Science.gov

Sample records for chronic anal fissure

  1. Anal fissure.

    PubMed

    Schlichtemeier, Steven; Engel, Alexander

    2016-02-01

    An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary. Primary fissures are usually benign and located in the posterior or anterior position. Secondary fissures are lateral or multiple and often indicate a more serious underlying pathology. The management of primary anal fissures is generally non-operative and includes increased dietary fibre, sitz baths, topical ointments and botulinum toxin injections. If these treatments are ineffective the patient will need a surgical referral. Secondary anal fissures require further investigation. Multidisciplinary management is preferable and is essential in the case of malignancy. PMID:27041801

  2. Anal fissure

    PubMed Central

    Schlichtemeier, Steven; Engel, Alexander

    2016-01-01

    SUMMARY An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary. Primary fissures are usually benign and located in the posterior or anterior position. Secondary fissures are lateral or multiple and often indicate a more serious underlying pathology. The management of primary anal fissures is generally non-operative and includes increased dietary fibre, sitz baths, topical ointments and botulinum toxin injections. If these treatments are ineffective the patient will need a surgical referral. Secondary anal fissures require further investigation. Multidisciplinary management is preferable and is essential in the case of malignancy. PMID:27041801

  3. Changing patterns of treatment for chronic anal fissure.

    PubMed

    Farouk, R; Gunn, J; Duthie, G S

    1998-05-01

    To assess changing patterns of treatment for chronic anal fissure, a retrospective analysis of treatment for chronic anal fissure within one hospital between January 1990 and December 1996 was undertaken. A total of 221 patients received treatment for a chronic anal fissure in this period, of whom 209 had a surgical procedure. Manual dilatation of the anus was performed in 21 patients (10%) and has not been performed since 1995. Lateral internal sphincterotomy was performed in 183 patients (88%) and continues to be the mainstay of treatment. Five female patients (2%) were identified as having a sphincter defect by anal manometry combined with endoanal ultrasound and were treated by an anal advancement flap. From 1996 onwards, 15 patients (7%) were treated by topical glyceryl trinitrate (GTN) paste as the first line of treatment. Of these patients, nine have experienced healing of their fissure, and three have had relief of pain without healing of the fissure. Three have gone on to have a lateral internal sphincterotomy. Lateral internal sphincterotomy remains the primary form of treatment for chronic anal fissure. GTN cream has increasingly been offered as preliminary treatment over the last 12 months. Perioperative use of endoanal ultrasound allowed identification of patients who may be at high risk of postoperative incontinence from a sphincterotomy. An anal advancement flap has been used as an alternative surgical approach for these patients.

  4. Modern Perspectives in the Treatment of Chronic Anal Fissures

    PubMed Central

    Bhardwaj, R; Parker, MC

    2007-01-01

    INTRODUCTION Anal fissures are commonly encountered in routine colorectal practice. Developments in the pharmacological understanding of the internal anal sphincter have resulted in more conservative approaches towards treatment. Simple measures are often effective for early fissures. Glyceryl trinitrate is well established as a first-line pharmacological therapy. The roles of diltiazem and botulinum, particularly as rescue therapy, are not well understood. Surgery has a defined role and should not be discounted completely. METHODS Data were obtained from Medline publications citing ‘anal fissure’. Manual cross-referencing of salient articles was conducted. We have sought to highlight various controversies in the management of anal fissures. FINDINGS Acute fissures may heal spontaneously, although simple conservative measures are sufficient. Idiopathic chronic anal fissures need careful evaluation to decide what therapy is suitable. Pharmacological agents such as glyceryl trinitrate (GTN), diltiazem and botulinum toxin have been subjected to most scrutiny. Though practices in the UK vary, GTN or diltiazem would be suitable as first-line therapy with botulinum toxin used as rescue treatment. Sphincterotomy is indicated for unhealed fissures; fissurectomy has been revisited and advancement flaps have a role in patients in whom sphincter division is not suitable. PMID:17688717

  5. Innovations in chronic anal fissure treatment: A systematic review

    PubMed Central

    Poh, Aaron; Tan, Kok-Yang; Seow-Choen, Francis

    2010-01-01

    A chronic anal fissure is a common perianal condition. This review aims to evaluate both existing and new therapies in the treatment of chronic fissures. Pharmacological therapies such as glyceryl trinitrate (GTN), Diltiazem ointment and Botulinum toxin provide a relatively non-invasive option, but with higher recurrence rates. Lateral sphincterotomy remains the gold standard for treatment. Anal dilatation has no role in treatment. New therapies include perineal support devices, Gonyautoxin injection, fissurectomy, fissurotomy, sphincterolysis, and flap procedures. Further research is required comparing these new therapies with existing established therapies. This paper recommends initial pharmacological therapy with GTN or Diltiazem ointment with Botulinum toxin as a possible second line pharmacological therapy. Perineal support may offer a new dimension in improving healing rates. Lateral sphincterotomy should be offered if pharmacological therapy fails. New therapies are not suitable as first line treatments, though they can be considered if conventional treatment fails. PMID:21160880

  6. Identifying the best therapy for chronic anal fissure

    PubMed Central

    Madalinski, Mariusz H

    2011-01-01

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

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

    PubMed

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

    2016-09-01

    Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and pain, which leads to internal anal sphincter hypertonia. Increased anal basal pressure leads to diminished anodermal blood flow and local ischemia, which delays healing and leads to chronic anal fissure. The current treatment of choice for chronic anal fissure is either lateral internal sphincterotomy or botulinum toxin injections. In contrast to current thinking, we hypothesize that the external, rather than the internal, anal sphincter is responsible for increased anal basal pressure in patients suffering from chronic anal fissure. We think that damage to the anal mucosa leads to hypersensitivity of the contact receptors of the anal-external sphincter continence reflex, resulting in overreaction of the reflex. Overreaction causes spasm of the external anal sphincter. This in turn leads to increased anal basal pressure, diminished anodermal blood flow, and ischemia. Ischemia, finally, prevents the anal fissure from healing. Our hypothesis is supported by two findings. The first concerned a chronic anal fissure patient with increased anal basal pressure (170mmHg) who had undergone lateral sphincterotomy. Directly after the operation, while the submucosal anesthetic was still active, basal anal pressure decreased to 80mmHg. Seven hours after the operation, when the anesthetic had completely worn off, basal anal pressure increased again to 125mmHg, even though the internal anal sphincter could no longer be responsible for the increase. Second, in contrast to previous studies, recent studies demonstrated that botulinum toxin influences external anal sphincter activity and, because it is a striated muscle relaxant, it seems reasonable to presume that it affects the striated

  8. Anal fissure - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100154.htm Anal fissure - series—Normal anatomy To use the sharing ... rectum through which passes stool during defecation. The anal sphincter is a critical mechanism for control of ...

  9. Study of Operated Patients of Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure

    PubMed Central

    Patel, Harshad Shankarlal; Chavda, Jagdish; Parikh, Jayesh; Naik, Nehal

    2013-01-01

    Introduction: Anal fissure causes significant morbidity in the population. It is proposed that elevated sphincter pressures may cause ischaemia of the anal lining and this may be responsible for the pain of anal fissures and their failure to heal. When pharmacologic therapy fails or fissures recur frequently, lateral internal sphincterotomy is the surgical treatment of choice. Material and Methods: Retrospective analysis was done of admitted and operated patients of anal fissure by lateral anal internal sphincterotomy either by open or closed technique between April 2010 and November 2011 in Gujarat Medical Education & Research Society Medical College, Sola, Ahmedabad, India. The follow-up data of all patients was evaluated for pain relief, recurrence, wound infection, incontinence to flatus or stool or both for a period of up to 6 months. Results: Wound infection rate was 10.3% in open method and 4.2% in closed method. Incontinence to flatus was 8.3% in closed method and 3.4% in open method. This was temporary and controlled within a 1 week. Incontinence to stool was 3.4% in open method which was temporary and controlled within 2 weeks while none in closed method. None of the patients in either group had come with recurrence within 6 months follow-up. Conclusion: Lateral anal internal sphincterotomy is safe regarding long term incontinence and effective regarding recurrence. PMID:24551659

  10. [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.

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

    PubMed Central

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

    2012-01-01

    AIM: To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity. METHODS: Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study. The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment. All data were analyzed in univariate and multivariate analysis. RESULTS: Two months after treatment, 65.4% of the patients had a healing scar. Only one patient had mild incontinence to flatus that lasted 3 wk after treatment, but this disappeared spontaneously. In the multivariate analysis of the data, two registered months after the treatment, sex (P = 0.01), baseline resting anal pressure (P = 0.02) and resting anal pressure 2 mo after treatment (P < 0.0001) were significantly related to healing rate. CONCLUSION: Botulinum toxin, despite worse results than in non-obese individuals, appears the best alternative to surgery for this group of patients with a high risk of incontinence. PMID:22416176

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

    PubMed

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

    2015-02-01

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

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

    PubMed Central

    Farkas, Nicholas; Solanki, Kohmal; Frampton, Adam E.; Black, John; Gupta, Ashish; West, Nicholas J.

    2015-01-01

    Background Anal fissure is one of the commonest proctological diseases with considerable national variation in sequential treatment. We aimed to audit our compliance of chronic anal fissure (CAF) management with national guidance provided by the Association of Coloproctology of Great Britain and Ireland (ACPGBI). Methods We retrospectively audited patients presenting to outpatient clinics with CAF over a 6-month period. Using electronic patient records, notes and clinic letters, we compared their management with ACPGBI algorithm. A prospective re-audit was then performed. Results Forty-one patients were included in the analysis (59% male). Sixty-eight percent (n = 28/41) of patients were appropriately started on conservative dietary therapy, of whom only 7.1% (n = 2/28) had treatment success. Eighty-nine percent (n = 25/28) were then appropriately treated with either topical diltiazem 2% or GTN 0.4%. Overall, 43.9% (n = 18/41) of all patients' entire management strategy adhered to the ACPGBI guidelines. In total, 48.8% (n = 20/41) patients had surgical treatment (excluding Botox), of which only 15% (n = 3/20) had undergone ACPGBI-compliant management. After local dissemination of results and education, the re-audit of 20 patients showed significant improvement in adherence to the guidelines (43.9% vs. 95%; P = 0.0001). Conclusions Topical creams were the most successful treatments (50%; n = 9/18) in ACPGBI-compliant strategies. Importantly, these data suggests that compliance with the ACPGBI algorithm leads to healing without surgery in 83.3% (n = 15/18) of patients, compared to 26.1% (n = 6/23) with non-compliant methods (P = 0.0004). This highlights the benefit of early conservative and medical management of CAF, before attempting surgery. PMID:26858833

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

    PubMed Central

    Dudhamal, Tukaram S.; Baghel, Madhav Singh; Bhuyan, Chaturbhuja; Gupta, Sanjay Kumar

    2014-01-01

    Background: Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano. Aim: To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano. Materials and Methods: Total 100 patients of chronic fissure-in-ano were selected and randomly divided into two groups (50 in each group). In group-A, patients were undergone by KSS; while in patients of Group-B Lord's anal dilatation followed by KSS was done under spinal anesthesia. The KSS was done once and after slough out of Ksharasutra, the wound was treated for 4 weeks and assessment of the result was done on the basis of gradation adopted. Results: The pain relief on 14th day in Group-A was 86% while in Group-B 100% was observed. As on 7th day in Group-A, oozing was stopped in 68% patients, while in Group-B, oozing was stopped in 82% patients. On 21st day, Group-B showed more healing (85%) as compared to Group-A (69%). In this study 68% of patients were cured. Conclusion: In Group-B (KSS with Lord's anal dilatation) patients were cured early as compared to patients of Group-A (KSS alone). PMID:25558158

  15. [Anal fissure--a new therapy concept].

