

    PubMed

    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.

  2. Electrocautery for Precancerous Anal Lesions

    Cancer.gov

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  3. Modern management of anal fistula.

    PubMed

    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

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

    USGS Publications Warehouse

    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

  5. Hardness testing of some fissure-sealing materials.

    PubMed

    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.

  6. Implications of ground-deformation measurements across earth fissures in subsidence areas in the southwestern USA

    USGS Publications Warehouse

    Holzer, Thomas L.

    2010-01-01

    Ground deformation was monitored at earth fissures in areas of land subsidence induced by groundwater extraction in the southwestern United States. The ground deformation is consistent with the mechanism that fissures are caused by horizontal strains generated by bending of overburden in response to localized differential compaction. Subsidence profiles indicated that localized differential subsidence occurred across the fissures and that maximum convex-upward curvature was at the fissure. The overall shape of the profile stayed similar with time, and maximum curvature remained stationary at the fissure. Horizontal displacements were largest near the fissure, and generally were small to negligible away from the fissure. Maximum tensile horizontal strains were at the fissure and coincided with maximum curvature in the subsidence profiles. Horizontal tensile strain continued to accumulate at fissures after they formed with rates of opening ranging from 30 to 120 microstrain/year at fissures in Arizona.

  7. Primary radiation therapy in the treatment of anal carcinoma

    SciTech Connect

    Cantril, S.T.; 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.

  8. Conservative treatment for anal incontinence

    PubMed Central

    Carter, Dan

    2014-01-01

    Anal incontinence (AI) in adults is a troublesome condition that negatively impacts upon quality of life and results in significant embarrassment and social isolation. The conservative management of AI is the first step and targets symptomatic relief. The reported significant improvement with conservative treatments for AI is close to 25% and involves prescribed changes in lifestyle habits, a reduced intake of foods that may cause or aggravate diarrhea or rectal urgency, and the use of specific anti-diarrheal agents. The use of a mechanical barrier in the form of an anal plug and the outcomes and principles of pelvic kinesitherapies and biofeedback options are outlined. This review discusses a gastroenterologist's approach towards conservative therapy in patients referred with anal incontinence. PMID:24759347

  9. Anal fistula. Past and present.

    PubMed

    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. 

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

    PubMed

    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 < 0.05). Likewise, the average specificity was higher for DELF (0.64) than for LF (0.29) (p < 0.05). In the presence of plaque, sensitivity was higher for 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 < 0.05), and specificity increased consistently (average 0.51, p < 0.05). It was concluded that, in the absence of plaque, DELF was a better diagnostic tool than LF for detection of demineralization in artificial fissures.

  11. Open Fissure Folds record coseismic loading and postseismic stress relaxation

    NASA Astrophysics Data System (ADS)

    Nüchter, Jens-Alexander

    2015-03-01

    Open Fissure Folds hosted by high pressure/low temperature metamorphic rocks of south Evia (Greece) are introduced, their structural and microstructural record is analysed, and a mechanical model is proposed. Open Fissure Folds are preserved as at least two parallel folded quartz-feldspar veins separated by narrow buckled rock columns. The veins originated as tensile cracks that propagated in the middle crust driven by high differential stress. Features diagnostic for Open Fissure Folds indicate that the rock columns represented the layers of high viscosity, and not the veins as consistently reported in many previous studies on folded veins. This record is taken to indicate that buckling of the rock columns initiated after arrest of the fractures and terminated prior to complete vein sealing. Accordingly, mechanical decoupling by open fissures allowed for buckling of the rock columns in response to episodic creep of the host rocks according to stress relaxation, as expected for postseismic deformation in the earthquake cycle. I propose that the parental fractures propagated in response to quasi-instantaneous coseismic loading of the middle crust. Buckling was attributed to transient postseismic creep and stress relaxation. Complete sealing of the veins occurred when stresses were largely relaxed. Each Open Fissure Fold records the stress and strain history of a single earthquake.

  12. HDR brachytherapy for anal cancer

    PubMed Central

    Kovács, Gyoergy

    2014-01-01

    The challenge of treating anal cancer is to preserve the anal sphincter function while giving high doses to the tumor and sparing the organ at risk. For that reason there has been a shift from radical surgical treatment with colostomy to conservative treatment. Radiotherapy combined with chemotherapy has an important role in the treatment of anal cancer patients. New techniques as intensity modulated radiotherapy (IMRT) have shown reduced acute toxicity and high rates of local control in combination with chemotherapy compared to conventional 3-D radiotherapy. Not only external beam radio-chemotherapy treatment (EBRT) is an established method for primary treatment of anal cancer, brachytherapy (BT) is also an approved method. BT is well known for boost irradiation in combination with EBRT (+/– chemotherapy). Because of technical developments like modern image based 3D treatment planning and the possibility of intensity modulation in brachytherapy (IMBT), BT today has even more therapeutic potential than it had in the era of linear sources. The combination of external beam radiotherapy (EBRT) and BT allows the clinician to deliver higher doses to the tumor and to reduce dose to the normal issue. Improvements in local control and reductions in toxicity therefore become possible. Various BT techniques and their results are discussed in this work. PMID:24982770

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

    PubMed Central

    Rahimian-Imam, Sara; Fayazi, Mohammad Reza

    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 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. PMID:26884777

  14. Engineering a robotic approach to mapping exposed volcanic fissures

    NASA Astrophysics Data System (ADS)

    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

  15. Dental Pit and Fissure Sealants: Implications for School Health Personnel.

    ERIC Educational Resources Information Center

    McCormack-Brown, K. R.; And Others

    1989-01-01

    To promote good personal hygiene practices in students, school health personnel must be informed about dental pit and fissure sealants and related programs. Adoption and maintenance of such programs may depend on the success of school health personnel in educating administrators and policymakers. (SM)

  16. Flow characteristics and sealing ability of fissure sealants.

    PubMed

    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.

  17. Palpebral fissure changes after monobloc frontofacial advancement in faciocraniosynostosis.

    PubMed

    Cruz, Antonio Augusto V; Akaishi, Patricia Mitiko S; Arnaud, Eric; Marchac, Daniel; Renier, Dominique

    2008-01-01

    There is virtually no literature on the effect of correction of syndromal faciocraniosynostosis with monobloc advancement on the palpebral fissure shape. Using image processing software, we measured the effect of monobloc advancement on the position of the upper and lower eyelids as well as the palpebral fissure slant in a series of 18 patients with syndromal faciocraniosynostosis who had undergone surgery for correction of orbital and midface hypoplasia. For both eyes of each patient, 3 variables were measured on the pre- and postoperative photographs: the linear distances between the upper and lower eyelid margins, the pupil center and the angle between the inner and outer canthi. The globe protrusion was also measured on axial computed tomography scans before and after surgery. The results indicate that the exorbitism reduction induced by monobloc advancement is accompanied by a diminution of the distance between both eyelids and the pupil center. However, the downward slant of the palpebral fissure is increased after surgery. The data suggest that the lower and upper eyelid retraction seen preoperatively in the majority of patients with faciocraniosynostosis tend to be corrected when the frontofacial region is advanced by the monobloc. On the other hand, the surgery tends to lower the outer canthus, increasing the negative slant of the fissure. The postoperative changes induced by the frontofacial monobloc advancement need to be taken into account when the surgery is going to be performed.

  18. New method opens opportunity to proactively select for fissure resistance in early breeding generations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    WANTED: New rice varieties improved for resistance to kernel fissuring. Rice kernel fissuring is one of the leading causes of reduced milling yield. Any reduction in fissuring can result in direct increases in yield and profit for both producers and millers. While most U.S. rice varieties yield a...

  19. Selection for fissure resistance now made possible in early breeding generations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rice kernel fissuring is one of the leading causes of milling yield losses. Any reduction in fissuring can result in direct increases in yield and profit for both producers and millers. While most U.S. rice varieties yield around 55% head rice, the fissure-resistant varieties ‘Cypress’, ‘Saber’ an...

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

    PubMed

    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.

  1. Surveillance of Anal Canal Cancers.

    PubMed

    Adams, Richard

    2017-01-01

    Anal squamous cell cancer is most frequently a locoregional disease that is amenable to curative therapy in a majority of fit patients. Complete response rates after chemoradiotherapy (CRT) are good, with up to 75% of patients with no evidence of relapse on surveillance. Relapse is most frequently locoregional and is often amendable to salvage surgery with curative intent. Effective surveillance attempts to improve outcomes by identifying recurrent or persistent disease early, managing both acute and late toxicities, and offering reassurance to patients. This article explores the rationale and evidence for surveillance programs after definitive CRT.

  2. Anal fistula: intraoperative difficulties and unexpected findings.

    PubMed

    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.

  3. Basaltic fissure eruptions, plume heights, and atmospheric aerosols

    NASA Technical Reports Server (NTRS)

    Stothers, R. B.; Wolff, J. A.; Self, S.; Rampino, M. R.

    1986-01-01

    Convective plumes that rise above Hawaiian-style fire fountains consist of volcanic gases, aerosols, fine ash, and entrained heated air. Plume theory has been applied to observational estimates of the rate of thermal energy release from large fire fountains. The theoretically predicted heights of maintained plumes agree very well with the heights found from actual observations. Predicted plume heights for both central-vent (point-source) and fissure (line-source) eruptions indicate a stratospheric penetration by plumes that form over vents with very high magma-production rates. Flood basalt fissure eruptions that produce individual lava flows with volumes greater than 100 cu km at very high mass eruption rates are capable of injecting large quantities of sulfate aerosols into the lower stratosphere, with potentially drastic short-term atmospheric consequences, like acid precipitation, darkening of the sky, and climatic cooling.

  4. Injectabilite des coulis de ciment dans des milieux fissures

    NASA Astrophysics Data System (ADS)

    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.

  5. The fissure: interlobar collateral ventilation and implications for endoscopic therapy in emphysema.

    PubMed

    Koster, Theodoor David; Slebos, Dirk-Jan

    2016-01-01

    In patients with severe emphysema, bronchoscopic lung volume reduction using one-way valves is a promising therapeutic option to improve lung function and quality of life. The goal of this treatment is to achieve a complete lobar atelectasis. In a significant proportion of patients, this atelectasis cannot be achieved due to interlobar collateral ventilation. This collateral ventilation is generated through incomplete lobar fissures. Therefore, only patients with complete fissures and no collateral ventilation can be selected for endobronchial therapy with one-way valves. Incomplete fissures are very common and exhibit a great variation in anatomy. The reported prevalence is 17%-85% for the right major fissure, 19%-74% for the left major fissure, and 20%-90% for the minor fissure. There are several methods of measuring or predicting the presence of collateral ventilation, with computed tomography (CT)-fissure analysis and the Chartis measurement being the most important. CT-fissure analysis is an indirect method to measure the completeness of fissures as a surrogate for collateral ventilation. The Chartis system is an endobronchial method to directly measure the presence of collateral ventilation. Both methods have unique value, and the combination of both can accurately predict the treatment response to the bronchoscopic placement of endobronchial valves. This review provides an in-depth view of lung fissure and collateral ventilation to help understand its importance in selecting the appropriate patients for new emphysema treatments and thus avoid useless treatment in unsuitable patients.

  6. What's New in Anal Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Anal Cancer About Anal Cancer What’s New in Anal Cancer Research and Treatment? Important research ... cancer cells is expected to help scientists develop new drugs to fight this disease. Early detection Ongoing ...

  7. Cisplatin and Fluorouracil Compared With Carboplatin and Paclitaxel in Treating Patients With Inoperable Locally Recurrent or Metastatic Anal Cancer

    ClinicalTrials.gov

    2016-03-22

    Anal Basaloid Carcinoma; Anal Canal Cloacogenic Carcinoma; Anal Squamous Cell Carcinoma; Metastatic Anal Canal Carcinoma; Recurrent Anal Canal Carcinoma; Stage IIIB Anal Canal Cancer; Stage IV Anal Canal Cancer

  8. Abnormal vasculature interferes with optic fissure closure in lmo2 mutant zebrafish embryos.

    PubMed

    Weiss, Omri; Kaufman, Rivka; Michaeli, Natali; Inbal, Adi

    2012-09-15

    Ocular coloboma is a potentially blinding congenital eye malformation caused by failure of optic fissure closure during early embryogenesis. The optic fissure is a ventral groove that forms during optic cup morphogenesis, and through which hyaloid artery and vein enter and leave the developing eye, respectively. After hyaloid artery and vein formation, the optic fissure closes around them. The mechanisms underlying optic fissure closure are poorly understood, and whether and how this process is influenced by hyaloid vessel development is unknown. Here we show that a loss-of-function mutation in lmo2, a gene specifically required for hematopoiesis and vascular development, results in failure of optic fissure closure in zebrafish. Analysis of ocular blood vessels in lmo2 mutants reveals that some vessels are severely dilated, including the hyaloid vein. Remarkably, reducing vessel size leads to rescue of optic fissure phenotype. Our results reveal a new mechanism leading to coloboma, whereby malformed blood vessels interfere with eye morphogenesis.

  9. Enamel fusion using a carbon dioxide laser: A technique for sealing pits and fissures

    SciTech Connect

    Walsh, L.J.; Perham, S.J. )

    1991-05-01

    The well-established enhanced resistance of lased enamel to demineralization is the basis for clinical application of the carbon dioxide laser to caries prevention. This in vitro study examined the effect of focused infrared laser radiation on sound enamel and early pit and fissure caries. Low power levels (2-5 W) induced localized melting and resolidification of enamel with little surface destruction. For sound fissures, fusion of enamel from the lateral walls of the fissure eliminated the fissure space, providing a sealant effect; while in carious fissures, carious enamel was vaporized and adjacent sound enamel fused to partially eliminate the defect. The technique for enamel fusion using CO2 lasers has potential application for sealing pits and fissures and producing physicochemical alterations in enamel which may have preventive benefits.

  10. Joints, fissures, and voids in rhyolite welded ash-flow tuff at Teton damsite, Idaho

    USGS Publications Warehouse

    Prostka, Harold J.

    1977-01-01

    Several kinds of joints, fissures, and voids are present in densely welded rhyolite ash-flow tuff at Teton damsite. Older fissures and voids probably were formed in the ash-flow sheet during secondary flowage, which probably was caused by differential compaction or settling over irregular topography. The younger, more abundant fissures are mostly steep cooling joints that probably have been opened farther by horizontal tectonic extension and gravitational creep, perhaps aided by lateral stress relief.

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

    PubMed

    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

  12. Prophylactic HPV vaccination and anal cancer.

    PubMed

    Stier, Elizabeth A; Chigurupati, Nagasudha L; Fung, Leslie

    2016-06-02

    The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. A retrospective analysis also suggests that qHPV vaccination of older MSM treated for AIN2+ may significantly decrease the risk of recurrence of the AIN2+. The HPV types detected in anal cancer are included in the 9-valent vaccine. Thus, the 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer.

  13. New techniques for treating an anal fistula.

    PubMed

    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.

  14. Bonding Agents in Pit and Fissure Sealants: A Review

    PubMed Central

    Das, Usha Mohan; G, Suma

    2009-01-01

    Dental adhesive systems used for bonding dental resins to enamel and dentin have evolved through several "generations," with changes in chemistry, mechanism, number of bottles, application technique, and clinical effectiveness. The trend in the latest generation of dental bonding systems is to reduce the number of components and clinical placement steps. The introduction of i bond, a single-bottle dental adhesive system, is the latest of the new generation materials, and combines etchant, adhesive, and desensitizer in one component. This paper describes different dentin bonding agents, its evolution, mechanism of action and different commercially available dentin bonding agents and their role in the retention of pit and fissure sealant. PMID:25206115

  15. Sylvian fissure epidermoid cyst presenting with intention tremor

    PubMed Central

    Shah, Abhidha; Makkiyah, Feda; Goel, Atul

    2016-01-01

    Epidermoid tumors are benign tumors which contain keratin, cellular debris, and cholesterol, and are lined with stratified squamous epithelium. They grow in discreet silence sustained over a multitude of years. The tumors most commonly present with headache and seizures. We report the case of a 24-year-old male with a large sylvian fissure epidermoid tumor who presented with intention tremor. The patient was operated, and a near-total excision of the tumor was performed with a resolution of the tremor. PMID:27057232

  16. Research of features related to land subsidence and ground fissure disasters in the Beijing Plain

    NASA Astrophysics Data System (ADS)

    Yang, Y.; Luo, Y.; Liu, M.; Wang, R.; Wang, H.

    2015-11-01

    This study overviews the development history, current situation, impact, and hazards of land subsidence and ground fissure disasters in the Beijing Plain (BP) and focuses on the disaster distribution and features of disaster-causing mechanisms. Currently, the BP is still in a rapid developmental stage of land subsidence. The development and distribution of land subsidence are affected by various factors including the thickness of Quaternary compressible clay, groundwater overexploitation, and the rapid development of urban construction. The causes of ground fissures in the BP are complex and diverse, with evidence of structure fissures, non-structure fissures, and mixed genesis fissures. Investigations of the Gaoliying ground fissure have shown that this fissure has evidence of fracture activity, with vertical deformation that is more significant than horizontal deformation. Furthermore, this ground fissure has characteristics of inter-annual periodicity and annual jumping. The land subsidence and ground fissures are all under structural control and impact each other, and more severe hazards may be induced under the superimposition of these two types of disasters. Effective measures and suggestions for disaster prevention and control are recommended on the basis of this study.

  17. On homogenization of a variational inequality for an elastic body with periodically distributed fissures

    SciTech Connect

    Pastukhova, S E

    2000-02-28

    We study the problem of small deformations of an elastic body with periodically distributed fissures, where one-sided constraints are imposed on the sides of the fissures; this problem is equivalent to a variational inequality. We prove that if the linear size of the period of the distribution of the fissures tends to zero, then the solutions of this problem converge in the L{sup 2}-norm to the solution of the homogenized problem, which is a non-linear boundary-value problem of elasticity theory for a domain without fissures.

  18. Anal erogeneity: the goose and the rat.

    PubMed

    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.

  19. Anal melanosis diagnosed by reflectance confocal microscopy.

    PubMed

    Cinotti, Elisa; Chol, Christelle; Perrot, Jean Luc; Labeille, Bruno; Forest, Fabien; Cambazard, Frédéric

    2014-11-01

    Until now, in vivo reflectance-mode confocal microscopy (IVCM) has been applied only to pigmented lesions of the vulvar and oral mucosa, but not to anal mucosa lesions. We present the first case in which IVCM has been used to diagnose anal melanosis. Clinical and dermoscopic features were of concern while IVCM found the draped pattern already described for genital melanosis. IVCM adds information to the clinical and dermatoscopic examination and allows skin biopsies to be avoided. Further studies are needed to define the IVCM features of anal melanosis and to compare the performance of IVCM with the findings of histological examinations.

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

    NASA Astrophysics Data System (ADS)

    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.

  1. Preserving rice quality: fine mapping and introgressing a fissure resistance locus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rice (Oryza sativa L.) kernel fissuring is a major concern of both rice producers and millers. Fissures are small cracks in the rice kernels that increase the percentage of breakage among the kernels when they are transported and milled, which decreases the value of processed rice. This study employ...

  2. Early screening of recombinant inbred lines for fissure resistance in non-semidwarf rice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rice (Oryza sativa L.) kernel fissuring poses a major problem for both rice farmers and millers. It results in the decreased value of milled rice because of the increase in the percentage of broken kernels associated with fissuring. This study employs the use of fine mapping to increase the genetic ...

  3. Response to early generation selection for resistance to rice kernel fissuring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The value of milled rice (Oryza sativa L.) depends on the percent whole versus broken kernels after milling. Kernel fissures caused by pre- or post-harvest stresses are the leading cause of breakage upon milling. ‘Cypress’ is known to be more fissure resistant (FR) than most cultivars, but breeding ...

  4. Video monitoring analysis of the dynamics at fissure eruptions

    NASA Astrophysics Data System (ADS)

    Witt, Tanja; Walter, Thomas R.

    2016-04-01

    At basaltic eruption often lava fountains occur. The fountains mainly develop at erupting fissures, underlain by a magma-filled dike transporting the magma horizontally and vertically. Understanding of the dynamics of the deep dike and fracture mechanisms are mainly based on geophysical data as well as observations from seismic or geodetic networks. At the surface, however, new methods are needed to allow detailed interpretation on the eruption velocities, interactions between vents and complexities in the magma paths. With video cameras we collected imaging data from different erupting fissures. We find that lava fountaining is often correlated at distinct vents. From the frames of the videos we calculated the height and velocities of fountains as a function of time. Lava fountains often show a pulsating regime, that may change over time. Comparing the fountain height as a function of time of different vents by an time-dependent cross-correlation, we find a time lag between the pulses at adjacent vents. From this we derive an apparent velocity of temporal separation between vents, associated with the fountaining activity based on the calculated time lag and the vent distances. Although the correlation system can change episodically and sporadically, both the frequency of the fountains and eruption and the rest time between single fountains remain remarkably similar for adjacent lava fountains imply a controlling process in the magma feeder system itself. We present and compare our method for the Kamoamoa eruption 2011 (Hawaii) and the Holuhraun eruption 2014/2015 (Iceland). Both sites show a significant time shift between the single pulses of adjacent vents. We compare our velocities determined by this time shift to the assumed magma flow velocity in the dike as determined by independent models. Therefore we conjecture that the time shift of venting activity may allow to estimate the dynamics of magma and fluid migration at depth, as well as to identify the

  5. Pleistocene microvertebrates from fissure-fillings in Thailand

    NASA Astrophysics Data System (ADS)

    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

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

    PubMed Central

    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

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

    PubMed

    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.

  8. Discrete element modeling on the crack evolution behavior of brittle sandstone containing three fissures under uniaxial compression

    NASA Astrophysics Data System (ADS)

    Yang, Sheng-Qi; Huang, Yan-Hua; Ranjith, P. G.; Jiao, Yu-Yong; Ji, Jian

    2015-12-01

    Based on experimental results of brittle, intact sandstone under uniaxial compression, the micro-parameters were firstly confirmed by adopting particle flow code (PFC^{2D}). Then, the validation of the simulated models were cross checked with the experimental results of brittle sandstone containing three parallel fissures under uniaxial compression. The simulated results agreed very well with the experimental results, including the peak strength, peak axial strain, and ultimate failure mode. Using the same micro-parameters, the numerical models containing a new geometry of three fissures are constructed to investigate the fissure angle on the fracture mechanical behavior of brittle sandstone under uniaxial compression. The strength and deformation parameters of brittle sandstone containing new three fissures are dependent to the fissure angle. With the increase of the fissure angle, the elastic modulus, the crack damage threshold, and the peak strength of brittle sandstone containing three fissures firstly increase and secondly decrease. But the peak axial strain is nonlinearly related to the fissure angle. In the entire process of deformation, the crack initiation and propagation behavior of brittle sandstone containing three fissures under uniaxial compression are investigated with respect to the fissure angle. Six different crack coalescence modes are identified for brittle sandstone containing three fissures under uniaxial compression. The influence of the fissure angle on the length of crack propagation and crack coalescence stress is evaluated. These investigated conclusions are very important for ensuring the stability and safety of rock engineering with intermittent structures.

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

    PubMed

    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.

  10. Infrasound from the 2007 fissure eruptions of Kīlauea Volcano, Hawai'i

    USGS Publications Warehouse

    Fee, D.; Garces, M.; Orr, T.; Poland, M.

    2011-01-01

    Varied acoustic signals were recorded at Kīlauea Volcano in mid-2007, coincident with dramatic changes in the volcano's activity. Prior to this time period, Pu'u 'Ō'ō crater produced near-continuous infrasonic tremor and was the primary source of degassing and lava effusion at Kīlauea. Collapse and draining of Pu'u 'Ō'ō crater in mid-June produced impulsive infrasonic signals and fluctuations in infrasonic tremor. Fissure eruptions on 19 June and 21 July were clearly located spatially and temporally using infrasound arrays. The 19 June eruption from a fissure approximately mid-way between Kīlauea's summit and Pu'u 'O'o produced infrasound for ~30 minutes-the only observed geophysical signal associated with the fissure opening. The infrasound signal from the 21 July eruption just east of Pu'u 'Ō'ō shows a clear azimuthal progression over time, indicative of fissure propagation over 12.9 hours. The total fissure propagation rate is relatively slow at 164 m/hr, although the fissure system ruptured discontinuously. Individual fissure rupture times are estimated using the acoustic data combined with visual observations.

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

    NASA Astrophysics Data System (ADS)

    Panda, B. B.; Rucker, M. L.; Fergason, K. C.

    2015-11-01

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

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

    SciTech Connect

    Scanlon, B.R.; Raney, J.A. . Bureau of Economic Geology)

    1992-01-01

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

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

    DTIC Science & Technology

    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

  14. Moisture and solute flux along preferred pathways characterized by fissured sediments in desert soils

    NASA Astrophysics Data System (ADS)

    Scanlon, Bridget R.

    1992-06-01

    Evaluation of preferred flow pathways is critical for waste disposal. These pathways reduce the effectiveness of thick desert soils in attenuating contaminants by short-circuiting flow through the unsaturated zone. Unsaturated flow in fissured sediments in the Chihuahuan Desert of Texas, U.S.A., was examined to determine if these sediments act as preferred pathways for water and solute transport. Fissures are surface features, or gulleys, that are underlain by fractures filled with loose sediment washed in from surrounding areas. Hydraulic and chemical approaches were used to investigate unsaturated flow processes beneath and adjacent to fissures, and the results were compared with data from surrounding geomorphic systems such as arroyos, ephemeral streams and interstreams. Typically, high water potentials in surficial sediments result from infiltration of recent precipitation. Below this surficial zone of high water potentials lies a zone of low water potentials that is much thinner beneath the fissure than in adjacent sediments or in sediments beneath ephemeral streams and interstreams. Maximum chloride concentrations in profiles in the fissured sediments (80-105 gm -3) were much lower than those measured in all other geomorphic systems (2000-6000 gm -3) because chloride is leached in the vicinity of the fissures. Minimum estimates of the moisture flux from chloride data ranged from 1 to 8 mm yr -1 in the fissured sediments and were up to 350 times greater than those calculated for ephemeral stream and interstream settings. The corresponding moisture velocities in the fissured sediments ranged from 10 to 70 mm yr -1. A tracer experiment demonstrated higher downward water and solute transport in the fracture fill beneath the fissure relative to adjacent sediments. Numerical simulations of the tracer experiment with the computer code TRACR3D reproduced the overall shape of the tracer plume. Sensitivity analyses demonstrated that the tracer plume is most sensitive

  15. [Fissure sealants as primary preventive measures. Four-year evaluation in Stara Pazova].

    PubMed

    Andjelic, P; Pazova, S; Vojinovic, J; Tatic, E; Pintaric, J

    1991-04-01

    Worldwide studies have shown that fissure caries prophylaxis is very difficult using conventional preventive methods. The scientific council of the prophylaxis programme for the protection of mouth and teeth in Vojvodina has begun sealing fissures in Stara Pazova and Novi Sad. The molars of all 6-year-old children were sealed completely. A 77.8% reduction in fissure caries was found at the end of the four-year study. Losses of sealing material came to 16% after four years. Cost-effectiveness analysis: The sealings are three times cheaper than an amalgam filling. Application time: 8-9 minutes.

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

    NASA Astrophysics Data System (ADS)

    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

  17. Analysis of anal secretions from phlaeothripine thrips.

    PubMed

    Suzuki, Takahisa; Haga, Kazuo; Tsutsumi, Tadaaki; Matsuyama, Shigeru

    2004-02-01

    The anal secretions of 16 phlaeothripine thrips species (Thysanoptera: Phlaeothripidae) were studied, including a reinvestigation of three species previously reported. A total of 37 components were detected, including hydrocarbons, acetates, terpenes, carboxylic acids, a quinone, an aromatic compound, and a pyranone compound. The secretions of all species were composed of some of these components, with Xylaplothrips inquilinus possessing as many as 11 components. Of these components, (Z)-9-octadecene, (Z)-9-nonadecene, nonadecadiene, octanoic acid, decanoic acid, geranial, neral, alpha-pinene, beta-pinene, caryophyllene, 2-hydroxy-6-methylbenzaldehyde, and two unidentified monoterpenes [UK-I (M+136) and UK-II (M+168)] were detected for the first time. The chemicals were species-specific; four Liothrips species and three Holothrips species could be distinguished from each other and their congeners by the GC profiles of the ether extracts of their anal secretions. The anal secretions of gall-inducing thrips commonly contained terpenes. of which citral (a mixture of geranial and neral) and beta-acaridial repelled ants or had antifungal activity. The findings suggest that these terpenes play a defensive role and prevent galls from fungal infestation. 3-Butanoyl-4-hydroxy-6-methyl-2H-pyran-2-one, found from three Holothrips spp., caused paralysis in ants. Chemical analysis of anal secretion components is a useful method for the classification of tubuliferan species that are difficult to distinguish on the basis of morphological characters.

  18. Midwestern Rural Adolescents' Anal Intercourse Experience

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  19. What Are the Risk Factors for Anal Cancer?

    MedlinePlus

    ... uncircumcised male. For more information about HPV and HPV vaccines, see HPV Vaccines . Anal warts Anal warts (also known as condyloma acuminata ) are caused by infection with certain types of HPV – usually different types from those most likely to ...

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

    PubMed

    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.

  1. Painless Ulcers and Fissures of Toes: Hereditary Sensory Neuropathy, Not Leprosy.

    PubMed

    Rao, Angoori Gnaneshwar

    2016-01-01

    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.

  2. Painless Ulcers and Fissures of Toes: Hereditary Sensory Neuropathy, Not Leprosy

    PubMed Central

    Rao, Angoori Gnaneshwar

    2016-01-01

    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. PMID:26955138

  3. Putative fissure-resistance QTLs mapped to chromosomes 1 and 8 based on allelic frequency differences observed between fissure-resistant and fissure-susceptible progeny from two segregating populations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Whole rice kernels have two to three times more market value than broken, which means that any reduction in milling yield results in financial losses for both rice producers and millers. One of the primary causes of rice breakage during milling is fissuring of the rice before it even enters the mil...

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

    NASA Astrophysics Data System (ADS)

    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.

  5. Cadherin-mediated cell adhesion is critical for the closing of the mouse optic fissure.

    PubMed

    Chen, Shuyi; Lewis, Brandy; Moran, Andrea; Xie, Ting

    2012-01-01

    Coloboma is a congenital disease that contributes significantly to childhood blindness. It results from the failure in closing the optic fissure, a transient opening on the ventral side of the developing eye. Although human and mouse genetic studies have identified a number of genes associated with coloboma, the detailed cellular mechanisms underlying the optic fissure closure and coloboma formation remain largely undefined. N-cadherin-mediated cell adhesion has been shown to be important for the optic fissure closure in zebrafish, but it remains to be determined experimentally how cell-cell adhesions are involved in the mammalian optic fissure closing process. α-Catenin is required for cell adhesion mediated by all of the classic cadherin molecules, including N-cadherin. In this study, we used the Cre-mediated conditional knockout technique to specifically delete α-catenin from the developing mouse eye to show that it is required for the successful closing of the optic fissure. In α-catenin conditional mutant optic cups, the major cell fates, including the optic fissure margin, neural retina and retinal pigmented epithelium, are specified normally, and the retinal progenitor cells proliferate normally. However, adherens junctions components, including N-cadherin, β-catenin and filamentous actin, fail to accumulate on the apical side of α-catenin mutant retinal progenitor cells, where adherens junctions are normally abundant, and the organization of the neural retina and the optic fissure margin is disrupted. Finally, the α-catenin mutant retina gradually degenerates in the adult mouse eye. Therefore, our results show that α-catenin-mediated cell adhesion and cell organization are important for the fissure closure in mice, and further suggest that genes that regulate cell adhesion may underlie certain coloboma cases in humans.

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

    NASA Astrophysics Data System (ADS)

    Geshi, Nobuo; Oikawa, Teruki

    2016-11-01

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

  7. [Adenocarcinoma of anal canal. Report of a case and review of the literature].

    PubMed

    Pollastri, E; Brosutti, O; Montenovo, A; Bergero, A; Moroni, J

    1994-01-01

    Carcinomas of the anal channel includes only 2 to 6 per cent of all colorectal tumors. They are squamous cell carcinomas, cloacogenic carcinoma and unusually, adenocarcinomas. A 41 year old man in which an adenocarcinoma of the anal channel developed within a chronic perianal fistula, is presented. A review of the literature about adenocarcinoma or the anus is made, and then the incidence, probable etiologies, biologic behavior, clinical features, diagnosis, differential diagnosis and treatment are enunciated. This rare tumor is associated with chronic inflammatory disease of the anal channel because of its etiology (fistula-in-ano, condyloma acuminata), because of cellular changes that are perpetuated by local immunologic blockade. We conclude that any chronic inflammatory disease must be treated early and adequately to avoid metaplastic and frank neoplastic changes. A deep and early biopsy of any benign lesion must be made if it does not respond to treatment, and a histopathologic exam of any tissue resected in orificial surgery must be performed. We suggest to use the classification of histological typing used by the W.H.O. and the staging of cancer by the U.I.C.C. and A.J.C.C. (1987).

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

    ERIC Educational Resources Information Center

    Branfman, Jonathan; Ekberg Stiritz, Susan

    2012-01-01

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

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

    PubMed

    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.

  10. Monitoring on Xi'an ground fissures deformation with TerraSAR-X data

    USGS Publications Warehouse

    Zhao, C.; Zhang, Q.; Zhu, W.; Lu, Zhiming

    2012-01-01

    Owing to the fine resolution of TerraSAR-X data provided since 2007, this paper applied 6 TerraSAR data (strip mode) during 3rd Dec. 2009 to 23rd Mar. 2010 to detect and monitor the active fissures over Xi'an region. Three themes have been designed for high precision detection and monitoring of Xi'an-Chang'an fissures, as small baseline subsets (SBAS) to test the atmospheric effects of differential interferograms pair stepwise, 2-pass differential interferogram with very short baseline perpendicular to generate the whole deformation map with 44 days interval, and finally, corner reflector (CR) technique was used to closely monitor the relative deformation time series between two CRs settled crossing two ground fissures. Results showed that TerraSAR data are a good choice for small-scale ground fissures detection and monitoring, while special considerations should be taken for their great temporal and baseline decorrelation. Secondly, ground fissures in Xi'an were mostly detected at the joint section of stable and deformable regions. Lastly, CR-InSAR had potential ability to monitor relative deformation crossing fissures with millimeter precision.

  11. Dysregulation of Autophagy Contributes to Anal Carcinogenesis

    PubMed Central

    Carchman, Evie H.; Matkowskyj, Kristina A.; Meske, Louise; Lambert, Paul F.

    2016-01-01

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

  12. HIV– positive anal cancer: an update for the clinician

    PubMed Central

    Dandapani, Savita V; Eaton, Michael; Pagnini, Paul G

    2010-01-01

    Anal cancer used to be a rare cancer traditionally associated with elderly women. There are approximately 5260 cases per year in the U.S. (1). The onslaught of the Human Immunodeficiency Virus (HIV) virus has led to a change in anal cancer demographics. Anal cancer is on the rise in the U.S and the number of anal cases documented has quadrupled in the past 20 yrs correlating with the rise of the HIV epidemic. The incidence of anal cancer is 40 to 80 fold higher in the HIV positive (HIV+) population when compared to the general population (2). With the advent of highly active antiretroviral therapy (HAART), HIV+ patients are living longer as less are progressing to AIDS. As a consequence non AIDS defining cancers such as anal cancer are on the rise. Factors implicated in the etiology of anal cancer in HIV+ patients include (Human papillomavirus) HPV virus status, sexual habits, and a history of smoking. HPV 16 and receptive anal intercourse (RAI) increase the risk of anal cancer by 33% over the general population. In the general population, the rate of anal cancer is approximately 0.9 cases per 100,000. In patients with a history of RAI, the rate approaches 35 cases per 100,000 which is equivalent to the prevalence of cervical cancer (3). Smokers are eight times more likely to develop anal cancer. There has been much discussion about tailoring treatment decisions in HIV+ patients with anal cancer. This review focuses on squamous cell carcinomas of the anal canal which comprise 80 to 90% of all anal cancers diagnosed and highlight key issues in the management of HIV+ anal cancer patients including recent clinical trials. PMID:22811803

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

    PubMed

    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.

  14. Multiscale Strain as a Predictor of Impact-Induced Fissuring in Articular Cartilage.

    PubMed

    Henak, Corinne R; Bartell, Lena R; Cohen, Itai; Bonassar, Lawrence J

    2017-03-01

    Mechanical damage is central to both initiation and progression of osteoarthritis (OA). However, specific causal links between mechanics and cartilage damage are incompletely understood, which results in an inability to predict failure. The lack of understanding is primarily due to the difficulty in simultaneously resolving the high rates and small length scales relevant to the problem and in correlating such measurements to the resulting fissures. This study leveraged microscopy and high-speed imaging to resolve mechanics on the previously unexamined time and length scales of interest in cartilage damage, and used those mechanics to develop predictive models. The specific objectives of this study were to: first, quantify bulk and local mechanics during impact-induced fissuring; second, develop predictive models of fissuring based on bulk mechanics and local strain; and third, evaluate the accuracy of these models in predicting fissures. To achieve these three objectives, bovine tibial cartilage was impacted using a custom spring-loaded device mounted on an inverted microscope. The occurrence of fissures was modulated by varying impact energy. For the first objective, during impact, deformation was captured at 10,000 frames per second and bulk and local mechanics were analyzed. For the second objective, data from samples impacted with a 1.2 mm diameter rod were fit to logistic regression functions, creating models of fissure probability based on bulk and local mechanics. Finally, for the third objective, data from samples impacted with a 0.8 mm diameter rod were used to test the accuracy of model predictions. This study provides a direct comparison between bulk and local mechanical thresholds for the prediction of fissures in cartilage samples, and demonstrates that local mechanics provide more accurate predictions of local failure than bulk mechanics provide. Bulk mechanics were accurate predictors of fissure for the entire sample cohort, but poor predictors

  15. Treatment of anal fistula and abscess.

    PubMed

    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.

  16. Anal Cancer: An Examination of Radiotherapy Strategies

    SciTech Connect

    Glynne-Jones, Rob; Lim, Faye

    2011-04-01

    The Radiation Therapy Oncology Group 9811, ACCORD-03, and ACT II Phase III trials in anal cancer showed no benefit for cisplatin-based induction and maintenance chemotherapy, or radiation dose-escalation >59 Gy. This review examines the efficacy and toxicity of chemoradiation (CRT) in anal cancer, and discusses potential alternative radiotherapy strategies. The evidence for the review was compiled from randomized and nonrandomized trials of radiation therapy and CRT. A total of 103 retrospective/observational studies, 4 Phase I/II studies, 16 Phase II prospective studies, 2 randomized Phase II studies, and 6 Phase III trials of radiotherapy or chemoradiation were identified. There are no meta-analyses based on individual patient data. A 'one-size-fits-all' approach for all stages of anal cancer is inappropriate. Early T1 tumors are probably currently overtreated, whereas T3/T4 lesions might merit escalation of treatment. Intensity-modulated radiotherapy or the integration of biological therapy may play a role in future.

  17. Retention of resin-based filled and unfilled pit and fissure sealants: A comparative clinical study

    PubMed Central

    Reddy, V. Rajashekar; Chowdhary, Nagalakshmi; Mukunda, K. S.; Kiran, N. K.; Kavyarani, B. S.; Pradeep, M. C.

    2015-01-01

    Background and Objectives: The most caries-susceptible period of a permanent first molar tooth is the eruption phase, during which the enamel is not fully matured and it is usually difficult for the child to clean the erupting tooth surfaces. Sealing occlusal pits and fissures with resin-based pit and fissure sealants is a proven method to prevent occlusal caries. The difference in the viscosity of the sealants differs in the penetration into pit and fissures and abrasive wear resistance property due to the addition of filler particles. The present study was conducted to evaluate and compare the retention of the resin-based filled (Helioseal F, Ivoclar Vivadent) and unfilled (Clinpro, 3M ESPE) pit and fissure sealants, which is important for their effectiveness. Materials and Methods: Fifty-six children between the age group of 6 and 9 years, with all four newly erupted permanent first molars were selected. Sealants were applied randomly using split mouth design technique on permanent first molars. Evaluation of sealant retention was performed at regular intervals over 12 months, using Simonsen's criteria at 2nd, 4th, 6th, 8th, 10th and 12th month. The results were subjected to statistical analysis. Results: At the end of our study period (12th month), 53.57% showed complete retention, 37.50% showed partial retention, and 8.83% showed complete missing of resin-based filled (Helioseal F) pit and fissure sealant. And, 64.29% showed complete retention, 32.14% showed partial retention, and 3.57% showed complete missing of resin-based unfilled (Clinpro) pit and fissure sealant. This difference in retention rates between filled and unfilled pit and fissure sealants was not statistically significant. Conclusion: The difference in retention rates between Helioseal F and Clinpro was not statistically significant, but Clinpro (unfilled) sealant showed slightly higher retention rates and clinically better performance than Helioseal F (filled). PMID:25821368

  18. Comparison of Various Concentrations of Tricalcium Phosphate Nanoparticles on Mechanical Properties and Remineralization of Fissure Sealants

    PubMed Central

    Tavassoli-Hojjati, Sara; Atai, Mohammad; Haghgoo, Roza; Rahimian-Imam, Sara; Kameli, Somayeh; Ahmaian-Babaki, Fatemeh; Hamzeh, Faezeh; Ahmadyar, Maryam

    2014-01-01

    Objective: 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. Materials and Methods: 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. Results: 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) (p<0.05). There was no significant difference between micro-shear bond strengths of the experimental groups (1–5 wt.%), and between the commercial and the prepared (0%) fissure sealant groups (p>0.05). 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). Conclusion: Addition of 1–5 wt.% β-TCP nanoparticles to the fissure sealants significantly increased the remineralization potential without affecting the mechanical properties. PMID:25584048

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

    PubMed

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

    2015-09-01

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

  20. Premalignant Lesions of the Anal Canal and Squamous Cell Carcinoma of the Anal Canal

    PubMed Central

    Poggio, Juan Lucas

    2011-01-01

    Squamous cell carcinoma of the anus (SCCA) is a rare tumor. However, its incidence has been increasing in men and women over the past 25 years worldwide. Risk factors associated with this cancer are those behaviors that predispose individuals to human papillomavirus (HPV) infection and immunosuppression. Anal cancer is generally preceded by high-grade anal intraepithelial neoplasia (HGAIN), which is most prevalent in human immunodeficiency virus-positive men who have sex with men. High-risk patients may benefit from screening. The most common presentation is rectal bleeding, which is present in nearly 50% of patients. Twenty percent of patients have no symptoms at the time of presentation. Clinical staging of anal cancer requires a digital rectal exam and a positron emission tomography/computed tomography scan of the chest, abdomen, and pelvis. Endorectal/endoanal ultrasound appears to add more-specific staging information when compared with digital rectal examination alone. Treatment of anal cancer prior to the 1970s involved an abdominoperineal resection. However, the current standard of care for localized anal cancer is concurrent chemoradiation therapy, primarily because of its sphincter-saving and colostomy-sparing potential. Studies have addressed alternative chemoradiation regimens to improve the standard protocol of fluorouracil, misogynic, and radiation, but no alternative regimen has proven superior. Surgery is reserved for those patients with residual disease or recurrence. PMID:22942800

  1. Geometry of the September 1971 eruptive fissure at Kilauea volcano, Hawaii

    NASA Astrophysics Data System (ADS)

    Dvorak, John J.