    PubMed

    Hetzer, F H; Baumann, M; Röthlin, M

    2000-08-24

    The anal fissure is one of the most frequent causes for anal pain. Conservative treatment usually consists of laxatives, local anesthetics and nitroglycerin cream. These therapies have a high recurrency rate. Surgical interventions, i.e. manual dilatation and sphincterotomy are fraught with the danger of fecal incontinence. The completely reversible effect of botulinum toxin injection opens new possibilities in the treatment of anal fissures. Its use is discussed as part of a 3-stage therapeutic regimen.

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

    PubMed

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

    2014-01-01

    Aloe vera is a medicinal plant that promotes wound healing in burn injuries. A prospective clinical trial was conducted to evaluate the effects of a topical cream containing 0.5% Aloe vera juice powder in the treatment of chronic anal fissures. The aloe cream was applied by the patients to the wound site 3 times per day for 6 weeks following the instructions of a physician. Pain was assessed with a visual analog scale before treatment and at the end of each week of treatment. Wound healing and the amount and severity of bleeding were examined and evaluated before and at the end of each week of treatment. There were statistically significant differences in chronic anal fissure pain, hemorrhaging upon defection and wound healing before and at the end of the first week of treatment also in comparison with control group (p < 0.0001). In this study, a topical cream containing aloe vera juice was an effective treatment for chronic anal fissures. This is a promising result indicating that further comparative studies are justified.

  17. 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

  18. 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

  19. [The treatment of chronic fissure in ano with nitrate ointment].

    PubMed

    Stassen, L P; Schouten, W R

    1999-01-01

    A chronic anal fissure may be regarded as an ischaemic ulcer. Until recently, its treatment necessitated surgical intervention to lower the tension of the internal sphincter (lateral internal sphincterotomy), or manual dilatation of the anus. A disadvantage of both methods is the risk of permanent sphincter injury resulting in reduced continence. Local application of ointment containing nitroglycerin (glyceryltrinitrate) or isosorbide dinitrate reduces the pressure at rest in the anal canal and increases the anodermal blood circulation. Both ointments in most patients lead to healing of the chronic anal fissure. Nitroglycerin ointment in a prospective, randomized trial brought about better healing than placebo treatment. The advantage of the ointment treatment, the needlessness of sphincterotomy, is particularly important in cases of existing sphincter abnormalities. It has the disadvantage that it takes longer for the fissure pain to abate. The principal side effect is headache. In over 50% of the patients the treatment has to be continued for longer than 6 weeks. Little is known as yet about the risk of recurrence. Before surgical interventions as the treatment of first choice can be definitely replaced by treatment with nitrate ointment the good results of the ointment treatment have to be confirmed. Also, more has to be found out about the risk of recurrence, the optimal duration of the treatment and the choice of the type of nitrate ointment.

  20. Anal fissure

    MedlinePlus

    ... cream, if pain interferes with normal bowel movements Petroleum jelly Zinc oxide, 1% hydrocortisone cream, Preparation H, ... is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation ...

  1. Anal Fissure

    MedlinePlus

    Skip to main content ASCRS Patients Educational Resources Diseases and Conditions Patient Education Library Patient Success Stories Treatments and Screening Resources Find a Surgeon Hereditary Colorectal Cancer Registries Helpful Links Physicians ...

  2. 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

  3. Medical and surgical treatment of haemorrhoids and anal fissure in Crohn’s disease: a critical appraisal

    PubMed Central

    2013-01-01

    Background The principle to avoid surgery for haemorrhoids and/or anal fissure in Crohn’s disease (CD) patients is still currently valid despite advances in medical and surgical treatments. In this study we report our prospectively recorded data on medical and surgical treatment of haemorrhoids and anal fissures in CD patients over a period of 8 years. Methods Clinical data of patients affected by perianal disease were routinely and prospectively inserted in a database between October 2003 and October 2011 at the Department of Surgery, Tor Vergata University Hospital, Rome. We reviewed and divided in two groups records on CD patients treated either medically or surgically according to the diagnosis of haemorrhoids or anal fissures. Moreover, we compared in each group the outcome in patients with prior diagnosis of CD and in patients diagnosed with CD only after perianal main treatment. Results Eighty-six CD patients were included in the study; 45 were treated for haemorrhoids and 41 presented with anal fissure. Conservative approach was initially adopted for all patients; in case of medical treatment failure, the presence of stable intestinal disease made them eligible for surgery. Fifteen patients underwent haemorrhoidectomy (open 11; closed 3; stapled 1), and two rubber band ligation. Fourteen patients required surgery for anal fissure (Botox ± fissurectomy 8; LIS 6). In both groups we observed high complication rate, 41.2% for haemorrhoids and 57.1% for anal fissure. Patients who underwent haemorrhoidectomy without certain diagnosis of CD had significantly higher risk of complications. Conclusions Conservative treatment of proctologic diseases in CD patients has been advocated given the high risk of complications and the evidence that spontaneous healing may also occur. From these preliminary results a role of surgery is conceivable in high selected patients, but definitve conclusions can’t be made. Further randomized trials are needed to establish the

  4. [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. PMID:12865195

  5. 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.

  6. 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. PMID:7855720

  7. Chronic constipation due to delayed diagnosis of a congenital anal web.

    PubMed

    Kundu, Neilendu; Alkhouri, Naim; Seifarth, Federico G

    2012-07-01

    Congenital anal web is a rare form of anorectal malformation. In cases of delayed diagnosis, patients can present with signs ranging from mild constipation to complete bowel obstruction. The diagnosis is made by thorough anorectal inspection and a digital rectal exam. We present the case of a 9-month-old boy with Down's syndrome with chronic constipation secondary to an anal web. To our best knowledge, this is the first report of an anal web in a patient with Down's syndrome presenting with severe chronic constipation. PMID:22271242

  8. Anal Cancer

    MedlinePlus

    ... saved articles window. My Saved Articles » My ACS » Anal Cancer Download Printable Version [PDF] » Whether you (or ... the topics below to get started. What Is Anal Cancer? What is anal cancer? What are the ...

  9. Accessory fissures of the lung

    SciTech Connect

    Godwin, D.; Tarver, R.D.

    1985-01-01

    Accessory fissures of the lung are commonly observed in lung specimens, but are often unappreciated or misinterpreted in radiographs and computer tomographic (CT) scans. They usually occur at the boundaries between bronchopulmonary segments. Most common are the inferior accessory fissure, which demarcates the medial basal segment; the superior accessory fissure, which demarcates the superior segment; and the left minor fissure, which demarcates the lingula. This essay will illustrate the findings of the common accessory fissures both on plain radiographs and on CT scans.

  10. Anal Cancer

    MedlinePlus

    ... are here Home > Types of Cancer > Anal Cancer Anal Cancer This is Cancer.Net’s Guide to Anal Cancer. Use the menu below to choose the ... social workers, and patient advocates. Cancer.Net Guide Anal Cancer Introduction Statistics Risk Factors and Prevention Screening ...

  11. 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.

  12. Anal cancer

    MedlinePlus

    ... common type of anal cancer. It starts in cells that line the anal canal and grow into the deeper tissue. Cloacogenic carcinoma. Almost all the rest of anal cancers are tumors that start in cells lining the area between the anus and rectum. ...

  13. Defensive anality and anal narcissism.

    PubMed

    Shengold, L

    1985-01-01

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

  14. 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.

  15. Anal lesions presenting in a cohort of child gastroenterological examinations. Implications for sexual traumatic injuries.

    PubMed

    Rougé-Maillart, Clotilde; Houdu, Sora; Darviot, Estelle; Buchaillet, Céline; Baron, Céline

    2015-05-01

    The purpose of this study was to describe the anal lesions found in children during a pediatric gastroenterology consultation when the reason for the complaint was related to a digestive disease. This prospective descriptive study included 100 children under 15 years of age over a 13-month period, consulting due to digestive symptoms. The children were under 8 years old (90%) and 25% were under 3.1 years old. Constipation was the most frequent reason for consultation (69%). Fifty-one anal lesions were observed, of which 58.8% were anal fissures, 15.7% were skin tags and 5.8% were venous congestions related to straining. Anal fissures and skin tags were located at the median line, according to the clock-face method in supine position. No child had more than two anal lesions. No anal dilatation, sphincter hypotonia, anal scars, anal lacerations or bruises were found. The two most common anal lesions were anal fissures and skin tags. These anal lesions were mainly observed at the median line and were due to constipation. No cases of multiple anal lesions were found in terms of common digestive diseases. PMID:25882145

  16. Automatic pulmonary fissure detection and lobe segmentation in CT chest images

    PubMed Central

    2014-01-01

    Background Multi-detector Computed Tomography has become an invaluable tool for the diagnosis of chronic respiratory diseases. Based on CT images, the automatic algorithm to detect the fissures and divide the lung into five lobes will help regionally quantify, amongst others, the lung density, texture, airway and, blood vessel structures, ventilation and perfusion. Methods Sagittal adaptive fissure scanning based on the sparseness of the vessels and bronchi is employed to localize the potential fissure region. Following a Hessian matrix based line enhancement filter in the coronal slice, the shortest path is determined by means of Uniform Cost Search. Implicit surface fitting based on Radial Basis Functions is used to extract the fissure surface for lobe segmentation. By three implicit fissure surface functions, the lung is divided into five lobes. The proposed algorithm is tested by 14 datasets. The accuracy is evaluated by the mean (±S.D.), root mean square, and the maximum of the shortest Euclidian distance from the manually-defined fissure surface to that extracted by the algorithm. Results Averaged over all datasets, the mean (±S.D.), root mean square, and the maximum of the shortest Euclidian distance are 2.05 ± 1.80, 2.46 and 7.34 mm for the right oblique fissure. The measures are 2.77 ± 2.12, 3.13 and 7.75 mm for the right horizontal fissure, 2.31 ± 1.76, 3.25 and 6.83 mm for the left oblique fissure. The fissure detection works for the data with a small lung nodule nearby the fissure and a small lung subpleural nodule. The volume and emphysema index of each lobe can be calculated. The algorithm is very fast, e.g., to finish the fissure detection and fissure extension for the dataset with 320 slices only takes around 50 seconds. Conclusions The sagittal adaptive fissure scanning can localize the potential fissure regions quickly. After the potential region is enhanced by a Hessian based line enhancement filter, Uniform Cost Search can

  17. 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.