    1990-09-01

    A three-dimensional model has been used to estimate the location and dimensions of the eruptive fissure for the 24 29 September 1971 eruption along the southwest rift zone of Kilauea volcano, Hawaii. The model is an inclined rectangular sheet embedded in an elastic half-space with constant displacement on the plane of the sheet. The set of “best” model parameters suggests that the sheet is vertical, extends from a depth of about 2 km to the surface, and has a length of about 14 km. Because this sheet intersects the surface where eruptive vents and extensive ground cracking formed during the eruption, this sheet probably represents the conduit for erupted lava. The amount of displacement perpendicular to the sheet is about 1.9 m, in the middle range of values measured for the amount of opening across the September 1971 eruptive fissure. The thickness of the eruptive fissure associated with the January 1983 east rift zone eruption was determined in an earlier paper to be 3.6 m, about twice the thickness determined here for the September 1971 eruption. Because the lengths (12 km for 1983 and 14 km for 1971) and heights (about 2 km) of the sheet models derived for the January 1983 and September 1971 rift zone eruptions are nearly identical, the greater thickness for the January 1983 eruptive fissure implies that the magma pressure was about a factor of two greater to form the January 1983 eruptive fissure. Because the September 1971 and January 1983 eruptive fissures extent to depths of only a few kilometers, the region of greatest compressive stress produced along the volcano's flank by either of these eruptive fissures would also be within a few kilometers of the surface. Previous work has shown that rift eruptions and intrusions contribute to the buildup of compressive stress along Kilauea's south flank and that this buildup is released by increased seismicity along the south flank. Because south flank earthquakes occur at significantly greater depths, i

  2. Geometry of the September 1971 eruptive fissure at Kilauea volcano, Hawaii

    USGS Publications Warehouse

    Dvorak, J.J.

    1990-01-01

    A three-dimensional model has been used to estimate the location and dimensions of the eruptive fissure for the 24-29 September 1971 eruption along the southwest rift zone of Kilauea volcano, Hawaii. The model is an inclined rectangular sheet embedded in an elastic half-space with constant displacement on the plane of the sheet. The set of "best" model parameters suggests that the sheet is vertical, extends from a depth of about 2 km to the surface, and has a length of about 14 km. Because this sheet intersects the surface where eruptive vents and extensive ground cracking formed during the eruption, this sheet probably represents the conduit for erupted lava. The amount of displacement perpendicular to the sheet is about 1.9 m, in the middle range of values measured for the amount of opening across the September 1971 eruptive fissure. The thickness of the eruptive fissure associated with the January 1983 east rift zone eruption was determined in an earlier paper to be 3.6 m, about twice the thickness determined here for the September 1971 eruption. Because the lengths (12 km for 1983 and 14 km for 1971) and heights (about 2 km) of the sheet models derived for the January 1983 and September 1971 rift zone eruptions are nearly identical, the greater thickness for the January 1983 eruptive fissure implies that the magma pressure was about a factor of two greater to form the January 1983 eruptive fissure. Because the September 1971 and January 1983 eruptive fissures extent to depths of only a few kilometers, the region of greatest compressive stress produced along the volcano's flank by either of these eruptive fissures would also be within a few kilometers of the surface. Previous work has shown that rift eruptions and intrusions contribute to the buildup of compressive stress along Kilauea's south flank and that this buildup is released by increased seismicity along the south flank. Because south flank earthquakes occur at significantly greater depths, i.e., from 5

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

    PubMed Central

    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

  4. Squamous-cell Carcinoma of the Anus and Anal Canal: An Analysis of 55 Cases

    PubMed Central

    Gabriel, W. B.

    1941-01-01

    The analysis is of 55 cases admitted into St. Mark's Hospital from 1922 to 1940. The incidence was 3.35% of all cases of cancer of the rectum, anal canal and anus admitted during this period. Sex distribution—27 males and 28 females. The average age (61.7 years) is higher than that of columnar-cell carcinoma of the rectum (57.4 years). Histology.—The cases have been graded into three grades of malignancy—low grade, medium grade, and high grade. Low grade squamous carcinoma is twice as frequent in men as in women, and generally originates at the anal margin. Medium grade squamous carcinoma is equally distributed between men and women; it may arise at the anus or in the anal canal. High grade squamous carcinoma is much more common in the female sex and is almost entirely limited to the anal canal. Quadrant affected—about one-third of the anal margin growths and one-half of the anal canal growths were situated anteriorly. Differential diagnosis from simple papilloma, simple ulcer, chronic inflammation, tuberculous ulcer, tuberculide, primary chancre, amœbic ulcer, basal-cell carcinoma, columnar-cell carcinoma. Biopsy and grading essential before treatment is decided upon. The results of treatment in the three grades of malignancy are described. The best results were obtained in the early low-grade cases treated by interstitial radium needling. In the medium and high grades only three five-year survivals can be reported and these followed excision of the rectum. The management of the inguinal glands is discussed and the importance of a very close post-operative supervision emphasized. Squamous carcinoma of the anal canal may cause lymphatic metastases in the superior hæmorrhoidal glands; there have been four such cases in this series. Diathermy perineal excision is indicated in these cases. ImagesFig. 1Fig. 2Fig. 3Fig. 5Fig. 6aFig. 6bFig. 7Fig. 1Fig. 2Fig. 3Fig. 4 PMID:19992316

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

    NASA Astrophysics Data System (ADS)

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

    PubMed

    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<0.05). Results revealed differences regarding DC between all groups: FT (89%) > GS (55.02%) > CL (%51.10) (p<0.05). The VHN values were significantly different among all groups in the following order: GS > 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.

  7. Cyp1b1 Regulates Ocular Fissure Closure Through a Retinoic Acid–Independent Pathway

    PubMed Central

    Williams, Antionette L.; Eason, Jessica; Chawla, Bahaar; Bohnsack, Brenda L.

    2017-01-01

    Purpose Mutations in the CYP1B1 gene are the most commonly identified genetic causes of primary infantile-onset glaucoma. Despite this disease association, the role of CYP1B1 in eye development and its in vivo substrate remain unknown. In the present study, we used zebrafish to elucidate the mechanism by which cyp1b1 regulates eye development. Methods Zebrafish eye and neural crest development were analyzed using live imaging of transgenic zebrafish embryos, in situ hybridization, immunostaining, TUNEL assay, and methylacrylate sections. Cyp1b1 and retinoic acid (RA) levels were genetically (morpholino oligonucleotide antisense and mRNA) and pharmacologically manipulated to examine gene function. Results Using zebrafish, we observed that cyp1b1 was expressed in a specific spatiotemporal pattern in the ocular fissures of the developing zebrafish retina and regulated fissure patency. Decreased Cyp1b1 resulted in the premature breakdown of laminin in the ventral fissure and altered subsequent neural crest migration into the anterior segment. In contrast, cyp1b1 overexpression inhibited cell survival in the ventral ocular fissure and prevented fissure closure via an RA-independent pathway. Cyp1b1 overexpression also inhibited the ocular expression of vsx2, pax6a, and pax6b and increased the extraocular expression of shha. Importantly, embryos injected with human wild-type but not mutant CYP1B1 mRNA also showed colobomas, demonstrating the evolutionary and functional conservation of gene function between species. Conclusions Cyp1b1 regulation of ocular fissure closure indirectly affects neural crest migration and development through an RA-independent pathway. These studies provide insight into the role of Cyp1b1 in eye development and further elucidate the pathogenesis of primary infantile-onset glaucoma. PMID:28192799

  8. The effect of CT technical factors on quantification of lung fissure integrity

    NASA Astrophysics Data System (ADS)

    Chong, D.; Brown, M. S.; Ochs, R.; Abtin, F.; Brown, M.; Ordookhani, A.; Shaw, G.; Kim, H. J.; Gjertson, D.; Goldin, J. G.

    2009-02-01

    A new emphysema treatment uses endobronchial valves to perform lobar volume reduction. The degree of fissure completeness may predict treatment efficacy. This study investigated the behavior of a semiautomated algorithm for quantifying lung fissure integrity in CT with respect to reconstruction kernel and dose. Raw CT data was obtained for six asymptomatic patients from a high-risk population for lung cancer. The patients were scanned on either a Siemens Sensation 16 or 64, using a low-dose protocol of 120 kVp, 25 mAs. Images were reconstructed using kernels ranging from smooth to sharp (B10f, B30f, B50f, B70f). Research software was used to simulate an even lower-dose acquisition of 15 mAs, and images were generated at the same kernels resulting in 8 series per patient. The left major fissure was manually contoured axially at regular intervals, yielding 37 contours across all patients. These contours were read into an image analysis and pattern classification system which computed a Fissure Integrity Score (FIS) for each kernel and dose. FIS values were analyzed using a mixed-effects model with kernel and dose as fixed effects and patient as random effect to test for difference due to kernel and dose. Analysis revealed no difference in FIS between the smooth kernels (B10f, B30f) nor between sharp kernels (B50f, B70f), but there was a significant difference between the sharp and smooth groups (p = 0.020). There was no significant difference in FIS between the two low-dose reconstructions (p = 0.882). Using a cutoff of 90%, the number of incomplete fissures increased from 5 to 10 when the imaging protocol changed from B50f to B30f. Reconstruction kernel has a significant effect on quantification of fissure integrity in CT. This has potential implications when selecting patients for endobronchial valve therapy.

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

    PubMed

    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.

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

    PubMed Central

    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

  11. Breeding for rice fissure resistance made possible through development of a new selection technique and identification of molecular gene tags

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Value: One of the primary causes of rice grain breakage during milling is fissuring, or cracking, of the rice before it enters the mill. Any reduction in kernel fissuring can result in direct increases in profit for both producers and millers. For a producer yielding 7,000 lb/A paddy, even a small (...

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

    PubMed Central

    Shindhe, Pradeep S.

    2014-01-01

    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. PMID:25538355

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

    USGS Publications Warehouse

    Willden, R.; Mabey, D.R.

    1961-01-01

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

  14. Influence of matrix diffusion and exchange reactions on radiocarbon ages in fissured carbonate aquifers

    SciTech Connect

    Maloszewski, P. ); Zuber, A. )

    1991-08-01

    The parallel fissure model coupled with the equation of diffusion into the matrix and with exchange reaction equations has been used to derive a simple formula for estimating the influence of matrix porosity and reaction parameters on the determination of radiocarbon ages in fissured carbonate rocks. Examples of evidently too great radiocarbon ages in carbonate formations, which are not explainable by models for the initial {sup 14}C corrections, can easily be explained by this formula. Parameters obtained for a chalk formation from a known multitracer experiment combined with a pumping test suggest a possibility of {sup 14}C ages more than three orders of magnitude greater than the ages which would be observed if the radiocarbon transport took place only in the mobile water in the fissures. It is shown that contrary to the solute movement on a small scale and with a variable input, the large-scale movement, characteristic for the {sup 14}C dating, does not necessarily require the knowledge of kinetic parameters, because they may be replaced by the distribution coefficient. Discordant tritium and {sup 14}C concentrations are commonly interpreted as a proof of mixing either in the aquifer or at the discharge site. For fissured carbonate formations, however, an alternative explanation is given by the derived model showing a considerable delay of {sup 14}C with respect to nonsorbable tracers.

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

    PubMed

    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.

  16. Mapping the fissure potential zones based on microtremor measurement in Denpasar City, Bali

    NASA Astrophysics Data System (ADS)

    Prabowo, U. N.; Marjiyono; Sismanto

    2016-01-01

    Denpasar City and its vicinity considered as the areas with excessive ground water exploitation and high earthquake intensity. These conditions will cause these area potential with land subsidence which is triggering ground fissures. This research aims are to mapping the fissures potential areas based on microtremor measurement in Denpasar City and its vicinity. Ground fissures will happen if the land subsidence occurs in the areas which have different bedrock height beneath its sedimentary layer. The height of bedrock is determined by reducing surface elevation with the sedimentary layer thickness. This sedimentary layer thickness obtained from microtremor measurement using HVSR method, and Shear wave velocity (VS) obtained from microtremor array measurement which is analyzed by Spatial Auto Correlation (SPAC) method. The result from HVSR method as well as Peak Ground Acceleration (PGA) value are then analyzed to get ground shear strain value, which is the soil surface strain and its effect when earthquake occurs. Based on the bedrock map, it can be estimated that the bedrock layer forms structure in the southern part of the research areas and the potential fissuring area due to the massive ground water exploitation is in the west Denpasar Subdistrict. In addition, based on the bedrock map and ground shear strain value which combined with Simple Additive Weight (SAW) method, there are two areas having Assuring potential, i.e west and south Denpasar Subdistricts.

  17. 21 CFR 872.3765 - Pit and fissure sealant and conditioner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Pit and fissure sealant and conditioner. 872.3765 Section 872.3765 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... depressions (faults in the enamel) in the biting surfaces of teeth to prevent cavities. (b)...

  18. 21 CFR 872.3765 - Pit and fissure sealant and conditioner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Pit and fissure sealant and conditioner. 872.3765 Section 872.3765 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... depressions (faults in the enamel) in the biting surfaces of teeth to prevent cavities. (b)...

  19. 21 CFR 872.3765 - Pit and fissure sealant and conditioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pit and fissure sealant and conditioner. 872.3765 Section 872.3765 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... depressions (faults in the enamel) in the biting surfaces of teeth to prevent cavities. (b)...

  20. 21 CFR 872.3765 - Pit and fissure sealant and conditioner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Pit and fissure sealant and conditioner. 872.3765 Section 872.3765 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... depressions (faults in the enamel) in the biting surfaces of teeth to prevent cavities. (b)...

  1. 21 CFR 872.3765 - Pit and fissure sealant and conditioner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Pit and fissure sealant and conditioner. 872.3765 Section 872.3765 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... depressions (faults in the enamel) in the biting surfaces of teeth to prevent cavities. (b)...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    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.…

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

    NASA Astrophysics Data System (ADS)

    Fergason, K. C.; Rucker, M. L.; Panda, B. B.

    2015-11-01

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

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

    PubMed Central

    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

  7. Treatment of non-IBD anal fistula.

    PubMed

    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).

  8. Effect of Local Crystallographic Texture on the Fissure Formation During Charpy Impact Testing of Low-Carbon Steel

    NASA Astrophysics Data System (ADS)

    Ghosh, Abhijit; Patra, Sudipta; Chatterjee, Arya; Chakrabarti, Debalay

    2016-06-01

    The severity of the formation of fissures (also known as splitting or delamination) on the fracture surface of Charpy impact-tested samples of a low-carbon steel has been found to increase with the decrease in finish rolling temperature [1093 K to 923 K (820 °C to 650 °C)]. Combined scanning electron microscopy and electron back-scattered diffraction study revealed that crystallographic texture was the prime factor responsible for the fissure formation. Through-thickness texture band composed of cube [Normal Direction (ND)║<001>] and gamma [ND║<111>] orientations developed during the inter-critical rolling treatment. Strain incompatibility between these two texture bands causes fissure cracking on the main fracture plane. A new approach based on the angle between {001} planes of neighboring crystals has been employed in order to estimate the `effective grain size,' which is used to determine the cleavage fracture stress on different planes of a sample. The severity of fissure formation was found to be directly related to the difference in cleavage fracture stress between the `main fracture plane' and `fissure plane.' Clustering of ferrite grains having cube texture promoted the fissure crack propagation along the transverse `fissure plane,' by increasing the `effective grain size' and decreasing the cleavage fracture stress on that plane.

  9. Anal Cancer: What Happens After Treatment?

    MedlinePlus

    ... cancer survivors have learned to live with this uncertainty and are leading full lives. For other people, ... very stressful. It has its own type of uncertainty. Managing Cancer as a Chronic Illness covers more ...

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  11. A symptomatic Sylvian fissure lipoma in a post-traumatic patient

    PubMed Central

    Bokhari, Rakan Farouk; Bangash, Mohammad Hasan; Ahamed, Naushad Ali Basheer; Addas, Jameel

    2014-01-01

    Lipomatous extra-axial lesions in the Sylvian fissure are a rare entity. Their identification, however, is usually simple if a systematic radiological approach is adopted. The best line of management for these lesions is still a matter of controversy and fraught with complications. We present a case of a Sylvian fissure lipoma referred to our neurosurgery services with symptomatic seizures and in a post-traumatic patient. The radiological differentiating features of intracranial lipomas and intracranial dermoids have been discussed. The unusual location of the lesion, in combination with the history of seizures and the nature of presentation (trauma being a red-herring) make this case an interesting find. The lesion was managed conservatively with good outcomes at follow up, on anti-epileptic medications. PMID:24967029

  12. Fissure basalts and ocean-floor spreading on the East pacific rise.

    PubMed

    Bonatti, E

    1968-08-30

    A basalt pavement outcrops almost continuously in a band along the crestal region of the East Pacific Rise from about 14 degrees S to 6 degrees S, that is, for more than 800 ikilometers; the outcrop may well extend beyond the above limits along the axis of the rise. The basalt band is generally between 40 and 60 kilometers wide and is replaced laterally by sediment. The lavas are fresh, "oceanic tholeiites" which were emplaced less than I million years ago by fissure eruptions. These findings, can be explained by the hypothesis of ocean-floor spreading; the basalts are the expression of material originating from the mantle and rising through fissures along the axis of the ridge. The absence of an axial rift valley on the East Pacific Rise may be explained by the fact that large volumes of lava are being outpoured along its crest.

  13. The influence of geometry on the ascent of magma in open fissures

    NASA Astrophysics Data System (ADS)

    Giberti, G.; Wilson, L.

    1990-09-01

    During steady eruption, the flow conditions (emitted mass flux, exit velocity and exit pressure) depend on the geometry of the conduit in which the eruption occurs. This dependence is examined for the onedimensional, isothermal ascent of a homogeneous basaltic magma with an aqueous volatile phase and newtonian rheology. By fixing the geometry of the feeding fissure, the mass flux flowing in steady conditions can be determined at any depth, as well the magma pressure and vertical velocity. Flow behaviour is analysed for three fissure shapes: constant width, slowly upward narrowing and lenticular. In all the cases examined the magma arrives at the earth's surface with a pressure greater than atmospheric. The results are compared with those obtained when a lithostatic pressure gradient is assumed for the magma column. Some speculations are made, moreover, about the change in eruption style, if conduit geometry varies during a non-steady phase.

  14. Hough transform detection of the longitudinal fissure in tomographic head images.

    PubMed

    Brummer, M E

    1991-01-01

    A technique is presented for automatic detection of the longitudinal fissure in tomographic scans of the brain. The technique utilizes the planar nature of the fissure and is a three-dimensional variant of the Hough transform principle. Algorithmic and computational aspects of the technique are discussed. Results and performance on coronal and transaxial magnetic resonance data show that the algorithm is robust with respect to variations in image contrast in the data and to slight anatomic anomalies. A crucial resolution requirement in the data for accurate parameter estimations is a sufficient number of slices covering the whole brain. The Sobel magnitude edge operator, used for preprocessing, proved adequate for magnetic resonance scans with positive and negative brain/cerebrospinal fluid contrast.

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

    PubMed Central

    Ghasemi, Leila

    2016-01-01

    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. PMID:27536329

  16. Comparative Evaluation of the Marginal Sealing Ability of two Commercially Available Pit and Fissure Sealants

    PubMed Central

    Moses, Joyson; Rangeeth, Bollam Nammalwar; Sivakumar, Subramanian

    2016-01-01

    Introduction The occlusal surfaces of the teeth usually have pits and fissures which provide a good environment for demineralization with minimal salivary access and make them caries prone. The success of pit and fissure sealing materials is highly dependent on the marginal sealing ability of the fissures. Aim The present study was carried out to evaluate and compare the marginal sealing ability of two commercially available pit and fissure sealants. Materials and Methods A total of 50 human premolar teeth were used in this invitro study. Group 1 included 25 teeth for application of Clinpro sealant and Group 2 included twenty 25 for application of Helioseal F sealant. Samples were stored in artificial saliva for 72 hours before thermocycling. The samples were immersed in 2% methylene blue solution for 24 hours. The sectioned samples were examined under an Optical Stereomicroscope and compared in terms of the extent of microleakage based on the amount of dye penetration between the sealant and tooth substance interface. The dye penetration scores in both the groups was statistically analysed using Chi square test and Mann Whitney Test. A p-value of less than 0.05 was considered to be statistically significant. Results It was seen that in Group 1, 12 samples (48%) had no dye penetration (Grade 0) while in Group 2, 6 samples (24%) demonstrated Grade 0 penetration. Group 2 had the most extensive dye penetration (Grade 3) in 8 of 25 samples (32%) (p=0.014). Conclusion On comparison of the microleakage scores of the groups, a statistically significant difference was found between the two groups; indicating a much better performance of Clinpro as compared to Helioseal F. PMID:27790568

  17. Artificial recharge through a well in fissured carbonate rock, west St. Paul, Minnesota

    USGS Publications Warehouse

    Reeder, Harold O.; Wood, Warren W.; Ehrlich, G.G.; Sun, Ren Jen

    1976-01-01

    The injection test demonstrated that it is hydrologically feasible to recharge the Prairie du Chien Group and the Jordan Sandstone artificially through wells completed in the Prairie du Chien Group. The fissures in the Prairie du Chien Group act as conduits through which water spreads. The water passes into the Jordan Sandstone from the Prairie du Chien over a larger area than it would if it were injected directly into the Jordan.

  18. The pattern of circumferential and radial eruptive fissures on the volcanoes of Fernandina and Isabela islands, Galapagos

    USGS Publications Warehouse

    Chadwick, W.W.; Howard, K.A.

    1991-01-01

    Maps of the eruptive vents on the active shield volcanoes of Fernandina and Isabela islands, Galapagos, made from aerial photographs, display a distinctive pattern that consists of circumferential eruptive fissures around the summit calderas and radial fissures lower on the flanks. On some volcano flanks either circumferential or radial eruptions have been dominant in recent time. The location of circumferential vents outside the calderas is independent of caldera-related normal faults. The eruptive fissures are the surface expression of dike emplacement, and the dike orientations are interpreted to be controlled by the state of stress in the volcano. Very few subaerial volcanoes display a pattern of fissures similar to that of the Galapagos volcanoes. Some seamounts and shield volcanoes on Mars morphologically resemble the Galapagos volcanoes, but more specific evidence is needed to determine if they also share common structure and eruptive style. ?? 1991 Springer-Verlag.

  19. Squamotympanic fissure in the Ngandong and Sambungmacan hominids: a reply to Delson et al.

    PubMed

    Durband, Arthur C

    2002-03-01

    In the present study the course of the squamotympanic fissure of the mandibular fossa is examined in several fossil hominid specimens. While previous work by several authors had found that the course of this fissure was potentially autapomorphic for the Ngandong and Sambungmacan fossil samples from Indonesia, a more recent study performed by Delson et al. (Anat Rec 2001; 262:380--397) reported that a number of other fossils, including OH 9, Sangiran 4 and 17, and KNM WT 15000 were similar to the Ngandong and Sambungmacan specimens in the expression of this feature. To test these findings, those specimens purported to share similarities with Ngandong and Sambungmacan were examined. The results of this study indicate clearly differing morphologies between the Ngandong and Sambungmacan fossils, on the one hand, and the four African and Indonesian fossils named by Delson et al. (2001). Hence, the course of the squamotympanic fissure remains a potentially autapomorphic feature separating the Ngandong and Sambungmacan samples from the remaining specimens allocated to Homo erectus.

  20. A Nonoperative Approach for Neurosurgical Management of a Sylvian Fissure Dermoid Cyst

    PubMed Central

    Haider, Ali S; Kee, Clarence; DeBacker, Danielle L; Watson, Ian T; Arrey, Eliel N; Osumah, Tijani; Chen, Chen; Alam, Maryam; Toussaint III, L. Gerard

    2016-01-01

    The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation. Conservative management of our patient has not resulted in a complication in over five years, with the continued offer of surgical resection rejected by the patient. This article suggests the possibility of a safe, non-operative management of dermoid/epidermoid cysts of the sylvian fissure; however, the paucity of literature calls for larger studies yielding reliable data regarding the comparative risk of nonoperative management, including the rate of spontaneous rupture, versus the risk and complication incidence of surgical intervention. PMID:27909631

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

    PubMed

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

    2013-05-01

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

  2. Potential for aquifer compaction, land subsidence, and earth fissures in the Tucson basin, Pima County, Arizona

    USGS Publications Warehouse

    Anderson, S.R.

    1987-01-01

    In 1979 the U.S. Geological Survey, in cooperation with the city of Tucson, began an investigation of aquifer compaction and its effects in the Tucson basin, including the potential hazards of aquifer compaction and subsequent damage to engineered structures, roads, water supply systems, gaslines, and sewage systems. Groundwater is the main source of water for irrigation, public supply, and industry. Pumping has exceeded recharge for several decades, and declines in groundwater levels have occurred in parts of the basin. In places, water level declines have resulted in small amounts of aquifer compaction and land subsidence. Further water level declines in parts of the Tucson basin may result in large amounts of aquifer compaction and land subsidence. Differential land subsidence may, in places, be accompanied by the formation of earth fissures. Aquifer compaction, land subsidence, and earth fissures can damage or affect the functional capability of manmade features. Specifically, aquifer compaction may damage wells, fissures may damage engineered structures, and differential land subsidence may affect structures such as sewers and water-supply systems that are dependent on gravity for their operation. (USGS)

  3. Arteries and Veins of the Sylvian Fissure and Insula: Microsurgical Anatomy.

    PubMed

    Delion, Matthieu; Mercier, Philippe; Brassier, Gilles

    2016-01-01

    We present a vascular anatomical study of the arteries and veins of the sylvian fissure and insula.A good knowledge of the sylvian fissure, the insula, and their vascular relationship would seem mandatory before performing surgery in this area, whatever the type of surgery (aneurysms, arteriovenous malformations, insular tumors).We start with the sylvian fissure and insula morphology, followed by the MCA description and its perforators, with special attention paid to the insular perforators. We demonstrate that the long insular perforators penetrating in the superior part of the posterior short gyrus and long gyri vascularize, respectively, the corticonuclear and corticospinal fasciculi. We particularly insist too on three anatomical constants regarding the vascularization of the insula, already described in the literature: The superior periinsular sulcus is the only sulcus on the lateral surface of the brain without an artery along its axis; the superior branch of the MCA supplies the anterior insular pole and both the anterior and middle short gyri in 100 % of cases; in at least 90 % of cases, the artery that supplied the central insular sulcus continued on to become the central artery.We end with the anatomical study of the veins and cisterns.

  4. Prediction of caries development for molar fissures with semiquantitative mutans streptococci test.

    PubMed

    Splieth, C; Bernhardt, O

    1999-06-01

    Risk-specific caries prevention requires validated and simple parameters for a caries risk assessment. The aim of the study was to evaluate the validity of a site-specific chair-side mutans streptococci (MS) test for the prediction of caries incidence in fissures. In 230 6- to 7-yr-old children, occlusal plaque samples of teeth 16 and 36 were cultured with Dentocult SM tests at 37 degrees C for 24 hr. Caries (DMFS), initial caries, sealants, and a plaque index (QHI) were recorded and oral hygiene habits were assessed. Not erupted, carious, filled and sealed teeth were excluded from the analysis (n = 154). After 2 yr, the status of the fissures was re-examined, and a fluoride history was recorded with a questionnaire filled out by the children's parents. Sealed teeth were excluded again (n = 54). With a classification of MS score 0 or 1 as low and MS score 2 or 3 as high caries risk, 92% agreement was reached by two independently working examiners. The MS scores and caries incidence correlated significantly. Seventy-eight % of the caries progression in fissures was prognosed correctly. Sensitivity was 50%, specificity 82%, positive predictive value 29%, and negative predictive value 92%. Children with caries progression tended to have lower fluoride scores. Low MS scores were most likely to be associated with low caries incidence, while high mutans streptococci scores seem to be partially compensated by other parameters.

  5. Distributed Computing for Seismic Data Retrieval using FISSURES DHI Client FMI Implimented from MatSeis 1.9

    NASA Astrophysics Data System (ADS)

    Hart, D. M.; Li, Q.; Creager, K. C.; Ning, R.; Crotwell, H. P.; Zuzlewski, S.; Hellman, S. B.; Schoch, K. S.; Laughbon, C. J.; Stromme, S. R.

    2004-12-01

    Three software development efforts have recently combined to allow a seamless method for obtaining data from the IRIS DMC over the Internet and analyzing it in MATLAB. During the past few years IRIS has constructed the initial framework and definitions for FISSURES servers and Data Handling Interface (DHI) clients. FISSURES uses the distributed computing language Common Object Request Broker Architecture (CORBA), which allows software systems to work across the Internet in a platform independent and computer-language neutral manner. Starting from the FISSURES object model three seismic services have been defined: event, network and seismogram. From these three object types a DHI client is used to access information through FISSURES services. Using the University of Washington developed FISSURES-Matlab-Interface (FMI) DHI client, all three FISSURES objects can be accessed via the Internet and downloaded into local MATLAB objects, allowing access to earthquake event catalogs, seismograms, network and instrument information. The DHI client FMI can be implemented from MatSeis. MatSeis, developed at Sandia National Laboratory, is a MATLAB based, Graphical User Interface (GUI) controlled software package with seismic data visualization, signal processing, and database importing and exporting capabilities, to list just a few. In this poster, we will discuss the seismic data retrieval currently prototyped for the IRIS DMC, as well as the planned connections to the Northern California Earthquake Data Center (NCEDC), Southern California Earthquake Data Center (SCEDC), and South Carolina Earth Physics Project (SCEPP) data center.

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

    PubMed Central

    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 collagen plug was pulled through the fistula tract. Results Twelve patients were included in this case study. All patients had previously undergone failed surgical therapy to cure their fistula and had previously-placed Setons. There were eight males and four females with an average age of 44 who were treated for complex fistulas. At a median time of follow-up of 22.7 months, 10 of the 12 patients had healed (83.3%). One patient developed an abscess that was noted on the sixth postoperative day, and there was one recurrence during follow-up. Conclusions Fistula plugs are effective for the long-term closure of complex anal fistulas. Success of treatment with the fistula plug depends on the eradication of sepsis prior to plug placement. PMID:27280009

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

    NASA Astrophysics Data System (ADS)

    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

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

    NASA Astrophysics Data System (ADS)

    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

  9. Current treatment options for management of anal intraepithelial neoplasia

    PubMed Central

    Weis, Stephen E

    2013-01-01

    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-fluorouracil or imiquimod. Topical therapies have the advantage of being nonsurgical and are well suited for treating widespread multifocal disease. Topical treatments have the disadvantage of requiring extended treatment courses and causing a symptomatic

  10. HPV DNA prevalence and type distribution in anal carcinomas worldwide

    PubMed Central

    Alemany, L; Saunier, M; Alvarado, I; Quirós, B; Salmeron, J; Shin, HR; Pirog, E; Guimerà, N; Hernández, GA; Felix, A; Clavero, O; Lloveras, B; Kasamatsu, E; Goodman, MT; Hernandez, BY; Laco, J; Tinoco, L; Geraets, DT; Lynch, CF; Mandys, V; Poljak, M; Jach, R; Verge, J; Clavel, C; Ndiaye, C; Klaustermeier, J; Cubilla, A; Castellsagué, X; Bravo, IG; Pawlita, M; Quint, W; Muñoz, N; Bosch, FX; Sanjosé, S

    2014-01-01

    Knowledge about the human papillomaviruses (HPV) types in anal cancers in some world regions is scanty. Here we describe the HPV DNA prevalence and type distribution in a series of invasive anal cancers and anal intraepithelial neoplasias (AIN) grades 2/3 from 24 countries. We analyzed 43 AIN 2/3 cases and 496 anal cancers diagnosed from 1986 to 2011. After histopathological evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping was performed using SPF-10/DEIA/LiPA25 system (version 1). A subset of 116 cancers was further tested for p16INK4a expression, a cellular surrogate marker for HPV-associated transformation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance in cancer dataset. HPV DNA was detected in 88.3% of anal cancers (95%CI:85.1–91.0%) and in 95.4% of AIN 2/3 (95%CI:84.2–99.4%). Among cancers, the highest prevalence was observed in warty-basaloid subtype of squamous cell carcinomas, in younger patients and in North American geographical region. There were no statistically significant differences in prevalence by gender. HPV16 was the most frequent HPV type detected in both cancers (80.7%) and AIN 2/3 lesions (75.4%). HPV18 was the second most common type in invasive cancers (3.6%). p16INK4a overexpression was found in 95% of HPV DNA positive anal cancers. In view of HPV DNA results and high proportion of p16INK4a overexpression, infection by HPV is most likely to be a necessary cause for anal cancers in both men and women. The large contribution of HPV16 reinforces the potential impact of HPV vaccines in the prevention of these lesions. PMID:24817381

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

  14. Performance of a conventional sealant and a flowable composite on minimally invasive prepared fissures.

    PubMed

    Francescut, Paola; Lussi, Adrian

    2006-01-01

    Three different fissure preparation procedures were tested and compared to the non-invasive approach using a conventional unfilled sealant and a flowable composite. Eighty permanent molars were selected and divided into 4 groups of 20 teeth each. All the teeth were split into 2 halves, and the exposed fissures were photographed under a microscope (35x) before and after being prepared using the following methods: (I) Er:YAG laser (KEY Laser, KaVo) 600 mJ pulse energy, 6 Hz; (II) diamond bur; (III) Er: YAG laser (KEY Laser, KaVo) 200 mJ pulse energy, 4 Hz; (IV) Control group: Powder jet cleaner (Prophyflex, KaVo, Germany). The pre-and postimages were superimposed in order to evaluate the amount of hard tissue removed. Ten teeth in each group were then acid etched and sealed with an unfilled sealant (Delton opaque, Dentsply), while the remaining 10 teeth were acid etched, primed and bonded (Prime & Bond NT, Dentsply) and sealed with a flowable composite (X-flow, DeTrey, Dentsply). Material penetration and microleakage were evaluated after thermocycling (5000 cycles) and staining with methylene blue 5%. ANOVA and Mann-Whitney tests were applied for statistical analysis. The laser 600 mJ and bur eliminated the greatest amount of hard tissue. The control teeth presented the least microleakage when sealed with Delton or X-flow. A correlation between material penetration and microleakage could not be statistically confirmed. Mechanical preparation prior to fissure sealing did not enhance the final performance of the sealant.

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

    NASA Astrophysics Data System (ADS)

    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.

  16. Fissured Tongue

    MedlinePlus

    ... and Vision Leadership Executive Committee Board of Trustees Governance Past Presidents Staff/Contact History Awards Our Partners ... symptoms. No treatment is necessary except to encourage good oral hygiene including brushing the top surface of ...

  17. Continuous monitoring of an earth fissure in Chino, California, USA - a management tool

    NASA Astrophysics Data System (ADS)

    Carpenter, M. C.

    2015-11-01

    Continuous measurements of deformation have been made in Chino, California across an earth fissure and nearby unfissured soil since 2011 in two buried, horizontal, 150 mm pipes, 51 m long, which are connected by sealed boxes enclosing vertical posts at mostly 6 m intervals. Horizontal displacements and normal strain are measured in one line using nine end-to-end quartz tubes that are attached to posts and span fissured or unfissured soil. The free ends of the tubes are supported by slings and move relative to the attachment post of the next quartz tube. Linear variable differential transformer (LVDT) sensors measure the relative movements. Five biaxial tilt sensors were also attached to selected posts in that line. Relative vertical movement was measured at nine locations along the line in the second pipe using low-level differential pressure sensors. The second pipe is half full of water giving a free water surface along its length. Data are recorded on a Campbell CR10 using multiplexers. The quartz-tube horizontal extensometers have exhibited more than 3 mm of predominantly elastic opening and closing in response to about 32 m of seasonal drawdown and recovery, respectively, in an observation well 0.8 km to the south. The nearest production well is 1.6 km to the west. The horizontal strain was 5.9 × 10-5 or 30 % of the lowest estimate of strain-at-failure for alluvium. Maximum relative vertical movement was 4.8 mm. Maximum tilt in the fissure zone was 0.09 arcdeg while tilt at a separate sensor 100 m to the east was 0.86 arcdeg, indicating a wider zone of deformation than is spanned by the instrumentation. High correlation of horizontal displacements during drawdown, and especially recovery, with change in effective stress supports differential compaction as the mechanism for earth-fissure movement. The continuous measurements of horizontal strain coupled with water-level fluctuations and vertical borehole extensometry can provide a real-time adaptive management

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

    PubMed

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

    2014-03-01

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

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

    PubMed Central

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

    2014-01-01

    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. PMID:25309057

  20. Anal Neuroendocrine Tumor Masquerading as External Hemorrhoids: A Case Report

    PubMed Central

    Khan, Muhammad; Dirweesh, Ahmed; Alvarez, Chikezie; Conaway, Herbert; Moser, Robert

    2017-01-01

    Neuroendocrine tumors in gastrointestinal (GI) tract are a rare source of GI malignancy with an estimated incidence of 2.5 - 5 per 100,000 people per year and the prevalence of 35 per 100,000. In the GI tract, they are located in decreasing order of frequency in appendix, ileum, rectum, stomach, and colon. Those found in the anal region represent just 1% of all malignancies of the anal canal. Their clinical presentation can be widely varying, sometimes being found incidentally with metastatic disease and an unknown primary source. We report a case of a 60-year-old male who presented with a 2-week history of intermittent bright red blood per rectum and anal pain. He was found to have a lesion in the perianal area which was subsequently diagnosed has a poorly differentiated large cell type neuroendocrine carcinoma (NEC) with hepatic metastasis. PMID:28270879

  1. Anal sphincter dysfunction in multiple sclerosis: an observation manometric study.

    PubMed

    Marola, Silvia; Ferrarese, Alessia; Gibin, Enrico; Capobianco, Marco; Bertolotto, Antonio; Enrico, Stefano; Solej, Mario; Martino, Valter; Destefano, Ines; Nano, Mario

    2016-01-01

    Constipation, obstructed defecation, and fecal incontinence are frequent complaints in multiple sclerosis. The literature on the pathophysiological mechanisms underlying these disorders is scant. Using anorectal manometry, we compared the anorectal function in patients with and without multiple sclerosis. 136 patients referred from our Center for Multiple Sclerosis to the Coloproctology Outpatient Clinic, between January 2005 and December 2011, were enrolled. The patients were divided into four groups: multiple sclerosis patients with constipation (group A); multiple sclerosis patients with fecal incontinence (group B); non-multiple sclerosis patients with constipation (group C); non-multiple sclerosis patients with fecal incontinence (group D). Anorectal manometry was performed to measure: resting anal pressure; maximum squeeze pressure; rectoanal inhibitory reflex; filling pressure and urge pressure. The difference between resting anal pressure before and after maximum squeeze maneuvers was defined as the change in resting anal pressure calculated for each patient.

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

    PubMed

    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.

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

    PubMed

    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.

  4. Volatile compounds from anal glands of the wolverine, Gulo gulo.

    PubMed

    Wood, William F; Terwilliger, Miranda N; Copeland, Jeffrey P

    2005-09-01

    Dichloromethane extracts of wolverine (Gulo gulo, Mustelinae, Mustelidae) anal gland secretion were examined by gas chromatography-mass spectrometry. The secretion composition was complex and variable for the six samples examined: 123 compounds were detected in total, with the number per animal ranging from 45 to 71 compounds. Only six compounds were common to all extracts: 3-methylbutanoic acid, 2-methylbutanoic acid, phenylacetic acid, alpha-tocopherol, cholesterol, and a compound tentatively identified as 2-methyldecanoic acid. The highly odoriferous thietanes and dithiolanes found in anal gland secretions of some members of the Mustelinae [ferrets, mink, stoats, and weasels (Mustela spp.) and zorillas (Ictonyx spp.)] were not observed. The composition of the wolverine's anal gland secretion is similar to that of two other members of the Mustelinae, the pine and beech marten (Martes spp.).

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    NASA Astrophysics Data System (ADS)

    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.

  9. The link between circumferential dikes and eruptive fissures around calderas: insights from numerical and analog models

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

    Active calderas are seldom associated with circumferential eruptive fissures along their rim, but eroded portions of extinct magmatic complexes reveal widespread evidence of circumferential dikes. This discrepancy suggests that, while the conditions to emplace circumferential dikes below volcanoes are easily met, mechanisms must exist to arrest the dikes before they reach the surface. Here we explain this discrepancy with laboratory experiments of air injection into a gelatin medium shaped to mimic a volcanic edifice with caldera. Our models show that the ascending dikes experience a variable degree of deflection, depending on the competition between dike overpressure, Pe, and the forcing induced by the topographic load, Pl. When Pl/Pe = 4.3 - 4.5 the analog dikes proceed almost insensitive to the stress rotation and erupt within the caldera. When Pl/Pe = 4.8 - 5.3 the analog dikes closely propagate orthogonal to the least compressive stress σ3 and stall below the caldera rim in a circumferential arrangement. Progressive buoyancy increase through repeated supply of fluid is fundamental for the occurrence of circumferential fissures. Complementary numerical models explain the observed circumferential arrangement and validate the experiments. These results contribute defining the shallow magma transfer and related hazard assessment within calderas.

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

    PubMed

    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.

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

    PubMed

    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

    PubMed Central

    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. Experimental and theoretical study of entrainment in volcanic line plumes produced by fissure eruptions

    NASA Astrophysics Data System (ADS)

    Paillat, S.; Kaminski, E. C.

    2013-12-01

    Basaltic fissure eruptions can produce turbulent line plumes injecting gas and particles in the atmosphere. The dynamic of these line plumes is controlled by the efficiency of entrainment as quantified by the so-called entrainment coefficient α. There are only scarce experimental constraints on α in planar jets and plumes. Whereas a constant value of the entrainment coefficient is used in models, data from the literature show a variation of α in pure planar jets. Only a few data are available for plumes. In order to better constrain the entrainment coefficient, we propose a theoretical expression of the entrainment coefficient α, as a function of buoyancy and turbulent structure. The model is validated first, using data from the literature and new experiments in pure jets and plumes. We show that the entrainment coefficient reaches a constant value at large distances from the source and high Reynolds number in pure jets. Positive buoyancy enhances the entrainment in pure plumes where α is about two times larger. The theoretical expression of the entrainment coefficient is then used to study the effect of variable entrainment on the dynamics of volcanic line plumes produced above an eruptive fissure at different scales, ranging from small Hawaiian fountains to basaltic Plinian eruptions (e.g. 1783 Laki eruption) and flood basalts. Both the stability of the eruptive column and the maximum height it reaches in the atmosphere are affected by variable entrainment.

  14. Monitoring an eruption fissure in 3D: video recording, particle image velocimetry and dynamics

    NASA Astrophysics Data System (ADS)

    Witt, Tanja; Walter, Thomas R.

    2015-04-01

    The processes during an eruption are very complex. To get a better understanding several parameters are measured. One of the measured parameters is the velocity of particles and patterns, as ash and emitted magma, and of the volcano itself. The resulting velocity field provides insights into the dynamics of a vent. Here we test our algorithm for 3 dimensional velocity fields on videos of the second fissure eruption of Bárdarbunga 2014. There we acquired videos from lava fountains of the main fissure with 2 high speed cameras with small angles between the cameras. Additionally we test the algorithm on videos from the geyser Strokkur, where we had 3 cameras and larger angles between the cameras. The velocity is calculated by a correlation in the Fourier space of contiguous images. Considering that we only have the velocity field of the surface smaller angles result in a better resolution of the existing velocity field in the near field. For general movements also larger angles can be useful, e.g. to get the direction, height and velocity of eruption clouds. In summary, it can be stated that 3D velocimetry can be used for several application and with different setup due to the application.

  15. Wear of two pit and fissure sealants in contact with primary teeth

    PubMed Central

    Galo, Rodrigo; Contente, Marta Maria Martins Giamatei; Borsatto, Maria Cristina

    2014-01-01

    Objectives: Wear simulations may provide an indication of the clinical performance of pit-and-fissure sealants when associated with primary teeth as counterbody, restricting the involved variables. The aim of this study was to evaluate wear of dental materials used as pit-and-fissure sealants in contact with primary teeth. Materials and Methods: A resinous sealant (Fluroshield®) and a resin-modified glass ionomer cement (Vitremer®) were selected in a post-plate design, using as counterbody primary tooth pins (4 × 4 × 2 mm) at 3 and 10 N vertical load, 1 Hz frequency, 900 wear cycles in artificial saliva (n = 15). Attrition coefficient values were obtained and the material and primary tooth volumes were analyzed. Data were analyzed statistically by ANOVA and Duncan's test (P < 0.05). Results: Fluroshield® presented the highest attrition coefficient values for the 3 N but these values decreased significantly for the 10 N load. The means for volume loss (3 mm) of the different samples after the wear test were not statistically different for the materials. The volume loss values for the primary teeth were statistically different and there was an increase in volume loss with the increase of the load applied in the wear tests. Conclusions: Differences were also observed with regard to the surface deformation characteristics. The wear rates of primary tooth enamel vary according to the type of material and the load applied during mastication. PMID:24966777

  16. Sylvian fissure asymmetries in monozygotic twins: a test of laterality in schizophrenia.

    PubMed

    Bartley, A J; Jones, D W; Torrey, E F; Zigun, J R; Weinberger, D R

    1993-12-15

    To address prior reports that schizophrenia is associated with loss of normal brain asymmetry and that it might be linked to a defect of a gene controlling cerebral lateralization, we measured on three-dimensional cortical renderings from magnetic resonance imaging (MRI) scans the lengths and angles of the sylvian fissures in 10 normal monozygotic (MZ) twin pairs (n = 10 pairs) and in 10 MZ pairs discordant for schizophrenia (n = 10 pairs). We confirmed in both sets of twins the expected normal asymmetries of length and angle of the sylvian fissure. We also confirmed that the length asymmetry occurs solely in the region of the planum temporale. In the discordant twins, affected and unaffected twins did not differ in asymmetry measures, thus failing to support an association between illness per se and diminished asymmetry. Moreover, the discordant twins as a group did not differ from the normal twins as a group, thus failing to confirm the hypothesis of a genetic association with abnormal asymmetry. The implications of variations in methodology and patient samples are discussed.

  17. Hawaiian fissure fountains 1: decoding deposits-episode 1 of the 1969-1974 Mauna Ulu eruption

    USGS Publications Warehouse

    Parcheta, C.E.; Houghton, B.F.; Swanson, D.A.

    2012-01-01

    Deposits from episode 1 of the 1969–1974 Mauna Ulu eruption of Kīlauea provide an exceptional opportunity to study processes of low intensity Hawaiian fissure fountains. Episode 1 lava flows passed through dense forest that had little impact on flow dynamics; in contrast, the pattern of spatter preservation was strongly influenced by the forest (through the formation of tree molds) and the preexisting topography. A low, near-continuous spatter rampart is present upwind and upslope, on the north side of the fissure. Most of the pyroclastic products, however, fell downwind to the south of the fissure, but little was preserved due to two processes: (1) incorporation of proximal spatter in rheomorphic lava flows 10–20 m from the vents, and (2) the downslope transport of cooler spatter falling on top of these flows beyond 20 m from vent. The lava flow field itself shows a complex history. Initially, discharge from the fissure exceeded the transport capacity of the southern drainage pathways, and lava ponded dynamically to a maximum height of 4 m for 40–120 min, until fountains began to decline. During declining discharge, lava flowed both southward away from the fissure and increasingly back into the vents. There is a clear “lava-shed” or delineation between where lava drained northwards back into the fissure, and where it continued flowing to the south. The 1969 deposits suggest that care is needed when products of less well-documented eruptions are analyzed, as postdepositional transport of spatter may preclude the formation of classic paired (symmetrical) ramparts.

  18. Monitoring of land subsidence and ground fissures in Xian, China 2005-2006: Mapped by sar Interferometry

    USGS Publications Warehouse

    Zhao, C.Y.; Zhang, Q.; Ding, X.-L.; Lu, Zhiming; Yang, C.S.; Qi, X.M.

    2009-01-01

    The City of Xian, China, has been experiencing significant land subsidence and ground fissure activities since 1960s, which have brought various severe geohazards including damages to buildings, bridges and other facilities. Monitoring of land subsidence and ground fissure activities can provide useful information for assessing the extent of, and mitigating such geohazards. In order to achieve robust Synthetic Aperture Radar Interferometry (InSAR) results, six interferometric pairs of Envisat ASAR data covering 2005–2006 are collected to analyze the InSAR processing errors firstly, such as temporal and spatial decorrelation error, external DEM error, atmospheric error and unwrapping error. Then the annual subsidence rate during 2005–2006 is calculated by weighted averaging two pairs of D-InSAR results with similar time spanning. Lastly, GPS measurements are applied to calibrate the InSAR results and centimeter precision is achieved. As for the ground fissure monitoring, five InSAR cross-sections are designed to demonstrate the relative subsidence difference across ground fissures. In conclusion, the final InSAR subsidence map during 2005–2006 shows four large subsidence zones in Xian hi-tech zones in western, eastern and southern suburbs of Xian City, among which two subsidence cones are newly detected and two ground fissures are deduced to be extended westward in Yuhuazhai subsidence cone. This study shows that the land subsidence and ground fissures are highly correlated spatially and temporally and both are correlated with hi-tech zone construction in Xian during the year of 2005–2006.

  19. [Anal verruciform xanthoma in a transplant background for primary hyperoxaluria. Anal verruciform xanthoma after a combined hepato-renal transplantation].

    PubMed

    Moktefi, Anissa; De Parades, Vincent; Fléjou, Jean-François

    2013-10-01

    We report a case of anal verruciform xanthoma in a patient who underwent a combined liver and kidney transplantation for primary hyperoxaluria. Verruciform xanthoma is a rare and benign lesion arising in oral cavity and genital mucosa. It is characterized pathologically by papillary epithelial hyperplasia and aggregates of foamy macrophages in connective tissue papillae. This condition, whose pathogenesis remains unclear, has been reported in immunosuppressive background or associated with underlying dermatosis. We report here the second case of anal verruciform xanthoma. To our knowledge, this is the first report of verruciform xanthoma in association with primary hyperoxaluria.

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

    PubMed

    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.

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

    PubMed

    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.

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

    Cancer.gov

    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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  4. Three QTLs conferring resistance to kernel fissuring in rice (Oryza sativa L.) identified by selective genotyping in two tropical japonica populations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Kernel fissures caused by pre- or post-harvest stresses are the leading cause of breakage among milled rice, causing economic losses for producers, millers, and processors. Being an environmentally sensitive trait, it is difficult to reliably select for rice fissure resistance among breeding progen...

  5. Hidrosadenoma of the anal canal: a case report with review of the literature.

    PubMed

    Vainer, B; Bille Brahe, N E; Horn, T

    2003-02-01

    Hidrosadenoma of the anal canal is an extremely rare tumour. Only nine cases with similar histologic structure have been described in the literature, most representing tumours resected from the anal or rectal mucosa. We present a case of anal hidrosadenoma with immunohistochemical staining features identifying it as a true sweat gland tumour.

  6. Chronic pancreatitis

    MedlinePlus

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... hospital for: Pain medicines Fluids given through a vein (IV) Stopping food or fluid by mouth to ...

  7. Rise and Collapse of Volcanic Plumes Produced By Explosive Basaltic Fissure Eruptions

    NASA Astrophysics Data System (ADS)

    Paillat, S.; Kaminski, E. C.

    2014-12-01

    Explosive basaltic fissure eruptions, which release large amounts of sulfur gases in the atmosphere, can have a big impact on climate. The effect on climate depends on the rate of gas injection above the tropopause. The key parameter is the height reached by the eruptive plume as a function of mass flux and entrainment rate. We propose a model of entrainment in 2D volcanic plumes based on lab scale experiments on turbulent jets and plumes. In this model, entrainment varies with the Richardson number and we predict that the height of the column critically depends on the source buoyancy flux determined by the eruptive temperature and the amount of gas in the volcanic mixture at the vent. We obtain that "hot" basaltic planar plumes form stable eruptive columns, even for large eruption rates. Only if fragmentation is not efficient enough, the column collapse will prevent the injection of gas in the stratosphere.

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

    PubMed Central

    Kianimanesh, Nasrin; Shayeghi, Bahareh

    2014-01-01

    Objectives The purpose of this in vitro study was to evaluate the microleakage and penetration of fissure sealant in permanent molar teeth with fluorosis after pretreatment of the occlusal surface. Materials and Methods A total of 120 third molars with mild dental fluorosis were randomly divided into 6 groups (n = 20). The tooth surfaces were sealed with an unfilled resin fissure sealant (FS) material. The experimental groups included: 1) phosphoric acid etching (AE) + FS (control); 2) AE + One-Step Plus (OS, Bisco) + FS; 3) bur + AE + FS; 4) bur + AE + OS + FS; 5) Er:YAG laser + AE + FS; and 6) Er:YAG laser + AE + OS + FS. After thermocycling, the teeth were immersed in 0.5% fuchsin and sectioned. Proportions of mircoleakage (PM) and unfilled area (PUA) were measured by digital microscope. Results Overall, there were significant differences among all groups in the PM (p = 0.00). Group 3 showed the greatest PM, and was significantly different from groups 2 to 6 (p < 0.05). Group 6 showed the lowest PM. Pretreatment with Er:YAG with or without adhesive led to less PM than bur pretreatment. There were no significant differences among groups in PUA. Conclusions Conventional acid etching provided a similar degree of occlusal seal in teeth with fluorosis compared to those pretreated with a bur or Er:YAG laser. Pretreatment of pits and fissures with Er:YAG in teeth with fluorosis may be an alternative method before fissure sealant application. PMID:25110641

  9. Normal values of inner canthal distance, interpupillary distance and palpebral fissure length in normal Chinese children in Taiwan.

    PubMed

    Wu, K H; Tsai, F J; Li, T C; Tsai, C H; Peng, C T; Wang, T R

    2000-01-01

    Ocular measurements, including inner canthal distance, outer canthal distance, interpupillary distance, and palpebral fissure length are important in the evaluation of congenital deformities and posttraumatic telecanthus. In this research, 4446 normal Chinese children in Taiwan were enrolled in our study. The sample of 284 full term neonates, 2742 infants and children aged from 1 month to 3 years, and 1420 preschool children were measured for inner canthal distance, outer canthal distance, interpupillary distance and palpebral fissure length. We calculated the mean value and standard deviation of the ocular measurements in normal Chinese newborns, infants and preschool children in Taiwan under 5 years. No significant sex differences were observed. Compared with previous studies, inner canthal distance, outer canthal distance and interpupillary distance in Chinese children in Taiwan were wider than those in Caucasian children, but the palpebral fissure length was not significantly different. We also found that inner canthal distance was wider than palpebral fissure length at the same age; therefore it was not correct to diagnose hypertelorism in Chinese children in Taiwan; as if an imaginary third eye could fit between the eyes. Thus, we suggest that measurements should be adjusted with normal standards specific for race. Consideration of the position of eyes is relevant for the diagnosis of a large number of syndromes.

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

    NASA Astrophysics Data System (ADS)

    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.

  11. Exploring rock fissures: does a specialized root morphology explain endemism on granite outcrops?

    PubMed Central

    Poot, Pieter; Hopper, Stephen D.; van Diggelen, Josepha M.H.

    2012-01-01

    Background and Aims Worldwide, many plant species are confined to open, shallow-soil, rocky habitats. Although several hypotheses have been proposed to explain this habitat specificity, none has been convincing. We suggest that the high level of endemism on shallow soils is related to the edaphic specialization needed to survive in these often extremely drought-prone habitats. Previous research has shown that species endemic to ironstone communities in SW Australia have a specialized root morphology that enhances their chance to access fissures in the underlying rock. Here we test the generality of these findings for species that are confined to a shallow-soil habitat that is of much greater global significance: granite outcrops. Methods We compared temporal and spatial root growth and allocation of three endemic woody perennials of SW Australian granite outcrop communities with those of congeners occurring on nearby deeper soils. Seedlings of all species were grown in 1·2 m long custom-made containers with a transparent bottom that allowed monitoring of root growth over time. Key Results The granite outcrop endemics mostly differed in a predictable way from their congeners from deeper soils. They generally invested a larger portion of their biomass in roots, distributed their roots faster and more evenly over the container and had a lower specific root length. In different species pairs the outcrop endemics achieved their apparent advantage by a different combination of the aforementioned traits. Conclusions Our results are consistent with earlier work, indicating that species restricted to different types of drought-prone shallow-soil communities have undergone similar selection pressures. Although adaptive in their own habitat in terms of obtaining access to fissures in the underlying rock, these root system traits are likely to be maladaptive in deeper soil habitats. Therefore, our results may provide an explanation for the narrow endemism of many shallow

  12. Stratigraphy and geochronology of pitfall accumulations in caves and fissures, Bermuda

    NASA Astrophysics Data System (ADS)

    Hearty, Paul J.; Olson, Storrs L.; Kaufman, Darrell S.; Edwards, R. Lawrence; Cheng, Hai

    2004-05-01

    Deep fractures ("fissures") and avens ("skylights") in limestone cave roofs create natural traps for sediments and biota. Fissures fill quickly with surface sediment and organisms soon after opening. Debris cones are formed as materials fall, wash, or drift on air through openings in cave skylights. Such deposits in Admiral's and Grand Canyon Cave, Bermuda contain distinct beds and are composed of mixtures of sediment and charcoal, together with fossils of land snails, crabs, birds, reptiles, and bats. The "pitfall" accumulations were periodically sealed over by calcite flowstone. A stratigraphic record of surface activity and fauna through both glacial and interglacial periods has been preserved. The succession also provides an ideal setting in which to compare several geochronological methods. Calibrated 14C ages on charcoal and shells provide dated horizons at 1600, 12,800, and about 35,000 14C yr BP. Thermal ionization mass spectrometric (TIMS) ages on several flowstone layers constrain the entire sequence in the Admiral's Cave sequence between 126,300±900 yr (Termination II) and historical times. A continuous relative-age record generated by amino acid epimerization (AAE) geochronology ( D-alloisoleucine/ L-isoleucine or aIle/Ile) on the pulmonate land gastropod Poecilozonites verifies the biostratigraphy, reveals a minimal degree of mixing between stratigraphic units, and establishes an independent temporal link between the subterranean and subaerial deposits of Bermuda. This convergence between stratigraphy and geochronology yields a precisely dated succession from the oceanic island of Bermuda, and thus presents a unique opportunity to assess the rates and processes of evolutionary and climate change during that interval.

  13. Anatomical Disruption & Length-Tension Dysfunction of Anal Sphincter Complex Muscles in Women with Fecal Incontinence

    PubMed Central

    Kim, Young Sun; Weinstein, Milena; Raizada, Varuna; Jiang, Yanfen; Bhargava, Valmik; Rajasekaran, M. Raj; Mittal, Ravinder K.

    2013-01-01

    BACKGROUND Anal sphincter complex muscles; internal anal sphincter, external anal sphincter and puborectalis muscles, play important role in the anal continence mechanism. Patients with symptoms of fecal incontinence have weak anal sphincter complex muscles; however, their length-tension properties and relationship to anatomical disruption have never been studied. OBJECTIVE To assess the anatomy of anal sphincter complex muscles using 3D-ultrasound imaging system and determine the relationship between anatomical defects and length-tension property of external anal sphincter and puborectalis muscles in women with incontinence symptoms and control subjects. DESIGN Severity of anal sphincter muscle damage was determined by static and dynamic 3Dimensional-ultrasound imaging. Length-tension property was determined by anal and vaginal pressure respectively using custom designed probes. PATIENTS 44 asymptomatic controls and 24 incontinent patients participated in this study. MAIN OUTCOME MEAUSURES Anatomical defects and length-tension dysfunction of anal sphincter complex muscles in FI patients were evaluated. RESULT Prevalence of injury to sphincter muscles are significantly higher in the incontinent patients compared to controls. 85% of patients but only 9% controls reveal damage to ≥2 of the 3 muscles of anal sphincter complex. Anal and vaginal squeeze pressure increased with increase in the probe size (length-tension curve) in majority of controls. In patients, the increase in anal and vaginal squeeze pressures was either significantly smaller than controls or it decreased with the increasing probe size (abnormal length-tension). CONCLUSIONS Length-tension property of the external anal sphincter and puborectalis muscles is significantly impaired in incontinent patients. Our findings have therapeutic implication in the treatment of anal incontinence. PMID:24105004

  14. Shift from magmatic to phreatomagmatic explosion controlled by the evolution of lateral fissure eruption in Suoana Crater, Miyakejima

    NASA Astrophysics Data System (ADS)

    Geshi, Nobuo; Nemeth, Karoly; Noguchi, Rina; Oikawa, Teruki

    2016-04-01

    Combined analysis of the proximal deposit and exposed feeder-diatreme structure of the Suoana Crater of Miyakejima reveals the process of magma-water interaction controlled by the evolution of lateral fissure eruption in a stratovolcanic edifice. The Suoana Crater, an oval maar with 400 x 300 m across is one of the craters of the Suoana-Kazahaya crater chain which is formed during a fissure eruption in the 7th Century. The eruption fissure extends ~3 km from the summit area (~700 m asl) to the lower-flank area (~200m asl). The eruption fissure consists of upper maar-chain (>450 m asl) and lower scora-cone chain. As the wall of the 2000 AD caldera truncated at near the center of the Suoana Crater, the vertical section of the feeder dike - diatreme - maar system of the Suoana Crater is exposed in the caldera wall (Geshi et al., 2011). The ejected materials from the Suoana crater indicate the transition of eruption style from magmatic to phreatomagmatic. The juvenile clasts in the lower half of the deposit exhibit spatter-like shape, indicating the typical deposit from a vigorous fire fountain. Contrary, the juvenile clasts in the upper half are less vesiculated and exhibit cauliflower-shape, indicating the typical phreatomagmatic activity. This transition indicates that the magma-water interaction started at the middle of the eruption. Judging from the ratio of the thickness of the lower and upper parts, the contrast of the content of juvenile clasts, and bulk density of the deposit, the total ejected volume of magma is larger in the lower part compare to the upper part. The transition from magmatic to phreatomagmatic occurred only in the upper half of the eruption fissure, including the Suoana crater, whereas the lower half of the fissure continued dry magmatic eruption throughout their activity. The limited distribution of phreatomagmatic activity can be resulted by the magma extraction from the upper feeder dike system to the lower eruption fissure as it

  15. Challenges faced in the clinical application of artificial anal sphincters*

    PubMed Central

    Wang, Ming-hui; Zhou, Ying; Zhao, Shuang; Luo, Yun

    2015-01-01

    Fecal incontinence is an unresolved problem, which has a serious effect on patients, both physically and psychologically. For patients with severe symptoms, treatment with an artificial anal sphincter could be a potential option to restore continence. Currently, the Acticon Neosphincter is the only device certified by the US Food and Drug Administration. In this paper, the clinical safety and efficacy of the Acticon Neosphincter are evaluated and discussed. Furthermore, some other key studies on artificial anal sphincters are presented and summarized. In particular, this paper highlights that the crucial problem in this technology is to maintain long-term biomechanical compatibility between implants and surrounding tissues. Compatibility is affected by changes in both the morphology and mechanical properties of the tissues surrounding the implants. A new approach for enhancing the long-term biomechanical compatibility of implantable artificial sphincters is proposed based on the use of smart materials. PMID:26365115

  16. Managing faecal incontinence or leakage: the Peristeen Anal Plug.

    PubMed

    Doherty, Willie

    Incontinence can be a devastating problem to many individuals. It is embarrassing and limiting socially, and prevents those with the problem from going about their day-to-day activities. People adopt coping strategies to manage the problem and those with urinary incontinence often look for containment products such as disposable pads or nappy-style products. These products have been developed using different absorbent materials and are accessible to sufferers in local supermarkets. Absorbency of the products has improved so that once wetted, they hold urine more easily. However, the same cannot be said for faecal incontinence management products and there are few that can be called upon to manage this devastating condition. The Peristeen Anal Plug, developed originally as the Conveen Anal Plug, stands alone in the search for a device to manage faecal incontinence or leakage.

  17. Anal sphincter dysfunction in multiple sclerosis: an observation manometric study

    PubMed Central

    Marola, Silvia; Gibin, Enrico; Capobianco, Marco; Bertolotto, Antonio; Enrico, Stefano; Solej, Mario; Martino, Valter; Destefano, Ines; Nano, Mario

    2016-01-01

    Abstract Constipation, obstructed defecation, and fecal incontinence are frequent complaints in multiple sclerosis. The literature on the pathophysiological mechanisms underlying these disorders is scant. Using anorectal manometry, we compared the anorectal function in patients with and without multiple sclerosis. 136 patients referred from our Center for Multiple Sclerosis to the Coloproctology Outpatient Clinic, between January 2005 and December 2011, were enrolled. The patients were divided into four groups: multiple sclerosis patients with constipation (group A); multiple sclerosis patients with fecal incontinence (group B); non-multiple sclerosis patients with constipation (group C); non-multiple sclerosis patients with fecal incontinence (group D). Anorectal manometry was performed to measure: resting anal pressure; maximum squeeze pressure; rectoanal inhibitory reflex; filling pressure and urge pressure. The difference between resting anal pressure before and after maximum squeeze maneuvers was defined as the change in resting anal pressure calculated for each patient. Results Group A patients were noted to have greater sphincter hypotonia at rest and during contraction compared with those in group C (p=0.02); the rectal sensitivity threshold was lower in group B than in group D patients (p=0.02). No voluntary postcontraction sphincter relaxation was observed in either group A or group B patients (p=0.891 and p=0.939, respectively). Conclusions The decrease in the difference in resting anal pressure before and after maximum squeeze maneuvers suggests post-contraction sphincter spasticity, indicating impaired pelvic floor coordination in multiple sclerosis patients. A knowledge of manometric alterations in such patients may be clinically relevant in the selection of patients for appropriate treatments and for planning targeted rehabilitation therapy. PMID:28352843

  18. Thermal responses of shape memory alloy artificial anal sphincters

    NASA Astrophysics Data System (ADS)

    Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

    2003-08-01

    This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

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

    PubMed

    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.

  20. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia

    PubMed Central

    Long, Kevin C.; Menon, Raman; Bastawrous, Amir; Billingham, Richard

    2016-01-01

    The prevalence of anal intraepithelial neoplasia has been increasing, especially in high-risk patients, including men who have sex with men, human immunodeficiency virus positive patients, and those who are immunosuppressed. Several studies with long-term follow-up have suggested that rate of progression from high-grade squamous intraepithelial lesions to invasive anal cancer is ∼ 5%. This number is considerably higher for those at high risk. Anal cytology has been used to attempt to screen high-risk patients for disease; however, it has been shown to have very little correlation to actual histology. Patients with lesions should undergo history and physical exam including digital rectal exam and standard anoscopy. High-resolution anoscopy can be considered as well, although it is of questionable time and cost–effectiveness. Nonoperative treatments include expectant surveillance and topical imiquimod or 5-fluorouracil. Operative therapies include wide local excision and targeted ablation with electrocautery, infrared coagulation, or cryotherapy. Recurrence rates remain high regardless of treatment delivered and surveillance is paramount, although optimal surveillance regimens have yet to be established. PMID:26929753

  1. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods

    PubMed Central

    Jelovsek, J. Eric; Markland, Alayne D.; Whitehead, William E.; Barber, Matthew D.; Newman, Diane K.; Rogers, Rebecca G.; Dyer, Keisha; Visco, Anthony; Sung, Vivian W.; Sutkin, Gary; Meikle, Susan F.; Gantz, Marie G.

    2015-01-01

    The goals of this trial are to determine the efficacy and safety of two treatments for women experiencing fecal incontinence. First, we aim to compare the use of loperamide to placebo and second, to compare the use of anal sphincter exercises with biofeedback to usual care. The primary outcome is the change from baseline in the St. Mark's (Vaizey) Score 24 weeks after treatment initiation. As a Pelvic Floor Disorders Network (PFDN) trial, subjects are enrolling from eight PFDN clinical centers across the United States. A centralized data coordinating center supervises data collection and analysis. These two first-line treatments for fecal incontinence are being investigated simultaneously using a two-by-two randomized factorial design: a medication intervention (loperamide versus placebo) and a pelvic floor strength and sensory training intervention (anal sphincter exercises with manometry-assisted biofeedback versus usual care using an educational pamphlet). Interventionists providing the anal sphincter exercise training with biofeedback have received standardized training and assessment. Symptom severity, diary, standardized anorectal manometry and health-related quality of life outcomes are assessed using validated instruments administered by researchers masked to randomized interventions. Cost effectiveness analyses will be performed using prospectively collected data on care costs and resource utilization. This article describes the rationale and design of this randomized trial, focusing on specific research concepts of interest to researchers in the field of female pelvic floor disorders and all other providers who care for patients with fecal incontinence. PMID:26291917

  2. Analysis of displacements and fissure structures on a slow-moving landslide through very high-resolution orthophoto mosaicing

    NASA Astrophysics Data System (ADS)

    Rothmund, Sabrina; Joswig, Manfred; Niethammer, Uwe; Malet, Jean-Philippe

    2010-05-01

    Very high-resolution multi-temporal images with a ground resolution of a few centimeters allowed to detect and analyze displacements and fissure patterns of the Super-Sauze landslide (Southern French Alps). Images taken by an unmanned aerial vehicle (UAV) during a flight campaign in October 2008 have been used to produce a very high-resolution orthophoto-mosaic of the landslide. In this study, a set of 59 of a total of 1486 images was selected and photogrammetrically processed using different non-parametric rectification approaches (projective transformation, piecewise affine transformation and polynomial transformations of the second and third order). The generated orthophoto-mosaic covers the entire landslide area of 0.09 km² with a ground resolution of 3 to 8 cm. The comparison of this UAV-based orthophoto-mosaic with an orthophotograph from May 2007 (ground resolution of 20 cm) allowed the characterization of the horizontal displacements of the landslide. Displacement vectors were estimated by visually inspecting the images to identify distinct features (rocks, boulders and vegetation patches) in the two orthophotographs. This approach was chosen because of the high dynamics of the landslide and the disadvantageous long period between the repeated image acquisitions. Displacements between 7.1 and 55.4 m in varying directions have been detected and areas of different dynamics could be distinguished for the period between May 2007 and October 2008. Various structures, in particular fissures of different distributions and orientations, could be resolved in the UAV-based orthophoto-mosaic. The similarity of the observed fissures with glacial crevasses is striking and suggests a similar genesis. The identified longitudinal, transverse and cross-shaped fissures are linked to abrupt changes of in-situ crest orientation in the shallow subsurface. The observed shear fissures occur at the lateral boundary of emerging in-situ crests. The fissure genesis could be traced

  3. Interaction between central volcanoes and fissure swarms along divergent plate boundaries: an example from Askja Volcano, Northern Iceland.

    NASA Astrophysics Data System (ADS)

    Trippanera, Daniele; Ruch, Joel; Acocella, Valerio; Urbani, Stefano; Thordarson, Thor

    2016-04-01

    Central volcanoes located along divergent plate boundaries are typically part of a larger volcanic system that consists of a central edifice and a fissure swarm through which magma propagates and spreads plates apart. Regional normal faults and graben structures develop within the volcanic system, also dissecting portions of the central volcano with ring-faults faults and eruptive fissures related to the caldera structure. Both the fissure swarm and the caldera structure influence the pathway of the ascending magma, however, the influences of the structures on magma propagation and vice versa are not well defined and understood. Here we aim to understand the relationship between the activity of the central volcano structures (e.g. caldera ring faults, radial dykes and cone sheets) and those of the fissure swarm (e.g. regional normal faults, regional dikes). We focus on Askja volcano, located in the Northern Volcanic Zone of Iceland. It is comprised of three nested calderas, largely filled in with subaerial basaltic lava flows and surrounded by a massive hyaloclastite mountain on the Eastern side. Formation of the youngest, the Öskjuvatn caldera, was initiated during the 1874-1876 rifting episode on the Askja system. This major event was followed by several localized radial and circumferential magmatic intrusions taking place along the new-formed caldera ring fault, as well as intruding in the fissure swarm related to the regional tectonics. In order to characterize the influence of the caldera structure on the regional tectonics, we analysed the structural framework of the caldera and direct surroundings using remote sensing (optical imagery and high resolution DEM from TanDEM-X data). Then we made detailed field measurements (500 data) by analysing azimuth, dip, and opening of eruptive fissures, dikes, faults and extension fractures. Both remote sensing and field measurements have been then integrated producing a detailed structural map of Askja. Our results show

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

    PubMed

    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

  5. Chronic Cough

    MedlinePlus

    Chronic cough Overview By Mayo Clinic Staff A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children. A chronic cough is more than just an annoyance. A chronic ...

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

    NASA Astrophysics Data System (ADS)

    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

  7. Influence of Laser Irradiation on Pits and Fissures: An In Situ Study

    PubMed Central

    Correa–Afonso, Alessandra M; Pécora, Jesus D

    2013-01-01

    Abstract Objective: The aim of this in situ study was to analyze the influence of the Er:YAG, Nd:YAG, and CO2 lasers on the enamel acid resistance of pits and fissures. Background data: The laser tissue interaction has been studied as a method of preventing occlusal caries. Methods: Thirteen volunteers wore palatal acrylic appliances containing human occlusal enamel blocks that were divided into four groups (G1, control; G2, Er:YAG; G3, Nd:YAG; G4, CO2). Each palatal acrylic appliance was used in the four studied groups and was used for 14 consecutive days. A sucrose solution was applied to the specimens six times per day. The specimens were then sectioned in half, and a microhardness test was applied. The other halves were analyzed using polarized light microscopy to measure the caries-like lesion areas, and a morphological analysis was conducted using a scanning electron microscope (SEM). Results: For the statistical analysis of the data obtained from the microhardness test (Knoop hardness number. [KHN]) (α=5%), Fisher's exact test was performed, and the group means were as follows: G1, 247±71; G2, 258±70; G3, 272±73; and G4, 298±56. The results demonstrated that the control group was significantly different from G3 and G4, which presented higher microhardness values. The Wilcoxon signed-rank test was used to analyze the data obtained from the caries-lesion area measurements (mm2) (α=5%) (G1, 0.01±1.08; G2, 0.13±0.18; G3, 0.05±0.17; and G4, 0.09±0.22). The results no showed significant differences among the groups in this analysis. Conclusions: Based on the results from the present study, it may be concluded that the CO2 and Nd:YAG lasers increased the enamel acid resistance in pits and fissures. PMID:23336742

  8. Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

    PubMed Central

    Luz, Paula M.; Lake, Jordan E.; Levi, José Eduardo; Coutinho, José Ricardo; de Andrade, Angela; Heinke, Thais; Derrico, Mônica; Veloso, Valdilea G.; Friedman, Ruth K.; Grinsztejn, Beatriz

    2015-01-01

    Abstract Identifying factors, including human papillomavirus (HPV) genotypes, associated with abnormal anal cytology in HIV-infected women have implications for anal squamous cell cancer (SCC) prevention in HIV-infected women. Anal and cervical samples were collected for cytology, and tested for high-(HR-HPV) and low-risk HPV (LR-HPV) genotypes in a cross-sectional analysis of the IPEC Women's HIV Cohort (Rio de Janeiro, Brazil). Multivariate log-binomial regression models estimated prevalence ratios for factors associated with abnormal anal cytology [≥atypical squamous cells of undetermined significance, (ASC-US)]. Characteristics of the 863 participants included: median age 42 years, 57% non-white, 79% current CD4+ T-cell count >350 cells/mm3, 53% HIV-1 viral load <50 copies/mL, median ART duration 5.8 years. Fifty-one percent of anal specimens contained ≥1 HR-HPV genotype; 31% had abnormal anal cytology [14% ASC-US, 11% low-grade squamous intra-epithelial lesion, (LSIL); 2% atypical squamous cells-cannot exclude high-grade SIL (ASC-H); 4% high-grade SIL/cancer (HSIL+)]. In multivariate analysis, cervical LSIL+, nadir CD4+ T-cell count ≤50 cells/mm3, HIV-1 viral load ≥50 copies/mL, and anal HPV 6, 11, 16, 18, 33, 45, 52, 56, and 58 were associated with ≥anal ASC-US (p<0.05). Abnormal anal cytology and HR-HPV prevalences were high. HIV-infected women with cervical LSIL+, low nadir CD4+ counts, or detectable HIV-1 viral loads should be a particular focus for enhanced anal SCC screening efforts. PMID:25361401

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

    PubMed

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

    2004-01-01

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

  10. Evidence for Bacterial Sulfate Reduction in a Fissured-porous Karst System in Southern Germany

    NASA Astrophysics Data System (ADS)

    Einsiedl, F.; Mayer, B.

    2005-12-01

    Twenty five percent of the world's population uses karst water as drinking water resources. Since karst groundwater systems are highly vulnerable to contamination, groundwater protection and self purification is a major challenge. Up to now research in karst groundwater systems has predominantly concentrated on hydrodynamic processes. Little is known about anoxic processes in oxygen dominated, fracture-matrix diffusion controlled karst aquifers. Isotope measurements comprise a promising tool to identify biogeochemical processes such as bacterial (dissimilatory) sulfate reduction in karstic aquifers. The goal of this study was to determine the sources and the processes affecting sulfate in an oxygen-rich karst aquifer in southern Germany and their dependence on hydrogeological parameters. This was achieved by interpreting tritium data with a simple lumped parameter approach and assessing variations in concentrations and isotopic compositions of sulfate and dissolved inorganic carbon (DIC) with respect to groundwater age. Young groundwater (<30 years) was characterized by comparatively high sulfate concentrations (0.36 mM) and δ34S values similar to those of recent atmospheric deposition (1.5‰). In contrast groundwater with mean residence times >60 years had significantly lower sulfate concentrations (0.08 mM) and markedly higher δ34S values (7.5‰). These results indicate that in karst systems with matrix porosity, bacterial (dissimilatory) sulfate reduction may occur. This process has the potential to contribute to long-term biodegradation of contaminants in the porous rock matrix representing the dominant water reservoir in fissured-porous karst aquifers.

  11. Analysis of anticaries potential of pit and fissures sealants containing amorphous calcium phosphate using synchrotron microtomography.

    PubMed

    Delben, A C B; Cannon, M; Vieira, A E M; Basso, M D; Danelon, M; Santo, M R E; Stock, S R; Xiao, X; De Carlo, F

    2015-01-01

    The aim of this study was to analyze the anticaries potential of pit and fissure sealants containing amorphous calcium phosphate (ACP) by synchrotron microtomography. Bovine enamel blocks (4×4 mm; n=50) were selected through surface hardness (Knoop) analysis. Slabs were obtained through cross-sections taken 1 mm from the border of the enamel. Five indentations, spaced 100 μm apart, were made 300 μm from the border. Ten specimens were prepared for each tested material (Ultraseal XT plus TM, Aegis, Embrace, Vitremer and Experimental Sealant). The materials were randomly attached to the sectioned surfaces of the enamel blocks and fixed with sticky wax. The specimens were submitted to pH cycling. After that, the surface hardness (SH1) was determined, and the blocks were submitted to synchrotron microcomputed tomography analysis to calculate the mineral concentration (ΔgHAp cm(-3)) at different areas of the enamel. The comparison between the SH1 and ΔgHAp cm(-3) showed a correlation for all groups (r=0.840; p<0.001). The fluoride groups presented positive values of ΔgHAp cm(-3), indicating a mineral gain that was observed mainly in the outer part of the enamel. The ACP showed mineral loss in the outer enamel compared with fluoride groups, although it inhibited the demineralization in the deeper areas of enamel. The combination of two remineralizing agents (fluoride and ACP) was highly effective in preventing demineralization.

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

    SciTech Connect

    Strack, O.D.L.

    1982-02-01

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

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

    PubMed Central

    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

  14. Recurrent anal fistulae: Limited surgery supported by stem cells

    PubMed Central

    Garcia-Olmo, Damian; Guadalajara, Hector; Rubio-Perez, Ines; Herreros, Maria Dolores; de-la-Quintana, Paloma; Garcia-Arranz, Mariano

    2015-01-01

    AIM: To study the results of stem-cell therapy under a Compassionate-use Program for patients with recurrent anal fistulae. METHODS: Under controlled circumstances, and approved by European and Spanish laws, a Compassionate-use Program allows the use of stem-cell therapy for patients with very complex anal fistulae. Candidates had previously undergone multiple surgical interventions that had failed to resolve the fistulae, and presented symptomatic recurrence. The intervention consisted of limited surgery (with closure of the internal opening), followed by local implant of stem cells in the fistula-tract wall. Autologous expanded adipose-derived stem cells were the main cell type selected for implant. The first evaluation was performed on the 8th postoperative week; outcome was classified as response or partial response. Evaluation one year after the intervention confirmed if complete healing of the fistula was achieved. RESULTS: Ten patients (8 male) with highly recurrent and complex fistulae were treated (mean age: 49 years, range: 28-76 years). Seven cases were non-Crohn’s fistulae, and three were Crohn’s-associated fistulae. Previous surgical attempts ranged from 3 to 12. Two patients presented with preoperative incontinence (Wexner scores of 12 and 13 points). After the intervention, six patients showed clinical response on the 8th postoperative week, with a complete cessation of suppuration from the fistula. Three patients presented a partial response, with an evident decrease in suppuration. A year later, six patients (60%) remained healed, with complete reepithelization of the external opening. Postoperative Wexner Scores were 0 in six cases. The two patients with previous incontinence improved their scores from 12 to 8 points and from 13 to 5 points. No adverse reactions or complications related to stem-cell therapy were reported during the study period. CONCLUSION: Stem cells are safe and useful for treating anal fistulae. Healing can be achieved in

  15. Shear bond strength and microleakage of a self-etching adhesive for fissure sealing after different types of aging.

    PubMed

    Schuldt, Christoph; Birlbauer, Sebastian; Pitchika, Vinay; Crispin, Alexander; Hickel, Reinhard; Kühnisch, Jan

    2016-01-01

    The aim of this study was to evaluate shear bond strength (SBS) and microleakage of a self-etching adhesive (Adper Prompt L-Pop) in comparison to acid etching prior fissure sealing. Each procedure was tested with 3 aging procedures (1-day water storage, 3-month water storage and 1-day water storage/5,000× thermocycling). SBS was determined according to ISO standard 29022. Additional 30 third molars were utilized for the microleakage analyses. Data were analyzed using Mann-Whitney-U-Test and multiple linear regression models. The SBS of the self-etching adhesive were significantly lower (14.9, 11.9, and 13.0 MPa) than those of conventional fissure sealing (19.1, 18.2, and 15.6 MPa). Multiple linear regression models predicted that material and alteration significantly influenced SBS. The microleakage revealed no difference between both groups (1.3% vs. 1.2%). It can be concluded that the selfetching adhesive might be a pre-treatment alternative for fissure sealing in terms of the easier and shorter clinical workflow.

  16. Effect of topical applications of a chlorhexidine/thymol-containing varnish on fissure caries assessed by laser fluorescence.

    PubMed

    Sköld-Larsson, Kerstin; Fornell, Ann-Charlott; Lussi, Adrian; Twetman, Svante

    2004-12-01

    The aim of this study was to monitor the effect of an antibacterial varnish using the readings of a caries-detecting device (DIAGNOdent) in fissures of young permanent molars. The material consisted of 32 healthy patients with a mean age of 14.1 years undergoing orthodontic treatment with fixed appliances. The inclusion criteria were presence of one homologous pair of 2nd upper or lower molars with clinically intact occlusal surfaces. A split-mouth study design was used in which the fissures were treated with either an antibacterial chlorhexidine/thymol-containing varnish or a placebo varnish every 6th week. The follow-up period was 42 weeks and laser fluorescence (LF) readings were carried out every 12th week. The mean LF values increased significantly (P < 0.05) after 24, 36, and 48 weeks compared to baseline following the placebo treatments but not after treatment with the active antibacterial varnish. During the study period, micro-cavities were diagnosed in two test-treated and five placebo-treated teeth. In conclusion, the results reinforce previous findings that frequent applications of a chlorhexidine/thymol-containing dental varnish might have a protective role in fissures of young permanent molars and that this could be monitored with a chair-side caries detecting LF device.

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

    NASA Astrophysics Data System (ADS)

    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.

  18. Feasibility and safety of prophylactic tentorium cerebelli hiatus incision in surgery of glioma located in lateral fissure area

    PubMed Central

    Jin’an, Zhao; Yamei, Gao; Huanli, Yang

    2015-01-01

    To discuss the feasibility and safety of prophylactic tentorium cerebelli hiatus incision in surgery of glioma located in lateral fissure area. There were 80 patients with glioma located in lateral fissure area who received treatment from May 2012 to May 2015, divided into two groups, the research group (n=40) and control group (n=40), and then statistical analysis was carried out. Difference in total resection rate and subtotal resection rate of glioma between patients of the research group and those of the control group was not significant (P>0.05); intracranial pressure of patients in the research group was significantly lower than that of control group (P<0.05), their hospital stay was significantly shorter than that of the control group (P<0.05), times of using mannitol were significantly fewer than control group (P<0.05), but the differences of acute renal function damage and second surgery occurrence rate between patients of the two groups were not significant (P>0.05). Prophylactic tentorium cerebelli hiatus incision in surgery of glioma located in lateral fissure area can effectively reduce patients’ intracranial pressure, shorten patients’ hospital stay and reduce patients’ times of using mannitol without increasing the rate of patients’ acute renal function damage and second surgery.

  19. Unexpected Anal Squamous Cells Carcinoma after Open Hemorrhoidectomy

    PubMed Central

    Luca, Navarra; Valentina, Abruzzese; Federico, Sista; Renato, Pietroletti

    2015-01-01

    We report a case of unexpected anal squamous cells carcinoma found in hemorrhoidectomy specimen. The patient had a 3-year history of prolapsing hemorrhoids. A prolapsing hemorrhoid was present at eleven o'clock in lithotomy. Milligan-Morgan was performed and gross examination of the specimen was unremarkable. Histopathologic evaluation showed noninvasive squamous cells carcinoma. The present case report evidences the opportunity of routine histopathologic analysis of hemorrhoidal specimens particularly in case of long-standing prolapse. Questions arise in the option of those techniques where no specimens are collected or tissue is excised far from deceased area. PMID:25922781

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

    PubMed

    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.

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

    PubMed

    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).

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

    PubMed

    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.

  3. Drivers of explosivity and elevated hazard in basaltic fissure eruptions: The 1913 eruption of Ambrym Volcano, Vanuatu (SW-Pacific)

    NASA Astrophysics Data System (ADS)

    Németh, Károly; Cronin, Shane J.

    2011-04-01

    Fissure-eruptions along linear structures can extend for several tens of kilometres with distinct separate manifestations of volcanism along their length. They typically involve low-viscosity mafic magmas forming long lava flows and cinder cones. Eruptions in 1894 and 1913 on Ambrym volcano, Vanuatu, showed how these mildly explosive eruptions can rapidly transform into violent explosive events, producing significant hazard and widespread volcanic ash clouds. During the 1913 episode, a fissure began in the central caldera and basaltic magmas broke out in a series of locations down the island's western flank. In all sites over 100 m in elevation, fissure outbreaks produced vigorous lava fountains and highly fluid lava flows that travelled rapidly to the shoreline. When the outbreaks propagated along the island's axis into coastal plain areas, a climactic series of explosive eruptions occurred, producing a 1.2 km long by 600 m wide maar and tephra ring. A further small tuff ring was formed later, creating a temporary island 400 m offshore. The onshore tephra ring destroyed a hospital and associated buildings. Its last evacuating occupants were close witnesses to the eruption processes. Deposits exposed in the lower portion of the tephra ring show that this part of the eruption began with a mild phreatomagmatic explosive eruption from a narrow vent, followed by a magmatic scoria-producing phase. Subsequently a complex sequence of highly explosive phreatomagmatic eruptions occurred, producing pyroclastic surges, along with repeated distinctive breccia-horizons, rich in coral and lava country rock. These features tally with eye-witness accounts to indicate that the main eruption phase was produced by a periodically shifting locus of phreatomagmatic fragmentation and eruption along a single E-W fissure. The glassy and vesicle-poor pyroclasts produced during this eruption phase were dominantly fragmented in a brittle manner by magma water interaction. Low volatile content

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

    PubMed

    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.