  18. 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.

  19. Clinical Manifestations among Children with Chronic Functional Constipation

    PubMed Central

    Dehghani, Seyed Mohsen; Kulouee, Niloofar; Honar, Naser; Imanieh, Mohammad-Hadi; Haghighat, Mahmood; Javaherizadeh, Hazhir

    2015-01-01

    BACKGROUND Constipation is one of the most frequent cause of patient visits to pediatric gastroenterology clinics. Early diagnosis and treatment is important. There are few studies about clinical manifestations of constipation in children. We aimed to find the relative frequency of gastrointestinal manifestations of constipation among constipated children. METHODS This cross-sectional study was carried out on children aged < 18 years old with chronic functional constipation referred to Imam Reza Clinic of Shiraz University of Medical Sciences. Children with organic causes of chronic constipation were excluded from study. Rome III criteria were used for defining constipation. The duration of study was 1 year starting from September 2010. Abdominal pain, fecal mass, rectal bleeding, anorexia, fecal soiling, retentive posture, withholding behavior, anal fissure, and peri-anal erythema were recorded for each case based on history and physical examination. Data were analyzed using SPSS software, version 13.0 (Chicago, IL, USA). RESULTS Of 222 children with functional constipation, 124(55.9%) were girls and 98 (44.1%) were boys with a mean ± SD age of 5±3.12 years. The mean ± SD duration of constipation was 2.2±1.9 years. Large and hard stool was present in 93.7% of the patients. Painful defecation and withholding behavior were seen in 92.3% and 91.9% of the patients, respectively. Fecal impaction was more frequent among boys compared with girls (p<0.01). Fecal soiling was present in 40.8% of the boys and 28.2% of the girls (p=0.04). CONCLUSION Large and hard stool, painful defecation and withholding behavior were the most frequent signs or symptoms among children with chronic functional constipation. Fresh rectal bleeding and anal fissure were the least frequent signs and symptoms in this group. PMID:25628851

  20. Anal Warts and Anal Intradermal Neoplasia

    PubMed Central

    Echenique, Ignacio; Phillips, Benjamin R.

    2011-01-01

    For the last five millennia we have been dealing with the annoyance of verrucas. Anogenital human papillomavirus (HPV) infection is the most common sexually transmitted disease in the United States and is increasing in incidence. As in other gastrointestinal conditions, HPV infection can lead to a stepwise transition from normal cells to dysplastic cells and then to invasive anal cancer. Knowledge of the natural history of HPV infection, risk factors, diagnostic tools, and therapeutic methods gives us the tools to adequately prevent, evaluate, treat, and counsel our patients. In this review, the authors detail the diagnosis, management, and treatment of anal condyloma and anal intraepithelial neoplasia with a focus on prevention, early detection, and treatment using current data and technology. PMID:22379403

  1. Earth fissures and localized differential subsidence.

    USGS Publications Warehouse

    Holzer, Thomas L.; Pampeyan, Earl H.

    1981-01-01

    Long linear tension cracks associated with declining groundwater levels at four sites in subsiding areas in south-central Arizona, Fremont Valley, California, and Las Vegas Valley, Nevada, occur near points of maximum convex-upward curvature in subsidence profiles oriented perpendicular to the cracks. Profiles are based on repeated precise vertical control surveys of lines of closely spaced bench marks. Association of these fissures with zones of localized differential subsidence indicates that linear earth fissures are caused by horizontal tensile strains probably resulting from localized differential compaction. Horizontal tensile strains across the fissures at the point of maximum convex-upward curvature, ranging from approximately 100 to 700 microstrains (0.01 to 0.07% per year), were indicated based on measurements with a tape or electronic distance meter.

  2. Anal condyloma acuminatum.

    PubMed

    McCutcheon, Tonna

    2009-01-01

    Anal condyloma acuminatum is a human papillomavirus (HPV) that affects the mucosa and skin of the anorectum and genitalia. Anal condyloma acuminatum is the most commonly diagnosed sexually transmitted disease in the United States. To date, there are more than 100 HPV types, with HPV-6, HPV-10, and HPV-11 predominately found in the anogenital region and causing approximately 90% of genital warts. Risk factors for anal condyloma acuminatum include multiple sex partners, early coital age, anal intercourse, and immunosuppression. Transmission occurs by way of skin-to-skin contact through sexual intercourse, oral sex, anal sex, or other contact involving the genital area. The virus may remain latent for months to years until specific mechanisms cause production of viral DNA, leading to the presentation of anal condyloma acuminatum.Patients with anal condyloma acuminatum may be asymptomatic or present with presence of painless bumps, itching, and discharge or bleeding. It is not uncommon to have involvement of more than one area, and multiple lesions may also be present and extend into the anal canal or rectum. To date, there is no serologic testing or culture to detect anal condyloma acuminatum; therefore, diagnosis is made clinically or by detection of HPV DNA. Multiple factors determine the choice of treatment, which may range from patient-applied medications to surgical intervention. Despite treatment choice, recurrence rates are high, indicating the importance of patient education on prevention of HPV infection and reinfection. Unfortunately, at this time, no cure exists for anal condyloma acuminatum; however, recently Gardasil and Cervarix (in Australia only) vaccines have become available and are showing promising results. PMID:19820442

  3. Effect of surface fissure on apparent resistivity measurements

    NASA Astrophysics Data System (ADS)

    Sailhac, P.; Gance, J.; Malet, J.

    2013-12-01

    Fissures are features of interest, prone to create preferential flow path, modifying locally the soil hydrogeological behavior. Electrical Resistivity Tomography (ERT) is a suitable tool to monitor such preferential flow path. However, this technique is not efficient in the presence of surface fissure, due to a bad resistivity recovering around the fissure vicinity during the inversion process. Therefore, we propose a description of fissure effect on raw apparent resistivity on three resistivity arrays. The purposes of the study are multiple. First, we aim at making ERT users aware of surface fissure effect, and propose a first help to interpret basically resistivity pseudo sections. Second, we propose to ERT users to automatically conduct a surface fissure survey on the studied profile, in order to consider each fissure in a forward DC model and to suppress their effect. Finally, this study is only a first step toward 2D fissure shape inversion, and time-lapse monitoring of fissure drying and filling. In this study, we create a fissure model based on different geomorphological descriptors. After describing the FEM-DC forward modeling strategy, we investigate the fissure effect on pseudo section of apparent resistivity for a Wenner-Schlumberger (WS), a dipole-dipole (DD) and a gradient (GRAD) array. We determine a fissure detectability threshold for each array and perform a sensitivity analysis on the different fissure parameters (position, width, depth, dip angles...). The crack filling or drying effect is also investigated. The possibility to remove fissure effect and to propose a first interpretation of time-lapse data is illustrated on real data. This study show again the higher sensitivity of the DD array compared to the GRAD and WS arrays. Not only the maximal amplitude in the pseudo section is higher for the DD array, but also the anomaly pattern created by the fissure is much larger for this acquisition geometry. The minimal depth detectable for the DD

  4. Relationship Among Anal Sphincter Injury, Patulous Anal Canal, and Anal Pressures in Patients with Anorectal Disorders

    PubMed Central

    Prichard, David; Harvey, Doris M.; Fletcher, Joel G.; Zinsmeister, Alan R.; Bharucha, Adil E.

    2015-01-01

    Background & Aims The anal sphincters and puborectalis are routinely imaged with an endoanal magnetic resonance imaging (MRI) coil, which does not assess co-aptation of the anal canal at rest. Using a MRI torso coil, we identified a patulous anal canal in some patients with anorectal disorders. We aimed to evaluate the relationship between anal sphincter and puborectalis injury, a patulous anal canal, and anal pressures. Methods We performed a retrospective analysis of data from 119 patients who underwent MRI and manometry analysis of anal anatomy and pressures, respectively, from February 2011 through March 2013 at the Mayo Clinic. Anal pressures were determined by high-resolution manometry, anal sphincter and puborectalis injury was determined by endoanal MRI, and anal canal integrity was determined by torso MRI. Associations between manometric and anatomical parameters were evaluated with univariate and multivariate analyses. Results Fecal incontinence (55 patients, 46%) and constipation (36 patients. 30%) were the main indications for testing; 49 patients (41%) had a patulous anal canal, which was associated with injury to more than 1 muscle (all P≤.001) and internal sphincter (P<.01), but not puborectalis (P=.09) or external sphincter (P=.06) injury. Internal (P<.01) and external sphincter injury (P=.02) and a patulous canal (P<.001), but not puborectalis injury, predicted anal resting pressure. A patulous anal canal was the only significant predictor (P<.01) of the anal squeeze pressure increment. Conclusions Patients with anorectal disorders commonly have a patulous anal canal, associated with more severe anal injury, anal resting pressure, and squeeze pressure increment. It is therefore important to identify patulous anal canal because it appears to be a marker of not only anal sphincter injury but disturbances beyond sphincter injury, such as damage to the anal cushions or anal denervation. PMID:25869638

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

    PubMed

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

    2014-01-01

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management. PMID:24898408

  7. 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

  8. Heterosexual anal sexuality and anal sex behaviors: a review.

    PubMed

    McBride, Kimberly R; Fortenberry, J Dennis

    2010-03-01

    Little research addresses the role of anal sexuality and anal sexual behaviors as a widely practiced but relatively less frequent element of a heterosexual sexual repertoire. However, the importance of anal sex in sexual health is increasingly well-defined by epidemiological and clinical studies. This article reviews existing data on a range of heterosexual anal sex practices and provides conceptual and methodological recommendations for new research.