  5. Human Papillomavirus Positivity in the Anal Canal in HIV-Infected and HIV-Uninfected Men Who Have Anal Sex with Men in Guangzhou, China: Implication for Anal Exams and Early Vaccination

    PubMed Central

    Ren, Xuqi; Ke, Wujian; Yang, Ligang; Huang, Shujie; Qin, Xiaolin

    2017-01-01

    Background. The epidemiology of HPV in men who have sex with men (MSM) in Guangzhou, China, had not been reported previously. Methods. HIV-infected and HIV-uninfected MSM were recruited from a Guangzhou-based MSM clinic in 2013. Sociodemographic characteristics and sexual behaviors were collected. An anal cytological sample was taken for HPV testing. Results. We recruited 79 HIV-infected and 85 HIV-uninfected MSM. The median age was 26 years in both groups. The positivities of anal HPV of any type (81.0% versus 48.2%), any high risk type (50.6% versus 27.1%), any low risk type (55.7% versus 31.8%), and any 9-valent vaccine type (74.7% versus 36.5%) were all significantly higher among HIV-infected compared to that among HIV-negative MSM (p for all < 0.05). The great majority of HPV-infected MSM were infected with 9-valent vaccine types (59 out of 64 HIV-infected and 31 out of 41 HIV-uninfected). Anal bacterial infections were associated with higher anal HPV positivity and greater number of anal HPV types. Conclusion. Sexually active MSM in Guangzhou, especially those infected with HIV, had high and multiple HPV detections. The majority of these cases were potentially preventable by HPV vaccine. Regular anal exams and early HPV vaccination are warranted in this population. PMID:28133605

  6. Recrystallized Granite Surface Fissures Of The Wasatch Range, Produced Not Later Than 1/4 Billion Years Ago

    NASA Astrophysics Data System (ADS)

    McDonald, Keith L.

    2000-05-01

    Our studies of numerous recrystallized fissures in 4 granite plutons of Wasatch Range, namely, Mount Tuscarora-Wolverine-Millicent,^1,6,7 Bonanza Peak-Midway,^2 Little Cottonwood Canyon and Ferguson Canyon plutons, all of which formed magma chambers reaching Earth-atmosphere interface, establish that they resulted from high thermal gradients rather than passages of earthquake waves. Magma chambers formed, solidified during Permo-Caroniferous Ice Age(roughly, 1/3...1/4 billion yr ago, a time interval preceding period of extrusion of Rocky Mountains, 10^8 yr ago), and while fluid, belched lava flows^5 extending over its reservoir walls to run hundred of meters. We have shown how the magma melts, dilutes and replaces overlying metamorphic rock^7 to reach Earth's surface so that a pluton containing large amounts of dross(Fe-ores, etc.) had a short fluid lifetime. We also described how offshoots from a long-running main fissure form acute angles with that fissure.^3 Such recrystallized fissures, reaching depths of perhaps 100 m, have initial fractures near time of solidification of their uppermost portion of magma chamber while still hot(<= 1600^oF), a time when max. stresses occur near granite surface due to high thermal gradients, owing to snow coverage, cold water contacts due to rain, stream flow over granite surface, partial coverage by ocean, etc., wherever heat sinks might occur, during P-C ice age--when region of Wasatch Range existed at sea level, Salt Lake Valley being covered entirely by ocean water and region east of Wasatch Bouleuard rising gently above Pacific Ocean to elevations of possibly 500-1000 ft, say, at a distance of 10-15 mi to east. This fact is implied by Chinese Wall of white limestone on Grandeur Peak, unequivocally, and similarly another in Neff's Canyon running e. from n. ridge of 9200 ft. saddle-summit, as well as a dozen other ancient calcified stream beds emptying into ocean to w., in Salt Lake Valley. This existed prior to regional

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

    PubMed Central

    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, p<0.001). The lased teeth presented enhanced surface roughness 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

  8. Sox4 regulates choroid fissure closure by limiting Hedgehog signaling during ocular morphogenesis

    PubMed Central

    Wen, Wen; Pillai-Kastoori, Lakshmi; Wilson, Stephen G.; Morris, Ann C.

    2015-01-01

    SoxC transcription factors play critical roles in many developmental processes, including neurogenesis, cardiac formation, and skeletal differentiation. In vitro and in vivo loss-of-function studies have suggested that SoxC genes are required for oculogenesis, however the mechanism was poorly understood. Here, we have explored the function of the SoxC factor Sox4 during zebrafish eye development. We show that sox4a and sox4b are expressed in the forebrain and periocular mesenchyme adjacent to the optic stalk during early eye development. Knockdown of sox4 in zebrafish resulted in coloboma, a structural malformation of the eye that is a significant cause of pediatric visual impairment in humans, in which the choroid fissure fails to close. Sox4 morphants displayed altered proximo-distal patterning of the optic vesicle, including expanded pax2 expression in the optic stalk, as well as ectopic cell proliferation in the retina. We show that the abnormal ocular morphogenesis observed in Sox4-deficient zebrafish is caused by elevated Hedgehog (Hh) signaling, and this is due to increased expression of the Hh pathway ligand Indian hedgehog b (ihhb). Consistent with these results, coloboma in sox4 morphants could be rescued by pharmacological treatment with the Hh inhibitor cyclopamine, or by co-knockdown of ihhb. Conversely, overexpression of sox4 reduced Hh signaling and ihhb expression, resulting in cyclopia. Finally, we demonstrate that sox4 and sox11 have overlapping, but not completely redundant, functions in regulating ocular morphogenesis. Taken together, our data demonstrate that Sox4 is required to limit the extent of Hh signaling during eye development, and suggest that mutations in SoxC factors could contribute to the development of coloboma. PMID:25557621

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

    NASA Astrophysics Data System (ADS)

    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.

  10. Earth-Fissure Movements Associated with Fluctuations in Ground-Water Levels near the Picacho Mountains, South-Central Arizona, 1980-84

    USGS Publications Warehouse

    Carpenter, M.C.

    1993-01-01

    The Picacho earth fissure transects subsiding alluvial sediments near the east periphery of the Picacho basin in south-central Arizona. The basin has undergone land subsidence of as much as 3.8 meters since the 1930's owing to compaction of the aquifer system in response to ground-water-Ievel declines that have exceeded 100 meters. The fissure, which extends generally north-south for 15 kilometers, exhibits horizontal tensile failure and as much as 0.6 meter of normal dip-slip movement at the land surface. The west side of the fissure is down thrown. The fissure was observed as early as 1927 and is the longest earth fissure in Arizona. Vertical and horizontal displacements were monitored along a line normal to the fissure. The survey line extends from a bedrock outcrop in the Picacho Mountains on the east, past an observation well near the fissure, to a point 1,422 meters to the west. From May 1980 to May 1984, the downthrown west side of the fissure subsided 167+-1.8 millimeters and moved 18+-1.5 millimeters westward into the basin. Concurrently, the relatively upthrown east side subsided 148+-1.8 millimeters and moved 14+-1.5 millimeters westward. Dislocation modeling of deformation along the survey line near the fissure indicates that dip-slip movement has occurred along a vertical fault surface that extends from the land surface to a depth of about 300 meters. Slip was 9 millimeters from May to December 1980 and also 9 millimeters from March to November 1981. Continuous measurements were made of horizontal movement across the fissure using a buried invar-wire horizontal extensometer, while water-level fluctuations were continuously monitored in four piezometers nested in two observation wells. The range of horizontal movement was 4.620 millimeters, and the range of water-level fluctuation in the nearest piezometer in the deep alluvium was 9.05 meters. The maximum annual opening of the fissure during the study period was 3.740 millimeters from March to October

  11. Chronic Sinusitis

    MedlinePlus

    Chronic sinusitis Overview By Mayo Clinic Staff Chronic sinusitis is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen for at least 12 weeks, despite treatment attempts. Also known as chronic rhinosinusitis, this condition ...

  12. Resisting the "Condom Every Time for Anal Sex" Health Education Message

    ERIC Educational Resources Information Center

    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…

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

    PubMed Central

    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. Diagnostic imaging features of normal anal sacs in dogs and cats

    PubMed Central

    Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo

    2016-01-01

    This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions. PMID:26645338

  15. Cervical and Anal Human Papillomavirus Infection in Adult Women in American Samoa

    PubMed Central

    Hernandez, Brenda Y.; Ka’opua, Lana S.; Scanlan, Luana; Ah Ching, John; Kamemoto, Lori E.; Thompson, Pamela J.; Zhu, Xuemei; Shvetsov, Yurii B.; Tofaeono, Jennifer; Williams, Victor Tofaeono

    2015-01-01

    The prevalence of cervical and anal human papillomavirus (HPV) and risk factors associated with infections were evaluated in a cross-sectional study of 211 adult women in American Samoa. Overall, 53% of women reported ever having a Pap smear. Cervical and anal HPV was detected in 10% and 16% of women, respectively; 4% of women had concurrent cervical and anal HPV. The most common cervical genotypes were HPV 6, HPV 16, and HPV 53. Cutaneous HPV types were detected in 40% of anal infections. Cervical HPV infection was associated with anal HPV (age-adjusted odds ratio = 3.32, 1.10–10.00). After age adjustment, cervical HPV was associated with being unmarried, postsecondary education, hot running water at home, multiple sexual partners, nulliparity, condom use, and other contraceptive methods. In multivariate analyses, only age remained associated with cervical HPV and anal HPV. Cervical and anal HPV was more prevalent among younger women; only anal HPV was detected in older women. PMID:22652246

  16. Efficacy of magnetic resonance imaging in the diagnosis of perianal hidradenitis suppurativa, complicated by anal fistulae: A report of two cases and review of the literature

    PubMed Central

    Takiyama, Hirotoshi; Kazama, Shinsuke; Tanoue, Yusuke; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Tanaka, Junichiro; Kiyomatsu, Tomomichi; Hata, Keisuke; Kawai, Kazushige; Nozawa, Hiroaki; Miyagawa, Takuya; Yamada, Daisuke; Yamaguchi, Hironori; Ishihara, Soichiro; Sunami, Eiji; Watanabe, Toshiaki

    2015-01-01

    Background Perianal hidradenitis suppurativa (PHS) is a chronic recurrent inflammatory disease of the apocrine glands present in the skin and soft tissue adjacent to the anus. It is often misdiagnosed or treatment is delayed, resulting in the formation of an abscess or, in the worst case, leading to sepsis. It is difficult to treat perianal lesions merged with fistulae completely due to its high recurrence rate. Therefore, we should diagnose it correctly and treat it with appropriate methods. Presentation of case We report two cases of PHS with anal fistulae that were examined preoperatively using magnetic resonance imaging (MRI) and treated safely by surgery without any recurrence. Discussion The anal sphincter area cannot be visualized and evaluated directly by fistulography. Also CT has only limited resolution, making it difficult to distinguish between soft tissues and inflammatory streaks. Endosonography is not suitable for the examination of supra-sphincteric or extra-sphincteric extensions, as it is limited by insufficient penetration of the ultrasonic beams. MRI can demonstrate the entire course of the fistulae owing to its high contrast resolution. Conclusion Our findings support the idea that PHS with complicated anal fistulae can be diagnosed accurately using MRI and treated safely and completely with surgery. PMID:26339787

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

    PubMed

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

    2017-01-17

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

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

    PubMed Central

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

    2017-01-01

    Squamous cell carcinomas of the anus and anal canal represent a model of a cancer and perhaps the first where level 1 evidence supported primary chemoradiotherapy (CRT) in treating locoregional disease with curative intent. The majority of tumours are associated with infection with oncogenic subtypes of human papilloma virus and this plays a significant role in their sensitivity to treatment. However, not all tumours are cured with CRT and there remain opportunities to improve outcomes in terms of oncological control and also reducing late toxicities. Understanding the biology of ASCC promises to allow a more personalised approach to treatment, with the development and validation of a range of biomarkers and associated techniques that are the focus of this review. PMID:27923035

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

    PubMed

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

    SciTech Connect

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

    2012-12-15

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

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

    PubMed

    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 (P< 0.05). In the scanning electron microscopy images, enamel 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

  2. Chemical transport in a fissured rock: Verification of a numerical model

    SciTech Connect

    Rasmuson, A.; Narasimhan, T. N.; Neretnieks, I.

    1982-10-01

    Numerical models for simulating chemical transport in fissured rocks constitute powerful tools for evaluating the acceptability of geological nuclear waste repositories. Due to the very long-term, high toxicity of some nuclear waste products, the models are required to predict, in certain cases, the spatial and temporal distribution of chemical concentration less than 0.001% of the concentration released from the repository. Whether numerical models can provide such accuracies is a major question addressed in the present work. To this end, we have verified a numerical model, TRUMP, which solves the advective diffusion equation in general three dimensions with or without decay and source terms. The method is based on an integrated finite-difference approach. The model was verified against known analytic solution of the one-dimensional advection-diffusion problem as well as the problem of advection-diffusion in a system of parallel fractures separated by spherical particles. The studies show that as long as the magnitude of advectance is equal to or less than that of conductance for the closed surface bounding any volume element in the region (that is, numerical Peclet number <2), the numerical method can indeed match the analytic solution within errors of ±10{sup -3} % or less. The realistic input parameters used in the sample calculations suggest that such a range of Peclet numbers is indeed likely to characterize deep groundwater systems in granitic and ancient argillaceous systems. Thus TRUMP in its present form does provide a viable tool for use in nuclear waste evaluation studies. A sensitivity analysis based on the analytic solution suggests that the errors in prediction introduced due to uncertainties in input parameters is likely to be larger than the computational inaccuracies introduced by the numerical model. Currently, a disadvantage in the TRUMP model is that the iterative method of solving the set of simultaneous equations is rather slow when time

  3. Chemical Transport in a Fissured Rock: Verification of a Numerical Model

    NASA Astrophysics Data System (ADS)

    Rasmuson, A.; Narasimhan, T. N.; Neretnieks, I.

    1982-10-01

    Numerical models for simulating chemical transport in fissured rocks constitute powerful tools for evaluating the acceptability of geological nuclear waste repositories. Due to the very long-term, high toxicity of some nuclear waste products, the models are required to predict, in certain cases, the spatial and temporal distribution of chemical concentration less than 0.001% of the concentration released from the repository. Whether numerical models can provide such accuracies is a major question addressed in the present work. To this end we have verified a numerical model, TRUMP, which solves the advective diffusion equation in general three dimensions, with or without decay and source terms. The method is based on an integrated finite difference approach. The model was verified against known analytic solution of the one-dimensional advection-diffusion problem, as well as the problem of advection-diffusion in a system of parallel fractures separated by spherical particles. The studies show that as long as the magnitude of advectance is equal to or less than that of conductance for the closed surface bounding any volume element in the region (that is, numerical Peclet number <2), the numerical method can indeed match the analytic solution within errors of ±10-3% or less. The realistic input parameters used in the sample calculations suggest that such a range of Peclet numbers is indeed likely to characterize deep groundwater systems in granitic and ancient argillaceous systems. Thus TRUMP in its present form does provide a viable tool for use in nuclear waste evaluation studies. A sensitivity analysis based on the analytic solution suggests that the errors in prediction introduced due to uncertainties in input parameters are likely to be larger than the computational inaccuracies introduced by the numerical model. Currently, a disadvantage in the TRUMP model is that the iterative method of solving the set of simultaneous equations is rather slow when time

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

    NASA Astrophysics Data System (ADS)

    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

  5. Reaction of the pterygomaxillary fissure and the condylar cartilage to intermaxillary Class III magnetic mechanics.

    PubMed

    Vardimon, A D; Graber, T M; Stutzmann, J; Voss, L; Petrovic, A G

    1994-04-01

    The skeletal reaction to Class III intermaxillary magnetic mechanics was previously found to affect two target areas, the pterygomaxillary fissure (PMF) and the condylar cartilage. The objectives of this study were to analyze, radiographically and histologically, the response of these tissues to Class III intermaxillary functional orthopedic magnetic appliance (FOMA III), and to postulate possible models of their dichotomous biomechanism. Nine Macaca fascicularis monkeys received periodic administration of vital bone procion dye and were treated for 4 months with FOMA III (6 subjects) and sham appliance (3 subjects). The PMF (the target area of the midfacial complex) demonstrated a decreased skeletal reaction in inferosuperior and lateromedial directions. Cephalometrically, the lowermost PMF point was displaced inferiorly 1.98 +/- 1.74 mm and 0.42 +/- 0.38 mm and anteriorly 1.42 +/- 0.96 mm and 0.58 +/- 0.38 mm in the treated and control groups, respectively. The displacement of the uppermost PMF point, compared with the lowermost point, was three to five times lower. Histologically, two modes of response were found; first, a sutural response (disarticulation and osteogenesis) of the palatomaxillary and pterygopalatine sutures, which was distinctive of the lateral PMF aspect, and second, a dentosutural response, which was characteristic of the medial PMF aspect (bony microfractures between the third molar germ and the maxillary tuberosity in conjunction with mild sutural response). In the mandible, a discrepancy was found between the histologic and the cephalometric findings. Radiographically, mandibular length was unaffected after 4 months of treatment, and the distance condylion-pogonion was equally increased in the treated (0.75 +/- 0.78 mm) and the control animals (0.77 +/- 0.32 mm). Histologically, however, the condylar cartilage demonstrated increased osteoclastic activity at the zone of endochondral ossification and a decreased apposition rate at the

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

    NASA Astrophysics Data System (ADS)

    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

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

    NASA Astrophysics Data System (ADS)

    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

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

    PubMed

    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. Correlates of Heterosexual Anal Intercourse Among At-Risk Adolescents and Young Adults

    PubMed Central

    Houck, Christopher D.; Brown, Larry K.; Doherty, Glenn; DiClemente, Ralph J.; Fernandez, M. Isabel; Pugatch, David; Schlenger, William E.; Silver, Barbara J.

    2009-01-01

    Objectives. We sought to learn what factors are associated with anal intercourse among adolescents and young adults. We examined demographic, behavioral, relationship context, attitudinal, substance use, and mental health correlates of recent heterosexual anal intercourse among adolescents and young adults who reported engaging in recent unprotected sex. Methods. Among 1348 at-risk adolescents and young adults aged 15 to 21 years in 3 US cities, we assessed sexual risk behavior with each sexual partner in the past 90 days. Data were collected from 2000 to 2001. Results. Recent heterosexual anal intercourse was reported by 16% of respondents. Females who engaged in anal intercourse were more likely to be living with a sexual partner, to have had 2 or more partners, and to have experienced coerced intercourse. For males, only a sexual orientation other than heterosexual was a significant predictor of engaging in heterosexual anal intercourse. Conclusions. Our findings document the prevalence of heterosexual anal intercourse among adolescents and young adults who had recent unprotected sex. Among females, the variables associated with anal intercourse relate to the context and power balance of sexual relationships. Different influences for males and females suggest different foci for interventions. PMID:19008522

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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. Fissural volcanism, polygenetic volcanic fields, and crustal thickness in the Payen Volcanic Complex on the central Andes foreland (Mendoza, Argentina)

    NASA Astrophysics Data System (ADS)

    Mazzarini, F.; Fornaciai, A.; Bistacchi, A.; Pasquarè, F. A.

    2008-09-01

    Shield volcanoes, caldera-bearing stratovolcanoes, and monogenetic cones compose the large fissural Payen Volcanic Complex, located in the Andes foreland between latitude 35°S and 38°S. The late Pliocene-Pleistocene and recent volcanic activity along E-W trending eruptive fissures produced basaltic lavas showing a within-plate geochemical signature. The spatial distribution of fractures and monogenetic vents is characterized by self-similar clustering with well defined power law distributions. Vents have average spacing of 1.27 km and fractal exponent D = 1.33 defined in the range 0.7-49.3 km. The fractal exponent of fractures is 1.62 in the range 1.5-48.1 km. The upper cutoffs of fractures and vent fractal distributions (about 48-49 km) scale to the crustal thickness in the area, as derived from geophysical data. This analysis determines fractured media (crust) thickness associated with basaltic retroarc eruptions. We propose that the Payen Volcanic Complex was and is still active under an E-W crustal shortening regime.

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

    PubMed Central

    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. PMID:25587389

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

    PubMed

    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.

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

    PubMed Central

    Eskandarian, Tahereh; Baghi, Saeid; Alipoor, Abbas

    2015-01-01

    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 molar 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 conditions; 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 difference 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 technical sensitivities and consequently decreases the apprehensions on saliva contamination of etched enamel during treatment procedures. PMID:26331144

  17. Retrospective Audit of the Management of Anal Insertion of Foreign Bodies: A Holistic Approach

    PubMed Central

    Yahya, Ahmed; Chukwuma, Jude

    2016-01-01

    Most patients with voluntary anal insertion of a foreign body (IFB) present to the emergency department and are then managed by the surgical team. This report reviews the medical literature on IFB and includes results of a chart review of operative logged interventions and clinically coded procedures for anal IFBs at a single acute hospital in the United Kingdom between May 2009 and September 2013. The objective was to establish the current practice in the management of anal IFB and update a framework for the initial workup, surgical procedure, and appropriate mental health intervention. PMID:27247831

  18. Successful hepatectomy for metastatic squamous cell carcinoma of the anal canal—a case report

    PubMed Central

    Sousa, Tercia Tarciane; Belotto, Marcos; Peixoto, Renata D’Alpino

    2016-01-01

    Despite rare, metastatic anal carcinoma confers a poor prognosis. Systemic chemotherapy is the mainstay of treatment for advanced disease while the role of biologics and/or surgical resection of metastatic disease are anecdotal. Compared to isolated liver colorectal or neuroendocrine cancer liver metastases, there is far less experience with resection or nonsurgical local ablative procedures for patients with metastatic anal carcinoma to the liver. We report the case of a 67-year-old woman with metastatic anal carcinoma to the liver who was successfully treated with liver resection and remains free of relapse more than one year later. PMID:28078133

  19. The ‘Excess’ Emission from the Warm Surface Adjacent to Active Fissures on Enceladus from Combined VIMS and CIRS Spectra

    NASA Astrophysics Data System (ADS)

    Goguen, Jay D.; Buratti, Bonnie J.; Howell, Robert R.

    2015-11-01

    The exciting discovery of thermal emission from the tiger stripe fissures at the S. pole of Enceladus is a major highlight of the Cassini mission. Both VIMS (Visible and Infrared Mapping Spectrometer) and CIRS (Composite InfraRed Spectrometer) detect the thermal ‘blackbody’ spectrum emitted from the warm fissure areas. The VIMS instrument is uniquely suited to measuring the hottest active locations because VIMS covers the 3 to 5 micron wavelength range where the rising edge of the Planck function for these T~200 K areas dominates the emission spectrum. At longer wavelengths, the spectrum is more complicated because contributions from small hot areas and larger cooler areas combine to form the broad emission spectrum that is detected by the CIRS instrument at wavelengths >6.7 microns. It is the combination of VIMS and CIRS spectra that paint a more complete portrait of the fissure heat transfer processes. Using spectra that span both the VIMS and CIRS wavelengths places a stronger constraint on the T distribution near the fissures than consideration of the spectra from either instrument alone.We show that when the best (= highest spatial resolution, 800 m/pixel and smaller) VIMS and CIRS spectra of the fissure thermal emission are considered together, there is a large (up to 400%) component of ‘excess’ emission spanning 7 to 17 microns that requires explanation. New analysis of ~2 km spatial resolution VIMS spectra of the Damascus hot spot on 8/13/2010 are similar to the highest resolution 4/14/2012 VIMS Baghdad spectra, confirming that differences in location or time between the best VIMS and CIRS spectra do not explain away the excess. The obvious interpretation is that there are processes that transfer heat from the fissure eruption to the surface within 400 m of the fissure center in addition to heat conduction through the fissure walls. Candidate heat transfer processes include fallback of large warm low velocity ice particles from the edges of the

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

    PubMed

    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.

  1. Chronic Pain

    MedlinePlus

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

  2. Chronic cholecystitis

    MedlinePlus

    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 ...

  3. Chronic Bronchitis

    MedlinePlus

    ... a disease, often call Chronic Obstructive Pulmonary Disease (COPD) . A person with COPD may have either emphysema or chronic bronchitis, but many have both. Some people with COPD may also have asthma . Let’s take a look ...

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

    PubMed

    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.

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

    Cancer.gov

    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.

  6. Outcomes of Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Anal Cancer in Immunocompetent Versus Immunodeficient Patients

    SciTech Connect

    Seo, Yuji; Kinsella, Michael T.; Reynolds, Harry L.; Chipman, Gregory; Remick, Scot C.; Kinsella, Timothy J.

    2009-09-01

    Purpose: Information is limited as to how we should treat invasive anal squamous cell carcinoma (SCC) in patients with chronic immunosuppression, since the majority of clinical studies to date have excluded such patients. The objective of this study is to compare treatment outcomes in immunocompetent (IC) versus immunodeficient (ID) patients with invasive anal SCC treated similarly with combined modality therapy. Methods and Materials: Between January 1999 and March 2007, a total of 36 consecutive IC and ID patients received concurrent chemoradiotherapy using three-dimensional conformal radiotherapy with infusional 5-fluorouracil and mitomycin C. The IC and ID groups consisted of 19 and 17 patients, respectively, with 14 human immunodeficiency virus-positive (HIV+) and 3 post-solid organ transplant ID patients. There were no significant differences in tumor size, T stage, N stage, chemotherapy doses, or radiation doses between the two groups. Results: With a median follow-up of 3.1 years, no differences were found in overall survival, disease-specific survival, and colostomy-free survival. Three-year overall survival was 83.6% (95% CI = 68.2-100) and 91.7% (95% CI = 77.3-100) in the IC and ID groups, respectively. In addition, there were no differences in acute and late toxicity profiles between the two groups. In the human immunodeficiency virus-positive patients, Cox modeling showed no difference in overall survival by pretreatment CD4 counts (hazard ratio = 0.994, 95% CI = 0.98-1.01). No correlation was found between CD4 counts and the degree of acute toxicities. Conclusion: Our data suggest that standard combined modality therapy with three-dimensional conformal radiotherapy and 5-fluorouracil plus mitomycin C is as safe and effective for ID patients as for IC patients.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    Singh, Siddharth; Verma, Satyajeet; Kala, Sanjay

    2014-01-01

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

  11. Deposition of anal-sac secretions by captive wolves (Canis lupus)

    USGS Publications Warehouse

    Asa, C.S.; Peterson, E.K.; Seal, U.S.; Mech, L.D.

    1985-01-01

    Deposition of anal-sac secretions by captive wolves was investigated by a labelling technique using protein-bound iodine125 and food dye. Wolves deposited secretions on some but not all scats. Adult males, especially the alpha male, deposited anal-sac secretions more frequently while defecating than did females or juveniles. Secretions sometimes also were deposited independently of defecation, suggesting a dual role in communication by these substances.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    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.

  16. An Electronic Daily Diary Study of Anal Intercourse in Drug-Using Women

    PubMed Central

    Fisher, Dennis G.; Laurenceau, Jean-Philippe; Fortenberry, J. Dennis

    2015-01-01

    Women (N = 138) with histories of illicit drug use were recruited into an electronic diary study that used Android smartphones for data collection. The diary was to be completed each day for 12 weeks using an “app” created in HTML5 and accessed over the Internet via smartphone. Data collection included information on sexual behaviors with up to 10 partners per day and contextual factors surrounding sexual behavior such as drug use before/after, type of sexual behavior (oral, vaginal, anal), and other activities such as using condoms for vaginal and anal intercourse and use of sexual lubricants. The sample was predominantly African American (58 %); 20 % Latina, 20 % White and 2 % reported as Other. Most women reported either less than a high school education (33 %) or having a high school diploma (33 %). The mean age was 39 years (SD = 11.78). Anal intercourse occurred on days when women also reported using illicit drugs, specifically methamphetamine and cocaine. Anal intercourse was not an isolated sexual activity, but took place on days when vaginal intercourse and giving and receiving oral sex also occurred along with illicit drug use. Anal intercourse also occurred on days when women reported they wanted sex. HIV prevention interventions must address the risks of anal intercourse for women, taking into account concurrent drug use and sexual pleasure that may reduce individual harm-reduction behaviors. PMID:25835461

  17. An Electronic Daily Diary Study of Anal Intercourse in Drug-Using Women.

    PubMed

    Reynolds, Grace L; Fisher, Dennis G; Laurenceau, Jean-Philippe; Fortenberry, J Dennis

    2015-12-01

    Women (N = 138) with histories of illicit drug use were recruited into an electronic diary study that used Android smartphones for data collection. The diary was to be completed each day for 12 weeks using an "app" created in HTML5 and accessed over the Internet via smartphone. Data collection included information on sexual behaviors with up to 10 partners per day and contextual factors surrounding sexual behavior such as drug use before/after, type of sexual behavior (oral, vaginal, anal), and other activities such as using condoms for vaginal and anal intercourse and use of sexual lubricants. The sample was predominantly African American (58 %); 20 % Latina, 20 % White and 2 % reported as Other. Most women reported either less than a high school education (33 %) or having a high school diploma (33 %). The mean age was 39 years (SD = 11.78). Anal intercourse occurred on days when women also reported using illicit drugs, specifically methamphetamine and cocaine. Anal intercourse was not an isolated sexual activity, but took place on days when vaginal intercourse and giving and receiving oral sex also occurred along with illicit drug use. Anal intercourse also occurred on days when women reported they wanted sex. HIV prevention interventions must address the risks of anal intercourse for women, taking into account concurrent drug use and sexual pleasure that may reduce individual harm-reduction behaviors.

  18. Therapeutic management of anal eczema: an evidence-based review

    PubMed Central

    Havlickova, B; Weyandt, G H

    2014-01-01

    Aim To conduct a systematic review of treatments for anal eczema (AE). Methods We conducted a Medline search for clinical trial data for the treatment of perianal diseases including AE, including papers not published in the English language. We assessed the study reports using the system recommended by the Oxford Centre for Evidence-based Medicine. No meta-analysis was attempted. Results The evidence base for topical treatments used to treat AE is very poor: there are very few studies and many of those that exist are of poor quality. The best evidence was found for medications that are yet to be licensed for AE. Among products with existing licences for the treatment of eczema, our assessment found some evidence to support the continued use of mild-to-moderate corticosteroids first line in most patients. Discussion Features of the perianal region, and the fact that it is almost always occluded, mean that not all medications recommended in the general treatment guidelines for eczema are appropriate for AE. However, there are no specific treatment guidelines for these patients. This may in part be because of the lack of high-quality evidence-based medicine in this therapy area. Many frequently prescribed medications were developed and licensed many years ago, in an era when clinical trial design was not expected to be as rigorous as it is today. Conclusion This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared. PMID:24898365

  19. Dike Propagation Mechanisms from Seismicity Accompanying the 2014 Bárðarbunga-Holuhraun Fissure Eruption, Iceland

    NASA Astrophysics Data System (ADS)

    Woods, J.; Ágústsdóttir, T.; Greenfield, T. S.; Green, R. G.; White, R. S.; Brandsdottir, B.

    2015-12-01

    We present data from our dense seismic network which captured in unprecedented detail the micro-seismicity associated with the 2014 dike intrusion from the subglacial Bárðarbunga volcano in central Iceland. Over 30,000 automatically located earthquakes delineate a complex 46 km dike propagation during the days preceding the onset of effusive magmatism at the Holuhraun lava field on 29 August 2014. Approximately 1.5 km3 of lava was erupted, making this the largest eruption in Iceland for over 200 years.Micro-seismicity tracks the lateral migration of the dike, with a concentration of earthquakes in the advancing tip where stresses are greatest, and trailing zones of lesser or no seismicity behind. Onset of an initial 4 hour fissure eruption was accompanied simultaneously by a backward retreat in seismic activity, followed by a gradual re-advance prior to the onset of a second, sustained fissure eruption in the same location on 31 August. Rock fracture mechanisms are determined from fault plane solutions of these seismic events. At the tip of the advancing dike, left-lateral strike-slip faulting parallel to the propagation is dominant, utilising pre-existing lineations and releasing stress accumulated in the brittle layer from rift zone extension. Behind the dike tip, both right-lateral and left-lateral strike-slip earthquakes are found, marking failure of solidifying magma plugs within the dike conduit. Contrary to many models of dike propagation, both normal faulting and failure at high angles to the dike are rare. Furthermore, a distinct lack of seismicity is observed in the 3-4 km region beneath the surface rupture. This suggests that opening is occuring aseismically, with earthquakes focused at the base of the dike near the brittle-ductile boundary.

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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 (p<0.05) than LF (0.49) and V (0.03) for detecting caries, but there were no significant differences among the methods in specificity (V 1.00; LF 0.67; DELF 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.

  2. Comparison of Hybribio GenoArray and Roche human papillomavirus (HPV) linear array for HPV genotyping in anal swab samples.

    PubMed

    Low, Huey Chi; Silver, Michelle I; Brown, Brandon J; Leng, Chan Yoon; Blas, Magaly M; Gravitt, Patti E; Woo, Yin Ling

    2015-02-01

    Human papillomavirus (HPV) is causally associated with anal cancer, as HPV DNA is detected in up to 90% of anal intraepithelial neoplasias and anal cancers. With the gradual increase of anal cancer rates, there is a growing need to establish reliable and clinically relevant methods to detect anal cancer precursors. In resource-limited settings, HPV DNA detection is a potentially relevant tool for anal cancer screening. Here, we evaluated the performance of the Hybribio GenoArray (GA) for genotyping HPV in anal samples, against the reference standard Roche Linear Array (LA). Anal swab samples were obtained from sexually active men who have sex with men. Following DNA extraction, each sample was genotyped using GA and LA. The overall interassay agreement, type-specific, and single and multiple genotype agreements were evaluated by kappa statistics and McNemar's χ(2) tests. Using GA and LA, 68% and 76% of samples were HPV DNA positive, respectively. There was substantial interassay agreements for the detection of all HPV genotypes (κ = 0.70, 86% agreement). Although LA was able to detect more genotypes per sample, the interassay agreement was acceptable (κ = 0.53, 63% agreement). GA had poorer specific detection of HPV genotypes 35, 42, and 51 (κ < 0.60). In conclusion, GA and LA showed good interassay agreement for the detection of most HPV genotypes in anal samples. However, the detection of HPV DNA in up to 76% of anal samples warrants further evaluation of its clinical significance.

  3. Relation between rectal sensation and anal function in normal subjects and patients with faecal incontinence.

    PubMed Central

    Sun, W M; Read, N W; Miner, P B

    1990-01-01

    The relation between sensory perception of rapid balloon distension of the rectum and the motor responses of the rectum and external and internal anal sphincters in 27 normal subjects and 16 patients with faecal incontinence who had impaired rectal sensation but normal sphincter pressures was studied. In both patients and normal subjects, the onset and duration of rectal sensation correlated closely with the external anal sphincter electrical activity (r = 0.8, p less than 0.0001) and with rectal contraction (r = 0.51, p less than 0.001), but not with internal sphincter relaxation. All normal subjects perceived a rectal sensation within one second of rapid inflation of a rectal balloon with volumes of 20 ml or less air. Six patients did not perceive any rectal sensation until 60 ml had been introduced, while in the remaining nine patients the sensation was delayed by at least two seconds. Internal sphincter relaxation occurred before the sensation was perceived in three of 27 normal subjects and 11 of 16 patients (p less than 0.001), and could be associated with anal leakage, which stopped as soon as sensation was perceived. The lowest rectal volumes required to induce anal relaxation, to cause sustained relaxation, or to elicit sensations of a desire to defecate or pain were similar in patients and normal subjects. In conclusion, these results show the close association between rectal sensation and external anal sphincter contraction, and show that faecal incontinence may occur as a result of delayed or absent external anal sphincter contraction when the internal anal sphincter is relaxed. PMID:2210452

  4. Chronic migraine.

    PubMed

    Schwedt, Todd J

    2014-03-24

    Chronic migraine is a disabling neurologic condition that affects 2% of the general population. Patients with chronic migraine have headaches on at least 15 days a month, with at least eight days a month on which their headaches and associated symptoms meet diagnostic criteria for migraine. Chronic migraine places an enormous burden on patients owing to frequent headaches; hypersensitivity to visual, auditory, and olfactory stimuli; nausea; and vomiting. It also affects society through direct and indirect medical costs. Chronic migraine typically develops after a slow increase in headache frequency over months to years. Several factors are associated with an increased risk of transforming to chronic migraine. The diagnosis requires a carefully performed patient interview and neurologic examination, sometimes combined with additional diagnostic tests, to differentiate chronic migraine from secondary headache disorders and other primary chronic headaches of long duration. Treatment takes a multifaceted approach that may include risk factor modification, avoidance of migraine triggers, drug and non-drug based prophylaxis, and abortive migraine treatment, the frequency of which is limited to avoid drug overuse. This article provides an overview of current knowledge regarding chronic migraine, including epidemiology, risk factors for its development, pathophysiology, diagnosis, management, and guidelines. The future of chronic migraine treatment and research is also discussed.

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

    PubMed Central

    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

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

    PubMed

    Nagai, Yuzo; 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

    2016-10-01

    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.

  7. Anal heterosex among young people and implications for health promotion: a qualitative study in the UK

    PubMed Central

    Marston, C; Lewis, R

    2014-01-01

    Objective To explore expectations, experiences and circumstances of anal sex among young people. Design Qualitative, longitudinal study using individual and group interviews. Participants 130 men and women aged 16–18 from diverse social backgrounds. Setting 3 contrasting sites in England (London, a northern industrial city, rural southwest). Results Anal heterosex often appeared to be painful, risky and coercive, particularly for women. Interviewees frequently cited pornography as the ‘explanation’ for anal sex, yet their accounts revealed a complex context with availability of pornography being only one element. Other key elements included competition between men; the claim that ‘people must like it if they do it’ (made alongside the seemingly contradictory expectation that it will be painful for women); and, crucially, normalisation of coercion and ‘accidental’ penetration. It seemed that men were expected to persuade or coerce reluctant partners. Conclusions Young people's narratives normalised coercive, painful and unsafe anal heterosex. This study suggests an urgent need for harm reduction efforts targeting anal sex to help encourage discussion about mutuality and consent, reduce risky and painful techniques and challenge views that normalise coercion. PMID:25122073

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

    PubMed

    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.

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

    PubMed

    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.

  10. Rectal atresia and anal stenosis: the difference in the operative technique for these two distinct congenital anorectal malformations.

    PubMed

    Lane, V A; Wood, R J; Reck, C; Skerritt, C; Levitt, M A

    2016-04-01

    Rectal atresia and anal stenosis are rare forms of anorectal malformations. The aim of the definitive surgical repair in such cases is to preserve the anal canal, the dentate line, and the sphincter complex. We present a case of rectal atresia and anal stenosis to demonstrate the differences in the operative repair. The techniques described leave the anterior wall of the very distal anal canal untouched in both rectal stenosis and anal atresia; however, the dissection of the rectum differs. The atretic rectum in rectal atresia is mobilized and sutured to the anal canal circumferentially. In anal stenosis, the posterior rectum is mobilized in the form of rectal advancement, and the posterior 180° is anastomosed directly to the skin (as in a standard PSARP) with preservation of the anal canal as the anterior 180° of the final anoplasty. These patients have an excellent prognosis for bowel control and fecal continence, and therefore, complete mobilization and resection of the anal canal must be avoided.

  11. Electrical activity from smooth muscle of the anal sphincteric area of the cat.

    PubMed Central

    Bouvier, M; Gonella, J

    1981-01-01

    1. The electrical activities of longitudinal and circular smooth muscle of the anal sphincteric area have been studied in the cat. 2. Electromyographic recordings were achieved with extracellular electrodes, in vivo on acute and chronic animals, and in vitro on the isolated organ. In addition, electrical and mechanical activities were recorded from muscle strips with the sucrose gap technique. 3. Circular muscle coat electrical activity consisted exclusively of slow variations of the membrane potential of the smooth muscle cells. Each slow potential variation was followed by a contraction. 4. The electrical activity and the concomitant contractions were tetrodotoxin resistant (10(-6) g/ml.). Both disappeared in Ca-free solution or in the presence of Mn ions (10(-3) M). 5. On circular muscle, noradrenaline (10(-8)-10(-7) g/ml. in vitro, or 0.1-0.15 mg/kg in vivo) had an excitatory effect consisting in an increase of slow potential frequency. The action of noradrenaline was antagonized by phentolamine (10(-6)-10(-5) g/ml. in vitro, or 0.2 mg/kg in vivo). 6. On circular muscle, acetylcholine (10(-8)-10(-6) g/ml.), used exclusively on muscle strips, did never produce any clear cut effect. 7. Longitudinal muscle coat electrical activity consisted of spike potentials superimposed on slow time course depolarizations which were never observed alone. Each spike was followed by a contraction. This electrical activity was tetrodotoxin resistant (10(-6) g/ml.). 8. Longitudinal muscle activity was abolished by noradrenaline (10(-6) g/ml.) and enhanced by acetylcholine (10(-8)-10(-6) g/ml.). The action of noradrenaline was antagonized by propranolol (0.2 mg/kg I.V.; 10(-6) g/ml.) and that of acetylcholine by atropine (10(-7) g/ml.). 9. Electrophysiological and pharmacological data indicate that electromechanical coupling is achieved (1) in circular muscle, through Ca dependent slow variations in membrane potential of the muscle cells and (2) in longitudinal muscle, through spike

  12. Potential for aquifer compaction, land subsidence, and earth fissures in Avra Valley, Pima and Pinal counties, Arizona

    USGS Publications Warehouse

    Anderson, S.R.

    1987-01-01

    Avra Valley is a large north-trending alluvial basin about 15 mi west of Tucson in Pima and Pinal Counties, Arizona. The climate of Avra Valley is semiarid, and the average annual precipitation ranges from 8 to 12 in. Two major ephemeral streams, the Santa Cruz River and Brawley Wash, drain the area. These streams and their tributaries provide a source of recharge to an extensive alluvial aquifer that underlies the valley floor. The aquifer consists of interbedded gravel, sand, silt, and clay and contains a vast quantity of groundwater. The physiography, fertile soil, and mild climate of Avra Valley make it an ideal environment for agriculture and urban development. Although the aquifer is replenished by natural recharge and underflow, rates of recharge and underflow have not kept pace with the rate of pumping. Pumping has exceeded recharge for several decades, resulting in a lowering of groundwater levels throughout most of the valley. In places, water level declines have resulted in small amounts of aquifer compaction and land subsidence. Earth fissures, some of which may be the result of localized differential subsidence, also have been observed in the valley. Geohydrologic characteristics of Avra Valley that may contribute to potential aquifer compaction, land subsidence, and earth fissures are described. The quantitative evaluation of potential land subsidence in this report is presented as an interim land- and water-use planning tool pending acquisition and study of additional data. Because of data limitations, the evaluation is made on the assumption that future rates of compaction and subsidence in Avra Valley will be similar to those in the Eloy-Picacho area. The evaluation also assumes that water level declines in the aquifer will continue. Several factors that may reduce groundwater withdrawals, and thus the potential for compaction and subsidence in Avra Valley, were not evaluated. These factors include the enactment of the 1980 Arizona Ground

  13. Extrapulmonary Small Cell Carcinoma of the Anal Canal: A Case Report and Review of the Literature

    PubMed Central

    Eberhardt, Joshua M.; Brown, Karen; Lo, Shelly; Nagda, Suneel; Yong, Sherri

    2012-01-01

    Purpose. Extrapulmonary small cell carcinoma affecting the anal canal is a rare and poorly understood entity which can, in its early stages, masquerade as benign anorectal disease such as hemorrhoids. Methods. We report a case of this rare malignancy which initially presented with hematochezia and anal pain. We also review the literature with regard to previously described cases and management strategies including the role of surgery. Results. Despite aggressive multidisciplinary treatment consisting of chemotherapy and radiation, the disease progressed rapidly with dissemination occurring only three months after completion of treatment. Because of the aggressive nature of this tumor, the treatment options for this almost universally fatal malignancy are often palliative in nature. Conclusion. Chemoradiotherapy is likely the most reasonable approach to extrapulmonary small cell carcinoma of the anal canal given its aggressiveness. PMID:22454644

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

    NASA Astrophysics Data System (ADS)

    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 < 0.001. So, CO2 laser is proved to be a definitely practical tool in surgical use for its bacteria killing power. While the 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.