  9. Encopresis and anal masturbation.

    PubMed

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

    2000-01-01

    Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children. PMID:11212192

  10. [Fissures in biliary calculi. Personal contribution (author's transl)].

    PubMed

    Nano, M; Potenzoni, F; Camandona, M; Casalegno, P A

    1979-04-01

    In a series of 70 patients suffering from biliary lithiasis, the roentgenologic findings of fissures in the calculi was observed in 5 cases examined by means of cholecystography and in 7 cases who underwent cholangiocholecystography. Fissures were demonstrated 11 times in calculi after surgery. The "Mercedes-Benz" sign was never observed at the abdominal examination without contrast medium. The presence of fissures may be an additional sign in the radiologic diagnosis of biliary calculi, but its value is not determinant.

  11. [Fissures in biliary calculi. Personal contribution (author's transl)].

    PubMed

    Nano, M; Potenzoni, F; Camandona, M; Casalegno, P A

    1979-04-01

    In a series of 70 patients suffering from biliary lithiasis, the roentgenologic findings of fissures in the calculi was observed in 5 cases examined by means of cholecystography and in 7 cases who underwent cholangiocholecystography. Fissures were demonstrated 11 times in calculi after surgery. The "Mercedes-Benz" sign was never observed at the abdominal examination without contrast medium. The presence of fissures may be an additional sign in the radiologic diagnosis of biliary calculi, but its value is not determinant. PMID:550199

  12. [Test of an electronic fissure caries detector].

    PubMed

    Pieper, K; Visser, H; Hülsmann, M; Wahner, M

    1990-11-01

    The reliability of an electronic detector for caries in pits and fissures was tested by means of physical measurements, histological sections and clinical evaluation. The device measures the ohmic resistance of the tooth, technical data are given. First we compared measurements and histological sections of teeth due for extraction. The results indicated a high sensitivity of the device for caries, false positive diagnoses did not occur. Based on this, a clinical evaluation on 179 teeth was performed. Under practical conditions the sensitivity of the electronic detector (0.77) was lower than in the first part of the study; conventional diagnosis revealed more carious lesions in dentine (sensitivity: 0.82).

  13. Corrections of surface fissure effect on apparent resistivity measurements

    NASA Astrophysics Data System (ADS)

    Gance, J.; Sailhac, P.; Malet, J.-P.

    2015-02-01

    Electrical resistivity tomography (ERT) is a useful tool to detect and track water flow paths in the subsoil. However, measurements are strongly affected by subsurface heterogeneities such as fissures of different sizes and genesis (shrinking-swelling, macropores and deformation). In this work, we focus on surface fissures characterized by dimensions lower than the interelectrode spacing and correct their effect on apparent resistivity pseudo-sections by incorporating fissure geometry in the topography. We show that fissures with depths greater than 0.10 times the interelectrode spacing for a dipole-dipole array and equal to 0.16 for the gradient array and the Wenner-Schlumberger arrays create significant anomalies (greater than 5 per cent) in the pseudo-section. Surface fissure widths and dip angles have little effect with respect to the fissure depths which can increase the apparent resistivity up to 200 per cent. The clogging of the fissures with water or soil material decreases the anomaly effect linearly with the percentage of filling. The correction of apparent resistivity values is possible for relatively simple fissure geometries and only requires a manual survey of the surface fissures. It allows to improve the quality of the inverted resistivity section by mitigating the inversion artefacts and therefore a better interpretation.

  14. 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

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

    PubMed Central

    2011-01-01

    Introduction Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. PMID:21838873

  16. 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. PMID:26888899

  17. 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

  18. 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.

  19. A visualization system for CT based pulmonary fissure analysis

    NASA Astrophysics Data System (ADS)

    Pu, Jiantao; Zheng, Bin; Park, Sang Cheol

    2009-02-01

    In this study we describe a visualization system of pulmonary fissures depicted on CT images. The purpose is to provide clinicians with an intuitive perception of a patient's lung anatomy through an interactive examination of fissures, enhancing their understanding and accurate diagnosis of lung diseases. This system consists of four key components: (1) region-of-interest segmentation; (2) three-dimensional surface modeling; (3) fissure type classification; and (4) an interactive user interface, by which the extracted fissures are displayed flexibly in different space domains including image space, geometric space, and mixed space using simple toggling "on" and "off" operations. In this system, the different visualization modes allow users not only to examine the fissures themselves but also to analyze the relationship between fissures and their surrounding structures. In addition, the users can adjust thresholds interactively to visualize the fissure surface under different scanning and processing conditions. Such a visualization tool is expected to facilitate investigation of structures near the fissures and provide an efficient "visual aid" for other applications such as treatment planning and assessment of therapeutic efficacy as well as education of medical professionals.

  20. 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 ...

  1. Newer Classification System for Fissured Tongue: An Epidemiological Approach

    PubMed Central

    Sudarshan, Ramachandran; Sree Vijayabala, G.; Samata, Y.; Ravikiran, A.

    2015-01-01

    Introduction. Fissured tongue is a commonly encountered tongue disorder in dental practice. But there is a lack of data on different pattern, severity, and association of fissuring with various systemic disorders and other tongue anomalies. This study attempts to establish a classification system for fissured tongue and to know the correlation with the systemic health and other disorders of the tongue. Materials and Methods. A total of 1000 subjects between the age groups of 10 and 80 years were included in the study. Pattern of fissuring, allied systemic diseases, and related tongue anomalies were tabulated. Results. Out of 1000 subjects, 387 subjects presented with fissured tongue. Out of 387 subjects, hypertension was present in 57 cases, 18 subjects had diabetes, and 3 subjects had both hypertension and diabetes. Central longitudinal type was found to be the most common type of tongue fissuring. Conclusion. Fissured tongue has been found to be associated with certain systemic disease and further researches are required to know positive correlation. If a correlation exists, such disorders could be diagnosed earlier by identifying fissured tongue at an earlier age. PMID:26457087

  2. 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.

  3. Study of the deformation mechanism of the Gaoliying ground fissure

    NASA Astrophysics Data System (ADS)

    Cheng, G.; Wang, H.; Luo, Y.; Guo, H.

    2015-11-01

    The Gaoliying ground fissure in Beijing has caused building cracking and road damage, and has seriously influenced city construction. Based on investigations and trenching, the influences of the fault and the variation of groundwater levels on the formation mechanism of the Gaoliying ground fissure were investigated by using FLAC3D. The results indicated that (1) the surface location of Gaoliying fissure is controlled by the underlying normal fault activity, and over pumping further exacerbates development of the ground fissure; (2) when the groundwater level declines, obvious differential settlement occurs at both sides of the ground fissure, in which greater settlement occurs in the vicinity of the hanging wall, the greater the distance from the hanging wall, the smaller the ground subsidence, however smaller ground subsidence occurs in the vicinity of the footwall, the greater the distance from the footwall, the greater the ground subsidence; (3) the vertical velocity of the ground fissure triggered by the fault activity and groundwater decline ranges from 15.5 to 18.3 mm a-1, which is basically in line with the monitoring data. The fault activity contributes about 28-39 %, and the groundwater contributes about 61-72 % to the deformation of the ground fissure, respectively.

  4. Screening for Anal Cancer in Women

    PubMed Central

    Moscicki, Anna-Barbara; Darragh, Teresa M.; Berry-Lawhorn, J. Michael; Roberts, Jennifer Margaret; Khan, Michelle J.; Boardman, Lori A.; Chiao, Elizabeth; Einstein, Mark H.; Goldstone, Stephen E.; Jay, Naomi; Likes, Wendy M.; Stier, Elizabeth A.; Welton, Mark Lane; Wiley, Dorothy J.; Palefsky, Joel M.

    2015-01-01

    Objective The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV) and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goal was to summarize the literature on anal cancer, HSIL and HPV infection in women, and provide screening recommendations in women. Methods A group of experts convened by the ASCCP and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL and anal cancer in women. Results Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with HIV-infected women and those with a history of lower genital tract neoplasia (LGTN) at highest risk compared with the general population. Conclusions While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and have digital anorectal examinations to detect anal cancers. HIV-infected women and women with LGTN, may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL. PMID:26103446

  5. 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, ...

  6. Do We Know What Causes Anal Cancer?

    MedlinePlus

    ... anal cancer be prevented? Do we know what causes anal cancer? Researchers have found some risk factors that increase ... now being done to learn how HPV might cause anal cancer. There is good evidence that HPV causes many ...

  7. Calcified gallstone fissures: the reversed Mercedes Benz sign.

    PubMed

    Strijk, S P

    1987-01-01

    This article describes the occurrence of an unusual radiating pattern of calcification in the center of large radiolucent gallstones. The radiographic findings are attributed to calcium deposition within the fissures of biliary calculi.

  8. Calcified gallstone fissures: the reversed Mercedes Benz sign.

    PubMed

    Strijk, S P

    1987-01-01

    This article describes the occurrence of an unusual radiating pattern of calcification in the center of large radiolucent gallstones. The radiographic findings are attributed to calcium deposition within the fissures of biliary calculi. PMID:3556975

  9. 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

  10. [Surgery of anal fistulas].

    PubMed

    Ricchi, E; Carriero, A; Spallanzani, A; Fundarò, S; Heydari, A; Piccoli, M; Gelmini, R

    1997-06-01

    The authors report a study on 120 patients with anal fistula (111 males and 9 females). The average age was 44.3 years (median 44, SD +/- 14.807). 64.1% of patients had an intersphincteric fistula, 23.3% hanal transphincteric fistula, 1.6% a suprasphincteric fistula, 7.5% a horseshoe fistula and the 3.3% an extrasphincteric fistula. We treated 14 patients (11.66%) with direct surgical treatment. The other 106 had various types of treatment depending on the localisation and the involvement of the anorectal sphincter. We had 11 cases (9.1%) of complications, such as recurrence in 5 patients (4.1%) transitory incontinence in 2 cases (1.6%) and finally postoperative bleeding in 3 patients (2.5%). PMID:9324655

  11. Telencephalic Flexure and Malformations of the Lateral Cerebral (Sylvian) Fissure.

    PubMed

    Sarnat, Harvey B; Flores-Sarnat, Laura

    2016-10-01

    After sagittal division of the prosencephalon at 4.5 weeks of gestation, the early fetal cerebral hemisphere bends or rotates posteroventrally from seven weeks of gestation. The posterior pole of the telencephalon thus becomes not the occipital but the temporal lobe as the telencephalic flexure forms the operculum and finally the lateral cerebral or Sylvian fissure. The ventral part is infolded to become the insula. The frontal and temporal lips of the Sylvian fissure, as well as the insula, all derive from the ventral margin of the primitive telencephalon, hence may be influenced by genetic mutations with a ventrodorsal gradient of expression. The telencephalic flexure also contributes to a shift of the hippocampus from a dorsal to a ventral position, the early rostral pole of the hippocampus becoming caudal and dorsal becoming ventral. The occipital horn is the most recent recess of the lateral ventricle, hence most vulnerable to anatomic variations that affect the calcarine fissure. Many major malformations include lack of telencephalic flexure (holoprosencephaly, extreme micrencephaly) or dysplastic Sylvian fissure (lissencephalies, hemimegalencephaly, schizencephaly). Although fissures and sulci are genetically programmed, mechanical forces of growth and volume expansion are proposed to be mainly extrinsic (including ventricles) for fissures and intrinsic for sulci. In fetal hydrocephalus, the telencephalic flexure is less affected because ventricular dilatation occurs later in gestation. Flexures can be detected prenatally by ultrasound and fetal magnetic resonance imaging and should be described neuropathologically in cerebral malformations. PMID:27590993

  12. Black Anal Canal: Acute Necrosis

    PubMed Central

    Martins, Catarina; Gonçalves, Cláudia; Alves, Paulo; Gil, Inês; Canhoto, Manuela; Silva, Filipe; Cotrim, Isabel; Amado, Cristina; Eliseu, Liliana; Vasconcelos, Helena

    2016-01-01

    Acute ischemia of the rectum or anal canal resulting in necrosis is extremely uncommon because both the rectum and the anal canal have excellent blood supplies. We present a case with spontaneous necrosis of the anal canal without rectal involvement. Surgical debridement was accomplished, and the recovery was uneventful. The patient was elderly, with probable atherosclerotic arterial disease, and presented with hypotension. Due to the lack of other precipitating factors, the hypoperfusion hypothesis seems to be the most suitable in this case. To the best of our knowledge, no similar cases have been reported in the literature on this subject.

  13. Black Anal Canal: Acute Necrosis.

    PubMed

    Barbeiro, Sandra; Martins, Catarina; Gonçalves, Cláudia; Alves, Paulo; Gil, Inês; Canhoto, Manuela; Silva, Filipe; Cotrim, Isabel; Amado, Cristina; Eliseu, Liliana; Vasconcelos, Helena

    2016-08-01

    Acute ischemia of the rectum or anal canal resulting in necrosis is extremely uncommon because both the rectum and the anal canal have excellent blood supplies. We present a case with spontaneous necrosis of the anal canal without rectal involvement. Surgical debridement was accomplished, and the recovery was uneventful. The patient was elderly, with probable atherosclerotic arterial disease, and presented with hypotension. Due to the lack of other precipitating factors, the hypoperfusion hypothesis seems to be the most suitable in this case. To the best of our knowledge, no similar cases have been reported in the literature on this subject. PMID:27626027

  14. Black Anal Canal: Acute Necrosis

    PubMed Central

    Martins, Catarina; Gonçalves, Cláudia; Alves, Paulo; Gil, Inês; Canhoto, Manuela; Silva, Filipe; Cotrim, Isabel; Amado, Cristina; Eliseu, Liliana; Vasconcelos, Helena

    2016-01-01

    Acute ischemia of the rectum or anal canal resulting in necrosis is extremely uncommon because both the rectum and the anal canal have excellent blood supplies. We present a case with spontaneous necrosis of the anal canal without rectal involvement. Surgical debridement was accomplished, and the recovery was uneventful. The patient was elderly, with probable atherosclerotic arterial disease, and presented with hypotension. Due to the lack of other precipitating factors, the hypoperfusion hypothesis seems to be the most suitable in this case. To the best of our knowledge, no similar cases have been reported in the literature on this subject. PMID:27626027

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

    NASA Astrophysics Data System (ADS)

    Krzeminska, D. M.; Bogaard, T. A.; van Asch, Th. W. J.; van Beek, L. P. H.

    2012-06-01

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

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

    PubMed

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

    2012-10-01

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

  17. 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.

  18. Modern management of anal fistula

    PubMed Central

    Limura, Elsa; Giordano, Pasquale

    2015-01-01

    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

  19. 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.

  20. 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.

  1. Asymmetries in the cerebral dimensions and fissures of the dog.

    PubMed

    Tan, U; Calişkan, S

    1987-02-01

    The surface dimensions and fissures of the right and left cerebral hemispheres were compared in dogs. The right hemisphere was significantly larger in length and height than the left hemisphere; there was no significant difference in the width of the right and left hemispheres. The mean length of the cruciate sulcus did not significantly differ on the right and left sides except individual for asymmetries. The difference in the mean length of the right and left Sylvian fissures was not significant, but the right Sylvian fissure was significantly lower than the left. The base of the right planum temporale tended to be larger than the left. These anatomical asymmetries did not correlate with paw preference. The data are consistent with notion that asymmetrical patterns cannot be a distinctive feature of the human brain.

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

    PubMed

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

    2011-11-01

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

  3. An opening magmatic fissure: structural pattern of its termination

    NASA Astrophysics Data System (ADS)

    Zelenin, Egor A.; Kozhurin, Andrey I.; Pinegina, Tatiana K.; Mikhaylyukova, Polina G.

    2014-05-01

    Volcanic zones of Kamchatka bear two types of active faults and fractures. Faults of the first type are tectonic, so they are long-living with net offset growing with time by repeating movement. Faults of the second type could be termed volcano-tectonic as they couple with or are caused by eruptions and thus move just once. Authors have explored and described a NE-SW-striking fissure on the SW side of Gorely plateau in the South Kamchatka volcanic zone, which conducted magma 200 years ago (Selyangin, Ponomareva, 1999). The fissure depression is filled with basaltic-andesite lava. The 900 meters long southern terminus of the fissure is situated on the hill slope and therefore not overlapped with lava. The fissure ending is an asymmetric graben, deeper at its west side, up to 300 m wide and bounded by two nearly parallel normal faults. The graben floor is gradually deepening to the north, away from the terminus, down to 9-10 m. Bounding faults are perfectly expressed in topography, thus providing a rare opportunity for determination of fissure parameters. Both faults dip at 80-85°, that gives approximately up to 3 m of perpendicular extension and the same thickness of the dyke beneath. Vertical movements on the western and eastern bounding faults were accompanied by horizontal components, left-lateral and right-lateral, respectively. There are also several transverse north-facing scarps breaking the graben floor and not extending beyond its limits. The observed deformations altogether suggests simultaneous sinking of the graben floor and northward compensating movement of masses into the graben. Tectonic landforms we studied illustrate how strain could be compensated at the end of an opening fissure and provide some insight into similar settings at a regional and even global scale.

  4. 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

  5. Surgery for Crohn's anal fistulas.

    PubMed

    Sugita, A; Koganei, K; Harada, H; Yamazaki, Y; Fukushima, T; Shimada, H

    1995-11-01

    The aim of this study was to analyze the features of Crohn's anal fistulas and to evaluate the efficacy of seton treatment. In 119 patients with Crohn's disease, the incidence of anal fistula was 56% (67/119), with no significant difference in the incidence among patients with ileitis, colitis, and ileocolitis. "Intractable" anal fistulas were found in 17% of patients with ileitis, compared to 64% of those with colitis (P = 0.051) and 68% of those with ileocolitis (P = 0.014). Seton treatment, i.e., non-cutting, long-term seton drainage, was performed for 21 patients (5 with intersphincteric, and 16 with transsphincteric fistulas). In the 16-month follow up, 9 patients required redrainage for recurrent fistulous abscess, mainly because of progressive colorectal disease. Finally, a good result was obtained in 17 of the 21 patients (81%) and no recurrent fistulous abscess developed in the 8 patients in whom all setons were removed. Anal continence was preserved in all the patients. These results indicate that anal fistulas with Crohn's ileitis were cured more easily than those with colitis or ileocolitis, and that seton treatment was effective for intersphincteric fistula with multiple fistula openings and for transphincteric fistulas in patients exhibiting remission of intestinal Crohn's disease. PMID:8563879

  6. [Day surgery for anal disease].

    PubMed

    Takano, M

    2000-10-01

    Historically, patients with anal diseases treated on a day surgery basis had inadequate cure rates and a high complication rate. After World War II, modern treatment methods were learned from the UK and USA and improved in Japan. However, the improved radical methods were so complex that approximately 2 weeks' hospitalization was needed. Recently, day surgery for various diseases including hemorrhoids has been recommended by the Japanese ministry of Health and Welfare. However, the characteristics of anal anatomy and physiology make the smooth healing of wounds difficult and tend to cause postoperative pain, bleeding, infection, prolonged healing time, etc. To prevent such difficulties, care must be well planned following the critical path of informed consent, careful surgery, postoperative observation, and management at home. However, hospital staff in charge of such surgery are under so much stress that only patients with less severe anal disease without local or systemic complications should be selected for day surgery.

  7. 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

  8. 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)

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

    PubMed Central

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

    2014-01-01

    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. PMID:25503366

  10. The effect of vegetation on infiltration in shallow soils underlain by fissured bedrock

    NASA Astrophysics Data System (ADS)

    Stothoff, S. A.; Or, D.; Groeneveld, D. P.; Jones, S. B.