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

    PubMed

    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.

  16. Summary of emerging targets in anal cancer: the case for an immunotherapy based-approach

    PubMed Central

    Morris, Van

    2016-01-01

    Squamous cell carcinoma of the anal canal (SCCA) remains a less common gastrointestinal malignancy despite a continued increase in the annual incidence in the United States and globally. The vast majority of all cases are attributed to persistent infection and integration into host cell DNA by human papillomavirus (HPV). For patients with metastatic anal cancer, there is currently no accepted consensus standard of care. Given the viral etiology associated with the oncogenesis of this tumor, great interest exists for the development of immunotherapy as a novel approach to improving clinical outcomes for patients afflicted with this disease. This review highlights various immunotherapies under investigation in the treatment of advanced human malignancies and discusses their potential as future treatments for metastatic anal cancer. PMID:27747086

  17. Combined radical radiation therapy and chemotherapy for primary squamous cell carcinoma of the anal canal

    SciTech Connect

    Cummings, B.J.; Rider, W.D.; Harwood, A.R.; Keane, T.J.; Thomas, G.M.; Erlichman, C.; Fine, S.

    1982-03-01

    Radical radiation therapy (5000 rads in 20 fractions in 4 weeks) combined with iv mitomycin (10 mg/m2) and 5-FU (1000 mg/m2/24 hours for 4 days) was used to treat 13 patients with locally advanced but operable squamous cell carcinoma of the anal canal. All patients achieved local control and retained anal continence, and none developed metastases. The patients were followed from 4 to 34 months (median, 12). Severe acute gastrointestinal toxic effects were seen in three patients; the same patients had significant thrombocytopenia or leukopenia. Treatment with this combined program may allow conservative management of squamous cell carcinoma of the anal canal and should be considered as an alternative to abdominoperineal resection.

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

    PubMed Central

    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 (<30 years of age), predominantly Black, men who have 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

  19. Intensity-Modulated Radiation Therapy for Anal Malignancies: A Preliminary Toxicity and Disease Outcomes Analysis

    SciTech Connect

    Pepek, Joseph M.; Willett, Christopher G.; Wu, Q. Jackie; Yoo, Sua; Clough, Robert W.; Czito, Brian G.

    2010-12-01

    Purpose: Intensity-modulated radiation therapy (IMRT) has the potential to reduce toxicities associated with chemoradiotherapy in the treatment of anal cancer. This study reports the results of using IMRT in the treatment of anal cancer. Methods and Materials: Records of patients with anal malignancies treated with IMRT at Duke University were reviewed. Acute toxicity was graded using the NCI CTCAEv3.0 scale. Overall survival (OS), metastasis-free survival (MFS), local-regional control (LRC) and colostomy-free survival (CFS) were calculated using the Kaplan-Meier method. Results: Forty-seven patients with anal malignancy (89% canal, 11% perianal skin) were treated with IMRT between August 2006 and September 2008. Median follow-up was 14 months (19 months for SCC patients). Median radiation dose was 54 Gy. Eight patients (18%) required treatment breaks lasting a median of 5 days (range, 2-7 days). Toxicity rates were as follows: Grade 4: leukopenia (7%), thrombocytopenia (2%); Grade 3: leukopenia (18%), diarrhea (9%), and anemia (4%); Grade 2: skin (93%), diarrhea (24%), and leukopenia (24%). The 2-year actuarial overall OS, MFS, LRC, and CFS rates were 85%, 78%, 90% and 82%, respectively. For SCC patients, the 2-year OS, MFS, LRC, and CFS rates were 100%, 100%, 95%, and 91%, respectively. Conclusions: IMRT-based chemoradiotherapy for anal cancer results in significant reductions in normal tissue dose and acute toxicities versus historic controls treated without IMRT, leading to reduced rates of toxicity-related treatment interruption. Early disease-related outcomes seem encouraging. IMRT is emerging as a standard therapy for anal cancer.

  20. Diversity of human papillomavirus in the anal canal of men: The HIM study

    PubMed Central

    Sichero, Laura; Nyitray, Alan G.; Nunes, Emily Montosa; Nepal, Bal; Ferreira, Silvaneide; Sobrinho, João S.; Baggio, Maria Luiza; Galan, Lenice; Silva, Roberto C.; Lazcano-Ponce, Eduardo; Giuliano, Anna R.; Villa, Luisa L.

    2015-01-01

    Human papillomavirus (HPV) infections are associated with development of anogenital lesions in men. There are no reports describing the distribution of non-alpha HPV types in the anal canal of a sexually diverse men group. The HIM (HPV in Men) Study is a multicenter study of the natural history of HPV infection in Brazil, Mexico and USA. At baseline, 12% of anal canal specimens PCR HPV-positive were not typed by the Roche Linear Array and were considered unclassified. Our goal was characterizing HPVs among these unclassified specimens at baseline and assess associations with participant socio-demographic and behavioral characteristics. Unclassified HPVs were typed by sequencing amplified PGMY09/11 products or cloning of PGMY/GP+ nested amplicons followed by sequencing. Further analysis was conducted using FAP primers. Of men with unclassified HPV at the anal canal, most (89.1%) were men who have sex with women (MSW). Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. A total of 18, 26, and 3 different α-, β- and γ-HPV types were detected, respectively. Compared to older men (45-70 years), α-HPVs were more commonly detected among young men (18-30 years) whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than non-heterosexual men. β2-HPV types composed all β-HPVs detected among non-heterosexual men. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse. PMID:25698660

  1. Locomotion of free-swimming ghost knifefish: anal fin kinematics during four behaviors.

    PubMed

    Youngerman, Eric D; Flammang, Brooke E; Lauder, George V

    2014-10-01

    The maneuverability demonstrated by the weakly electric ghost knifefish (Apteronotus albifrons) is a result of its highly flexible ribbon-like anal fin, which extends nearly three-quarters the length of its body and is composed of approximately 150 individual fin rays. To understand how movement of the anal fin controls locomotion we examined kinematics of the whole fin, as well as selected individual fin rays, during four locomotor behaviors executed by free-swimming ghost knifefish: forward swimming, backward swimming, heave (vertical) motion, and hovering. We used high-speed video (1000 fps) to examine the motion of the entire anal fin and we measured the three-dimensional curvature of four adjacent fin rays in the middle of the fin during each behavior to determine how individual fin rays bend along their length during swimming. Canonical discriminant analysis separated all four behaviors on anal fin kinematic variables and showed that forward and backward swimming behaviors contrasted the most: forward behaviors exhibited a large anterior wavelength and posterior amplitude while during backward locomotion the anal fin exhibited both a large posterior wavelength and anterior amplitude. Heave and hover behaviors were defined by similar kinematic variables; however, for each variable, the mean values for heave motions were generally greater than for hovering. Individual fin rays in the middle of the anal fin curved substantially along their length during swimming, and the magnitude of this curvature was nearly twice the previously measured maximum curvature for ray-finned fish fin rays during locomotion. Fin rays were often curved into the direction of motion, indicating active control of fin ray curvature, and not just passive bending in response to fluid loading.

  2. Ascending and descending reflex motor activity of recto-anal region-cholinergic and nitrergic implications in a rat model.

    PubMed

    Radomirov, Radomir; Ivancheva, Christina; Brading, Alison F; Itzev, Dimitar; Rakovska, Angelina; Negrev, Negrin

    2009-04-29

    The implications of cholinergic and nitrergic transmissions in ascending and descending reflex motor pathways of recto-anal region in rat model were evaluated using: (i) electrical stimulation; (ii) triple organ bath; and (iii) morphological techniques. Electrical stimulation to anal canal induced simultaneous ascending contractile responses of longitudinal and circular muscles of proximal rectum, local contraction of anal canal or contraction followed by relaxation of internal anal sphincter when external sphincter was dissected off. The stimulation of proximal rectum elicited local contractions of both rectal layers and descending contractions of internal sphincter or anal canal. Tetrodotoxin (0.1 microM) prevented the electrically elicited events. The ascending excitatory responses and the local and ascending contractions of longitudinal muscle were more pronounced than those of circular muscle suggesting dominant role of ascending reflex pathways and of longitudinal muscle in rectal motor activity. Choline acetyltransferase (ChAT)-containing fibres and nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase-positive neurons were observed in myenteric ganglia of rectum and anal canal. NG-nitro-l-arginine (0.5mM) increased the contractile ascending and descending responses. During atropine (0.3 microM) treatment the ascending and descending contractions were suppressed but not abolished and a relaxation revealed in ascending response of circular muscle and in descending responses of internal anal sphincter and anal canal. The relaxation was decreased by NG-nitro-l-arginine and increased by l-arginine (0.5mM). The results suggest that cholinergic excitatory ascending and descending pathways and nitric oxide-dependent inhibitory ascending neurotransmission(s) to rectal circular muscle and inhibitory descending to internal anal sphincter and anal canal are involved in reflex circuitry controlling motor activity of recto-anal region.

  3. Anal Canal Carcinoma in a Child With Disorders of Sex Development.

    PubMed

    Watanabe, Toshihiko; Horikawa, Reiko; Masaki, Hidekazu; Yoshioka, Takako; Matsumoto, Kimikazu; Kanamori, Yutaka

    2016-07-01

    Squamous cell carcinoma of the anal canal in children is rare. To date, the etiology and outcome of this condition have been not fully understood. Here, we report an 11-year-old child with anal canal cancer who had concomitant disorders of sex development. Radiotherapy followed by salvage surgery achieved disease-free survival of 3 years. Since overexpression of cell cycle regulatory protein p16 was immunohistochemically evident in tumor tissue, human papillomavirus infection was considered as a causative factor in the carcinogenesis.

  4. Human Papillomavirus at Multiple Sites Associated with Anal Squamous Intraepithelial Lesions in HIV-Seropositive Individuals

    PubMed Central

    Chuang, Eleanore; Lim, Eunjung; Milne, Cris; Zhu, Xuemei; Agsalda, Melissa; Killeen, Jeffrey; Miller, F DeWolfe; Hernandez, Brenda Y.; Shiramizu, Bruce

    2016-01-01

    Objective HIV-Seropositive patients have higher risk of HPV infection even on anti-retroviral therapy. Infection with high-risk HPV genotypes can cause dysplasia leading to cancer. This study assessed HPV at different anatomical sites in HIV-seropositive individuals and factors associated with anal squamous intraepithelial lesions (ASIL). Methods Specimens were obtained from multiple anatomical sites for each participant in conjunction with routine screening for anal dysplasia. Female specimens included cervical and anal cytologies and oral wash. Male specimens included anal cytologies, oral wash, and exfoliated cells from penile head, penile shaft, scrotum, and from uncircumcised subjects, inner foreskin. Demographic and clinical characteristics were recorded. Following DNA extraction, HIV DNA copy was assessed by qPCR; HPV was genotyped. Statistical analyses included calculation of odds ratios (OR) and 95% confidence intervals (CI), t-tests or Mann-Whitney tests. Results Males were more likely to have ASIL: 29/50 (58%) compared to 1/11 females (9%) (OR=13.81, 95% CI: 1.64–116.32). HPV 6 or 11 in anal specimens was significantly associated with ASIL (OR= 6.29, 95% CI: 1.49–26.44). Number of HPV genotypes in anal specimens was also significant: ASIL+ (3.4 ± 3.1) versus ASIL− (1.6 ± 3.1) (p=0.009). Among 44 males, HPV was detected from at least one anatomical site for 33 participants (75%): 27 anus (61%), 19 oral wash (44%), 17 penile shaft (39%), 11 scrotum (26%), 10 penile head (23%), 0 foreskin. Detection of HPV in penile shaft specimens was significantly associated with ASIL (OR=6.79, 95% CI: 1.57–29.36) as was number of HPV genotypes in penile shaft specimens: ASIL+ (2.4 ± 4.0) versus ASIL− (0.6 ± 1.7) (p=0.025). Only 1/11 females had ASIL; only 1/11 females had cervical dysplasia: OR was not estimable due to small numbers. Conclusions Males were more prone to ASIL than females. HPV at anal as well as non-anal sites may be indicative of ASIL. PMID

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

    PubMed

    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.

  6. Application of YAG laser technique in the treatment of anal fistula

    NASA Astrophysics Data System (ADS)

    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.

  7. RECURRENT ECTOPIC CRANIOPHARYNGIOMA IN THE SYLVIAN FISSURE THIRTY YEARS AFTER RESECTION THROUGH A PTERIONAL APPROACH: A CASE REPORT AND REVIEW OF THE LITERATURE

    PubMed Central

    CLARK, SHANNON W.; KENNING, TYLER J.; EVANS, JAMES J.

    2015-01-01

    ABSTRACT Local recurrence of craniopharyngiomas after apparently complete resection occurs frequently. Ectopic recurrence remote from the original site has been reported in 18 adult patients. The interval between the original diagnosis and the time of recurrence varies widely in these reports (1–26 years). We report a case of an ectopic recurrence in the sylvian fissure of an adamantinomatous type craniopharyngioma 34 years after the initial presentation and 30 years after the last surgical resection. In addition to this being the latest reported ectopic recurrence, the location of this new lesion in the sylvian fissure is fairly rare, having been reported in only three other cases. We also reviewed the English literature for reports of ectopic recurrent craniopharyngiomas in order to conduct an analysis of surveillance and treatment strategies. PMID:25797995

  8. Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus

    PubMed Central

    Yamada, Shigeki; Ishikawa, Masatsune; Iwamuro, Yasushi; Yamamoto, Kazuo

    2016-01-01

    To clarify the pathogenesis of two different types of adult-onset normal-pressure hydrocephalus (NPH), we investigated cerebrospinal fluid distribution on the high-field three-dimensional MRI. The subarachnoid spaces in secondary NPH were smaller than those in the controls, whereas those in idiopathic NPH were of similar size to the controls. In idiopathic NPH, however, the basal cistern and Sylvian fissure were enlarged in concurrence with ventricular enlargement towards the z-direction, but the convexity subarachnoid space was severely diminished. In this article, we provide evidence that the key cause of the disproportionate cerebrospinal fluid distribution in idiopathic NPH is the compensatory direct CSF communication between the inferior horn of the lateral ventricles and the ambient cistern at the choroidal fissure. In contrast, all parts of the subarachnoid spaces were equally and severely decreased in secondary NPH. Blockage of CSF drainage from the subarachnoid spaces could cause the omnidirectional ventricular enlargement in secondary NPH. PMID:27941913

  9. Turbulent atmospheric plumes above line sources with an application to volcanic fissure eruptions on the terrestrial planets

    NASA Technical Reports Server (NTRS)

    Stothers, Richard B.

    1989-01-01

    The theory of turbulent plumes maintained above steady line sources of buoyancy is worked out in detail within the limitations of Taylor's entrainment assumption. It is applied to the structure of a pure plume injected into a stably stratified atmosphere. Volcanic basalt eruptions that develop from long, narrow vents create line source plumes, which rise well above the magmatic fire fountains playing near the ground level. The eruption of Laki in 1783 may provide an example of this style of eruption. Flood basalts are more ancient examples. Evidence of enormous fissure eruptions that occurred in the past on Mars and Venus also exists. Owing to the different properties of the atmospheres on these two planets from those on the earth, heights of line source plumes are expected to vary in the ratios 1:6:0.6 (earth:Mars:Venus). It is very unlikely that the observed increase of sulfur dioxide above the Venusian cloud deck in 1978 could have been due to a line source volcanic eruption, even if it had been a flood basalt eruption.

  10. Comparative study of fluoride released and recharged from conventional pit and fissure sealants versus surface prereacted glass ionomer technology

    PubMed Central

    Salmerón-Valdés, Elias Nahum; Scougall-Vilchis, Rogelio J; Alanis-Tavira, Jorge; Morales-Luckie, Raúl Alberto

    2016-01-01

    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 8th 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. PMID:26957792

  11. Dental depth profilometric diagnosis of pit & fissure caries using frequency-domain infrared photothermal radiometry and modulated laser luminescence

    NASA Astrophysics Data System (ADS)

    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.

  12. 640-Slice CT Measurement of Superior Orbital Fissure as Gateway for Light into the Brain: Statistical Evaluation of Area and Distance

    PubMed Central

    La Marra, Alice; Quarchioni, Simone; Ferrari, Fabiana; Gravina, Giovanni Luca; Barile, Antonio; Gregori, Lorenzo Maria; Di Cesare, Ernesto

    2016-01-01

    Objective Our aim was to provide normative data concerning superior orbital fissure area (SOFA), ocular skin and the substantia nigra (D-SS) and orbital fissure and the substantia nigra (D-SOF-S) distances by CT scan in adult Caucasian population Methods The area of the superior orbital fissure (SOF), the distance between the ocular skin and the substantia nigra and the distance between the superior orbital fissure and the substantia nigra using CT and 3D-CT images. Results Normative data stratified for age and gender were obtained. The data here reported show that some degree of variability in SOFA, D-SS and D-SOF-S measurements can be observed healthy Caucasian subjects. Gender stratified prediction intervals (mean +/- 2 Standard Deviations) for SOFA and D-SOF-S were 69.2 (+/-15.8) and 38.4 (+/-7.6) for male and 56.8 (+/-11.9) and 36.5 (+/-6.1) for female, respectively. Age and gender significantly impacted on D-SS values and normative data were constructed generating data stratified for these two variables. D-SS was 89.4 (+/-10.3) and 86.4 (+/-9.7) for male and female, respectively. Conclusions Here we provide adjunctive anatomical information on specific anatomical cerebral zones. Our data may have implications for surgeons actively committed to treat pathological conditions involving these cerebral areas. Additionally, the anatomical variability found with respect to SOF and the potential different exposure of the substanzia nigra to the bright light could play a role in Parkinson’s disease as already speculated in literature. PMID:27661082

  13. 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

    PubMed Central

    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 (p<0.05) after three and six months follow up. The difference in sealant retention in primary and permanent molars was not significant (p>0.05). 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

  14. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

    PubMed Central

    Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles. PMID:28234947

  15. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    PubMed

    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.

  16. Chronic Pericarditis

    MedlinePlus

    ... unknown. However, it may be caused by cancer, tuberculosis , or an underactive thyroid gland ( hypothyroidism ), and it ... a previous injury, or a bacterial infection. Previously, tuberculosis was the most common cause of chronic pericarditis ...

  17. [Chronic migraine].

    PubMed

    Diener, H C; Holle, D; Müller, D; Nägel, S; Rabe, K

    2013-12-01

    The classification of the International Headache Society (IHS) generally differentiates episodic from chronic headache. Chronic migraine is defined as headache on 15 and more days a month over more than 3 months and headache on 8 days or more fulfils the criteria for migraine or were triptan/ergot-responsive when thought to be migrainous in early stages of the attack. The prevalence of chronic migraine is estimated at 2-4 %. The quality of life is highly compromised in this condition and comorbidities are much more frequent compared to episodic migraine. Data from prospective randomized studies are scarce as most patients with chronic migraine were excluded from previous trials and only few studies were conducted for this condition. The efficacy for prophylactic treatment compared with placebo is proven for topiramate and onabotulinum toxin A.

  18. Repeat ileal pouch-anal anastomosis to salvage septic complications of pelvic pouches: clinical outcome and quality of life assessment.

    PubMed Central

    Fazio, V W; Wu, J S; Lavery, I C

    1998-01-01

    OBJECTIVE: To evaluate the outcome of repeat ileal pouch-anal anastomosis (IPAA) for septic complications of pelvic pouch surgery; to assess the relationship between diagnosis and outcome; to assess quality of life after surgery. SUMMARY BACKGROUND DATA: Pelvic and perineal sepsis due to ileal pouch-anal anastomotic leaks frequently results in pouch loss. Many surgeons believe that pelvic sepsis and/or dense pelvic fibrosis makes salvage surgery unsafe or that pouches salvaged under these circumstances may not function well. As a result, there are few studies of pouch salvage procedures for septic indications. METHODS: The authors reviewed records of Cleveland Clinic Foundation patients who had undergone repeat IPAA surgery after septic complications from previous pelvic pouch surgery and who had completed at least 6 months of follow-up. Final diagnoses included ulcerative colitis (n = 22), Crohn's disease (n = 10), indeterminate colitis (n = 1), and familial polyposis (n = 2). Patients with functioning pouches were interviewed about functional problems and quality of life using an in-house questionnaire and the validated SF-36 Health Survey. RESULTS: Of 35 patients, 30 (86%) had a functioning pouch 6 months after repeat IPAA. In 4 patients, complications led to pouch removal or fecal diversion. One patient declined stoma closure. Of the patients with mucosal ulcerative colitis (MUC), 95% (21/22) had a functioning pouch 6 months after surgery. For patients with Crohn's disease (CD) 60% (6/10) have maintained a functioning pouch. Of the 30 patients with functioning pouches, 17 (57%) rated their quality of life as either "good" or "excellent," the remaining 13 (43%) selected "fair" or "poor." All said they would choose repeat IPAA surgery again. An SF-36 Health Survey completed by all patients with a functioning pouch at follow-up showed a mean physical component scale of 46.4 and a mean mental component scale of 47.6, scores well within the normal limit. CONCLUSIONS

  19. Gracilis muscle transposition as a workhorse flap for anal incontinence: Quality of life and functional outcome in adults

    PubMed Central

    Kalra, Guru Dayal Singh; Sharma, Amit Kumar; Shende, Kaustubh Sharad

    2016-01-01

    Background/Purpose: Anal incontinence is one of the most psychologically and socially debilitating conditions in an otherwise healthy individual. It can lead to social isolation, loss of self-esteem, self-confidence and depression. This study is devoted to the problem of anal incontinence in the adult patients. The aim of our study is to analyse the results of gracilis muscle transposition for anal incontinence and improvement in quality of life (QOL) of patients. Materials and Methods: This was a retrospective study. A total of 18 patients with complaint of anal incontinence were enrolled in this study. All patients were treated with gracilis muscle transposition. Results: All patients are continent, and there is an improvement in their QOL. Conclusion: Gracilis muscle transposition is a good option for patients of anal incontinence who are not treated by non-surgical means. PMID:28216815

  20. Chronic prostatitis

    PubMed Central

    2011-01-01

    Introduction 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. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for chronic bacterial prostatitis? What are the effects of treatments for chronic abacterial prostatitis/chronic pelvic pain syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 33 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, allopurinol, alpha-blockers, biofeedback, local injections of antimicrobial drugs, mepartricin, non-steroidal anti-inflammatory drugs (NSAIDs), oral antimicrobial drugs, pentosan polysulfate, prostatic massage, quercetin, radical prostatectomy, sitz baths, transurethral microwave thermotherapy, and transurethral resection. PMID:21736764

  1. Definition and Facts for Constipation in Children

    MedlinePlus

    ... action of the colon is not enough to push the stool out. Anal fissures Anal fissures are ... History Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney ...

  2. Anoscopy

    MedlinePlus

    ... polyps - anoscopy; Foreign object in the anus - anoscopy; Hemorrhoids - anoscopy; Anal warts - anoscopy ... fissures Anal polyps Foreign object in the anus Hemorrhoids Infection Inflammation Tumors

  3. Salvage abdominoperineal resection and perineal wound healing in local recurrent or persistent anal cancer.

    PubMed

    Ferenschild, Floris T J; Vermaas, Maarten; Hofer, Stefan O; Verhoef, Cornelis; Eggermont, Alexander M M; de Wilt, Johannes H W

    2005-11-01

    The primary treatment for anal cancer is chemoradiation (CRT). Failures after CRT are potentially curable with an abdominoperineal resection (APR). A major problem of surgery in the anal area is poor healing of the perineal wound. Between 1985 and 2000, 129 patients treated for anal cancer were retrospectively reviewed. Of the 24 patients with local failure, 18 patients were treated with an APR. The aim of this study was to review the results and long-term outcome after salvage APR, with special emphasis on perineal wound healing. Mean age at diagnosis was 59 (range: 41-83) years. After a median of 16 months, only 2 patients developed a local recurrence. The 5-year overall survival was 30%. In 11 patients the perineal wound was closed primarily, in 3 patients the perineal wound was left open, and in 4 patients a vertical rectus abdominus musculocutaneous (VRAM) flap was used. Perineal wound breakdown occurred in 5 of the 14 patients (36%) not treated with primary muscle reconstruction. In all patients treated with a VRAM flap the perineal wound healed primarily. In the present study salvage APR in recurrent or persistent anal cancer results in good local control and 5-year overall survival of 30%. When performing an APR a VRAM flap reconstruction should be considered to prevent disabling perineal wound complications.

  4. A liquid-film forming acrylate cream for the treatment of anal pruritus.

    PubMed

    Tomi, Nordwig; Weiser, Rudolf; Strohal, Robert; Mittlboeck, Martina

    Pruritus ani is a hidden but frequently occurring clinical condition, with a large impact on patients' quality of life. Currently, therapeutic options are scarce, offering mainly limited success. The authors performed a prospective, open-label, two-centre pilot study to analyse the efficacy and safety of a liquid-film forming acrylate cream for the treatment of pruritus ani and peri-anal skin irritation. A total of 28 patients were included and applied the cream to the cleansed anal and peri-anal skin once daily for a study period of 3-4 weeks. The primary outcome measure was the reduction of pruritis ani, comparing day 0 to day 28 results. For this purpose, a visual analog scale (VAS) was used. Secondary parameters included the physician global assessment score (PGA) of peri-anal skin condition, assessment of patients' quality of life using a specifically designed quality of life scoring tool, and patient satisfaction with the treatment regimen. The application of the acrylate skin protection cream resulted in a fast and substantial improvement of all study parameters, with a high score for patient satisfaction. The cream was well tolerated without any adverse events noted during the study period. The authors' pilot study has generated initial evidence that the acrylate skin protection cream may be effective for the treatment of pruritus ani. However, further randomized controlled studies are needed to confirm the authors' findings.

  5. Treatment of anal human papillomavirus-associated disease: a long term outcome study.

    PubMed

    Nathan, M; Hickey, N; Mayuranathan, L; Vowler, S L; Singh, N

    2008-07-01

    Treatment for human papillomavirus (HPV)-associated anal canal disease has been unsatisfactory. The objective of our study was to determine the treatment outcome in our cohort with anal HPV disease. Overall, 181 patients were evaluated over a median period of 19.1 months (range = 2.8-125.5). Eighty-eight patients (48.6%) with high-grade anal intraepithelial neoplasia (AIN) and 82 patients (45.3%) with low-grade AIN underwent treatment. One hundred and forty-one patients (77.9%) received laser ablative treatment as an outpatient procedure. The treatment yielded cure, defined as a disease-free state at 12 months after treatment, in 63.0% (114/181). Median time to cure for the cohort was 31.5 months (95% confidence interval: 23.0-40.0). Treatment outcome showed no evidence of being affected by age, sexual preference, history of smoking or presence of high-grade disease. Median time to cure was significantly affected by a positive HIV status (P = 0.02) and the extent (volume) of the disease (P = 0.01). Contrary to the current view that treatment of HPV-related anal disease is difficult, unrewarding due to recurrences and may lead to substantial morbidity, we demonstrate that effective treatment is possible for both low- and high-grade AIN. These findings should help with the general desire to introduce screening for AIN for at-risk groups.

  6. Anal extrusion of migrated ventriculo-peritoneal shunt catheter: An unusual complication and review of literature

    PubMed Central

    Sarkari, Avijit; Borkar, Sachin A.; Mahapatra, A. K.

    2016-01-01

    Authors present an unusual case of anal extrusion of peritoneal end of ventriculo-peritoneal shunt in a 2-year-old male child. Pertinent literature is reviewed regarding this rare complication of a very commonly performed neurosurgical procedure. PMID:27695576

  7. Relationship between heterosexual anal sex, injection drug use and HIV infection among black men and women.

    PubMed

    Risser, J M H; Padgett, P; Wolverton, M; Risser, W L

    2009-05-01

    US blacks carry a disproportionate risk of heterosexually transmitted HIV. This study aimed to evaluate the association between self-reported heterosexual anal intercourse and HIV. Using respondent-driven sampling (RDS), we recruited and interviewed 909 blacks from areas of high poverty and HIV prevalence in Houston, Texas, and who reported heterosexual sex in the last year. All individuals were tested for HIV. Weighted prevalence values were calculated to account for non-random recruitment associated with RDS. The weighted population prevalence of HIV infection was 2.4% and 2.5% among men and women, respectively. Education, employment status, income and crack cocaine use were not associated with HIV infection. Lifetime injection drug use (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.33%) and heterosexual anal intercourse (OR 2.41, 95% CI 1.02-5.73%) were associated with HIV infection. Individuals who reported both injection drug use and heterosexual anal intercourse had 6.21 increased odds of HIV (95% CI 2.47-15.61%). Our results suggest that heterosexual anal sex may be a vector for HIV transmission, especially in the context of injection drug use. Prevention strategies directed at curbing the HIV epidemic among black heterosexuals require that we correctly identify the risks so that appropriate interventions can be developed.

  8. Aedes aegypti Rhesus glycoproteins contribute to ammonia excretion by larval anal papillae.

    PubMed

    Durant, Andrea C; Chasiotis, Helen; Misyura, Lidiya; Donini, Andrew

    2017-02-15

    In larval Aedes aegypti, transcripts of the Rhesus-like glycoproteins AeRh50-1 and AeRh50-2 have been detected in the anal papillae, sites of ammonia (NH3/NH4(+)) excretion; however, these putative ammonia transporters have not been previously localized or functionally characterized. In this study, we show that the AeRh50s co-immunolocalize with apical V-type H(+)-ATPase as well as with basal Na(+)/K(+)-ATPase in the epithelium of anal papillae. The double-stranded RNA-mediated knockdown of AeRh50-1 and AeRh50-2 resulted in a significant reduction in AeRh50 protein abundance in the anal papillae, and this was coupled to decreased ammonia excretion. The knockdown of AeRh50-1 resulted in decreased hemolymph [NH4(+)] and pH whereas knockdown of AeRh50-2 had no effect on these parameters. We conclude that the AeRh50s are important contributors to ammonia excretion at the anal papillae of larval A. aegypti, which may be the basis for their ability to inhabit areas with high ammonia levels.

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

    PubMed

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

    2014-12-01

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

  10. Characterization and virulence of Beauveria bassiana associated with auger beetle (Sinoxylon anale) infesting allspice (Pimenta dioica).

    PubMed

    Senthil Kumar, C M; Jacob, T K; Devasahayam, S; D'Silva, Sharon; Nandeesh, P G

    2016-09-01

    The incidence of auger beetle, Sinoxylon anale Lesne (Bostrichidae: Coleoptera), a destructive pest of cosmopolitan occurrence is reported for the first time on allspice trees, Pimenta dioica (L.) Merr. in Kerala, India. The insects bored through the basal region of fresh twigs resulting in dieback symptoms. Morphological characterization and sequencing of a partially amplified fragment of the mitochondrial CO1 gene (696bp) revealed the insect to be Sinoxylon anale. An entomopathogenic fungus was isolated from infected cadavers of S. anale that was identified as Beauveria bassiana (Bals.-Criv.) Vuill., sensu stricto (s.s.) (Ascomycota: Hypocreales) based on morphological and molecular studies. The partial sequences of the ITS, TUB, TEF and Bloc gene regions were sequenced. The fungus grew well in ambient room temperature conditions (28-32±2°C; 60-70% relative humidity) and the infection process on the insect was documented by scanning electron microscopy. Bioassay studies with the isolate indicated that the fungus was virulent against adult beetles as evidenced by the LC50 (3.6×10(6)conidia/ml) and ST50 values (6.8days at a dose of 1×10(7)conidia/ml and 5.8days at a dose of 1×10(8)conidia/ml, respectively). This is the first record of B. bassiana naturally infecting S. anale and the fungus holds promise to be developed as a mycoinsecticide.

  11. Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

    ERIC Educational Resources Information Center

    Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

    2009-01-01

    Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

  12. Hematite (U-Th)/He and Apatite Fission-track Dating Constrain Paleofluid Circulation in Faults: An Example from Gower Peninsula Fissure Fills, Wales

    NASA Astrophysics Data System (ADS)

    Ault, A. K.; Frenzel, M.; Reiners, P. W.; Woodcock, N. H.; Thomson, S. N.

    2015-12-01

    Hematite-calcite fissure fills on the Gower Peninsula, Wales, preserve evidence of faulting, mineralization, and multiple fluid flow events. Fissures are associated with dilational strike-slip faults in early Carboniferous limestone and contain locally brecciated hematite, calcite, and red sediment. Hematite is macroscopically botryoidal, but lobes comprise an intricate aggregate of 0.15-0.5 μm-thick plates with high aspect ratios. Prior work suggests mineralization occurred in either late Carboniferous or late Triassic time. We combine hematite (U-Th)/He dating with apatite (U-Th)/He, apatite fission-track (AFT), and zircon (U-Th)/He thermochronology of fill materials to evaluate the timing and thermal effects of fluid circulation in these structures. Hematite He data from four fissures yield reproducible dates of 141.0 ± 5.1 Ma to 119.9 ± 5.0 Ma. Individual zircon He dates from a sandstone infill sample are ~402-260 Ma, reflecting erosion of source material, and imply a maximum late Permian depositional age. The sandstone AFT date of 131.4 ± 20.1 Ma overlaps with the hematite He results and the apatite He date is ~50 Ma. Reconstruction of the regional burial history from independent geologic constraints reveals modern exposures were not buried and reheated to temperatures hot enough to reset the AFT or hematite He systems in the Triassic-Early Cretaceous. Thus, these data do not simply record ambient cooling from erosion. Hot fluids (~100-150 °C) circulating through fissures in the Early Cretaceous reset the AFT system. Hematite either formed in the Triassic and was also reset by fluids or formed from these fluids. Similar hematite He dates from fault-related mineralization in adjacent south Glamorgan and Cumbria, England, imply concomitant regional hot fluid effects. Our data document hydrothermal fluid circulation, coeval with opening of the North Atlantic Ocean, in these higher permeability fissures and fault veins long after they initially formed

  13. Role of Positron Emission Tomography-Computed Tomography in the Management of Anal Cancer

    SciTech Connect

    Mistrangelo, Massimiliano; Pelosi, Ettore; Bello, Marilena; Ricardi, Umberto; Milanesi, Enrica; Cassoni, Paola; Baccega, Massimo; Filippini, Claudia; Racca, Patrizia; Lesca, Adriana; Munoz, Fernando H.; Fora, Gianluca; Skanjeti, Andrea; Cravero, Francesca; Morino, Mario

    2012-09-01

    Purpose: Pre- and post-treatment staging of anal cancer are often inaccurate. The role of positron emission tomograpy-computed tomography (PET-CT) in anal cancer is yet to be defined. The aim of the study was to compare PET-CT with CT scan, sentinel node biopsy results of inguinal lymph nodes, and anal biopsy results in staging and in follow-up of anal cancer. Methods and Materials: Fifty-three consecutive patients diagnosed with anal cancer underwent PET-CT. Results were compared with computed tomography (CT), performed in 40 patients, and with sentinel node biopsy (SNB) (41 patients) at pretreatment workup. Early follow-up consisted of a digital rectal examination, an anoscopy, a PET-CT scan, and anal biopsies performed at 1 and 3 months after the end of treatment. Data sets were then compared. Results: At pretreatment assessment, anal cancer was identified by PET-CT in 47 patients (88.7%) and by CT in 30 patients (75%). The detection rates rose to 97.9% with PET-CT and to 82.9% with CT (P=.042) when the 5 patients who had undergone surgery prior to this assessment and whose margins were positive at histological examination were censored. Perirectal and/or pelvic nodes were considered metastatic by PET-CT in 14 of 53 patients (26.4%) and by CT in 7 of 40 patients (17.5%). SNB was superior to both PET-CT and CT in detecting inguinal lymph nodes. PET-CT upstaged 37.5% of patients and downstaged 25% of patients. Radiation fields were changed in 12.6% of patients. PET-CT at 3 months was more accurate than PET-CT at 1 month in evaluating outcomes after chemoradiation therapy treatment: sensitivity was 100% vs 66.6%, and specificity was 97.4% vs 92.5%, respectively. Median follow-up was 20.3 months. Conclusions: In this series, PET-CT detected the primary tumor more often than CT. Staging of perirectal/pelvic or inguinal lymph nodes was better with PET-CT. SNB was more accurate in staging inguinal lymph nodes.

  14. Gender Nonconformity and Birth Order in Relation to Anal Sex Role Among Gay Men.

    PubMed

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2017-04-04

    Androphilia is associated with an elevated number of older brothers among natal males. This association, termed the fraternal birth order effect, has been observed among gay men who exhibit marked gender nonconformity. Gender nonconformity has been linked to gay men's preferred anal sex role. The present study investigated whether these two lines of research intersect by addressing whether the fraternal birth order effect was associated with both gender nonconformity and a receptive anal sex role (243 gay men, 91 heterosexual men). Consistent with previous research, we identified the fraternal birth order effect in our sample of gay men. Also, gay men were significantly more gender-nonconforming on adulthood and recalled childhood measures compared to heterosexual men. When gay men were compared based on anal sex role (i.e., top, versatile, bottom), all groups showed significantly greater recalled childhood and adult male gender nonconformity than heterosexual men, but bottoms were most nonconforming. Only gay men with a bottom anal sex role showed evidence of a fraternal birth order effect. A sororal birth order effect was found in our sample of gay men, driven by versatiles. No significant associations were found between fraternal birth order and gender nonconformity measures. These results suggest that the fraternal birth order effect may apply to a subset of gay men who have a bottom anal sex role preference and that this subgroup is more gender-nonconforming. However, there were no significant associations between fraternal birth order and gender nonconformity at the individual level. As such, based on the present study, whether processes underpinning the fraternal birth order effect influence gender nonconformity is equivocal.

  15. Preoperative Therapy for Lower Rectal Cancer and Modifications in Distance From Anal Sphincter

    SciTech Connect

    Gavioli, Margherita Losi, Lorena; Luppi, Gabriele; Iacchetta, Francesco; Zironi, Sandra; Bertolini, Federica; Falchi, Anna Maria; Bertoni, Filippo; Natalini, Gianni

    2007-10-01

    Purpose: To assess the frequency and magnitude of changes in lower rectal cancer resulting from preoperative therapy and its impact on sphincter-saving surgery. Preoperative therapy can increase the rate of preserving surgery by shrinking the tumor and enhancing its distance from the anal sphincter. However, reliable data concerning these modifications are not yet available in published reports. Methods and Materials: A total of 98 cases of locally advanced cancer of the lower rectum (90 Stage uT3-T4N0-N+ and 8 uT2N+M0) that had undergone preoperative therapy were studied by endorectal ultrasonography. The maximal size of the tumor and its distance from the anal sphincter were measured in millimeters before and after preoperative therapy. Surgery was performed 6-8 weeks after therapy, and the histopathologic margins were compared with the endorectal ultrasound data. Results: Of the 90 cases, 82.5% showed tumor downsizing, varying from one-third to two-thirds or more of the original tumor mass. The distance between the tumor and the anal sphincter increased in 60.2% of cases. The median increase was 0.73 cm (range, 0.2-2.5). Downsizing was not always associated with an increase in distance. Preserving surgery was performed in 60.6% of cases. It was possible in nearly 30% of patients in whom the cancer had reached the anal sphincter before the preoperative therapy. The distal margin was tumor free in these cases. Conclusion: The results of our study have shown that in very low rectal cancer, preoperative therapy causes tumor downsizing in >80% of cases and in more than one-half enhances the distance between the tumor and anal sphincter. These modifications affect the primary surgical options, facilitating or making sphincter-saving surgery possible.

  16. Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula: systematic review and meta-analysis.

    PubMed

    Hong, K D; Kang, S; Kalaskar, S; Wexner, S D

    2014-08-01

    Sphincter-preserving approaches to treat anal fistula do not jeopardize continence; however, healing rates are suboptimal. In this context, ligation of the intersphincteric fistula tract (LIFT) can be considered promising offering high success rates and a relatively simple procedure. This review aimed to investigate the outcomes of LIFT to treat anal fistula. We conducted a systematic review of the Pubmed, Web of Science, and Cochrane databases, to retrieve all relevant scientific original articles and scientific abstracts (Web of Science) related to the LIFT procedure for anal fistula between January 2007 and March 2013. The search yielded 24 original articles including 1,110 patients; these included one randomized controlled study, three case control studies, and 20 case series. Most studies included patients with trans-sphincteric or complex fistula, not amenable to fistulotomy. During a pooled mean 10.3 months of follow-up, the mean success, incontinence, intraoperative, and postoperative complication rates were 76.4, 0, 0, and 5.5%, respectively. A sensitivity analysis showed that the impact on success in terms of follow-up duration, study size, and combining other procedures was limited. There was no association between pre-LIFT drainage seton and success of LIFT. Ligation of the intersphincteric fistula tract appears to be an effective and safe treatment for trans-sphincteric or complex anal fistula. Combining other procedures and a pre-LIFT drainage seton does not seem to confer any added benefit in terms of success. However, given the lack of prospective randomized trials, interpretation of these data must be cautious. Further trials are mandatory to identify predictive factors for success, and true effectiveness of the LIFT compared to other sphincter-preserving procedures to treat anal fistula.

  17. Oral and anal vaccination confers full protection against enteric redmouth disease (ERM) in rainbow trout.

    PubMed

    Villumsen, Kasper Rømer; Neumann, Lukas; Ohtani, Maki; Strøm, Helene Kragelund; Raida, Martin Kristian

    2014-01-01

    The effect of oral vaccines against bacterial fish diseases has been a topic for debate for decades. Recently both M-like cells and dendritic cells have been discovered in the intestine of rainbow trout. It is therefore likely that antigens reaching the intestine can be taken up and thereby induce immunity in orally vaccinated fish. The objective of this project was to investigate whether oral and anal vaccination of rainbow trout induces protection against an experimental waterborne infection with the pathogenic enterobacteria Yersinia ruckeri O1 biotype 1 the causative agent of enteric redmouth disease (ERM). Rainbow trout were orally vaccinated with AquaVac ERM Oral (MERCK Animal Health) or an experimental vaccine bacterin of Y. ruckeri O1. Both vaccines were tested with and without a booster vaccination four months post the primary vaccination. Furthermore, two groups of positive controls were included, one group receiving the experimental oral vaccine in a 50 times higher dose, and the other group receiving a single dose administered anally in order to bypass the stomach. Each group was bath challenged with 6.3 × 10(8) CFU/ml Y. ruckeri, six months post the primary vaccination. The challenge induced significant mortality in all the infected groups except for the groups vaccinated anally with a single dose or orally with the high dose of bacterin. Both of these groups had 100% survival. These results show that a low dose of Y. ruckeri bacterin induces full protection when the bacterin is administered anally. Oral vaccination also induces full protection, however, at a dose 50 times higher than if the fish were to be vaccinated anally. This indicates that much of the orally fed antigen is digested in the stomach before it reaches the second segment of the intestine where it can be taken up as immunogenic antigens and presented to lymphocytes.

  18. Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study.

    PubMed

    Arora, Rahul; Pandhi, Deepika; Mishra, Kiran; Bhattacharya, Sambit N; Yhome, Vizodilhou A

    2014-09-01

    Summary Akin to cervical cancer in sexually-active women, men who have sex with men (MSM) are predisposed to anal cancers, especially those with HIV co-infection. This cross-sectional study endeavored to assess the prevalence of anal dysplasia using Pap smears and p16 immunostaining amongst Indian MSM. A total of 31 consecutive HIV-positive and 34 HIV-negative MSM, from a cohort of sexually transmitted infection clinic attendees, underwent anal cytological evaluation with Pap smear and p16 staining. Chi square test and coefficient of correlation were used for comparison. Eighteen (27.7%) had abnormal anal cytology; increased in HIV-positive as compared to HIV-negative men (35% versus 20%, p = 0.180). Similarly, both low-grade (25.8% versus 17.6%) and high-grade lesions (8.3% versus 4.8%) were comparable in HIV-positive and HIV-negative group. Thirteen (20%) smears were p16-positive with a sensitivity and specificity for anal dysplasia of 72.3% and 100%, respectively. Anal cytology may be used to screen for anal dysplasia in MSM irrespective of HIV status. Furthermore, the addition of p16, with greater specificity for high-grade lesions, may improve diagnostic accuracy especially for high-grade lesions. A larger study to further corroborate these observations is warranted.