    1999-05-01

    Mean annual infiltration above the high-level waste repository proposed to be sited at Yucca Mountain, Nevada, has a large impact on assessments of repository performance. Ongoing investigations of infiltration processes have identified the relatively horizontal caprock environment above portions of the repository as a potentially large source of infiltrating waters, due to shallow, permeable soils above a moderately welded tuff with large soil-filled fissures. The combination of shallow soils and fissured bedrock allows rapid penetration of wetting pulses to below the rooting zone. Plant uptake can strongly reduce net infiltration in arid environments with high water storage capacity, and, despite the low water storage capacity, there is a relatively high vegetation density in this environment. The apparent discrepancy between high vegetation density and low water storage motivates the study of plant-hydrologic interactions in this semiarid environment. Field observations were coupled with plant- and landscape-scale models to provide insight into plant-hydrologic interactions. Several lines of evidence, including: (i) linear plant growth features observed on aerial photographs; (ii) comparisons of plant cover within the fissured environment and comparable environments lacking fissures; and (iii) direct excavations, all suggest that the widely spaced soil-filled fissures are conducive to plant growth even when fissures are buried at soil depths exceeding 30 cm. Results from a mechanistic simulation model for root growth into fissures suggest that the additional (sheltered) plant-available soil water within fissures provides a competitive advantage for plant establishment. Therefore, plants that germinate above a fissure are more likely to survive, in turn developing linear features above fissures. Having established that plants preferentially root within soil-filled fissures in the caprock environment, a set of simulations were performed to examine the hydrologic

  11. 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.

  12. delta-Storage pool disease: a pitfall in the forensic investigation of sudden anal blood loss in children: a case report.

    PubMed

    De Munnynck, K; Van Geet, C; De Vos, R; Van de Voorde, W

    2007-01-01

    We present the case of a 3.5-year-old boy with sudden anal blood loss at school. Sexual abuse was suspected, and, apart from anal fissures seen on sigmoidoscopy, no other clinical signs of any sort of disorder were present. As no medical explanation for the blood loss could be given, penetrating anal trauma was suggested. During follow-up consultations, there were complaints of occasional blood loss. Platelet aggregation tests and electron microscopy finally helped diagnose a delta-storage pool disease which is a rare haemostatic disorder involving the dense granules of the platelets. Although exclusion of well-known blood diseases through routine laboratory testing is a common practice in children with sudden blood loss, this case illustrates the value of more specialised investigation both from a diagnostic and forensic point of view. PMID:16283350

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

    PubMed Central

    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. PMID:27110109

  14. A Review of Cyanoacrylate Liquid Skin Protectant and Its Efficacy on Pedal Fissures

    PubMed Central

    Vlahovic, Tracey C.; Hinton, Elizabeth A.; Chakravarthy, Debashish; Fleck, Cynthia Ann

    2011-01-01

    Introduction Skin fissures are a common dermatologic condition caused by excessive dry skin, numerous systemic diseases, and backless shoe gear. They are defects in skin that fall into the category of damaged, partial-thickness skin wounds, as opposed to full-thickness wounds. Patients with heel fissures are at an increased risk for developing infection, which could cause more severe issues, especially in patients with diabetes and peripheral vascular disease. Methods Five patients from Temple Foot and Ankle Institute, Philadelphia, PA, with a total of 8 heel fissures and 2 hallux fissures, were studied. Patients were dispensed 9 vials of a cyanoacrylate liquid skin protectant (Marathon™, Medline Industries, Inc, Mundelein, IL) to be applied to the fissure every 3 days. Patients returned every 2 weeks for follow-up in clinic. Results The hallux fissures and 4 of the heel fissures went to complete closure after 2 weeks. There was an average decrease of 1.16 cm in length of the heel fissure dimensions after 2 weeks and an average decrease of 1.1 cm in length of the hallux fissures. Conclusion This novel skin protectant proved to be a comfortable, easy, and effective tool in aiding the resolution of pedal skin fissures. PMID:24527155

  15. 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

  16. 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.

  17. Phimosis with Preputial Fissures as a Predictor of Undiagnosed Type 2 Diabetes in Adults.

    PubMed

    Huang, Yun-Ching; Huang, Yao-Kuang; Chen, Chih-Shou; Shindel, Alan W; Wu, Ching-Fang; Lin, Jian-Hui; Chiu, Kuo-Hsiung; Yang, Tzu-Hsin; Shi, Chung-Sheng

    2016-03-01

    Diabetes is usually asymptomatic in its early stage. Early diagnosis may improve outcomes by enabling initiation of treatment before end organ damage has progressed. The aim of this study was to determine whether the clinical sign of phimosis with preputial fissures is predictive of type 2 diabetes in patients not previously diagnosed with diabetes. Twenty-eight patients with acquired phimosis and preputial fissures were collected prospectively. Twenty-eight controls with acquired phimosis without preputial fissures were selected. Statistically significant differences were found in body mass index, random plasma glucose, glucosuria and glycosylated haemoglobin levels, but not in age, family history of diabetes, hypertension and classical hyperglycaemic symptoms. Diabetes was confirmed in all 28 patients in the preputial fissures group, but only 2 (7.1%) patients in the non-preputial fissures group (p < 0.0001). In conclusion, phimosis with preputial fissures may be a specific sign of undiagnosed diabetes mellitus. PMID:26349852

  18. 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.

  19. 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

  20. Clinical analysis of molar fissures by Cone-beam tomography.

    PubMed

    Cruvinel, V R N; Azevedo, B C; Gravina, D B L; Toledo, O A; Bezerra, A C B

    2007-01-01

    This study aimed to validate clinical analysis of 20 pediatric dentists on occlusal groove-fossa-system of molar depth comparing to Cone-beam tomography. The 48 sound third molars were visually classified from the shallowest to the deepest. Images were taken from the Accuitomo 3DX. There was a fair correlation between clinical analysis and the tomographic scorings (rs = 0.238; P = 0.103). It was concluded that pediatric dentists were not able to classify the fissures depth by visual analysis correctly. PMID:19161057

  1. Fluoride release and uptake abilities of different fissure sealants

    PubMed Central

    Andenna, Gianluigi; Ceci, Matteo; Beltrami, Riccardo; Colombo, Marco; Cucca, Lucia

    2016-01-01

    Background The long-term capability of resin sealants and glass ionomer cements to release fluoride is associated to a reduction in pit and fissure caries. The regular use of fluoride varnishes/toothpastes can result in the absorption of fluoride into the sealant. The objective of the present study was to assess the fluoride release/uptake capacities of different fissure sealants. Material and Methods Three different fissure sealants (Fuji Triage/GC, Fissurit FX/Voco and Grandio Seal/Voco) were examined. Ten discs of each material were prepared. Each disc was incubated with distilled water and then the solution analyzed for diluted for fluoride concentration, using a combination of fluoride electrode (OrionGP 1 S/N 13824, Orion Research Inc, Boston, MA, USA) connected to an expandable ion analyzer (Orion 720A, Orion Research Inc, Boston, MA, USA). Standard curves between 1 and 100 ppm F- were used to calibrate the electrode. Cumulative fluoride release was measured on days 1, 2, 3, 5, 7, 21, 35 and 49, then two different fluoride varnishes/pastes (Profluorid Varnish/Voco, MI Paste Plus/GC), were applied to the sealants tested, and fluoride release (after reuptake) was measured on days 56, 70 and 84. Results Kruskal Wallis test confirmed significant differences in fluoride release between Fuji Triage/GC and Fissurit FX/Voco and Grandio Seal/Voco from day 1 (P < 0.001). The application of fluoride varnish Profluorid Varnish enhanced the fluoride release for all sealants (P < 0.05). MI Paste Plus enhanced the fluoride release for all sealants except for Fuji Triage/GC (P > 0.05). Conclusions The GIC-based sealant (Fuji Triage/GC) released significantly more fluoride than the resin sealants tested. The exposure to the fluoridated varnish (Profluorid Varnish) significantly recharged the sealants tested more than the CPP-ACPF toothpaste (MI Paste Plus). Key words:Fissure sealants, fluoride release, fluoride uptake, glass ionomer cements. PMID:27398179

  2. 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.

  3. A calculus within an anal fistula tract in a diabetic patient.

    PubMed

    Ahmed, M E; Shumo, A I

    2001-02-01

    A non-insulin dependent diabetic patient with a chronic anal fistula underwent fistulectomy. At operation a calculus was discovered. The patient had an uneventful recovery and healing of the wound in 4 weeks duration. The only case reported previously was in a nondiabetic patient and interestingly from this department. PMID:11299415

  4. Biomaterials in the Treatment of Anal Fistula: Hope or Hype?

    PubMed Central

    Scoglio, Daniele; Walker, Avery S.; Fichera, Alessandro

    2014-01-01

    Anal fistula (AF) presents a chronic problem for patients and colorectal surgeons alike. Surgical treatment may result in impairment of continence and long-term risk of recurrence. Treatment options for AFs vary according to their location and complexity. The ideal approach should result in low recurrence rates and minimal impact on continence. New technical approaches involving biologically derived products such as biological mesh, fibrin glue, fistula plug, and stem cells have been applied in the treatment of AF to improve outcomes and decrease recurrence rates and the risk of fecal incontinence. In this review, we will highlight the current evidence and describe our personal experience with these novel approaches. PMID:25435826

  5. Contact sensitization in the anal and genital area.

    PubMed

    Bauer, A; Oehme, S; Geier, J

    2011-01-01

    We analysed the patch test results in 1,374 patients suffering from dermatoses in the anogenital area (n = 561 genital dermatoses, n = 470 anal dermatoses, n = 343 anogenital dermatoses) patch tested in 44 dermatological departments of the Information Network of Departments of Dermatology from 2004 to 2008. All other patients patch tested during this time period without anogenital dermatoses formed the control group (n = 49, 142). Of the total study group, 662 (48.2%) patients were male. 179 (13%) had a past or present atopic dermatitis. The vast majority of the patients was older than 40 years (n = 989, 72%). Suspected allergen sources were first of all topical medicaments, followed by cosmetics, cleansing agents, clothes, rubber products, systemic medicaments and disinfectants. Allergic contact dermatitis was diagnosed in 409 (29.8%) of the tested patients. Patients with anogenital dermatoses were sensitized mainly to active agents of topical medicaments, in particular bufexamac (5.3%). Sensitization pattern and sensitization rates observed in patients with genital and anal involvement differed significantly. Patients with anal disease had significantly higher sensitization rates for bufexamac (9.4 vs. 1.1%), fragrance mix I (8.7 vs. 4.2%) and II (4.5 vs. 2.6%), propolis (5.4 vs. 1.9%) and methyldibromoglutaronitrile (6.3 vs. 4.1%). Patients with chronic anal dermatoses seem to have a higher risk to develop sensitizations to topically applied products and drugs than patients with genital dermatoses. Recommended patch test series (German Contact Dermatitis Research Group) are standard series, local anaesthetics series, topical antibiotics, antimycotics, steroids, ointment bases and preservative series as well as the patients' own products.

  6. Fissure sealants: Knowledge and practice of Yemeni dental practitioners

    PubMed Central

    Al-Maweri, Sadeq Ali; Al-Jamaei, Aisha Ahmed; Halboub, Esam Saleh; Al-Soneidar, Walid Ahmed; Tarakji, Bassel; Alsalhani, Anas

    2016-01-01

    Objectives This study was conducted to evaluate Yemeni dental practitioners' knowledge and practices concerning fissure sealants. Materials and Methods: A modified questionnaire consisted of 25-items was distributed to 500 dentists working in Sana'a City. Descriptive statistics and Chi-square/Fisher's exact tests were used for statistical analyses. Results: The response rate was 74%. Most of the respondents were male (61.3%), general practitioners (84.2%), and had <5 years of clinical experience (48.3%). The respondents showed a reasonable level of knowledge about sealants, with the majority (88%) believed that there is strong scientific evidence about fissure sealants effectiveness and around 90% showed a good understanding of sealant placement instructions. On the other hand, respondents showed insufficient knowledge about sealants clinical practice. Conclusion: Although a high proportion of dental practitioners showed adequate knowledge about dental sealant, following guidelines and standardized procedures in clinical practice is lacking. These emphasize the need for regular continuing education courses for dental professional. PMID:27095903

  7. The effect of normal pulsed Nd-YAG laser irradiation on pits and fissures in human teeth.

    PubMed

    Bahar, A; Tagomori, S

    1994-01-01

    The effects of normal pulsed Nd-YAG laser irradiation on the acid resistance of human dental enamel of pits and fissures, the cleaning of the pit and fissure contents and fluoride uptake into deep pits and fissures were examined. The acid resistance of the pit and fissure enamel was evaluated by the amount of dissolved calcium per square millimeter of the surface area. The pit and fissure enamel treated with laser irradiation obtained an acid resistance 30% higher than that of the unlased controls. The cleaning effect of laser irradiation on the pit and fissure contents was compared with chemicomechanical and mechanical methods. The laser irradiation was found to clean the pits and fissures to a greater depth without alterating the shape of pits and fissures, compared with the other two methods. The distribution of calcium, phosphorus and fluoride in the enamel of the pits and fissures was then measured by electron probe microanalyzer. At the entrance and in the deep part of the pits and fissures, the fluoride content of the enamel treated with acidulated phosphate fluoride after laser irradiation was higher than that of the enamel treated with acidulated phosphate fluoride alone. These results thus suggest that Nd-YAG laser irradiation might be effective in increasing the acid resistance of the pit and fissure enamel, while removing the pit and fissure debris contents and increasing the fluoride uptake into the pit and fissure enamel.

  8. Fracture mechanical behavior of red sandstone containing a single fissure and two parallel fissures after exposure to different high temperature treatments

    NASA Astrophysics Data System (ADS)

    Yang, Sheng-Qi; Jing, Hong-Wen; Huang, Yan-Hua; Ranjith, P. G.; Jiao, Yu-Yong

    2014-12-01

    A detailed understanding of the brittle deformation behavior of sandstone containing pre-existing flaws at elevated temperatures is a key concern in underground engineering. In this research, uniaxial compression tests were performed to evaluate the effect of high temperature treatments (300, 600 or 900 °C) on the strength, deformability and fracture coalescence behavior of a sandstone containing either a single fissure or two parallel fissures. All experiments focused on rectangular prismatic (80 × 160 × 30 mm) specimens of red sandstone. Constant strain rate experiments were performed on either: (1) specimens that contained a single 2 mm-wide fissure or (2) specimens that contained two 2 mm-wide parallel fissures. The specimens containing either one or two fissures were either left at room temperature (i.e., no heat treatment), or heat treated to 300, 600 or 900 °C prior to experimentation. The results demonstrated that, in all cases, the strength and stiffness of red sandstone was increased at 300 °C, before decreasing up to our maximum temperature of 900 °C. However, the peak strain at failure always showed an increase when the temperature was increased. The crack initiation, propagation and coalescence process were monitored during the deformation using both photographic monitoring and acoustic emission (AE) monitoring techniques. The monitoring results showed that the cracking process depended on both the fissure geometry and the heat treatment temperature. The potential mechanisms causing the differences in the mechanical behavior observed with increasing temperature are discussed, as is the influence of the single fissure and the two parallel fissures on the crack evolution process. These results are important and valuable to understand the fracture mechanism of rock engineering in deep underground mining excavations and nuclear waste depositories.

  9. 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...

  10. Baghdad Suchus on Enceladus: Constraints on the Temperature and Width at the Fissure Mouth

    NASA Astrophysics Data System (ADS)

    Goguen, Jay D.; Buratti, B. J.; Brown, R. H.; Clark, R. N.; Nicholson, P. D.; Hedman, M. M.; Sotin, C.; Cruikshank, D. P.; Baines, K. H.

    2013-10-01

    A Cassini VIMS spectrum of an active location along Baghdad Sulchus is best fit by a fissure 9 m wide at T=197 K (Goguen et al. 2013, Icarus, accepted). We show that narrower and hotter fissures are unstable due to the exponential increase of the vapor pressure of ice for T greater than 200 K. Ice at 230 K will erode 1 meter/day due to sublimation, so a narrower and warmer fissure will quickly erode to meter widths. The same strong T dependence of the vapor pressure also means that wider fissures at T ~180 K cannot supply to total mass loss rate constraint from Cassini UVIS occultation data. The mass loss rate can be supplied if a significant fraction 190 km) of the total length of the fissures is active as a 9 m wide fissure with T=197 K. The contribution of this hottest component of the fissure emission contributes only a small fraction of the total observed radiated power from the fissures which is dominated by much larger areas at lower T and is best characterized using the CIRS instrument. Copyright 2013 California Institute of Technology.

  11. 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 (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3765 Pit and fissure sealant...

  12. 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 (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3765 Pit and fissure sealant...

  13. Holocene intracontinental deformation of the northern North China Plain: Evidence of tectonic ground fissures

    NASA Astrophysics Data System (ADS)

    Xu, Liqing; Li, Sanzhong; Cao, Xianzhi; Somerville, I. D.; Suo, Yanhui; Liu, Xin; Dai, Liming; Zhao, Shujuan; Guo, Lingli; Wang, Pengcheng; Cao, Huahua

    2016-04-01

    Following the collecting and analyzing of field data on the geometry and kinematics characteristics of ground fissures in the northern North China Plain (NNCP), this paper shows that en échelon ground fissures or tectonic ground fissures with a length of several meters to tens of kilometers extending along active faults are possibly controlled by underlying active faults. There are two groups of tectonic ground fissures developed in the NNCP. One group consists of ENE-trending "right-stepping" ground fissures, some of which have a component of sinistral motion. The other group is NNE-trending "left-stepping" ground fissures with dextral motion. A large amount of data from trenches, boreholes and seismic exploration reflect that they are active-faulting-related. The NNW-trending regional extensional stress field and the reactivation of pre-existing faults are the major factors controlling ground fissures. Data from the Quaternary sedimentary records, deep incised valleys, the distribution of earthquakes and ground fissures, and our field work show that the Holocene intracontinental deformation of the NNCP is characterized by intense faulting and northwestward tilting, which may be related to a NNW-SSE-oriented tensional stress field in the shallow crust and asthenospheric upwelling in the mantle.

  14. 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

  15. Prophylactic HPV vaccination and anal cancer.

    PubMed

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

    2016-06-01

    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. PMID:26933898

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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. PMID:27651887

  1. 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.

  2. 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.

  3. 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.

  4. Are pit and fissure sealants needed in children with a higher caries risk?

    PubMed

    Berger, Susanne; Goddon, Inka; Chen, Chih-Mei; Senkel, Helga; Hickel, Reinhard; Stösser, Lutz; Heinrich-Weltzien, Roswitha; Kühnisch, Jan

    2010-10-01

    The aim of this cross-sectional study was to analyse the preventive need of pit and fissure sealants (PFS) in a German population with a relatively high caries risk. The study involved 311 8- to 12-year-old children from the Ennepe-Ruhr District in North Rhine-Westphalia, Germany. Caries experience was scored according to WHO (1997) and ICDAS II criteria. PFS were assessed as intact or partially lost. The mean DFS values amounted to 0.5 for occlusal fissures, 0.2 for palatal/buccal pits and 0.3 for the remaining teeth. Non-cavitated caries lesions were recorded in average on 1.8 occlusal fissures and 1.5 palatal/buccal pits. Sealants were registered on 1.4 occlusal fissures and 0.4 palatal/buccal pits. The descriptive data and the adjusted Poisson regression models revealed that children with at least one fissure sealant are less likely to have decayed fissures or fissures with non-cavitated lesions on their permanent molars. Therefore, PFS are needed and indicated in caries-risk children.

  5. 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.

  6. Automatic segmentation of pulmonary fissures in computed tomography images using 3D surface features.

    PubMed

    Yu, Mali; Liu, Hong; Gong, Jianping; Jin, Renchao; Han, Ping; Song, Enmin

    2014-02-01

    Pulmonary interlobar fissures are important anatomic structures in human lungs and are useful in locating and classifying lung abnormalities. Automatic segmentation of fissures is a difficult task because of their low contrast and large variability. We developed a fully automatic training-free approach for fissure segmentation based on the local bending degree (LBD) and the maximum bending index (MBI). The LBD is determined by the angle between the eigenvectors of two Hessian matrices for a pair of adjacent voxels. It is used to construct a constraint to extract the candidate surfaces in three-dimensional (3D) space. The MBI is a measure to discriminate cylindrical surfaces from planar surfaces in 3D space. Our approach for segmenting fissures consists of five steps, including lung segmentation, plane-like structure enhancement, surface extraction with LBD, initial fissure identification with MBI, and fissure extension based on local plane fitting. When applying our approach to 15 chest computed tomography (CT) scans, the mean values of the positive predictive value, the sensitivity, the root-mean square (RMS) distance, and the maximal RMS are 91 %, 88 %, 1.01 ± 0.99 mm, and 11.56 mm, respectively, which suggests that our algorithm can efficiently segment fissures in chest CT scans.

  7. 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

  8. 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

  9. 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...

  10. Radar Observations of Fissure-fed Basaltic Lava Flows, Craters of the Moon, Idaho

    NASA Technical Reports Server (NTRS)

    Martel, L.; Greeley, R.