  19. Deep subsurface mine stalactites trap endemic fissure fluid Archaea, Bacteria, and Nematoda possibly originating from ancient seas.

    PubMed

    Borgonie, Gaëtan; Linage-Alvarez, Borja; Ojo, Abidemi; Shivambu, Steven; Kuloyo, Olukayode; Cason, Errol D; Maphanga, Sihle; Vermeulen, Jan-G; Litthauer, Derek; Ralston, Colin D; Onstott, Tullis C; Sherwood-Lollar, Barbara; Van Heerden, Esta

    2015-01-01

    Stalactites (CaCO3 and salt) from water seeps are frequently encountered in ceilings of mine tunnels whenever they intersect water-bearing faults or fractures. To determine whether stalactites could be mineralized traps for indigenous fracture water microorganisms, we analyzed stalactites collected from three different mines ranging in depth from 1.3 to 3.1 km. During sampling in Beatrix gold mine (1.4 km beneath the surface), central South Africa, CaCO3 stalactites growing on the mine tunnel ceiling were collected and observed, in two cases, to contain a living obligate brackish water/marine nematode species, Monhystrella parvella. After sterilization of the outer surface, mineral layers were physically removed from the outside to the interior, and DNA extracted. Based upon 16S and 18S rRNA gene sequencing, Archaea, Bacteria, and Eukarya in different combinations were detected for each layer. Using CT scan and electron microscopy the inner structure of CaCO3 and salt stalactites were analyzed. CaCO3 stalactites show a complex pattern of lamellae carrying bacterially precipitated mineral structures. Nematoda were clearly identified between these layers confirming that bacteria and nematodes live inside the stalactites and not only in the central straw. Salt stalactites exhibit a more uniform internal structure. Surprisingly, several Bacteria showing highest sequence identities to marine species were identified. This, together with the observation that the nematode M. parvella recovered from Beatrix gold mine stalactite can only survive in a salty environment makes the origin of the deep subsurface colonization enigmatic. The possibility of a Permian origin of fracture fluids is discussed. Our results indicate stalactites are suitable for biodiversity recovery and act as natural traps for microorganisms in the fissure water long after the water that formed the stalactite stopped flowing.

  20. Ground based measurements of the gas emission from the Holuhraun volcanic fissure eruption on Iceland 2014/2015

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

    The since 31 August 2014 ongoing volcanic eruption at Holuhraun on Iceland is 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 affects local population and has become a concern also for air traffic. The eruption has in December continued at constant pace for 3.5 months. Three scenarios are envisaged for the future; (1) the eruption stops, (2) the fissure extends under the Vattnajökul glacier and (3) Bardarbunga volcano erupts. The two later scenarios will cause increased gas emission, severe ash emissions and extended flooding. 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, we are developing a version of the Scanning DOAS instrument that is adapted to high latitudes with low UV radiation and severe meteorological conditions. Since the first day of the eruption several of these novel instruments has been monitoring the SO2 emission from the eruption. Data from our instruments are still after 3.5 months the only sustained ground-based monitoring of this gas emission. A lot of work is however needed to sustain this operation 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 require the development of novel methods to derive reliable flux estimates. In this presentation we will discuss the instrumental issues and present the latest version of the emission estimates made from our measurements.

  1. Deep subsurface mine stalactites trap endemic fissure fluid Archaea, Bacteria, and Nematoda possibly originating from ancient seas

    PubMed Central

    Borgonie, Gaëtan; Linage-Alvarez, Borja; Ojo, Abidemi; Shivambu, Steven; Kuloyo, Olukayode; Cason, Errol D.; Maphanga, Sihle; Vermeulen, Jan-G; Litthauer, Derek; Ralston, Colin D.; Onstott, Tullis C.; Sherwood-Lollar, Barbara; Van Heerden, Esta

    2015-01-01

    Stalactites (CaCO3 and salt) from water seeps are frequently encountered in ceilings of mine tunnels whenever they intersect water-bearing faults or fractures. To determine whether stalactites could be mineralized traps for indigenous fracture water microorganisms, we analyzed stalactites collected from three different mines ranging in depth from 1.3 to 3.1 km. During sampling in Beatrix gold mine (1.4 km beneath the surface), central South Africa, CaCO3 stalactites growing on the mine tunnel ceiling were collected and observed, in two cases, to contain a living obligate brackish water/marine nematode species, Monhystrella parvella. After sterilization of the outer surface, mineral layers were physically removed from the outside to the interior, and DNA extracted. Based upon 16S and 18S rRNA gene sequencing, Archaea, Bacteria, and Eukarya in different combinations were detected for each layer. Using CT scan and electron microscopy the inner structure of CaCO3 and salt stalactites were analyzed. CaCO3 stalactites show a complex pattern of lamellae carrying bacterially precipitated mineral structures. Nematoda were clearly identified between these layers confirming that bacteria and nematodes live inside the stalactites and not only in the central straw. Salt stalactites exhibit a more uniform internal structure. Surprisingly, several Bacteria showing highest sequence identities to marine species were identified. This, together with the observation that the nematode M. parvella recovered from Beatrix gold mine stalactite can only survive in a salty environment makes the origin of the deep subsurface colonization enigmatic. The possibility of a Permian origin of fracture fluids is discussed. Our results indicate stalactites are suitable for biodiversity recovery and act as natural traps for microorganisms in the fissure water long after the water that formed the stalactite stopped flowing. PMID:26441844

  2. Evolution of dike opening during the March 2011 Kamoamoa fissure eruption, Kīlauea Volcano, Hawai`i

    USGS Publications Warehouse

    Lundgren, Paul; Poland, Michael; Miklius, Asta; Orr, Tim R.; Yun, Sang-Ho; Fielding, Eric; Liu, Zhen; Tanaka, Akiko; Szeliga, Walter; Hensley, Scott; Owen, Susan

    2013-01-01

    The 5–9 March 2011 Kamoamoa fissure eruption along the east rift zone of Kīlauea Volcano, Hawai`i, followed months of pronounced inflation at Kīlauea summit. We examine dike opening during and after the eruption using a comprehensive interferometric synthetic aperture radar (InSAR) data set in combination with continuous GPS data. We solve for distributed dike displacements using a whole Kīlauea model with dilating rift zones and possibly a deep décollement. Modeled surface dike opening increased from nearly 1.5 m to over 2.8 m from the first day to the end of the eruption, in agreement with field observations of surface fracturing. Surface dike opening ceased following the eruption, but subsurface opening in the dike continued into May 2011. Dike volumes increased from 15, to 16, to 21 million cubic meters (MCM) after the first day, eruption end, and 2 months following, respectively. Dike shape is distinctive, with a main limb plunging from the surface to 2–3 km depth in the up-rift direction toward Kīlauea's summit, and a lesser projection extending in the down-rift direction toward Pu`u `Ō`ō at 2 km depth. Volume losses beneath Kīlauea summit (1.7 MCM) and Pu`u `Ō`ō (5.6 MCM) crater, relative to dike plus erupted volume (18.3 MCM), yield a dike to source volume ratio of 2.5 that is in the range expected for compressible magma without requiring additional sources. Inflation of Kīlauea's summit in the months before the March 2011 eruption suggests that the Kamoamoa eruption resulted from overpressure of the volcano's magmatic system.

  3. Chronic urticaria.

    PubMed Central

    Leznoff, A.

    1998-01-01

    OBJECTIVE: To review the pathophysiology of chronic urticaria in light of recent evidence for it being an autoimmune disease, and to recommend appropriate management. QUALITY OF EVIDENCE: An extensive literature review was supplemented with a MEDLINE search. Articles from easily available journals were preferred. These consisted of the most recent basic articles on autoimmunity in relation to chronic urticaria and a selection of previous articles on pathophysiology, which illustrate consistencies with recent evidence. The investigation and management protocol is supported by original and relevant literature. MAIN FINDINGS: The histopathology and immunohistology of chronic urticaria and certain clinical studies were a prelude to definitive evidence that most instances of chronic urticaria are autoimmune. Although allergic and other causes are uncommon, these must be sought because identification can lead to cure or specific treatment. Management of the much more common autoimmune urticaria is based on principles derived from the demonstrated pathogenesis and on results of published clinical trials. CONCLUSIONS: In most instances, chronic urticaria is an autoimmune disease, but uncommon allergic or other causes must be considered. PMID:9805172

  4. Loss of histone variant macroH2A2 expression associates with progression of anal neoplasm

    PubMed Central

    Hu, Wan-Hsiang; Miyai, Katsumi; Sporn, Judith C; Luo, Linda; Wang, Jean Y J; Cosman, Bard; Ramamoorthy, Sonia

    2016-01-01

    Aims The macroH2A histone variants are epigenetic marks for inactivated chromatin. In this study, we examined the expression of macroH2A2 in anal neoplasm from anal intraepithelial neoplasia (AIN) to anal squamous cell carcinoma (SCC). Methods AIN and anal SCC samples were analysed for macroH2A2 expression, HIV and human papilloma virus (HPV). The association of macroH2A2 expression with clinical grade, disease recurrence, overall survival and viral involvement was determined. Results macroH2A2 was expressed in normal squamous tissue and lower grade AIN (I and II). Expression was lost in 38% of high-grade AIN (III) and 71% of anal SCC (p=0.002). Patients with AIN with macroH2A2-negative lesions showed earlier recurrence than those with macroH2A2-positive neoplasm (p=0.017). With anal SCC, macroH2A2 loss was more prevalent in the HPV-negative tumours. Conclusions Loss of histone variant macroH2A2 expression is associated with the progression of anal neoplasm and can be used as a prognostic biomarker for high-grade AIN and SCC. PMID:26658220

  5. Chronic Cough.

    PubMed

    Pacheco, Adalberto; de Diego, Alfredo; Domingo, Christian; Lamas, Adelaida; Gutierrez, Raimundo; Naberan, Karlos; Garrigues, Vicente; López Vime, Raquel

    2015-11-01

    Chronic cough (CC), or cough lasting more than 8 weeks, has attracted increased attention in recent years following advances that have changed opinions on the prevailing diagnostic and therapeutic triad in place since the 1970s. Suboptimal treatment results in two thirds of all cases, together with a new notion of CC as a peripheral and central hypersensitivity syndrome similar to chronic pain, have changed the approach to this common complaint in routine clinical practice. The peripheral receptors involved in CC are still a part of the diagnostic triad. However, both convergence of stimuli and central nervous system hypersensitivity are key factors in treatment success.

  6. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    PubMed Central

    Chiarioni, Giuseppe; Asteria, Corrado; Whitehead, William E

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders. PMID:22110274

  7. Chronic myelogenous leukemia (CML)

    MedlinePlus

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... nuclear disaster. It takes many years to develop leukemia from radiation exposure. Most people treated for cancer ...

  8. Chronic Bronchitis

    MedlinePlus

    ... breathing. You may also have other tests. Chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. If you smoke, it is important to quit. Treatment can help with your symptoms. It often includes ...

  9. Chronic gastritis.

    PubMed

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  10. Caries-Preventive Effect of High-Viscosity Glass Ionomer and Resin-Based Fissure Sealants on Permanent Teeth: A Systematic Review of Clinical Trials

    PubMed Central

    Mickenautsch, Steffen; Yengopal, Veerasamy

    2016-01-01

    Background Glass-ionomers are traditionally regarded to be inferior to resin as fissure sealants in protecting teeth from dental caries, due to their comparatively lower retention rate. Unlike low-viscosity glass-ionomers, high-viscosity glass-ionomer cements (HVGIC) are placed as sealants by pressing the material into pits and fissures with a petroleum-jelly-coated index finger. Hence, HVGIC sealants are assumed to penetrate pits and fissures deeper, resulting in a higher material retention rate, which may increase its caries-preventive effect. Methods The aim of this review was to answer the question as to whether, in patients with fully erupted permanent molar teeth, HVGIC based fissure sealants are less effective to protect against dental carious lesions in occlusal pits and fissures than resin-based fissure sealants? A systematic literature search in eight databases was conducted. Heterogeneity of accepted trials and imprecision of the established evidence were assessed. Extracted sufficiently homogenous datasets were pooled by use of a random-effects meta-analysis. Internal trial validity was evaluated. The protocol of this systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO / Nr.: CRD42015016007). Results Seven clinical trials were provisionally included for further review. Of these, one was excluded. Seven trial reports reporting on six trials were accepted. From these, 11 datasets were extracted and pooled in four meta-analyses. The results suggest no statistically significant differences after up to 48 months and borderline significant differences in favour of HVGIC sealants after 60 months (RR 0.29; 95% CI: 0.09–0.95; p = 0.04 / RD -0.07; 95% CI: -0.14, -0.01). The point estimates and upper confidence levels after 24, 36, 48 and 60 months of RR 1.36; RR 0.90; RR 0.62; RR 0.29 and 2.78; 1.67; 1.21; 0.95, respectively, further suggest a chronological trend in favour of HVGIC above resin

  11. Soil gas composition from the 2001-2002 fissure in the Lakki Plain (Nisyros Island, Greece): evidences for shallow hydrothermal fluid circulation

    NASA Astrophysics Data System (ADS)

    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 (<50 m thick) induced by hydrothermal fluid circulation (Vougioukalakis and Fytikas, 2005). In June 2015, diffuse CO2 flux measurements, in combination with sampling and chemical analysis of the interstitial soil gases, were performed in (i) the fissure bottom, (ii) the adjacent vegetated areas in the Lakki Plain, (iii) the near hydrothermal craters (Stefanos, Kaminakia, Lofos domes), and (iv) sites located outside the caldera (blank values). The fissure showed neither temperature (<30 °C) nor CO2 fluxes (<10 gm-2d-1) anomalies with respect to the blank sites and the Lakki Plain, with values strikingly lower than those measured in the hydrothermal craters (up to 98 °C and 208 gm-2d-1, respectively). Contrarily, the CO2 concentrations in the interstitial soil gases from the fissure (up to 513 mmol/mol) were markedly higher than the background values and comparable with those measured in the craters (up to 841 mmol/mol). Relatively high H2S, H2 and CH4 contents in soil gases from the fissure confirm the hydrothermal origin of these soil gases. However, their CH4/CO2 ratio were lower than those measured in the soil gases from the craters

  12. Non-destructive measurement of demineralization and remineralization in the occlusal pits and fissures of extracted 3rd molars with PS-OCT

    NASA Astrophysics Data System (ADS)

    Lee, Chulsung; Hsu, Dennis J.; Le, Michael H.; Darling, Cynthia L.; Fried, Daniel

    2009-02-01

    Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image the remineralization of early artificial caries lesion on smooth enamel surfaces of human and bovine teeth. However, most new dental decay is found in the pits and fissures of the occlusal surfaces of posterior dentition and it is in these high risk areas where the performance of new caries imaging devices need to be investigated. The purpose of this study was to demonstrate that PS-OCT can be used to measure the subsequent remineralization of artificial lesions produced in the pits and fissures of extracted 3rd molars. A PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of occlusal surfaces exposed to a demineralizing solution at pH-4.5 followed by a fluoride containing remineralizing solution at pH-7.0 containing 2-ppm fluoride. The integrated reflectivity was calculated to a depth of 200-µm in the entire lesion area using an automated image processing algorithm. Although a well-defined surface zone was clearly resolved in only a few of the samples that underwent remineralization, the PS-OCT measurements indicated a significant (p<0.05) reduction in the integrated reflectivity between the severity of the lesions that were exposed to the remineralization solution and those that were not. The lesion depth and mineral loss were also measured with polarized light microscopy and transverse microradiography after sectioning the teeth. These results show that PS-OCT can be used to non-destructively monitor the remineralization potential of anti-caries agents in the important pits and fissures of the occlusal surface.

  13. Video monitoring reveals pulsating vents and propagation path of fissure eruption during the March 2011 Pu'u 'Ō'ō eruption, Kilauea volcano

    NASA Astrophysics Data System (ADS)

    Witt, Tanja; Walter, Thomas R.

    2017-01-01

    Lava fountains are a common eruptive feature of basaltic volcanoes. Many lava fountains result from fissure eruptions and are associated with the alignment of active vents and rising gas bubbles in the conduit. Visual reports suggest that lava fountain pulses may occur in chorus at adjacent vents. The mechanisms behind such a chorus of lava fountains and the underlying processes are, however, not fully understood. The March 2011 eruption at Pu'u 'Ō'ō (Kilauea volcano) was an exceptional fissure eruption that was well monitored and could be closely approached by field geologists. The fissure eruption occurred along groups of individual vents aligned above the feeding dyke. We investigate video data acquired during the early stages of the eruption to measure the height, width and velocity of the ejecta leaving eight vents. Using a Sobel edge-detection algorithm, the activity level of the lava fountains at the vents was determined, revealing a similarity in the eruption height and frequency. Based on this lava fountain time series, we estimate the direction and degree of correlation between the different vents. We find that the height and velocity of the eruptions display a small but systematic shift in time along the vents, indicating a lateral migration of lava fountaining at a rate of 11 m/s from W to E. This finding is in agreement with a propagation model of a pressure wave originating at the Kilauea volcano and propagating through the dyke at 10 m/s from W to E. Based on this approach from videos only 30 s long, we are able to obtain indirect constraints on the physical dyke parameters, with important implications for lateral magma flow processes at depth. This work shows that the recording and analysis of video data provide important constraints on the mechanisms of lava fountain pulses. Even though the video sequence is short, it allows for the confirmation of the magma propagation direction and a first-order estimation of the dyke dimensions.

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

    PubMed Central

    2014-01-01

    Anal canal carcinoma is a rare gastro-intestinal cancer. Radiochemotherapy is the recommended primary treatment for patients with non-metastatic carcinoma; surgery is generally reserved for persistent or recurrent disease. Follow-up and surveillance after primary treatment is paramount to classify patients in those with complete remission, persistent or progressive disease. Locally persistent disease represents a clinically significant problem and its management remains subject of some controversy. The aim of this systematic review is to summarise recommendations for the primary treatment of anal canal carcinoma, to focus on the optimal time to consider residual disease as genuine persistence to proceed with salvage treatment, and to discern how this analysis might inform future clinical trials in management in this class of patients. PMID:24472223

  15. Casual sexual encounters among gay men: familiarity, trust and unprotected anal intercourse.

    PubMed

    Zablotska, Iryna B; Grulich, Andrew E; De Wit, John; Prestage, Garrett

    2011-04-01

    Familiarity with and a history of prior sex with casual partners is associated with unprotected anal intercourse and may increase the risk of HIV transmission among gay men. Using data from the Sydney Gay Community Periodic Survey 2007, we explored the relationship between familiarity and unprotected anal intercourse with the last casual partner (UAI-LC). 51% of the men knew their last casual partner and 49% had previously had sex with him. Men were more inclined to engage in UAI-LC if they had previously had sex with this partner. HIV-negative men were more likely to have UAI-LC with a more familiar partner independent of his serostatus. Familiarity with and a previous history of sex between casual partners may result in a false sense of trust and may increase the risk of HIV transmission. HIV prevention services should address this issue and develop programs to improve men's skills in negotiating safer sex.

  16. A case of severe anal injury in an adolescent male due to bestial sexual experimentation.

    PubMed

    Blevins, Roger O

    2009-10-01

    This report delineates a case of anal injury in a 12-year-old boy who gave a detailed history of bestial behavior with a male bulldog. The child described how he had seen this behavior modeled on the internet and subsequently initiated contact with his own dog, causing the dog to penetrate him anally. This type of juvenile bestial behavior with injury has only been reported once previously in the medical literature. Zoophilia, along with a number of other paraphilias, frequently has its onset in the adolescent age group. Adolescents evidencing paraphilic behaviors require thorough psychological evaluation. Spontaneous sexual assault of a human by a canine has never been described in the human or veterinary medical literature, nor is such a thing likely. A clinician involved in evaluating serious ano-genital injury in a child reportedly due to spontaneous canine sexual assault must consider other possible traumatic etiologies including sexual abuse. Investigation in any such case is essential.

  17. Prevalence of genital, oral, and anal HPV infection among STI patients in Italy.

    PubMed

    Ciccarese, Giulia; Herzum, Astrid; Rebora, Alfredo; Drago, Francesco

    2016-12-09

    Human papillomavirus (HPV) is a carcinogenic agent responsible for tumor development in many sexually involved tissues. We present a survey on the prevalence of HPV infection in a risk population for sexually transmitted infections (STIs). The studied population was formed by 125 STI clinic attendees, who took part in a screening program on STIs. To be included in the study, the patients had to show no overt clinical signs of HPV infection. Genital (cervical in women, urethral in men), anal, and oral samples were collected with ThinPrep liquid based cytology preparation system. Overall, of the screened population, 56% proved positive for genital HPV, 37% for oral HPV, and 42% for anal HPV infection. Our data indicate that in STI patients, HPV infection is more prevalent, than previously estimated. Further studies are needed to better understand the epidemiological burden of HPV in sexually involved tissues, especially in the oral mucosa.

  18. Role of internal anal sphincter damage in the causation of idiopathic faecal incontinence: a prospective study.

    PubMed

    Petros, Peter; Anderson, Jim

    2005-02-01

    This prospective study aimed to examine the relationship between internal anal sphincter (IAS) damage and 'idiopathic' faecal incontinence (FI) in 50 consecutive patients, using endoanal ultrasound examination. The external anal sphincter (EAS) was intact on direct and ultrasonic assessment in all patients. IAS damage was defined as complete rupture or attenuation, less than 2 mm thickness in some part of the sphincter. Complete rupture was found in one patient and damage in a further 17 (total 36%). All three nulliparous patients had normal IAS and EAS. IAS damage was only minimally associated with 'idiopathic' FI, suggesting IAS per se is unlikely to be a direct cause of FI in the 'idiopathic' group of FI patients. Its role might be analogous to the periurethral striated horse-shoe shape muscle in the urethra, which is thought to act as a mucosal sealant.

  19. Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history.

    PubMed

    Brody, Stuart; Weiss, Petr

    2011-01-01

    Representative samples of the Czech population were surveyed with regard to sexual behavior in 1993, 1998, 2003, and 2008 (N = 7,720). Lifetime prevalence of Heterosexual Anal Intercourse increased from 1993 to 2008 (16.6% to 19.7% among women, 15.7% to 25.3% among men). Anal intercourse was associated with lifetime number of sex partners, current masturbation, and histories (prevalence of which increased from 1993 to 2008) of homosexual sex, prostitution, venereal disease (adjusted for number of sex partners), and women's sexual dysfunction. The authors discuss the possible reasons for the increasing prevalence and the associations. Multivariate predictors of ever having a sexual dysfunction or a venereal disease are also presented.

  20. The anal reflex elicited by cough and sniff: validation of a neglected clinical sign

    PubMed Central

    Chan, C; Ponsford, S; Swash, M

    2004-01-01

    Background: It is unclear whether contraction of the external anal sphincter (EAS) following a voluntary cough is an integral component of the cough response itself, or a reflex response to the abdominal and pelvic floor dynamics induced by the cough. Clinical experience suggests a reflex origin for this response. Objective: To compare motor latencies for intercostal, abdominal, and EAS muscle contraction after transcranial magnetic stimulation with those following voluntary coughing and sniffing. Methods: A needle electrode inserted into the EAS measured responses, which were confirmed by tonic electromyographic recording. Direct motor latencies from the cerebral cortex to the intercostal, rectus abdominis and EAS muscles were obtained using transcranial magnetic stimulation. Sniff and cough induced responses were also recorded in these muscles. Results: The results suggest that EAS responses following a voluntary cough or sniff represent a polysynaptic reflex. Conclusions: As the cough induced anal reflex response is consistent and easily elicited, its use in clinical neurological examination is appropriate. PMID:15377694

  1. Determining the shape of the turns-amplitude cloud during anal sphincter quantitative EMG.

    PubMed

    Gregory, W Thomas; Clark, Amanda L; Simmons, Kimberly; Lou, Jau-Shin

    2008-07-01

    We aimed to compare our normative data for quantitative interference pattern (IP) analysis of the anal sphincter to previously published data. In 28 nulliparous women, we performed IP analysis during quantitative concentric needle electromyography (QEMG) of the anal sphincter. At each sampling site, a 500-ms epoch was analyzed. The data were log transformed. Linear regression lines (with 95% confidence intervals) were calculated from the log transformed variables "turns-second" and "amplitude-turn." These confidence intervals were then transformed back into the original parameters to yield scatterplots with confidence curves. The mean turns-second were 203 (SD 174). The mean amplitude (mcv)-turn was 266 (SD 87). The regression coefficients for the log-transformed variables are constant = 1.5, slope = 0.3, and resultant cloud of raw data has a convex upper boundary. These appear slightly different than previously published reports, potentially influencing the determination of normal and abnormal studies.

  2. The Averno 2 fissure eruption: a recent small-size explosive event at the Campi Flegrei Caldera (Italy)

    NASA Astrophysics Data System (ADS)

    di Vito, Mauro Antonio; Arienzo, Ilenia; Braia, Giuseppe; Civetta, Lucia; D'Antonio, Massimo; di Renzo, Valeria; Orsi, Giovanni

    2011-04-01

    The Averno 2 eruption (3,700 ± 50 a B.P.) was an explosive low-magnitude event characterized by magmatic and phreatomagmatic explosions, generating mainly fall and surge beds, respectively. It occurred in the Western sector of the Campi Flegrei caldera (Campanian Region, South Italy) at the intersection of two active fault systems, oriented NE and NW. The morphologically complex crater area, largely filled by the Averno lake, resulted from vent activation and migration along the NE-trending fault system. The eruption generated a complex sequence of pyroclastic deposits, including pumice fall deposits in the lower portion, and prevailing surge beds in the intermediate-upper portion. The pyroclastic sequence has been studied through stratigraphical, morphostructural and petrological investigations, and subdivided into three members named A through C. Member A was emplaced during the first phase of the eruption mainly by magmatic explosions which generated columns reaching a maximum height of 10 km. During this phase the eruption reached its climax with a mass discharge rate of 3.2 106 kg/s. Intense fracturing and fault activation favored entry of a significant amount of water into the system, which produced explosions driven by variably efficient water-magma interaction. These explosions generated wet to dry surge deposits that emplaced Member B and C, respectively. Isopachs and isopleths maps, as well as areal distribution of ballistic fragments and facies variation of surge deposits allow definition of four vents that opened along a NE oriented, 2 km long fissure. The total volume of magma extruded during the eruption has been estimated at about 0.07 km3 (DRE). The erupted products range in composition from initial, weakly peralkaline alkali-trachyte, to last-emplaced alkali-trachyte. Isotopic data and modeling suggest that mixing occurred during the Averno 2 eruption between a more evolved, less radiogenic stored magma, and a less evolved, more radiogenic magma

  3. Monitoring of the volcanic rock compositions during the 2012-2013 fissure eruption at Tolbachik volcano, Kamchatka

    NASA Astrophysics Data System (ADS)

    Volynets, Anna O.; Edwards, Benjamin R.; Melnikov, Dmitry; Yakushev, Anton; Griboedova, Irina

    2015-12-01

    Here we present the results from monitoring of the composition of rocks produced during the 2012-2013 fissure eruption at Tolbachik volcano (FTE). Major and trace element concentrations in 75 samples are reported. Products of this eruption are represented by high alumina basaltic trachyandesites with higher alkalis and titanium contents than in all previously studied rocks of the Tolbachik monogenetic volcanic field. Rocks erupted during the first three days (27-30 November) from the northern (also called Menyailov) group of vents are the most silica- and alkali-rich (SiO2 concentrations up to 55.35 wt.% and K2O up to 2.67 wt.%). From December onwards, when the eruptive activity switched from the Menyailov vents to the southern (Naboko) group of vents, silica content dropped by 2 wt.%, concentrations of MgO, FeO, TiO2 and Mg# increased, and K2O and Na2O concentrations and K2O/MgO ratio decreased. For the rest of the eruption the compositions of rocks remained constant and homogeneous; no systematic compositional differences between lava, bombs and scoria samples are evident. Trace element distributions in the rocks of the Menyailov and Naboko vent lavas are relatively uniform; Menyailov lavas have slightly higher Th, Nb, Hf, Y, and HREE concentrations than the Naboko vent lavas at more or less constant element ratios. We explain the initial change in geochemistry by tapping of a slightly cooler and fractionated (~ 3% Mt and 8% Cpx) upper part of the magma storage zone before the main storage area began to feed the eruption. Thermodynamic constraints show that apparent liquidus temperatures varied from 1142 °C to 1151 °C, and thermodynamic modeling shows that variations in compositions are consistent with a high degree of low pressure (100-300 MPa), nominally anhydrous fractionation of a parent melt compositionally similar to the 1975 Northern Breakthrough high-Mg basalt. Geochemistry, petrological observations and modeling are in agreement with the newly erupted

  4. Tectono-volcanic control of fissure type vents for the 28 Ma Panalillo ignimbrite in the Villa de Reyes Graben, San Luis Potosí, México.

    NASA Astrophysics Data System (ADS)

    Tristán-González, Margarito; Labarthe-Hernández, Guillermo; Aguirre-Díaz, Gerardo J.; Aguillón-Robles, Alfredo

    2008-10-01

    The volcano-tectonic events at the Villa de Reyes Graben (VRG), in the southern Sierra Madre Occidental, Mexico, include 1) a regional NNE fault system developed before 32 Ma, 2) this pre-32 Ma faulting controlled the emplacement of 31.5 Ma dacitic domes, 3) NE faulting at 28 Ma that displaced the 31.5 Ma dacitic domes and formed the VRG, as well as the oblique grabens of Bledos and Enramadas oriented NW, 4) emplacement of Panalillo ignimbrite at 28 Ma filling the VRG and erupting from fissures related to the oblique grabens, and eruption of Placa basalt apparently also from fault-controlled vents.

  5. Tracking the seismicity preceding and during the March 2010 Fimmvörduháls fissure eruption and April 2010 summit eruption of Eyjafjallajökull, Iceland

    NASA Astrophysics Data System (ADS)

    Tarasewicz, J.; Brandsdottir, B.; Hensch, M.; White, R. S.

    2010-12-01

    Using Coalescence Microseismic Mapping (CMM) we have located over 9,000 earthquakes in the period starting two weeks prior to the Fimmvörduháls fissure eruption at the northeastern margin of the Eyjafjallajökull stratovolcano, South Iceland. CMM is an automatic earthquake detection and location program developed at Cambridge University which performs a search in time and space for a best-fit earthquake location. This is done by migrating both P and S wave energy from each seismometer location back into the subsurface and finding an optimum event location where the back-projected energy coalesces within a specified search volume by fitting it to a grid for which P- and S-wave travel times have been calculated from each point in the grid to every seismometer. Following a prolonged period of escalating seismicity we deployed six temporary, three-component, broadband seismometers around the Eyjafjallajökull volcano on 5th March 2010. Data from these seismometers were augmented by data from the eight closest seismometers of the permanent network operated by the Icelandic Meteorological Office (IMO). During March 2010, sustained seismic activity was concentrated primarily between 3-6 km depth under the northeastern flank of the Eyjafjallajökull volcano. To first order, the seismicity migrated eastwards away from the Eyjafjallajökull caldera and towards the first eruption site at Fimmvörduháls during the two weeks prior to eruption. We attribute this to melt movement within the crust. However, clusters in three (or more) discrete locations on the northeastern flank are observed to have been active simultaneously, or with activity alternating between locations, suggesting that magma movement was more complex than a single dyke propagating towards the Fimmvörduháls eruption site. Seismic activity decreased markedly in the two days prior to the onset of the fissure eruption on March 20th. The fissure eruption continued until 12th April and was a pre-cursor to the

  6. Embolization of a Cavernous Sinus Dural Arteriovenous Fistula with Onyx via Direct Puncture of the Cavernous Sinus through the Superior Orbital Fissure

    PubMed Central

    Amiridze, N.; Zoarski, G.; Darwish, R.; Obuchowski, A.; Soloveychic, N.

    2009-01-01

    Summary Treatment of cavernous sinus dural arteriovenous fistula (CSDAVF) may be challenging. We describe a patient who had presented with progressive ocular symptoms due to CSDAVF requiring urgent interventional therapy. Initial attempts to embolize the fistula utilizing a transvenous approach through the inferior petrosal sinus failed because of difficult anatomy. Successful occlusion of the fistula was subsequently achieved with injection of ethylene vinyl alcohol copolymer, Onyx (EV3 Neurovascular, Irvine, CA, USA), via direct percutaneous puncture of the cavernous sinus through the superior orbital fissure. A brief period of asystole during the initial injection of Onyx may be the result of the trigeminocardiac reflex. PMID:20465896

  7. The Alarcón Rise: detail mapping and preliminary results on the geometry, distribution and kinematics of faults and fissures on a ridge-transform system

    NASA Astrophysics Data System (ADS)

    Spelz, R. M.; Fletcher, J. M.; Nieves-Cardoso, C.; Santa Rosa-del Rio, M.; Caress, D. W.; Clague, D. A.; Paduan, J. B.; Martin, J. F.; Guardado-France, R.

    2012-12-01

    The Alarcón Rise, the northernmost segment of the East Pacific Rise before it enters the Gulf of California, is the oldest and perhaps most active spreading ridge-transform system along the oblique-divergent Pacific-North America plate boundary in the southern Gulf of California. Magnetic anomalies along the main ridge axis, which stretches for nearly 50 km long in a NE-SW (034o) direction, suggest that spreading with new oceanic crust was fully established ca. 2.5 Ma, and that its modern configuration as the main plate boundary initiated ca. 2 Ma (Umhoefer, P.J. et al., 2007 Basin Research). High resolution (1m lateral/0.2m vertical) bathymetry data and direct observations of the entire ridge segment, collected and performed by MBARI's autonomous underwater vehicle (AUV) and ROV dives, respectively, during the 2012 Expedition to the Gulf of California, have revealed the presence of an intense array of fault-scarps and fissures displacing numerous neovolcanic landforms such as huge lava domes and smaller cones, pillow mounds and large sheet flows along the entire ridge. The relative age of the surface ruptures is wide-ranging. At some places the fractures appear to be relatively recent, as evident by the apparent young age of the fractured flows, based on having few sessile organisms and/or relatively thin sediment cover. In contrast, fractures and fault-scarps elsewhere are observed to have been partially or totally overrun by lava flows, suggesting their preexistence and relatively older age. The ridge parallel faults and fissures change orientation dramatically as they approach and wrap around the bordering Pescadero and Tamayo fracture zones, which limit the northern and southern flanks of the rise, respectively, giving the ridge a sigmoidal geometry with a Z-shaped symmetry. Moreover, the presence of an en echelon volcanic fissure system near the southern end of the ridge, measuring several kilometers long and oriented somewhat obliquely (~15o clockwise) to

  8. Superior Orbital Fissure Syndrome and Ophthalmoplegia Caused by Varicella Zoster Virus with No Skin Eruption in a Patient Treated with Tumor Necrosis Alpha Inhibitor

    PubMed Central

    Jensen, Helene; Thomsen, Sidsel Thorup; Hansen, Stine Scott; Munksgaard, Signe Bruun; Lindelof, Mette

    2015-01-01

    Varicella zoster virus lies dormant in the dorsal root ganglia after symptomatic chicken pox infection, usually in childhood. If the virus reactivates in the trigeminal ganglia, it can cause varicella zoster ophthalmicus, which can have severe ocular complications. We report a case of a 73-year-old woman in severe immunosuppression due to treatment with mycophenolate mofetil, glucocorticosteroids and a tumor necrosis factor alpha inhibitor. The reactivation caused superior orbital fissure syndrome, which has only rarely been described in relation to varicella zoster virus reactivation. In our case, the syndrome was seen along with severe encephalitis. PMID:26600786

  9. Interstitial curietherapy in the conservative treatment of anal and rectal cancers

    SciTech Connect

    Papillon, J.; Montbarbon, J.F.; Gerard, J.P.; Chassard, J.L.; Ardiet, J.M. )

    1989-12-01

    Conservative treatment has become a valid alternative to radical surgery in most cases of cancer of the anal canal and in selected cases of cancer of the low rectum. In this strategy interstitial curietherapy has an appreciable role to play. The results of a series of 369 patients followed more than 3 years indicate that implantation of Iridium-192 is effective not as sole treatment but as a booster dose 2 months after a course of external beam or intracavitary irradiation. The dose delivered did not exceed 20 to 30 Gy and the implantations were always performed in one plane using either a plastic template or a steel fork. Three groups of cases must be considered: (a) among 221 patients with epidermoid carcinoma of the anal canal, the rate of death related to treatment failures was 20% and among the patients cured more than 90% retained normal sphincter function. (b) In 90 patients with T1-T2 invasive adenocarcinoma of the rectum, Iridium-192 was carried out after four applications of contact X ray therapy. The rate of control was 84%. (c) In 62 elderly, poor risk patients with T2-T3 tumor of the low rectum initially suitable for an abdomino-perineal resection, a tentative extension of the field of conservation was made using a split-course protocol combining a short course of external beam irradiation at a dose of 30-35 Gy in 10 fractions over 12 days and an Iridium-192 implant. The rate of death due to treatment failures was 14.5% and among the patients controlled 97% had a normal anal function. These results show that implantations of Iridium-192 may contribute to the control of anal and rectal cancers and may spare many patients a permanent colostomy, but the treatment requires great care in patient selection, treatment protocol, technical details, and follow-up. This treatment policy must be conceived as a team work of radiation oncologists and surgeons.

  10. Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model

    PubMed Central

    Budgeon, Lynn R.; Cladel, Nancy M.; Balogh, Karla; Myers, Roland; Cooper, Timothy K.

    2015-01-01

    Noninvasive and practical techniques to longitudinally track viral infection are sought after in clinical practice. We report a proof-of-principle study to monitor the viral DNA copy number using a newly established mouse papillomavirus (MmuPV1) mucosal infection model. We hypothesized that viral presence could be identified and quantified by collecting lavage samples from cervicovaginal, anal and oral sites. Nude mice infected at these sites with infectious MmuPV1 were tracked for up to 23 weeks starting at 6 weeks post-infection. Viral DNA copy number was determined by SYBR Green Q-PCR analysis. In addition, we tracked viral DNA load through three complete oestrous cycles to pinpoint whether there was a correlation between the DNA load and the four stages of the oestrous cycle. Our results showed that high viral DNA copy number was reproducibly detected from both anal and cervicovaginal lavage samples. The infection and disease progression were further confirmed by histology, cytology, in situ hybridization, immunohistochemistry and transmission electron microscopy. Interestingly, the viral copy number fluctuated over the oestrous cycle, with the highest level at the oestrus stage, implying that multiple sampling might be necessary to provide a reliable diagnosis. Virus DNA was detected in oral lavage samples at a later time after infection. Lower viral DNA load was found in oral samples when compared with those in anal and vaginal tracts. To our knowledge, our study is the first in vivo study to sequentially monitor papillomavirus infection from mucosal anal, oral and vaginal tracts in a preclinical model. PMID:26399579

  11. [Recurrent anal abscess and cecal perforation as a first presentation of Behçet's disease].

    PubMed

    Haller, Claude; Guenot, Cécile; Odman, Micaela; Bruttin, Jean-Marie; Rosso, Raphaël

    2003-10-01

    Intestinal involvement during Behçet's disease (entero-Behçet) is rare in Europe (<1%). We report the case of a 33-year-old Chad woman with Behçet's disease revealed by recurrent anal abscess and cecal perforation. We discuss the diagnosis of this atypical presentation and the different therapeutic strategies in severe attacks of Behçet's disease.

  12. Successful closure of gastrocutaneous fistulas using the Surgisis® anal fistula plug

    PubMed Central

    Kasem, H

    2014-01-01

    Introduction Gastrocutaneous fistulas remain an uncommon complication of upper gastrointestinal surgery. Less common but equally problematic are gastrocutaneous fistulas secondary to non-healing gastrostomies. Both are associated with considerable morbidity and mortality. Surgical repair remains the gold standard of care. For those unfit for surgical intervention, results from conservative management can be disappointing. We describe a case series of seven patients with gastrocutaneous fistulas who were unfit for surgical intervention. These patients were managed successfully in a minimally invasive manner using the Surgisis® (Cook Surgical, Bloomington, IN, US) anal fistula plug. Methods Between September 2008 and January 2009, seven patients with gastrocutaneous fistulas presented to Wishaw General Hospital. Four gastrocutaneous fistulas represented non-healing gastrostomies, two followed an anastomotic leak after an oesophagectomy and one following an anastomotic leak after a distal gastrectomy. All patients had poor nutritional reserve with no other identifiable reason for failure to heal. All were deemed unfit for surgical intervention. Five gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula plug positioned directly into the fistula tract under local anaesthesia and two gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula positioned endoscopically using a rendezvous technique. Results For the five patients with gastrocutaneous fistulas closed directly under local anaesthesia, oral alimentation was reinstated immediately. Fistula output ceased on day 12 with complete epithelialisation occurring at a median of day 26. For the two gastrocutaneous fistulas closed endoscopically using the rendezvous technique, oral alimentation was reinstated on day 5 with immediate cessation of fistula output. Follow-up upper gastrointestinal endoscopy confirmed re-epithelialisation at eight weeks. In none of the

  13. Human Papillomavirus Prevalence in Invasive Anal Cancers in the United States prior to Vaccine Introduction

    PubMed Central

    Steinau, M; Unger, ER; Hernandez, BY; Goodman, MT; Copeland, G; Hopenhayn, C; Cozen, W; Saber, MS; Huang, Y; Peters, ES; Lynch, CF; Wilkinson, EJ; Rajeevan, MS; Lyu, C; Saraiya, M

    2014-01-01

    Objective Conduct a representative survey of Human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the U.S. Methods Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana and Michigan cancer registries and SEER tissue repositories in Hawaii, Iowa and Los Angeles. Sections from one representative block per case were used for DNA extraction. All extracts were assayed first by Linear Array and re-tested with INNO-LiPA if inadequate or HPV negative. Results Among 146 unique invasive anal cancer cases, 93 (63.7%) were from women and 53 (36.3%) from men. HPV (any type) was detected in 133 (91.1%) cases and 129 (88.4%) contained at least one high risk type, most (80.1%) as a single genotype. HPV16 had the highest prevalence (113 cases, 77.4%); HPV6, 11, 18 and 33 were also found multiple times. Among HPV16 positive cases, 37% were identified as prototype variant Ep and 63% were non-prototypes: 33% Em, 12% E-G131G, 5% Af1, 4% AA/NA-1, 3% E-C109G, 3% E-G131T, 2% As and 1% Af2. No significant differences in the distributions of HPV (any), high-risk types, or HPV16/18 were seen between gender, race or age group. Conclusions The establishment of pre-vaccine HPV prevalence in the U.S. is critical to the surveillance of vaccine efficacy. Almost 80% of anal cancers were positive for the vaccine types HPV16 or HPV18 and in 70% these were the only types detected suggesting that a high proportion might be preventable by current vaccines. PMID:23609590

  14. Employees with Chronic Pain

    MedlinePlus

    ... Home | Accommodation and Compliance Series: Employees with Chronic Pain By Beth Loy, Ph.D. Preface Introduction Information ... at http://AskJAN.org/soar. Information about Chronic Pain How prevalent is chronic pain? Chronic pain has ...

  15. Chronic Pelvic Pain

    MedlinePlus

    ... Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  16. Low back pain - chronic

    MedlinePlus

    Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... Low back pain is common. Almost everyone has back pain at some time in their life. Often, the exact cause of ...

  17. Chronic motor tic disorder

    MedlinePlus

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  18. Chronic pain - resources

    MedlinePlus

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association -- theacpa.org National Fibromyalgia and Chronic Pain Association -- www.fmcpaware.org National ...

  19. Results of surgical treatment on benign anal diseases in Korean HIV-positive patients.

    PubMed

    Oh, Heung-Kwon; Moon, Sang-Hui; Ryoo, Seungbum; Choe, Eun Kyung; Park, Kyu Joo

    2014-09-01

    Perianal diseases are the most common reasons for surgery in HIV-positive patients. This study aimed to evaluate the outcomes of these surgical procedures in Korean patients, focusing on wound healing and postoperative complications. Retrospective analysis was performed on 72 HIV-positive patients who underwent surgery by a single surgeon for benign anal disease between 1998 and 2011. Of these, 68.1% (49/72) of patients received surgery for condyloma acuminata, 19.4% (14/72) for anal fistulas, 6.9% (5/72) for hemorrhoids, and 5.6% (4/72) for perianal abscesses. Patients with condyloma acuminata received surgical excision with electrical coagulation, and all wounds healed completely within 3 months, though 16.3% (8/49) of these patients experienced recurrence. Twelve of the 49 patients (24.5%) who were treated for condyloma acuminata underwent simultaneous operations for concomitant anal fistulas (n = 6), hemorrhoids (n = 4), and perianal abscesses (n = 2). Overall, 3 postoperative complications developed following a total of 94 procedures, and there was no significant increase in complication rate for patients with a low CD4+ T-cell count ( < 200/µL) compared to those with a higher count. The results demonstrate favorable results following perianal surgery in HIV-positive Korean patients.

  20. Molecular biology of anal squamous cell carcinoma: implications for future research and clinical intervention.

    PubMed

    Bernardi, Maria-Pia; Ngan, Samuel Y; Michael, Michael; Lynch, A Craig; Heriot, Alexander G; Ramsay, Robert G; Phillips, Wayne A

    2015-12-01

    Anal squamous cell carcinoma is a human papillomavirus-related disease, in which no substantial advances in treatment have been made in over 40 years, especially for those patients who develop disease relapse and for whom no surgical options exist. HPV can evade the immune system and its role in disease progression can be exploited in novel immunotherapy platforms. Although several studies have investigated the expression and inactivation (through loss of heterozygosity) of tumour suppressor genes in the pathways to cancer, no clinically valuable biomarkers have emerged. Regulators of apoptosis, including survivin, and agents targeting the PI3K/AKT pathway, offer opportunities for targeted therapy, although robust data are scarce. Additionally, antibody therapy targeting EGFR may prove effective, although its safety profile in combination with standard chemoradiotherapy has proven to be suboptimal. Finally, progress in the treatment of anal cancer has remained stagnant due to a lack of preclinical models, including cell lines and mouse models. In this Review, we discuss the molecular biology of anal squamous cell carcinoma, clinical trials in progress, and implications for novel therapeutic targets. Future work should focus on preclinical models to provide a resource for investigation of new molecular pathways and for testing novel targets.

  1. Case of anal fistula with Fournier's gangrene in an obese type 2 diabetes mellitus patient.

    PubMed

    Yoshino, Hiroshi; Kawakami, Kyoko; Yoshino, Gen; Sawada, Katsuhiro

    2016-03-01

    A 64-year-old man was admitted to Shin-suma General Hospital, Kobe, Japan, complaining of a 3-day history of scrotal swelling and high fever. He had type 2 diabetes mellitus. On examination, his body temperature had risen to 38.5 °C. Examination of the scrotum showed abnormal enlargement. Laboratory data were as follows: white cell count 35,400/μL and glycated hemoglobin 9.6%. Anal fistula was found in an endorectal ultrasound. Computed tomography scan showed a relatively high density of subcutaneous tissue and elevated air density. Thus, he was diagnosed with Fournier's gangrene. On the fourth hospital day, the patient underwent debridement of gangrenous tissue. Seton surgery was carried out for anal fistula on the 34th hospital day. He responded to the treatment very well. He was discharged on the 33rd postoperative day. Once Fournier's gangrene has been diagnosed, considering the association of anal fistula and perianal abscess is important.

  2. Distinct Ecological Niche of Anal, Oral, and Cervical Mucosal Microbiomes in Adolescent Women

    PubMed Central

    Smith, Benjamin C.; Zolnik, Christine P.; Usyk, Mykhaylo; Chen, Zigui; Kaiser, Katherine; Nucci-Sack, Anne; Peake, Ken; Diaz, Angela; Viswanathan, Shankar; Strickler, Howard D.; Schlecht, Nicolas F.; Burk, Robert D.

    2016-01-01

    Human body sites represent ecological niches for microorganisms, each providing variations in microbial exposure, nutrient availability, microbial competition, and host immunological responses. In this study, we investigated the oral, anal, and cervical microbiomes from the same 20 sexually active adolescent females, using culture-independent, next-generation sequencing. DNA from each sample was amplified for the bacterial 16S rRNA gene and sequenced on an Illumina platform using paired-end reads. Across the three anatomical niches, we found significant differences in bacterial community composition and diversity. Overall anal samples were dominated with Prevotella and Bacteriodes, oral samples with Streptococcus and Prevotella, and cervical samples with Lactobacillus. The microbiomes of a few cervical samples clustered with anal samples in weighted principal coordinate analyses, due in part to a higher proportion of Prevotella in those samples. Additionally, cervical samples had the lowest alpha diversity. Our results demonstrate the occurrence of distinct microbial communities across body sites within the same individual. PMID:27698612

  3. Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: A narrative review

    PubMed Central

    Sofo, Luigi; Caprino, Paola; Sacchetti, Franco; Bossola, Maurizio

    2016-01-01

    Restorative proctocolectomy with ileal pouch-anal anastomosis (RP-IPAA) is the gold standard surgical treatment for ulcerative colitis. However, despite the widespread use of RP-IPAA, many aspects of this treatment still remain controversial, such as the approach (open or laparoscopic), number of stages in the surgery, type of pouch, and construction type (hand-sewn or stapled ileal pouch-anal anastomosis). The present narrative review aims to discuss current evidence on the short-, mid-, and long-term results of each of these technical alternatives as well as their benefits and disadvantages. A review of the MEDLINE, EMBASE, and Ovid databases was performed to identify studies published through March 2016. Few large, randomized, controlled studies have been conducted, which limits the conclusions that can be drawn regarding controversial issues. The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases. Regarding 2- and 3-stage RP-IPAA, patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables, making any comparisons extremely difficult. The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly, although the J pouch is generally preferred by surgeons. Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages, and there is no clear benefit of one technique over the other. PMID:27648159

  4. [Clinical to target volume margins determination in radiotherapy for anal cancers].

    PubMed

    Libois, V; Mahé, M-A; Rio, E; Maingon, P

    2016-10-01

    There are very few data on the expansion from the clinical target volume (CTV) to the planning target volume (PTV) in the anal cancer treatment. This article aims to collect the different elements needed for the construction of a PTV from scientific data based on a literature analysis. We reviewed the articles published in the medical literature from the last 20years. They concerned setup errors and internal organ mobility of the different volumes of patients treated by conformational radiotherapy and intensity-modulated radiotherapy (anal canal, meso-rectum, common, intern and extern, inguinal and pre-sacral lymph nodes). CTV to PTV margins admitted in the guidelines and atlas of consensus groups (SFRO, RTOG, AGITG) are from 0.7 to 1cm in all directions, based on expert's opinions but not on scientific data. There are no specific studies on the canal anal mobility. Most of the data are from other pelvis cancers (gynecologic, rectum and prostate). Setup errors can be reduced by daily imaging. Patient repositioning and immobilization modalities are mostly local habits rather than scientific consensus. A three-dimensional 1cm margin is generally admitted. Margins reduction must be careful and has to be assessed.

  5. Seroconversion Following Anal and Genital HPV Infection in Men: The HIM Study

    PubMed Central

    Giuliano, Anna R.; Viscidi, Raphael; Torres, B. Nelson; Ingles, Donna J.; Sudenga, Staci L.; Villa, Luisa L.; Baggio, Maria Luiza; Abrahamsen, Martha; Quiterio, Manuel; Salmeron, Jorge; Lazcano-Ponce, Eduardo

    2015-01-01

    Background Protection from naturally acquired human papillomavirus (HPV) antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM) Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results Seroconversion to ≥1 HPV type (6/11/16/18) in this sub-cohort (N=384) varied by anatomic site, with 6.3, 18.9, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%). Overall, seroconversion was highest following anal HPV 6 infection (69.2%). HPV persistence was the only factor found to influence seroconversion. Conclusions Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease. PMID:26688833

  6. Biochemical evaluation of an artificial anal sphincter made from shape memory alloys.

    PubMed

    Liu, Hongjian; Luo, Yun; Higa, Masaru; Zhang, Xiumin; Saijo, Yoshifumi; Shiraishi, Yasuyuki; Sekine, Kazumitsu; Yambe, Tomoyuki

    2007-01-01

    Severe anal incontinence is a socially incapacitating disorder and a major unresolved clinical problem that has a considerable negative impact on quality of life. In this study, we developed a new artificial anal sphincter using shape memory alloys (SMAs) in order to improve the quality of life of such patients and evaluated the influence of this sphincter on blood serum chemistry in animal experiments. The artificial anal sphincter was driven by two Ti-Ni SMA actuators sandwiching the intestine and was implanted in three female goats. Blood was collected from the jugular vein on days 1 and 4; at weeks 1 and 2; and at months 1, 2, and 3, postoperatively. Biochemical parameters including total protein, albumin, total bilirubin, aspartate amino-transferase, blood urea nitrogen, creatinine, and C-reactive protein were examined. The time courses of total bilirubin and aspartate amino transferase of the three goats were within the baseline levels after 1 week of implantation and remained normal, demonstrating no liver function complications. The blood urea nitrogen and creatinine levels remained within the normal range, indicating no renal function complications. The total protein and albumin fluctuated within the normal range throughout the duration of this study. In these goats, it was also found that the level of C-reactive protein did not increase and that there was no stricture of the intestine where the artificial sphincter was attached. Our findings indicate that the artificial sphincter SMA demonstrated no adverse influence on blood serum chemistry and exhibited an effective system performance.

  7. Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: A narrative review.

    PubMed

    Sofo, Luigi; Caprino, Paola; Sacchetti, Franco; Bossola, Maurizio

    2016-08-27

    Restorative proctocolectomy with ileal pouch-anal anastomosis (RP-IPAA) is the gold standard surgical treatment for ulcerative colitis. However, despite the widespread use of RP-IPAA, many aspects of this treatment still remain controversial, such as the approach (open or laparoscopic), number of stages in the surgery, type of pouch, and construction type (hand-sewn or stapled ileal pouch-anal anastomosis). The present narrative review aims to discuss current evidence on the short-, mid-, and long-term results of each of these technical alternatives as well as their benefits and disadvantages. A review of the MEDLINE, EMBASE, and Ovid databases was performed to identify studies published through March 2016. Few large, randomized, controlled studies have been conducted, which limits the conclusions that can be drawn regarding controversial issues. The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases. Regarding 2- and 3-stage RP-IPAA, patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables, making any comparisons extremely difficult. The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly, although the J pouch is generally preferred by surgeons. Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages, and there is no clear benefit of one technique over the other.

  8. Chronic Myeloproliferative Neoplasms Treatment

    MedlinePlus

    ... Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Chronic Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Chronic ...

  9. Cost-effectiveness of screening for anal cancer using regular digital ano-rectal examinations in men who have sex with men living with HIV

    PubMed Central

    Ong, Jason J; Fairley, Christopher K; Carroll, Susan; Walker, Sandra; Chen, Marcus; Read, Tim; Grulich, Andrew; Bradshaw, Catriona; Kaldor, John; Clarke, Philip

    2016-01-01

    Introduction Anal cancer in men who have sex with men (MSM) living with HIV is an important issue but there are no consistent guidelines for how to screen for this cancer. In settings where screening with anal cytology is unavailable, regular anal examinations have been proposed in some guidelines but their cost-effectiveness is unknown. Methods Our objective was to estimate the cost-effectiveness of regular anal examinations to screen for anal cancer in HIV-positive MSM living in Australia using a probabilistic Markov model. Data sources were based on the medical literature and a clinical trial of HIV-positive MSM receiving an annual anal examination in Australia. The main outcome measures for calculating effectiveness were undiscounted and discounted (at 3%) lifetime costs, life years gained, quality-adjusted life years (QALY) gained and incremental cost-effectiveness ratio (ICER). Results Base-case analysis estimated the average cost of screening for and management of anal cancer ranged from $195 for no screening to $1,915 for lifetime annual screening of men aged ≥ 50. Screening of men aged ≥ 50 generated ICERs of $29,760 per QALY gained (for screening every four years), $32,222 (every three years) and $45,484 (every two years). Uncertainty for ICERs was mostly influenced by the cost (financially and decrease in quality of life) from a false-positive result, progression rate of anal cancer, specificity of the anal examination, the probability of detection outside a screening program and the discount rate. Conclusions Screening for anal cancer by incorporating regular anal examinations into routine HIV care for MSM aged ≥ 50 is most likely to be cost-effective by conventional standards. Given that anal pap smears are not widely available yet in many clinical settings, regular anal exams for MSM living with HIV to detect anal cancer earlier should be implemented. PMID:26942721

  10. The Study of the Prevention of Anal Cancer (SPANC): design and methods of a three-year prospective cohort study

    PubMed Central

    2013-01-01

    Background The incidence of human papillomavirus (HPV)-associated anal cancer is increasing in men who have sex with men (MSM). Screening for the presumed cancer precursor, high-grade anal squamous intraepithelial lesions (HSIL) in a manner analogous to cervical cancer screening has been proposed. Uncertainty remains regarding anal HPV natural history and the role of anal cytology and high-resolution anoscopy (HRA) as screening tests. Well-designed cohort studies are required to address these issues. Methods/design The SPANC study is a prospective study of the epidemiology of low-risk and high-risk anal HPV infection and related cytological and histological abnormalities in HIV-negative and HIV-positive homosexual men aged 35 years and over. The study aims to recruit 600 men from community-based settings in Sydney, Australia. There are six study visits over three years. At the first five visits men undergo a digital ano-rectal examination (DARE), an anal “Papanicolaou” (Pap) test for HPV detection, genotyping and anal cytology, followed by HRA and directed biopsy of any visible abnormalities. The men also complete a behavioural questionnaire before each visit. Questions include a detailed history of sexual behaviour, of anal symptoms, possible anal cancer risk factors and validated quality of life and psychosocial questions. Questionnaires are also completed 2 weeks and 3 months following the provision of test results and include questions on participant experience during the procedure and post-procedure symptoms, including pain and bleeding in addition to quality of life/ psychosocial outcomes. Discussion Recruitment for the study began in September 2010 and will conclude in mid-2015, with follow up continuing to 2018. Thus far, over 350 men have been recruited from a variety of community-based settings and are broadly representative of the target screening population. The SPANC study is one of only a small number of cohort studies globally to perform HPV

  11. Risk of Anal Cancer in HIV-Infected and HIV-Uninfected Individuals in North America

    PubMed Central

    Lau, Bryan; Justice, Amy C.; Engels, Eric; Gill, M. John; Goedert, James J.; Kirk, Gregory D.; D’Souza, Gypsyamber; Bosch, Ronald J.; Brooks, John T.; Napravnik, Sonia; Hessol, Nancy A.; Jacobson, Lisa P.; Kitahata, Mari M.; Klein, Marina B.; Moore, Richard D.; Rodriguez, Benigno; Rourke, Sean B.; Saag, Michael S.; Sterling, Timothy R.; Gebo, Kelly A.; Press, Natasha; Martin, Jeffrey N.; Dubrow, Robert

    2012-01-01

    Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34 189 HIV-infected (55% MSM, 19% other men, 26% women) and 114 260 HIV-uninfected individuals (90% men). Results. Among men, the unadjusted anal cancer incidence rates per 100 000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7–151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5–61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100 000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8–6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5–2.2). In comparison with the period 2000–2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI, .3–.9) in 1996–1999 and 0.9 (95% CI, .6–1.2) in 2004–2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued. PMID:22291097

  12. The influence of physical body traits and masculinity on anal sex roles in gay and bisexual men.

    PubMed

    Moskowitz, David A; Hart, Trevor A

    2011-08-01

    Sociological, psychological, and public health studies document that many gay and bisexual men may self-label by their anal penetrative role (i.e., bottom or exclusively receptive; top or exclusively insertive; or versatile, both receptive and insertive during anal intercourse). Yet, what orients men to think of themselves as tops, bottoms or versatiles is poorly understood. We surveyed 429 men engaging in same-sex anal intercourse to investigate the degree to which anal penetrative self-identity was concordant with actual penetrative behavior. Additionally, the roles of masculinity and physical body traits (e.g., penis size, muscularity, height, hairiness, and weight) were tested as correlates of anal penetrative identity and identity-behavior concordance. Tops and bottoms showed a high degree of concordance between identity and enacted behavior; however, only half of versatiles reported concordant identity and behavior (i.e., wanting to be versatile and actually reporting versatile behavior). Generally, tops reported larger penises than bottoms. They also reported being comparatively more masculine than bottoms. Versatiles fell somewhat between the tops and bottoms on these traits. Of the six independent variables, penis size and masculinity were the only two factors to influence concordance or discordance between identity and penetrative behavior. Our study suggests that the correlates of gay men's sexual self-labels may depend on objective traits in addition to the subjective pleasure associated with receptive or insertive anal intercourse.

  13. Sexual dysfunction and unprotected anal intercourse among men who have sex with men in two Chinese cities.

    PubMed

    Tsui, Hi Yi; Lau, Joseph T F; Feng, T; Hong, F; Cai, Y; Zhou, H; Liu, X

    2014-01-01

    This study investigated the associations between sexual dysfunction and unprotected anal intercourse among adult Chinese men who have sex with men; 519 participants who had had anal sex (past 12 months) were recruited from gay venues (Hong Kong and Shenzhen) and from the Internet (Hong Kong). Respectively, 48.9% and 59.6% (p< .05) of the Hong Kong and Shenzhen participants had had at least one type of sexual dysfunction for 3 consecutive months (past 12 months); the difference may be explained by differential income levels or other factors. After adjustment for significant background variables, three variables related to sexual dysfunction (premature ejaculation, erectile dysfunction, and experienced at least one sexual dysfunction) were significantly associated with unprotected anal intercourse in the Hong Kong (adjusted odds ratio = 1.65-2.80) and Shenzhen samples (adjusted odds ratio = 5.46-6.41). Anxiety about sex was significant only in the Shenzhen sample (adjusted odds ratio = 8.67). The associations may be results of coping toward sexual dysfunction. Sexual dysfunction is prevalent and may contribute to unprotected anal intercourse among men who have sex with men in China. Physiological damages of receptive anal sex may contribute to some types of sexual dysfunction. However, one limitation is that participants were not asked about insertion/receptive anal sex. HIV interventions targeting men who have sex with men in China need to take counseling related to sexual dysfunction into account.

  14. Posterior fossa decompression combined with resection of the cerebellomedullary fissure membrane and expansile duraplasty: a radical and rational surgical treatment for Arnold-Chiari type I malformation.

    PubMed

    Liang, Chen Jian; Dong, Qiu Jian; Xing, You Heng; Shan, Ma; Wen, Lian Xiao; Qiang, Zhong Yuan; Ping, Zhang Qing; Tao, Peng Zhi; Ping, Huang Xiao

    2014-12-01

    This study aims to introduce a new surgical procedure for the treatment of Arnold-Chiari type I malformation (ACM-1) and to compare its effectiveness with the techniques described in previous studies. We performed the following procedures: foramen magnum decompression combined with the removal of both the atlanto-occipital membrane, extended resection of the cerebellomedullary fissure arachnoid membrane, and artificial duraplasty to enlarge the membranic posterior fossa without resecting the cerebellar tonsils and syringosubarachnoid shunting. There were 21 ACM-1 patients: 12 cases had osteo-compression on the cerebellar hemisphere, 18 cases had thickened adhered fabric ring that stretched from arachnoid membrane to cerebellar hemisphere, and 15 cases with syringomyelia. The patients were followed up for 6 months to 3 years after the surgery. All patients showed a remarkable recovery of syringomyelia. There were no morbidity or death related to the surgery. Most of ACM-1 patients, the osteo- and membrane compression on cerebellar hemisphere and tonsil were observed during the operation. Therefore, decompression of foramen magnum and posterior craniocervical combined with the removal of cerebellomedullary fissure arachnoid membrane and placement of an artificial dural graft should be considered as a comprehensive option of minimally invasive surgery and rational and radical treatment of ACM-1. Our experience showed that, by using our procedure, shunting becomes no longer necessary in the treatment of ACM-1-associated syringomyelia.

  15. Can extended photoactivation time of resin-based fissure sealer materials improve ultimate tensile strength and decrease water sorption/solubility?

    PubMed Central

    Borges, Boniek Castillo Dutra; Souza-Júnior, Eduardo José; Catelan, Anderson; Paulillo, Luís Alexandre Maffei Sartini; Aguiar, Flávio Henrique Baggio

    2012-01-01

    Objective: This study aimed to evaluate the impact of extended photoactivation time on ultimate tensile strength (UTS), water sorption (WS) and solubility (WSB) of resin-based materials used as fissure-sealants. Methods: A fissure-sealant (Fluroshield) and a flowable composite (Permaflo) polymerized for 20 and 60 seconds were tested. For UTS, 20 hourglass shaped samples were prepared representing two materials and two photoactivation time (n=5). After 24-h dry-storage, samples were tested in tension using a universal testing machine at a cross-head speed of 0.5 mm/min (UTS was calculated in MPa). For WS and WSB, 20 disks with 5 mm diameter and 1 mm height (n=5) were prepared and volumes were calculated (mm3). They were transferred to desiccators until a constant mass was obtained (m1) and were subsequently immersed in distilled water until no alteration in mass was detected (m2). Samples were reconditioned to constant mass in desiccators (m3). WS and WSB were determined using the equations m2-m3/V and m1-m3/V, respectively. Data were subjected to two-way ANOVA and Tukey’s HSD test (P<.05). Results: There was no significant difference between materials or photoactivation times for the UTS and WS. Permaflo presented lower but negative WSB compared to Fluroshield. Conclusions: Extended photoactivation time did not improve the physical properties tested. Fluroshield presented physical properties that were similar to or better than Permaflo. PMID:23077420

  16. Influence of etching time and bonding strategies on the microshear bond strength of self- and light-cured pit-and-fissure sealants.

    PubMed

    Souza-Junior, Eduardo José; Borges, Boniek Castillo Dutra; Montes, Marcos Antônio Japiassú Resende; Alonso, Roberta Caroline Bruschi; Ambrosano, Glaucia Maria Bovi; Sinhoreti, Mário Alexandre Coelho

    2012-01-01

    This study evaluated the impact of extended etching and bonding strategies on the microshear bond strength of three sealant materials. Two pit-and-fissure sealants [FluroShield, Dentsply (light-cured) and AlphaSeal, DFL (self-cured)] and one light-cured flowable composite resin (Permaflo, Ultradent) were evaluated according to different enamel etching times (15 s or 30 s) and bonding procedures (no adhesive application, application of primer/hydrophobic resin or hydrophobic resin only). Intact enamel blocks were obtained from bovine teeth and sealed via the tested protocols. After 24 h, the microshear bond strength test was performed in a universal testing machine at a crosshead speed of 0.5 mm/min. Failure modes were classified by stereomicroscopy. Data were submitted to a three-way ANOVA and to Tukey's test (α=0.05). There was no statistically significant difference (p>0.05) among the materials. Permaflo showed higher bond strength when etched for 30 s alone. Enamel overetching decreased the bond strength of the light-cured sealant. Primer/bond previous treatment improved bond performance for AlphaSeal. In conclusion, from the tested conditions, all sealant materials presented similar bond strength values in relation to bonding protocol and etching time. The flowable composite can be used as a pit-and-fissure sealant. The use of a three-step adhesive system was essential for the self-cured sealant application.

  17. Remote sensing and petrological observations on the 2012-2013 fissure eruption at Tolbachik volcano, Kamchatka: Implications for reconstruction of the eruption chronology

    NASA Astrophysics Data System (ADS)

    Melnikov, Dmitry; Volynets, Anna O.

    2015-12-01

    We present a reconstruction of the chronological sequence of events that took place during the first days of the 2012-2013 Tolbachik fissure eruption using petrological data and remote sensing methods. We were forced to use this approach because bad weather conditions did not allow direct observations during the first two days of the eruption. We interpreted infrared images from the scanning radiometer VIIRS Suomi NPP and correlated the output with the results of the geochemical study, including comparison of the ash, deposited at the period from 27 to 29 November, with the samples of lava and bombs erupted from the Menyailov and Naboko vents. We argue that the compositional change observed in the eruption products (the decrease of SiO2 concentration and K2O/MgO ratio, increase of MgO concentration and Mg#) started approximately 24 h after the eruption began. At this time the center of activity moved to the southern part of the fissure, where the Naboko group of vents was formed; therefore, this timeframe also characterizes the timing of the Naboko vent opening. The Naboko group of vents remained active until the end of eruption in September 2013.

  18. 3D model of fault and fissures structure of the Kovdor Baddeleyite-Apatite-Magnetite Deposit (NE of the Fennoscandian Shield)

    NASA Astrophysics Data System (ADS)

    Zhirov, Dmitry; Klimov, Sergey

    2015-04-01

    The Kovdor baddeleyite-apatite-magnetite deposit (KBAMD) is represented by a large vertical ore body and is located in the southwestern part of the Kovdor ultramafic-alkaline central-type intrusion. The intrusion represents a concentrically zoned complex of rocks with an oval shape in plan, and straight zoning, which complies with the injection and displacement of each of further magma phases from the center towards the periphery. The operation of the deposit in open pits started in 1962, and nowadays, it has produced over 500,000,000 tons of ore. This is one of the largest open pits in the Kola region, which is ca. 2 km long, 1.8 km wide, and over 400 m deep. Regular structural studies has been carried out since late 1970. A unique massif of spatial data has been accumulated so far to include over 25,000 measurements of fissures and faults from the surface, ca. 20,000 measurements of fissures in the oriented drill core (over 18 km) etc. Using this data base the 3D model of fault and fissures structure was designed. The analysis of one has resulted in the identification of a series of laws and features, which are necessary to be taken into account when designing a deep open pit and mining is carried out. These are mainly aspects concerning the origin, kinematics, mechanics and ratio of spatial extension of various fault systems, variation of their parameters at deep horizons, features of a modern stress field in the country rocks, etc. The 3D model has allowed to divide the whole fracture / fissure systems of the massif rocks into 2 large groups: prototectonic system of joints, including cracks of 'liquid magmatic (carbonatite stage) contraction genesis', and newly formed faults due to the superimposed tectonic stages. With regard to the deposit scale, these are characterized as intraformational and transformational, respectively. Each group shows a set (an assemblage) of fault systems with unique features and signs, as well as regular interconnections. The

  19. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

    PubMed Central

    2012-01-01

    Background The incidence of anal cancer, a Human Papillomavirus (HPV)-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM). Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years). Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL). Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23), and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81). A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among MSM to protect them

  20. Identification of possible recent water/lava source fissures in the Cerberus Plains: stratigraphic and crater count age constraints

    NASA Astrophysics Data System (ADS)

    Thomas, Rebecca J.

    2013-04-01

    The Cerberus plains are one of the youngest surfaces on Mars. They are thought to have been formed by lava and/or water flows, but there is considerable debate regarding the source of this material. Much of the material forming the western plains, including the Athabasca Valles outflow channels, appears to have flowed from the region of the Cerberus Fossae graben system [1,2,3] and limited areas forming the eastern plains may have been erupted by low shield volcanoes [4,5]. However, flow of material from west to east is obstructed by a ridge centred on 157°E, 7°N and, prior to this study, vents which might be the source of fluid of a low enough viscosity to form the majority of the flat eastern plains had not been identified. We studied new HiRISE (25cm/px, High Resolution Science Imaging Experiment) images of the ridge between the east and west plains and observed possible source vents for this material: the ridge is cut by a series of pits and fissures which lie at the heads of flows and channels extending towards the surrounding plains. In order to establish the stratigraphic relationships between the vents and plains, this study produced large scale geomorphological maps based on the HiRISE images. The mapping showed that both incised channels and leveed flows extend onto the plain to the south of the ridge and that these were the final phase of plains-forming activity in that region. Conversely, to the north, ridge-sourced deposits only form the plains surface close to the ridge - beyond that, they are overlain by large-scale regional flows that appear to have originated from the direction of Athabasca Valles. In the southeast, a large-scale flow which does not emanate from this ridge forms the plains surface, but there is evidence that the youngest outflow activity from the ridge was contemporaneous with emplacement of this unit. We also performed crater counts to age-date the surfaces and these indicate that plains-forming and ridge-sourced units are of a

  1. Chronic migraine.

    PubMed

    Valade, D

    2013-05-01

    The second edition of the International Classification of Headache Disorders revised in 2006 (ICHD-2R) gives a definition which requires 15 or more headache days per month over the past 3months with at least eight headache days per month that meet criteria for migraine without aura or that responds to migraine specific treatment. Approximately 2% of the global population suffers of chronic migraine (CM). Frequency of headache and degree of disability distinguish CM from episodic migraine (EM). There is a high frequency of medication overuse. The treatment depends on evaluation with education, lifestyle modifications, and trigger management, behavioral and pharmacologic therapies.

  2. [Multiple chronic subdural hematoma in shaken-baby syndrome].

    PubMed

    Haga, Sei; Ishido, Katsuya; Inada, Nariyasu; Sakata, Shuji

    2004-08-01

    We described a case of shaken-baby syndrome with multiple chronic subdural hematomas. A 10-month-old male baby was admitted to our hospital because of loss of consciousness and convulsions. CT scan revealed an acute subarachnoid hemorrhage extending into the interhemispheric fissure and supracerebellar space. The patient was treated conservatively, and discharged from the hospitaL Two months after ictus, a baby was admitted to our hospital with general fatigue. CT scan demonstrated multiple chronic subdural hematomas. Burr hole irrigation and drainage brought about complete disappearance of these lesions. Retrospectively, it was found that these multiple subdural hematomas were due to shaken-baby syndrome. Shaken-baby syndrome is a form of child abuse that can cause significant head injury, and subdural hematoma is the most common manifestation. It is well known that the outcome of shaken-baby syndrome is generally not good. It is important to suspect shaken-baby syndrome when a chronic subdural hematoma is seen in a baby.

  3. Anal Pain

    MedlinePlus

    ... change in bowel habit or rectal bleeding. A hemorrhoid that develops quickly or is particularly painful may ... your doctor. The blood clot of a thrombosed hemorrhoid, although painful, can't break loose and travel, ...

  4. Anal Cancer

    MedlinePlus

    ... Content ASCO Conquer Cancer Foundation Journal of Clinical Oncology Journal of Oncology Practice ASCO University Donate eNEWS SIGNUP f Cancer. ... of medical, surgical, radiation, gynecologic, and pediatric oncologists, oncology nurses, physician assistants, social workers, and patient advocates. ...

  5. [Anal cytology].

    PubMed

    Tóth, Béla; Sápi, Zoltán; Bánhegyi, Dénes; Marschalkó, Márta; Kárpáti, Sarolta

    2015-01-04

    Bevezetés: Az anális carcinoma incidenciája az utóbbi évtizedekben folyamatosan emelkedett, különösen a humán immundeficientia vírussal fertőzött homoszexuális populációban. Az anális laphámrák potenciális prekurzora az anális intraepithelialis neoplasia, amelynek elődleges szűrőtesztje a citológiai vizsgálat. Célkitűzés: A szerzők a Semmelweis Egyetem, Bőr-, Nemikórtani és Bőronkológiai Klinika Országos STD Centrumában humán immundeficientia vírus pozitív betegeknél végzett anális citológiai vizsgálatok eredményének értékelését tűzték ki célul. Módszer: 2011. november 1. és 2014. augusztus 31. között a klinikán 140 betegnél 155 anális citológiai vizsgálat történt. Eredmények: A betegek 44%-ánál találtak anális dysplasiát, és mindössze 1,6%-ban high grade laesiót. Nagyobb betegszámú vizsgálatokkal összehasonlítva ez az arány alacsonyabb. Következtetések: A vizsgálat felhívja a figyelmet a kockázati csoportban végzett rendszeres szűrővizsgálat fontosságára. Orv. Hetil., 2015, 156(1), 24–27.

  6. Anal Itching

    MedlinePlus

    ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...

  7. Anal Warts

    MedlinePlus

    ... Resource Library Brochures and Product Store Career Center DC&R Journal Access Member Directory Educational Resources American ... all the circumstances presented by the individual patient. DC&R Journal Diseases and Conditions Find A Surgeon ...

  8. Chronic pancreatitis.

    PubMed

    Lindley, Keith J

    2006-10-01

    Chronic pancreatitis (CP) is characterised by pancreatic inflammation and fibrosis leading eventually to destruction of pancreatic parenchyma and loss of exocrine and endocrine function. A model of interactions between environmental triggers of pancreatic inflammation and disease susceptibility or modifying genes (including PRSS1, SPINK1 and CFTR) provides a framework within which to understand disease pathogenesis. Early in the disease, when fibrosis is mild and pancreatic damage limited, it is difficult to distinguish CP from recurrent acute pancreatitis (RAP) although it is likely these represent opposite ends of a spectrum of disease with a common aetiology in which CP represents either a later disease stage or disease in individuals predisposed to generate a chronic fibrogenic inflammatory response. Pain is a dominant feature resulting in part from neuroimmune interactions within the pancreas. Diagnosis at an early stage of disease is challenging, though in later stages is dependent upon the demonstration of pancreatic fibrosis and duct ectasia using one or more imaging modalities including transabdominal and endoscopic ultrasound, CT and MRCP or ERCP. Current treatments are largely supportive and reactive. The challenge for pediatricians is to achieve diagnosis at an early stage of the disease and to develop treatments that can alter its natural history.

  9. Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

    PubMed Central

    Kim, Sun Jung; Lee, Sang Gyu; Kim, Tae Hyun

    2015-01-01

    Purpose Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. Materials and Methods Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. Results Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. Conclusion Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out. PMID:26446659

  10. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

    PubMed

    Semple, Shirley J; Strathdee, Steffanie A; Pitpitan, Eileen V; Chavarin, Claudia; Patterson, Thomas L

    2015-05-01

    Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.

  11. Anal intraepithelial neoplasia among HIV-positive men who have sex with men.

    PubMed

    Mata-Marín, José A; Hernández-Figueroa, Jorge; Huerta-García, Gloria; Sandoval-Ramírez, Jorge; Pichardo-Farfán, Miguel; Manjarrez-Tellez, Bulmaro; Ramírez-Mendoza, Pablo; Gaytan-Martínez, Jesús

    2015-11-01

    Neoplasia is the second most common cause of mortality in HIV patients. The prevalence of anal cancer among men who have sex with men (MSM) has continued to increase since the introduction of antiretroviral therapy. We screened 94 HIV-infected MSM patients. We found high-grade squamous intraepithelial lesions (HSIL) in six of the patients. The calculated prevalence of HSIL was 6.4% (95% confidence interval: 2.9-13.2). The study and implementation of screening programs for high-risk groups is a priority.

  12. [Squamous carcinoma of the anal canal and its variations. Personal experience and review of the literature].

    PubMed

    Messinetti, S; Marzullo, A; Giacomelli, L; Manno, A; Pavone, M G; Fabrizio, G; Finizio, R; Porcelli, C; Granai, A V

    1994-01-01

    Six cases of anal canal squamous carcinoma are presented. The authors precise the present view about pathological, epidemiological, clinical and therapeutical aspects of these lesions. They stress, also, the primary role of embryology and anatomy in the oncogenesis of such tumours; the importance to single out specific population at risk, absolutely different from the typical one for rectal adenocarcinoma and the role of chemoradiation therapy as treatment of choice of these neoplasms. Particular importance is given to modern histologic and histogenetic classification of these tumours, stressing the difficulties to distinguish the various histologic types.

  13. Multisite HPV16/18 Vaccine Efficacy Against Cervical, Anal, and Oral HPV Infection

    PubMed Central

    Kreimer, Aimée R.; Schiffman, Mark; Herrero, Rolando; Wacholder, Sholom; Rodriguez, Ana Cecilia; Lowy, Douglas R.; Porras, Carolina; Schiller, John T.; Quint, Wim; Jimenez, Silvia; Safaeian, Mahboobeh; Struijk, Linda; Schussler, John; Hildesheim, Allan; Gonzalez, Paula

    2016-01-01

    Background: Previous Costa Rica Vaccine Trial (CVT) reports separately demonstrated vaccine efficacy against HPV16 and HPV18 (HPV16/18) infections at the cervical, anal, and oral regions; however, the combined overall multisite efficacy (protection at all three sites) and vaccine efficacy among women infected with HPV16 or HPV18 prior to vaccination are less known. Methods: Women age 18 to 25 years from the CVT were randomly assigned to the HPV16/18 vaccine (Cervarix) or a hepatitis A vaccine. Cervical, oral, and anal specimens were collected at the four-year follow-up visit from 4186 women. Multisite and single-site vaccine efficacies (VEs) and 95% confidence intervals (CIs) were computed for one-time detection of point prevalent HPV16/18 in the cervical, anal, and oral regions four years after vaccination. All statistical tests were two-sided. Results: The multisite woman-level vaccine efficacy was highest among “naïve” women (HPV16/18 seronegative and cervical HPV high-risk DNA negative at vaccination) (vaccine efficacy = 83.5%, 95% CI = 72.1% to 90.8%). Multisite woman-level vaccine efficacy was also demonstrated among women with evidence of a pre-enrollment HPV16 or HPV18 infection (seropositive for HPV16 and/or HPV18 but cervical HPV16/18 DNA negative at vaccination) (vaccine efficacy = 57.8%, 95% CI = 34.4% to 73.4%), but not in those with cervical HPV16 and/or HPV18 DNA at vaccination (anal/oral HPV16/18 VE = 25.3%, 95% CI = -40.4% to 61.1%). Concordant HPV16/18 infections at two or three sites were also less common in HPV16/18-infected women in the HPV vaccine vs control arm (7.4% vs 30.4%, P < .001). Conclusions: This study found high multisite vaccine efficacy among “naïve” women and also suggests the vaccine may provide protection against HPV16/18 infections at one or more anatomic sites among some women infected with these types prior to HPV16/18 vaccination. PMID:26467666

  14. Anal atresia, abnormal genitalia, and absent thumb: congenital malformations associated with mosaic ring chromosome 13.

    PubMed

    Ocak, Z; Ozlu, T; Vural, M

    2013-01-01

    Because of the deletion of a segment of the chromosome during the formation of a ring, several clinical findings may be associated with ring chromosomes. Ring chromosome 13 is one of such disorders in which the genotype-phenotype correlation is stronger by virtue of the accumulating literature. It can be associated with multiple congenital abnormalities and severe mental retardation. We report a case with mosaic ring chromosome 13 whose prenatal ultrasound revealed bilateral ventriculomegaly. Anal atresia, unidentifiable external genitalia, and an absent thumb were observed in the postmortem examination.

  15. Near-Vent, Fissure-Fed Lava Channel Network Morphologies in the Kīlauea December 1974 Flow: Implications for Differentiating Lava Construction From Fluvial Erosion on Planets

    NASA Astrophysics Data System (ADS)

    Bleacher, J. E.

    2015-12-01

    Streamlined islands are often assumed to be the product of erosion by water and are cited as evidence of aqueous flows on Mars. However, lava can build streamlined islands in a manner that is more easily explained by flow thickening followed by partial drainage of preferred lava pathways. Kīlauea's December 1974 (D1974) flow was emplaced as a broad sheet-like flow from a series of en echelon fissures across an older hummocky pāhoehoe tumulus field. The lavas surrounded the tumuli and coalesced to fill a topographic low near the basal scarp of the Koae Fault System. As these obstacles were inundated by the D1974 flow, the lava preferentially cooled around the tumuli to form a higher viscosity zone beneath a smooth crust. Stagnation of these thinner, cooler, and more viscous zones focused the flow into a series of preferred lava pathways located between the stagnant islands. Changes in the local discharge rate disrupted the crust of the flow above the lower viscosity pathways. Older tumuli adjacent to the D1974 flow display the same relief as the flow's islands and uncovered portions of this older flow are exposed at the tops of many islands, supporting an interpretation that islands were anchored by high-standing pre-flow tumuli. As the local lava supply waned, partial drainage of the preferred pathways occurred between the higher-standing surfaces anchored to the older tumuli. The resulting morphology consists of a relatively smooth flow field with thin margins that is dissected by depressed pathways or channels. This morphology resembles an erosional surface incised into a smooth plain, but actually represents an initial constructional process followed by partial drainage within a viscous lava flow. Many other Hawaiian rift zone, fissure-fed flow fields display comparable morphologies in the near vent facies, including islands, terraces, thin flow margins and a lack of well defined topographic levees along channels. Thus, branching channel networks and

  16. Drug use, interpersonal attraction, and communication: situational factors as predictors of episodes of unprotected anal intercourse among Latino gay men.

    PubMed

    Wilson, Patrick A; Díaz, Rafael M; Yoshikawa, Hirokazu; Shrout, Patrick E

    2009-08-01

    It is important to understand situational factors linked to episodes of unprotected sexual intercourse among Latino gay men (LGM), who are disproportionately affected by HIV/AIDS in the U.S. Past research has suggested that participation in difficult sexual situations mediates the relationship between socio-cultural factors and sexual risk behaviors among LGM. This study examined drug use by self and sex partners, interpersonal factors, and other key variables, each examined at the situation-level of analysis, as predictors of episodes of unprotected anal intercourse (UAI) among LGM. Study participants included 270 LGM living in New York City, Miami, and Los Angeles who reported inconsistent condom use during anal intercourse in the last year. Men participated in structured interviews in which they were asked sets of detailed questions about their most recent episode of anal intercourse in which they used condoms, and their most recent anal intercourse episode in which they did not use condoms. Conditional logistic regression was used to compare the relevance of specific situational factors to participants' episodes of UAI and protected anal intercourse. We found that drug use by a sex partner and lacks of discussions about condom use with partners, among other situational factors, were significantly related to episodes of UAI. The findings highlight the importance of considering the impact of sexual situations and interactions with sex partners when studying HIV risk among LGM and when designing interventions.

  17. Anal human papillomavirus infection in a street-based sample of drug using HIV-positive men.

    PubMed

    Cranston, R D; Murphy, R; Weiss, R E; Da Costa, M; Palefsky, J; Shoptaw, S; Gorbach, P M

    2012-03-01

    HIV facilitates an increase in human papillomavirus (HPV)-associated conditions. HIV-positive men living in a substance use context in Los Angeles, USA, were recruited using respondent-driven sampling, completed a questionnaire and had biological samples including an anal HPV swab taken. A total of 316 evaluable men were enrolled in the study. The prevalence of any HPV, high-risk (HR) infection and multiple-type infection was highest for men who have sex with men (MSM) (93.9%, 64.6% and 29.7%, respectively). When any HPV and HR-HPV prevalence in all men was stratified by age, the youngest group had 100% and 68.2% prevalence, respectively, with similarly high rates maintained up to age 49 years. The individual's use of alcohol, marijuana, cocaine, methamphetamine or heroin was not significantly associated with anal HPV detection. In this marginalized population, high prevalence rates of anal HPV and HR-HPV occurring over a wide age range may increase the individual's risk for anal dysplasia and anal cancer.

  18. A new possibility for repairing the anal dysfunction by promoting regeneration of the reflex pathways in the enteric nervous system.

    PubMed

    Katsui, Renta; Kojima, Yu; Kuniyasu, Hiroki; Shimizu, Juichiro; Koyama, Fumikazu; Fujii, Hisao; Nakajima, Yoshiyuki; Takaki, Miyako

    2008-04-01

    Moderate rectal distension elicits recto-rectal reflex contractions and simultaneous recto-internal anal sphincter reflex relaxations that together comprise the defecation reflex. Both reflexes are controlled by 1) pelvic nerves, 2) lumbar colonic nerves, and 3) enteric nervous system. The aim of the present study was to explore a novel approach to repairing the defecation reflex dysfunction by using the plasticity of enteric nervous pathways. Experiments were performed in anesthetized guinea pigs with ethyl carbamate. The rectum 30 mm oral from the anal verge was transected without damage to extrinsic nerves, and subsequent end-to-end one-layer anastomosis was performed. Recovery of the defecation reflex and associated reflex pathways were evaluated. Eight weeks after sectioning of intrinsic reflex nerve pathways in the rectum, the defecation reflex recovered to the control level, accompanied with regeneration of reflex pathways. The 5-HT(4)-receptor agonist mosapride (0.5 and 1.0 mg/kg) significantly (P < 0.01) enhanced the recovered defecation reflex 8 wk after surgery. Two weeks after local treatment with brain-derived neurotrophic factor (BDNF: 10(-6) g/ml) at the rectal anastomotic site, the recto-internal anal sphincter reflex relaxations recovered and some bundles of fine nerve fibers were shown to interconnect the oral and anal ends of the myenteric plexus. These results suggested a possibility for repairing the anal dysfunction by promoting regeneration of the reflex pathways in the enteric nervous system with local application of BDNF.

  19. Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada.

    PubMed

    Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

    2016-08-01

    This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called "sex drugs," i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.

  20. 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.

    PubMed

    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

    2015-12-01

    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 trained to label the detected nodule. The classification of the nodule in 3D is formulated as an ensemble of classifiers trained to recognize PFNs based on 2D views of the nodule. In order to describe nodule morphology in 2D views, we use the output of a pre-trained convolutional neural network known as OverFeat. We compare our approach with a recently presented descriptor of pulmonary nodule morphology, namely Bag of Frequencies, and illustrate the advantages offered by the two strategies, achieving performance of AUC = 0.868, which is close to the one of human experts.

  1. Metastatic anal sac carcinoma with hypercalcaemia and associated hypertrophic osteopathy in a dog

    PubMed Central

    Giuliano, A.; Salgüero, R.; Dobson, J.

    2015-01-01

    A seven-year-old male neutered Irish setter was treated for a metastatic anal sac adenocarcinoma (ASAC) and hypercalcaemia by complete surgical excision of the primary tumour and partial excision of the sublumbar lymph nodes. Further enlargement of the sublumbar lymph nodes was linked to recurrent hypercalcaemia 3 months after surgical treatment. Medical treatment with Toceranib and Clodronate showed modest results in the treatment of the tumour and the hypercalcaemia. Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy resulted in partial tumour remission with marked reduction in size of the lymph nodes and normalization of the calcaemia. Unfortunately, concurrently with subsequent relapse of the hypercalaemia, the dog developed hypertrophic osteopathy (HO) and lumbar spinal metastasis and the dog was euthanized. To the authors’ knowledge, this is the second case of metastatic apocrine gland carcinoma of the anal sac associated with HO and the first case that describe the development of HO late in the stage of the disease. PMID:26623365

  2. Novel artificial anal sphincter system based on transcutaneous energy transmission system tested in vivo.

    PubMed

    Wang, Yongbing; Liu, Hua; Xu, Qianqian; Yan, Guozheng

    2013-12-01

    This paper proposes a novel artificial anal sphincter system (AASS) for severe fecal incontinence. The AASS is composed of an artificial anal sphincter (AAS), an external transcutaneous energy transmission system (TETS), and an external control device. The AAS is composed of a cuff, a micropump, a reservoir, and a remote control device. It is designed to be implanted into the body of the patient. The function of the AAS is to open and close the patient's natural anus. Patients suffering from loss of their natural sphincter lose rectal sensation and are thus unable to perceive imminent fecal incontinence. In order to restore rectal sensation, a pressure sensor in the AAS cuff is designed to detect pressure in the colon. The pressure reflects the present quantity of colon contents, allowing patients to control the AAS to open or close the anus according to the pressure. The TETS is designed to provide electrical energy to the implanted AAS without wire connections. The external control device is designed to receive the pressure information from the AAS and send the patient's command to the implanted device. This paper provides a thorough discussion of the design of the novel AASS and describes the performance of the AASS when tested in vivo on two Beagle dogs who were chosen to be the subjects for receiving the implant. The experimental results verified that the performance of the AASS met the functional requirements it was designed for; however, the trial also revealed some challenges to be further studied.

  3. Correlates of unprotected anal sex among men who have sex with men in Tijuana, Mexico

    PubMed Central

    2012-01-01

    Background Although men who have sex with men (MSM) are disproportionately affected by HIV/AIDS in Mexico, data on current risk behaviors in this population are lacking. This study investigated the prevalence and correlates of unprotected anal intercourse (UAI) in a sample of 260 MSM in Tijuana, Mexico. Methods In June 2010, men attending a gay pride celebration were invited to complete a sexual risk survey. Men who reported UAI with a male partner in the past year were compared with men who reported only protected anal sex during the same period. Results Mean age of participants was 29.7; 54% had a high school diploma or less; and 43% were unemployed. In the past year, 55% had been tested for HIV, 21% reported using illicit drugs before or during sex, and 94% had sex only with men. Overall, 50% reported having UAI with another male in the past year. Factors independently associated with UAI in the past year were unemployment (AOR = 1.87), attending adult movie theaters (AOR = 2.21), using illicit drugs before or during sex (AOR = 2.43), and not having a recent HIV test (AOR = 1.85). Conclusions Interventions to promote HIV testing and condom use among men who have sex with men may want to consider venue-specific approaches, as well as focus on drug-use issues in the context of unsafe sex. PMID:22694837

  4. Extramammary Paget’s Disease of Anal Canal Associated With Rectal Adenoma Without Invasive Carcinoma

    PubMed Central

    Chumbalkar, Vaibhav; Jennings, Timothy A.; Ainechi, Sanaz; Lee, Edward C.; Lee, Hwajeong

    2016-01-01

    Extramammary Paget’s disease (EMPD) is a rare disease which is found in apocrine-rich locations such as anogenital region, axilla and rarely in other sites. Perianal EMPD is often reported as the involvement of perianal skin, but involvement of anal mucosa is very rare. Based on pathogenesis and association with either synchronous or metachronous malignancy, EMPD can be divided into primary and secondary types. Treatment approach for these two types of Paget’s disease and their prognosis is different, thus it is important to make the distinction. Secondary type of Paget’s disease is almost always described in association with invasive malignancy. While secondary Paget’s disease arising in association with ductal carcinoma in situ of the breast is common, secondary EMPD associated with precursor lesion of the rectum without invasion is exceedingly rare. We report a very rare case of secondary Paget’s disease of the anal canal in association with rectal tubular adenoma (precursor lesion) without malignancy. PMID:28058078

  5. Pharmacological evaluation for improvement of Kanazawa Sutra, medicinal thread for anal fistula.

    PubMed

    Yokogawa, Takami; Sasaki, Yohei; Ando, Hirokazu; Yamamoto, Katsuya; Mikage, Masayuki

    2017-04-01

    Kanazawa Sutra (KanS) is a medicinal thread that is used for the treatment of anal fistula. It is used as a substitute for Kshara Sutra (KS) which is used in Ayurvedic medicine. KanS is composed of Ficus carica latex (FCL), Capsicum annuum tincture (CAT), Achyranthes fauriei Kshara (which is processed ash from the whole plant) and powdered Curcuma longa rhizome (CLR). In this study, we evaluated the ingredients of KanS by measuring nitric oxide (NO) production in murine macrophage-like cell line J774.1 as well as examining cytotoxicity to rat skeletal muscle myoblasts (L6) and L6 differentiation, with a view to improving its pharmacological effect. We focused on Mallotus japonicus bark (MJB), which is described in the Japanese Pharmacopeia and belongs to the Euphorbiaceae family. Its biological activities were evaluated in a similar manner to the evaluation of KanS ingredients. We found that MJB extracts showed similar biological activity to Euphorbia neriifolia latex (ENL), an ingredient of KS. We conclude that the NO inhibitory activity of KanS is mainly due to CLR, and its cytotoxicity to L6 and inhibitory activity on L6 differentiation are mainly due to CLR and FCL. As CAT has no characteristic activity, the biological activity and the anal fistula treatment ability of KanS would be improved by substituting MJB for CAT.

  6. First anal intercourse and condom use among men who have sex with men in Switzerland.

    PubMed

    Balthasar, Hugues; Jeannin, André; Dubois-Arber, Françoise

    2009-12-01

    The aim of this study was to analyze the circumstances of first anal intercourse (FAI) among men who have sex with men (MSM) and to identify factors associated with condom use at this event. We conducted a cross-sectional survey among a convenience sample of MSM living in Switzerland (N = 2,200). Anonymous questionnaires were distributed using Swiss gay communication channels (newspapers, associations, websites) and gay bathhouses. We gathered data on age at FAI, age of the partner, degree of familiarity with him, place of first meeting, and sociodemographic indicators. We did not ask whether FAI was insertive, receptive, or both. Data were stratified by birth year classes (birth cohorts). The median age at FAI fell from 24.5 years among men born before 1965 to 20.0 years among those born between 1975 and 1984 (p < .001). In each birth cohort, between 20 and 30% reported a partner 10 years older or more. Of eight variables examined in multivariate analysis, two were positively associated with condom use: age of participants at FAI and low degree of familiarity between partners. Conversely, large age discrepancy between partners was negatively associated with condom use. In conclusion, our data showed that early initiation of anal intercourse and large age discrepancy were associated with risk taking: a pattern of initiation that may facilitate HIV transmission from older to younger cohorts of MSM. Since age at FAI is on the decrease, there is an urgent need to heighten awareness of prevention actions regarding sexual debut of MSM.

  7. [Perianal mucinous adenocarcinoma. A further reason for histological study of anal fistula or anorectal abscess].

    PubMed

    Marti, L; Nussbaumer, P; Breitbach, T; Hollinger, A

    2001-05-01

    A 39-year-old man came to us for surgical treatment of a hidradenitis suppurativa. Upon excision of a perianal abscess, the diagnosis of a rare tumor, a perianal mucinous adenocarcinoma (pT4, pN 1, MO), was made. An abdominoperineal resection was performed, followed by a combination of adjuvant radiation and chemotherapy. A year after the operation, the patient is doing well without any signs of recurrence. This carcinoma probably arises in the anal glands. It often presents as a perirectal abscess and/or an anal fistula. Therefore, the diagnosis is often delayed. At presentation, the tumor is bigger than 5 cm in diameter in 80% of the cases, and the prognosis is poor. It metastasizes mostly to the superficial inguinal or to the retrorectal lymph nodes. There are only case reports and no comparative studies in the literature. In the last 10 years, the carcinoma has mostly been treated by neoadjuvant radiation and chemotherapy, followed by abdominoperineal resection. Since then, the median survival has increased to 3 years. This is the first case report of a combination of a perianal mucinous adenocarcinoma with a hidradenitis suppurativa.

  8. Minimally Invasive Anal Fistula Treatment (MAFT)-An Appraisal of Early Results in 416 Patients.

    PubMed

    Chowbey, P K; Khullar, R; Sharma, A; Soni, V; Najma, K; Baijal, M

    2015-12-01

    Minimally invasive anal fistula treatment (MAFT) was introduced to minimize early postoperative morbidity, preserve sphincter continence, and reduce recurrence. We report our early experience with MAFT in 416 patients. Preoperative MRI was performed in 150 patients initially and subsequently thereafter. The technique involves fistuloscope-aided localization of internal fistula opening, examination and fulguration of all fistula tracks, and secure stapled closure of internal fistula opening within anal canal/rectum. MAFT was performed as day-care procedure in 391 patients (93.9 %). During surgery, internal fistula opening could not be located in 100 patients (24 %). Seven patients required readmission to hospital. Mean visual analog scale scores for pain on discharge and at 1 week were 3.1 (1-6) and 1.6 (0-3), respectively. Mean duration for return to normal activity was 3.2 days (2-11 days). Fistula recurrence was observed in 35/134 patients (26.1 %) at 1 year follow-up. MAFT may be performed as day-care procedure with benefits of less pain, absence of perianal wounds, faster recovery, and preservation of sphincter continence. However, long-term results from more centers are needed especially for recurrence.

  9. Management of low transsphincteric anal fistula with serial setons and interval muscle-cutting fistulotomy.

    PubMed

    Wang, Chen; Rosen, Lester

    2016-03-01

    This study evaluates low transsphincteric anal fistula managed by serial setons and interval fistulotomy, with attention to healing without recurrence and preservation of continence. Following Institutional Review Board approval, consecutive anal fistula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to follow up. Of the 71 patients, 26 (37%) had low transsphincteric fistula (23 males and 3 females; mean age: 46 years), treated at our institution by seton placement followed by interval surgical muscle cutting and subsequent seton replacement or final fistulotomy. Of the 26 patients, 22 (85%) were initially referred due to previous failed treatment, with a 30.6 month mean duration of fistula prior to referral and a mean of 2.2 (range: 0 -6) prior anorectal surgeries. At a mean follow-up of 11.9 months, none of the 21 patients experienced recurrence or fecal incontinence. Serial seton with interval muscle-cutting sphincterotomy followed by complete fistulotomy is an effective treatment for the management of patients who are either initially seen for low transsphincteric fistula, or referred after failed anorectal surgery for that condition.

  10. Do Eurasian beavers smear their pelage with castoreum and anal gland secretion?

    PubMed

    Rosell, Frank

    2002-08-01

    The scent-matching hypothesis postulates that scent marks provide an olfactory link between a resident owner and his territory, and that this enables intruding animals to recognize the chance of escalated conflicts. However, it is unclear if Eurasian beavers (Castor fiber) mark their own pelage with castoreum from their castor sacs (i.e., the same material used in territorial marking); and/or if beavers mark their pelage with anal gland secretion (AGS) from the anal glands to waterproof the pelage and to act as a "living-scent mark." Chemical analysis (gas chromatography and mass spectrometry) of hair samples from 22 live-trapped beavers revealed that castoreum compounds were not present in any samples, AGS compounds were found from 3 animals (13.6%) around the cloaca, and the compound squalene was found in all the samples. Beavers may release castoreum directly into the water when it meets an intruder. Thereby, the "scent mark" in the water can provide an olfactory link between a resident owner and his territory. Squalene, in contrast to AGS, may be essential for keeping beaver pelts water-repellant.

  11. Disconnection, pouch revision and reconnection of the ileal pouch-anal anastomosis.

    PubMed

    Sagar, P M; Dozois, R R; Wolff, B G; Kelly, K A

    1996-10-01

    The aim of this retrospective study was to determine the outcome of patients with a dysfunctional pelvic ileal reservoir in whom disconnection of an ileal pouch-anal anastomosis (IPAA), pouch revision and reanastomosis had been carried out. There were 23 patients (15 women). At the revision operation functional problems were found to be due to a long efferent spout (nine patients), sepsis and/or fistula (four), a redundant blind limb (three), a twisted pouch (three), anastomotic problems (three) or no reservoir (one). The pouch was salvaged in 16 patients and a new pouch was constructed in seven. The pouch-anal anastomosis was resutured in 22 patients and stapled in one. Postoperative complications (all minor) occurred in six patients. Two patients underwent two revision of IPAA. At a median follow-up of 5 (range 1-10) years, 11 patients reported good to excellent function, five reported fair function and one reported recurrent pouchitis. Revision surgery was unsuccessful in six of 23 patients (three had gross incontinence, two excessive bowel movements and one Crohn's disease), and they subsequently underwent pouch excision. It is concluded that revision of an ileal reservoir and IPAA can be undertaken safely with good results in carefully selected patients.

  12. [Guidelines for delineation of pelvic lymph nodes in anal cancer treatment].

    PubMed

    Vendrely, V; Galland-Girodet, S; Orré, M; Maire, J-P

    2013-10-01

    Squamous cell anal cancer is a rare malignancy, its incidence increases due to higher exposure of the young adults to risk factors. The current management is based on chemoradiotherapy, which is highly effective and achieves locoregional control but causes important morbidity. Improvement of radiation technique such as intensity modulated radiation therapy has led to reduce acute toxicities, but also requires an accurate delineation of the target volumes in order not to underestimate potential and pathological sites resulting in an increase of the locoregional failures. PET scanner has an important place in the pretreatment work-up for staging and targeting the delineation of the volumes, allowing to select patients with localized disease, avoid geographic miss and appropriately boost nodal disease. The study of recurrences sites has not yet provided a real mapping of the recurrences depending on the treatment volumes. Different radiation oncologist cooperative groups have published guidelines and tools for delineation, in order to provide homogeneity but also customize the management of anal carcinoma.

  13. Transanal minimally invasive surgery (TAMIS) approach for large juxta-anal gastrointestinal stromal tumour.

    PubMed

    Wachter, Nicolas; Wörns, Marcus-Alexander; Dos Santos, Daniel Pinto; Lang, Hauke; Huber, Tobias; Kneist, Werner

    2016-01-01

    Gastrointestinal stromal tumours (GISTs) are rarely found in the rectum. Large rectal GISTs in the narrow pelvis sometimes require extended abdominal surgery to obtain free resection margins, and it is a challenge to preserve sufficient anal sphincter and urogenital function. Here we present a 56-year-old male with a locally advanced juxta-anal non-metastatic GIST of approximately 10 cm in diameter. Therapy with imatinib reduced the tumour size and allowed partial intersphincteric resection (pISR). The patient underwent an electrophysiology-controlled nerve-sparing hybrid of laparoscopic and transanal minimally invasive surgery (TAMIS) in a multimodal setting. The down-to-up approach provided sufficient dissection plane visualisation and allowed the confirmed nerve-sparing. Lateroterminal coloanal anastomosis was performed. Follow-up showed preserved urogenital function and good anorectal function, and the patient remains disease-free under adjuvant chemotherapy as of 12 months after surgery. This report suggests that the TAMIS approach enables extraluminal high-quality oncological and function-preserving excision of high-risk GISTs.

  14. Transanal minimally invasive surgery (TAMIS) approach for large juxta-anal gastrointestinal stromal tumour

    PubMed Central

    Wachter, Nicolas; Wörns, Marcus-Alexander; dos Santos, Daniel Pinto; Lang, Hauke; Huber, Tobias; Kneist, Werner

    2016-01-01

    Gastrointestinal stromal tumours (GISTs) are rarely found in the rectum. Large rectal GISTs in the narrow pelvis sometimes require extended abdominal surgery to obtain free resection margins, and it is a challenge to preserve sufficient anal sphincter and urogenital function. Here we present a 56-year-old male with a locally advanced juxta-anal non-metastatic GIST of approximately 10 cm in diameter. Therapy with imatinib reduced the tumour size and allowed partial intersphincteric resection (pISR). The patient underwent an electrophysiology-controlled nerve-sparing hybrid of laparoscopic and transanal minimally invasive surgery (TAMIS) in a multimodal setting. The down-to-up approach provided sufficient dissection plane visualisation and allowed the confirmed nerve-sparing. Lateroterminal coloanal anastomosis was performed. Follow-up showed preserved urogenital function and good anorectal function, and the patient remains disease-free under adjuvant chemotherapy as of 12 months after surgery. This report suggests that the TAMIS approach enables extraluminal high-quality oncological and function-preserving excision of high-risk GISTs. PMID:27279406

  15. In situ hybridization analysis of human papillomavirus in anal squamous cell carcinoma.

    PubMed

    Gal, A A; Saul, S H; Stoler, M H

    1989-09-01

    To investigate the association between human papillomavirus (HPV) infection and anal carcinoma, we applied a sensitive in situ hybridization technique to detect HPV messenger RNA (HPV m-RNA) in formalin-fixed, paraffin-embedded sections from 18 patients. Using tritium-labeled probes, HPV m-RNA was detected in 12/18 (67%) patients. HPV 6 was detected in four patients, coexisting with HPV 18 in two cases, and HPV 16 was found in eight patients. In six patients, hybridization failed to demonstrate the presence of HPV. With respect to histology, HPV 6 was detected in 1/4 cases of well differentiated invasive squamous cell carcinoma. Ten of thirteen moderately or poorly differentiated invasive squamous cell carcinomas demonstrated HPV m-RNA (HPV 16, eight cases; HPV 6, one case; HPV 6 and 18, one case). HPV 31 was not detected in any specimens. These results suggest that HPV infection may play an important role in the pathogenesis of anal carcinoma.

  16. Squamous cell carcinoma of the anal sac in a spotted hyena (Crocuta crocuta).

    PubMed

    Goodnight, Andrea L; Traslavina, Ryan P; Emanuelson, Karen; Affolter, Verena K; Gaffney, Patricia M; Vernau, William; Williams, Colette; Wu, Connie I-kuan; Sturges, Beverly K; Lowenstine, Linda J

    2013-12-01

    A 25-yr-old spayed female spotted hyena (Crocuta crocuta) developed intermittent right pelvic limb lameness that persisted following conservative medical therapy. No obvious musculoskeletal lesions were noted on initial physical exam; however, spinal radiography was suspicious for possible intervertebral degenerative joint disease or discospondylitis. Despite prolonged medical therapy, the lameness progressed to minimal weight bearing and marked muscle atrophy of the right pelvic limb. Electromyography showed spontaneous activity in the muscles of right sciatic nerve distribution. Sensory and motor nerve conduction velocities in the right tibial and peroneal nerves were undetectable and markedly reduced, respectively. A magnetic resonance imaging (MRI) scan revealed a large, space-occupying mass on the right side of the sacrum and pelvis. Antemortem fine-needle aspiration of the mass and postmortem histopathology resulted in diagnosis of a high-grade squamous cell carcinoma of the anal sac. Squamous cell carcinoma of the anal sac is very rare in domestic dogs and previously unreported in spotted hyenas.

  17. Application of Bistatic TanDEM-X Interferometry to Measure Lava Flow Volume and Lava Extrusion Rates During the 2012-13 Tolbachik, Kamchatka Fissure Eruption

    NASA Astrophysics Data System (ADS)

    Kubanek, J.; Westerhaus, M.; Heck, B.

    2015-12-01

    Aerial imaging methods are a well approved source for mapping lava flows during eruptions and can serve as a base to assess the eruption dynamics and to determine the affected area. However, clouds and smoke often hinder optical systems like the Earth Observation Advanced Land Imager (EO-1-ALI, operated by NASA) to map lava flows properly, which hence affects its reliability. Furthermore, the amount of lava that is extruded during an eruption cannot be determined from optical images - however, it can significantly contribute to assess the accompanying hazard and risk. One way to monitor active lava flows is to quantify the topographic changes over time while using up-to-date high-resolution digital elevation models (DEMs). Whereas photogrammetric methods still fail when clouds and fume obstruct the sight, innovative radar satellite missions have the potential to generate high-resolution DEMs at any time. The innovative bistatic TanDEM-X (TerraSAR-X Add-on for Digital Elevation Measurements) satellite mission enables for the first time generating high-resolution DEMs from synthetic aperture radar satellite data repeatedly with reasonable costs and high resolution. The satellite mission consists of the two nearly identical satellites TerraSAR-X and TanDEM-X that build a large synthetic aperture radar interferometer with adaptable across- and along-track baselines aiming to generate topographic information globally. In the present study, we apply the TanDEM-X data to study the lava flows that were emplaced during the 2012-13 Tolbachik, Kamchatka fissure eruption. The eruption was composed of very fluid lava flows that effused along a northeast-southwest trending fissure. We used about fifteen bistatic data pairs to generate DEMs prior to, during, and after the eruption. The differencing of the DEMs enables mapping the lava flow field at different times. This allows measuring the extruded volume and to derive the changes in lava extrusion over time.

  18. Effect of the application of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste and adhesive systems on bond durability of a fissure sealant.

    PubMed

    Borges, Boniek Castillo Dutra; Catelan, Anderson; Sasaki, Robson Tetsuo; Ambrosano, Gláucia Maria Bovi; Reis, André Figueiredo; Aguiar, Flávio Henrique Baggio

    2013-01-01

    This study aimed to evaluate the effect of the previous application of a casein phosphopeptide-amorphous calcium phosphate paste (MI Paste, MI) and adhesive systems on the bond durability of a fissure sealant. Ninety-eight enamel blocks were obtained from proximal surfaces of erupted third molars. Specimens were divided into 14 groups (n = 7) according to the previous application of MI (with and without) and the adhesive systems used (no adhesive system; hydrophobic resin of a three-step etch-and-rinse adhesive system; etch-and-rinse single-bottle adhesive system; all-in-one adhesive system; two-step self-etching adhesive system; additional phosphoric acid conditioning and all-in-one adhesive system; additional phosphoric acid conditioning and two-step self-etching adhesive system). A fissure sealant (Fluroshield) was applied and photoactivated for 20 s. Beams (~0.7 mm(2)) were prepared for the microtensile bond strength test, which was executed after 24 h or 6 months of water storage. Fractured specimens were analyzed by scanning electronic microscopy. Data were analyzed by two-way ANOVA with repeated measures/Tukey's test (P < 0.05). Groups that received MI application and adhesive systems presented higher means than those groups where MI was not applied. Higher frequency of cohesive failures was observed for groups with MI. Applying a CPP-ACP containing paste on enamel before adhesive systems was an effective method to increase bond durability of the sealant tested.

  19. Marginal integrity of pit and fissure sealants. Qualitative and quantitative evaluation of the marginal adaptation before and after in vitro thermal and mechanical stressing.

    PubMed

    Stavridakis, Minos M; Favez, Valerie; Campos, Edson A; Krejci, Ivo

    2003-01-01

    This research quantitatively evaluated the marginal adaptation of pit and fissure sealants. The occlusal surfaces of 48 intact, caries-free human molars were cleaned with an air-abrasion unit. The teeth were then randomly divided into eight groups of six teeth each according to the type of enamel conditioning, sealant material applied and curing unit used. After applying either 40% phosphoric acid gel (K-etch, Kuraray Co) or a self-etching primer adhesive system (Clearfil SE Bond, Kuraray Co), sealant materials of two viscosities were applied (Teethmate F-1 and Protect-Liner-F, Kuraray Co) and cured with halogen (Optilux 500, Demetron) or plasma arc (Apollo-95E, Dental & Medical Diagnostic Systems, Ltd) curing units. The marginal adaptation of the pit and fissure sealant restorations was evaluated by using a computer-assisted quantitative margin analysis in a scanning electron microscope (SEM) on epoxy replicas before and after thermal and mechanical stressing of the teeth. The results were statistically analyzed with one-way analysis of variance (ANOVA) at a confidence level of 95% (p=0.05). A post-hoc Tukey HSD-test was used for multiple pairwise comparisons between groups. The null hypothesis was that there was no statistically significant difference between the groups that were tested in this study. The statistically significant differences between groups were more pronounced after loading. In most cases, the self-etching adhesive system (SE Bond) proved as effective as phosphoric acid etching (K-etch). The low viscosity sealant material (Teethmate F-1), in most cases, exhibited better marginal adaptation than the high viscosity material (Protect-Liner F). The high viscosity material performed equally well only when used in combination with the self-etching primer adhesive system as an intermediate layer. The halogen curing unit (Optilux 500) led to better marginal adaptation than the plasma arc curing unit (Apollo 95E), especially after thermal and mechanical

  20. Chronic subdural hematoma

    MedlinePlus

    Subdural hemorrhage - chronic; Subdural hematoma - chronic; Subdural hygroma ... A subdural hematoma develops when bridging veins tear and leak blood. These are the tiny veins that run between the ...

  1. [Surgical treatment of anal stenosis following hemorrhoid surgery. Results of 150 combined mucosal advancement and internal sphincterotomy].

    PubMed

    Carditello, Antonio; Milone, Antonino; Stilo, Francesco; Mollo, Francesco; Basile, Maurizio

    2002-01-01

    The aim of the study was to evaluate the efficacy of anoplasty by mucosal advancement combined with internal sphincterotomy for the treatment of iatrogenic anal stenosis. From January 1990 to December 2000, 149 patients with post-haemorrhoidectomy anal strictures underwent internal sphincterotomy and mucosal advancement flap anoplasty. Seventy-one percent of patients were operated on under local anaesthesia by perineal block according to Marti. In 90 percent of the patients, postoperative pain was mild. No significant complications were seen. The mean hospital stay was two days. Ninety-seven percent of patients were well satisfied with the surgical result one year after operation. Current surgical options for the treatment of post-haemorrhoidectomy anal stricture are reported and the advantages of mucosal advancement flap anoplasty outlined.

  2. HPV16 E6 seropositivity among cancer-free men with oral, anal or genital HPV16 infection.

    PubMed

    Beachler, Daniel C; Waterboer, Tim; Campbell, Christine M Pierce; Ingles, Donna J; Kuhs, Krystle A Lang; Nyitray, Alan G; Hildesheim, Allan; Pawlita, Michael; Kreimer, Aimée R; Giuliano, Anna R

    2016-12-01

    Antibodies against the Human papillomavirus 16 (HPV16) E6 oncoprotein appear years prior to clinical diagnosis of anal and oropharyngeal cancer, but whether they develop around the time of HPV infection is unclear. Serum samples from 173 cancer-free men from the Human Papillomavirus Infection in Men (HIM) Study were tested for HPV antibodies and DNA. HPV16 E6 seropositivity was low among men with oral HPV16-infection (1/28; 3.6%, 95%CI=0.0%-18.4%), anal HPV16-infection (1/61; 1.6%, 95%CI=0.0%-8.8%), and 24-month persistent genital HPV16-infection (1/84; 1.2%, 0.0-6.5%). This suggests E6 seroconversion may not occur around the time of oral, anal, or genital HPV16 acquisition.

  3. Mean Absorbed Dose to the Anal-Sphincter Region and Fecal Leakage among Irradiated Prostate Cancer Survivors

    SciTech Connect

    Alsadius, David; Hedelin, Maria; Lundstedt, Dan; Pettersson, Niclas; Wilderaeng, Ulrica; Steineck, Gunnar

    2012-10-01

    Purpose: To supplement previous findings that the absorbed dose of ionizing radiation to the anal sphincter or lower rectum affects the occurrence of fecal leakage among irradiated prostate-cancer survivors. We also wanted to determine whether anatomically defining the anal-sphincter region as the organ at risk could increase the degree of evidence underlying clinical guidelines for restriction doses to eliminate this excess risk. Methods and Materials: We identified 985 men irradiated for prostate cancer between 1993 and 2006. In 2008, we assessed long-term gastrointestinal symptoms among these men using a study-specific questionnaire. We restrict the analysis to the 414 men who had been treated with external beam radiation therapy only (no brachytherapy) to a total dose of 70 Gy in 2-Gy daily fractions to the prostate or postoperative prostatic region. On reconstructed original radiation therapy dose plans, we delineated the anal-sphincter region as an organ at risk. Results: We found that the prevalence of long-term fecal leakage at least once per month was strongly correlated with the mean dose to the anal-sphincter region. Examining different dose intervals, we found a large increase at 40 Gy; {>=}40 Gy compared with <40 Gy gave a prevalence ratio of 3.8 (95% confidence interval 1.6-8.6). Conclusions: This long-term study shows that mean absorbed dose to the anal-sphincter region is associated with the occurrence of long-term fecal leakage among irradiated prostate-cancer survivors; delineating the anal-sphincter region separately from the rectum and applying a restriction of a mean dose <40 Gy will, according to our data, reduce the risk considerably.

  4. Male Sex Workers Who Sell Sex to Men Also Engage in Anal Intercourse with Women: Evidence from Mombasa, Kenya

    PubMed Central

    Mannava, Priya; Geibel, Scott; King’ola, Nzioki; Temmerman, Marleen; Luchters, Stanley

    2013-01-01

    Objective To investigate self-report of heterosexual anal intercourse among male sex workers who sell sex to men, and to identify the socio-demographic characteristics associated with practice of the behavior. Design Two cross-sectional surveys of male sex workers who sell sex to men in Mombasa, Kenya. Methods Male sex workers selling sex to men were invited to participate in surveys undertaken in 2006 and 2008. A structured questionnaire administered by trained interviewers was used to collect information on socio-demographic characteristics, sexual behaviors, HIV and STI knowledge, and health service usage. Data were analyzed through descriptive and inferential statistics. Bivariate logistic regression, after controlling for year of survey, was used to identify socio-demographic characteristics associated with heterosexual anal intercourse. Results From a sample of 867 male sex workers, 297 men had sex with a woman during the previous 30 days – of whom 45% did so with a female client and 86% with a non-paying female partner. Within these groups, 66% and 43% of male sex workers had anal intercourse with a female client and non-paying partner respectively. Factors associated with reporting recent heterosexual anal intercourse in bivariate logistic regression after controlling for year of survey participation were being Muslim, ever or currently married, living with wife only, living with a female partner only, living with more than one sexual partner, self-identifying as basha/king/bisexual, having one’s own children, and lower education. Conclusions We found unexpectedly high levels of self-reported anal sex with women by male sex workers, including selling sex to female clients as well as with their own partners. Further investigation among women in Mombasa is needed to understand heterosexual anal sex practices, and how HIV programming may respond. PMID:23300978

  5. Chronic Pancreatitis

    PubMed Central

    DiMagno, Matthew J.; DiMagno, Eugene P.

    2012-01-01

    Purpose of review We review important new clinical observations in chronic pancreatitis (CP) reported in 2011. Recent findings Smoking increases the risk of non-gallstone acute pancreatitis (AP) and the progression of AP to CP. Binge drinking during Oktoberfest did not associate with increased hospital admissions for AP. The unfolded protein response is an adaptive mechanism to maintain pancreatic health in response to noxious stimuli such as alcohol. Onset of diabetes mellitus in CP is likely due to progressive disease rather than individual variables. Insufficient pancreatic enzyme dosing is common for treatment of pancreatic steatorrhea; 90,000 USP U of lipase should be given with meals. Surgical drainage provides sustained, superior pain relief compared to endoscopic treatment in patients advanced CP with a dilated main duct +/− pancreatic stones. The central acting gabapentoid pregabalin affords a modest 12% pain reduction in patients with CP but ~30% of patients have significant side effects. Summary Patients with non-gallstone related AP or CP of any etiology should cease smoking. Results of this year’s investigations further elucidated the pancreatic pathobiology due to alcohol, onset of diabetes mellitus in CP, and the mechanisms and treatment of neuropathic pain in CP. PMID:22782018

  6. CHRONIC URTICARIA

    PubMed Central

    Sachdeva, Sandeep; Gupta, Vibhanshu; Amin, Syed Suhail; Tahseen, Mohd

    2011-01-01

    Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ‘idiopathic’ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented. PMID:22345759

  7. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    SciTech Connect

    Sveistrup, Joen; Loft, Annika; Berthelsen, Anne Kiil; Henriksen, Birthe Merete; Nielsen, Michael Bachmann; Engelholm, Svend Aage

    2012-05-01

    Purpose: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. Methods and Materials: Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68%) and 30 males (32%), and the median age was 58 years (range, 35-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. Results: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14% of the cases and changed the treatment plan proposed by TAUS/US in 17%. Conclusion: PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.

  8. Role of Brachytherapy in the Boost Management of Anal Carcinoma With Node Involvement (CORS-03 Study)

    SciTech Connect

    Moureau-Zabotto, Laurence; Ortholan, Cecile; Hannoun-Levi, Jean-Michel; Teissier, Eric; Cowen, Didier; Salem, Nagi; Lemanski, Claire; Ellis, Steve; Resbeut, Michel

    2013-03-01

    Purpose: To assess retrospectively the clinical outcome in anal cancer patients, with lymph node involvement, treated with split-course radiation therapy and receiving a boost through external beam radiation therapy (EBRT) or brachytherapy (BCT). Methods and Materials: From 2000 to 2005, among 229 patients with invasive nonmetastatic anal squamous cell carcinoma, a selected group of 99 patients, with lymph node involvement, was studied. Tumor staging reported was T1 in 4 patients, T2 in 16 patients, T3 in 49 patients, T4 in 16 patients, and T unknown in 14 patients and as N1 in 67 patients and N2/N3 in 32 patients. Patients underwent a first course of EBRT (mean dose, 45.1 Gy) followed by a boost (mean dose, 18 Gy) using EBRT (50 patients) or BCT (49 patients). All characteristics of patients and tumors were well balanced between the BCT and EBRT groups. Prognostic factors of cumulative rate of local recurrence (CRLR), cumulative rate of distant (including nodal) recurrence (CRDR), colostomy-free survival (CFS) rate, and overall survival (OS) rate were analyzed for the overall population and according to the nodal status classification. Results: The median follow-up was 71.5 months. The 5-year CRLR, CRDR, CFS rate, and OS rate were 21%, 19%, 63%, and 74.4%, respectively. In the overall population, the type of node involvement (N1 vs N2/N3) was the unique independent prognostic factor for CRLR. In N1 patients, by use of multivariate analysis, BCT boost was the unique prognostic factor for CRLR (4% for BCT vs 31% for EBRT; hazard ratio, 0.08; P=.042). No studied factors were significantly associated with CRDR, CFS, and OS. No difference with regard to boost technique and any other factor studied was observed in N2/N3 patients for any kind of recurrence. Conclusion: In anal cancer, even in the case of initial perirectal node invasion, BCT boost is superior to EBRT boost for CRLR, without an influence on OS, suggesting that N1 status should not be a contraindication to

  9. Intentional Condomless Anal Intercourse Among Latino MSM Who Meet Sexual Partners on the Internet

    PubMed Central

    Balán, Iván C.; Carballo-Diéguez, Alex; Ventuneac, Ana; Remien, Robert H.

    2009-01-01

    Data on intentional condomless anal intercourse in risky contexts, also known as “barebacking,” among ethnic minority MSM, whose rates of HIV infection continue to rise, is extremely limited. In this study, thirty-one Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex due to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. While a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV-risk behavior. In this sample, culture did not seem to play a large role in barebacking. PMID:19243228

  10. Stressful events, avoidance coping, and unprotected anal sex among gay and bisexual men.

    PubMed

    Martin, James I; Alessi, Edward J

    2010-07-01

    This study examined associations among stressful life events, avoidance coping, and unprotected anal sex (UAS) in a convenience sample of 297 men obtained through the Internet and who either reported having sex with men or self-identified as gay or bisexual. Participants completed an Internet-hosted self-administered questionnaire that included measures of victimization experiences and other stressful life events, and avoidance coping. More than half of the sample reported engaging in UAS during the previous 6 months. Victimization predicted UAS regardless of partner type; victimization, HIV-positive serostatus, and avoidance coping predicted UAS with nonprimary partners. The findings provide evidence that American gay and bisexual men may experience a variety of stressful life events, including a surprising amount of victimization, and that at least some episodes of UAS may be associated with attempts to cope with distress associated with such events.

  11. Biomechanical modeling of the rectum for the design of a novel artificial anal sphincter.

    PubMed

    Zan, Peng; Yan, Guozheng; Liu, Hua; Yang, Banghua; Zhao, Yujuan; Luo, Nianting

    2010-01-01

    This paper discusses biomechanical issues that are related to the option of a novel artificial anal sphincter around the human rectum. The prosthesis consists of a compression cuff system inside and a reservoir cuff system outside, which is placed around the debilitated sphincter muscle. The micropump shifts fluid between the cuffs and thus takes over the expansion and compression function of the sphincter muscle. However, the human rectum is not a rigid pipe, and motion in it is further complicated by the fact that the bowel is susceptible to damage. With the goal of engineering a safe and reliable machine, the biomechanical properties of the in-vivo porcine rectum are studied and the tissue ischemia is analyzed.

  12. The treatment of squamous anal carcinoma: guidelines of the Italian Society of Colo-Rectal Surgery.

    PubMed

    Giani, I; Mistrangelo, M; Fucini, C

    2013-04-01

    The Italian society of colo-rectal surgery (SICCR) is dedicated to improving the study, prevention and management of the diseases of the colon, rectum and anus. One of the aims of the society is to establish guidelines to the treatment of these diseases. These guidelines are based on the international literature and on the best available evidence. Clinical practice guidelines are one of the most important instruments to provide therapeutic decision-making support, based on the best scientific evidence available at the time. Guidelines are advisory and not prescriptive, susceptible to continual variations secondary to innovations and new scientific evidence. These guidelines are a guide for all colo-rectal surgeons and physicians who approach anal cancer.

  13. Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet.

    PubMed

    Balán, Iván C; Carballo-Diéguez, Alex; Ventuneac, Ana; Remien, Robert H

    2009-02-01

    Data on intentional condomless anal intercourse in risky contexts, also known as "barebacking," among ethnic minority MSM, whose rates of HIV infection continue to rise, are extremely limited. In this study, 31 Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex owing to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. Although a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV risk behavior. In this sample, culture did not seem to play a large role in barebacking.

  14. Cutaneous presentation of disseminated histoplasmosis as a solitary peri-anal ulcer. Case report and discussion.

    PubMed

    Hong, Janet H; Stetsenko, Galina Y; Pottinger, Paul S; George, Evan

    2016-05-01

    Disseminated histoplasmosis has a diverse and non-specific range of clinical signs and symptoms. In a significant minority of patients, cutaneous lesions are apparent at the time of initial presentation, affording an opportunity to establish the diagnosis from a skin biopsy. The most frequently reported clinical scenario in immunocompromised patients with cutaneous involvement is that of multiple papulo-nodular lesions on the face, trunk or extremities. The following report features an immunocompetent patient who presented with a solitary ulcerated plaque on the buttocks close to the anal verge. This case presentation underscores the broad spectrum of clinical presentations as well as the potential for diagnostic confusion with protozoa such as Leishmania or Trypanosoma species during histopathologic examination if special stains for fungal organisms are not performed.

  15. No evidence of NRAS mutation in squamous cell anal carcinoma (SCAC)

    PubMed Central

    Capelli, Laura; Casadei Gardini, Andrea; Scarpi, Emanuela; Frassineti, Giovanni Luca; Saragoni, Luca; Puccetti, Maurizio; Scartozzi, Mario; Giannini, Massimo; Tamberi, Stefano; Corbelli, Jody; Ulivi, Paola

    2016-01-01

    Epidermal growth factor receptor (EGFR) is usually expressed in squamous cell anal carcinoma (SCAC) and anti-EGFR agents could represent a valid treatment strategy, also considering that KRAS and BRAF mutations are rare events in this type of cancer. However, no data are available on NRAS status in SCAC. In this study we analyzed NRAS status (exons 2–4) by Pyrosequencing in a case series of 50 SCAC patients previously characterized in our laboratory for KRAS, BRAF, PIK3CA mutations and HPV and HIV infections. We found no mutation in NRAS gene. These results confirm that since the principal anti-EGFR resistance mechanisms are almost absent in SCAC, anti-EGFR agents should be considered for the treatment of this type of cancer. PMID:27886225

  16. Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

    PubMed Central

    Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

    2015-01-01

    Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA). PMID:26195886

  17. Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

    PubMed

    Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

    2015-01-01

    Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA).

  18. Malignant familial adenomatous polyposis treated by laparoscopic colectomy and ileal pouch anal anastomosis: a case report.

    PubMed

    Zaharie, Florin; Ciorogar, George; Zaharie, Roxana; Tantau, Marcel; Iancu, Cornel; Mocan, Lucian

    2014-12-01

    The mean age of colorectal cancer in untreated familial adenomatous polyposis (FAP) is 39 years. We present the case of a 21-year-old patient with FAP and colorectal cancer. The patient was detected with significant family history: her mother died at age 45 with colon cancer; two uncles were diagnosed with colon cancer at the age of 40 and 43 and one aunt at the age of 45 with colon cancer and gastric cancer. The treatment was laparoscopic restorative proctocolectomy with total excision of the mesorectum and ileal pouch anal anastomosis completed with endoanal excision of inferior rectal polyps. The histopathological report described a well differentiated rectal adenocarcinoma T1N1aMx developed on a tubulo-villous adenoma located on the rectosigmoid jonction, the rest of the polyps with benign histology.

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

    SciTech Connect

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

    2014-10-01

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

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

    SciTech Connect

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

    2012-06-01

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