    1985-01-01

    Changes in surface roughness of lava flows, estimated from dual polarization, synthetic aperture, X and L band side-looking airborne radar images, were tested as a means of locating fissure vent areas. If lava textures proess from smooth, near-vent shelly pahoehoe to hummocky pahoehoe to aa with distance from fissure vents, then radr images of the lava flows would show a progression from dark to brighter tones due to the flows' increasing radar back-scatter.

  11. 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.

  12. Proctology - diseases of the anal region.

    PubMed

    Kreuter, Alexander

    2016-04-01

    Proctology is a medical subspecialty that encompasses diseases of the perianal region, anal canal, and rectum. Dermatologists play a pivotal role in this realm, as inflammatory perianal disorders, infectious and sexually transmitted diseases, as well as perianal tumors and their precursor lesions fall within the core competency of dermatology. In a concise manner, the present article highlights all relevant disease groups in the field of proctology. With a particular focus on aspects pertinent to dermatologists, this includes inflammatory disorders, "classic" proctologic diseases, sexually transmitted diseases, malignancies of the anal region, as well as pathogen-induced diseases. Despite the wide variety of disorders, there are only five key symptoms prompting patients to consult a proctologist, including anal pruritus and burning, discharge, bleeding, pain, and foreign body sensation. A simple algorithm, which incorporates these symptoms as well as key clinical features, may assist in quickly establishing the correct diagnosis in everyday clinical practice. PMID:27027745

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

    PubMed Central

    2012-01-01

    Background Human papillomavirus (HPV) is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM) and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia), when compared to cervical cancer and CIN (cervical intraepithelial neoplasia). This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer. PMID:22958276

  14. Fracturing and earthquake activity within the Prestahnúkur fissure swarm in the Western Volcanic Rift Zone of Iceland

    NASA Astrophysics Data System (ADS)

    Hjartardóttir, Ásta Rut; Hjaltadóttir, Sigurlaug; Einarsson, Páll; Vogfjörd, Kristín.; Muñoz-Cobo Belart, Joaquín.

    2015-12-01

    The Prestahnúkur fissure swarm is located within the ultraslowly spreading Western Volcanic Zone in Iceland. The fissure swarm is characterized by normal faults, open fractures, and evidence of subglacial fissure eruptions (tindars). In this study, fractures and faults within the Prestahnúkur fissure swarm were mapped in detail from aerial photographs to determine the extent and activity of the fissure swarm. Earthquakes during the last ~23 years were relocated to map the subsurface fault planes that they delineate. The Prestahnúkur fissure swarm is 40-80 km long and up to ~20 km wide. Most of the areas of the fissure swarm have been glacially eroded, although a part of it is covered by postglacial lava flows. The fissure swarm includes numerous faults with tens of meters vertical offset within the older glacially eroded part, whereas open fractures are found within postglacial lava flows. Comparison of relocated earthquakes and surface fractures indicates that some of the surface fractures have been activated at depth during the last ~23 years, although no dike intrusions have been ongoing. The existence of tindars nevertheless indicates that dike intrusions and rifting events do occur within the Prestahnúkur fissure swarm. The low-fracture density within postglacial lava flows and low density of postglacial eruptive fissures indicate that rifting episodes occur less often than in the faster spreading Northern Volcanic Zone.

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

    MedlinePlus

    ... Next Topic Additional resources for 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 ...

  16. 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

  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. 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,…

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

    PubMed Central

    Chan, Dedrick Kok-Hong; Chong, Choon-Seng; Tan, Ker-Kan

    2016-01-01

    Anal adenocarcinoma is a rare condition and can arise in chronic inflammatory states such as in Crohn's disease, or in a chronic fistula-in-ano. We report our diagnosis and management of a patient who presented with a large perineal lump with a long-standing history of perianal fistulous disease. This was initially evaluated with a Magnetic Resonance Imaging, and the diagnosis was confirmed with biopsy. Multimodality treatment with chemoradiotherapy and surgery should be offered to achieve the best outcomes. PMID:27057309

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

    PubMed

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

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

  1. 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…

  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.

  4. 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

  5. Maps showing water-level declines, land subsidence, and earth fissures in south-central Arizona

    USGS Publications Warehouse

    Laney, R.L.; Raymond, R.H.; Winikka, C.C.

    1978-01-01

    From 1915 to 1975, more than 109 million acre-feet of ground water was withdrawn from about 4,500 square miles in Pinal and Maricopa Counties in south-central Arizona. The volume of water withdrawn greatly exceeds the volume of natural recharge, and water levels have been declining since 1923. As a result of the water-level declines, the land surface has subsided, the alluvial deposits have been subjected to stress, and earth fissures have developed. Land subsidence and earth fissures have damaged public and private properties. Subsidence and fissures will continue to occur as long as ground water is being mined and water levels continue to decline. As urban development expands, land subsidence and earth fissures will have an increasing socioeconomic impact. Information on maps includes change in water levels, measurements of land subsidence, and location of earth fissures. A section showing land subsidence between Casa Grande and the Picacho Peak Interchange also is included. Scale 1:250,000. (Woodard-USGS)

  6. 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

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

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

  8. A polarized light and scanning electron microscopic study of human fissure and lingual enamel of unerupted mandibular third molars.

    PubMed

    Ekstrand, K; Holmen, L; Qvortrup, K

    1999-01-01

    Using histological and ultrastructural techniques the aims of this study were to investigate whether the mineralization pattern and surface microanatomy of the caries-susceptible fissure enamel were different from those on the caries-inactive lingual surface. The material consisted of 31 unerupted third mandibular molars. The specimens were initially grouped into four categories: (1) without, (2) with initial, (3) with almost completed and (4) with completed root formation. One ground section with fissure-like morphology was selected from each tooth. Using water as a medium the observed birefringence was negative along the lingual and fissure transverses in specimens with almost completed and with completed root formation, while the observed birefringence was positive at different distances in the enamel in sections representing less maturation stages. Qualitative imbibition studies revealed hypomineralized enamel in the lower part of the fissures in specimens representing almost and completed root formation. Imbibed in quinoline, parts of the hypomineralized enamel behaved like a molecular sieve due to the presence of micropores, indicating that the structural arrangement is different from that in the enamel adjacent to this areas. After division of the sections into a lingual and a buccal part, SEM features were described from lower and upper parts of the buccal fissure wall and on lingual enamel in the area corresponding to the bottom part of the fissure. The surface microanatomy varied greatly. Negative developmental irregularities such as fissures and holes were associated with the immature enamel, while matured enamel - particularly fissures - housed many positive developmental irregularities such as enamel caps and protrusions. The crystal size in the mature specimens appeared smaller and more uniform than the crystals from the immature specimens. Apart from the occurrence of hypomineralized enamel in fissures and numerous positive developmental

  9. Thermal control of shape memory alloy artificial anal sphincters for complete implantation

    NASA Astrophysics Data System (ADS)

    Luo, Yun; Okuyama, Takeshi; Takagi, Toshiyuki; Kamiyama, Takamichi; Nishi, Kotaro; Yambe, Tomoyuki

    2005-02-01

    This paper presents an approach for the thermal control of an artificial anal sphincter using shape memory alloys. An artificial anal sphincter has been proposed by the authors to resolve problems of severe fecal incontinence in patients. The basic design of the artificial sphincter consists of two all-round shape memory alloy plates as the main functional parts, and heaters that are attached to the SMA plates for generating the thermal cycles required for the phase transformation accompanied shape changes of the plates. The SMA artificial sphincter could be fitted around intestines, performing an occlusion function at body temperature and a release function upon heating. Thermal compatibility of such prostheses is most important and is critical for practical use. Since a temperature rise of approximately 20 °C from body temperature is needed to activate a complete transformation of SMA plates, an earlier model of ours allowed only a short period of heating, resulting in incomplete evacuation. In this work, a thermal control approach using a temperature-responsive reed switch has been incorporated into the device to prevent the SMA plates from overheating. Then, with thermal insulation the artificial anal sphincter is expected to allow a long enough opening period for fecal continence; without any thermal impact to the surrounding tissues that would be in contact with the artificial sphincter. Thermal control was confirmed in both in vitro and in vivo experiments, suggesting the effectiveness of the present approach. The modified SMA artificial anal sphincter has been implanted into animal models for chronic experiments of up to 4 weeks, and has exhibited good performance by maintaining occlusion and release functions. At autopsy, no anomaly due to thermal impact was found on the surfaces of intestines that had been in contact with the artificial anal sphincter.

  10. 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.

  11. 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.

  12. 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.

  13. Anthropometric Analysis of Palpebral Fissure Dimensions and its Position in South Indian Ethnic Adults

    PubMed Central

    Vasanthakumar, P.; Kumar, Pramod; Rao, Mohandas

    2013-01-01

    Objectives The morphology and anatomical relationship of periorbital features vary according to age, sex and ethnicity. Standard database regarding periorbital region is available for other ethnic groups. Since there is no data available in the literature, specifically for south Indian ethnic adults, the present study was carried out to determine the normal average values for South Indian ethnic population related to gender. Methods Anthropometric measurements of both eyes were done on standardized frontal view photograph of 200 South Indian ethnic adults aged 18 to 26 years. Parameters included were palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI), outercanthal distance (OCD), interpupillary distance (IPD), intercanthal distance (ICD) and comparisons were made between the genders using the independent t test. Results Significant sexual dimorphism was noted in the given parameters. Palpebral fissure width (male: 31.08 mm; female: 29.90 mm), palpebral fissure inclination (male: 5.053°; female: 6.102°), outercanthal distance (male: 95.55 mm; female: 92.44 mm) and interpupillary distance (male: 66.72 mm; female: 62.59 mm). The palpebral fissure height (male: 11.30 mm; female: 11.58 mm) and intercanthal distance (male: 34.27 mm; female: 33.41 mm) showed no significant sexual differences. Conclusion Statistically significant differences were found between South Indian ethnic males and female in certain key parameters. The present study suggests that ethnicity and gender should be considered in orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have knowledge of these local norms. PMID:23386941

  14. Immunosuppressive disorders and risk of anal squamous cell carcinoma: a nationwide cohort study in Denmark, 1978-2005.

    PubMed

    Sunesen, Kåre G; Nørgaard, Mette; Thorlacius-Ussing, Ole; Laurberg, Søren

    2010-08-01

    Compromised immune function may increase the risk of anal squamous cell carcinoma (SCC). We examined the risk of anal SCC in patients with HIV infection and other chronic disorders associated with immunosuppression. A population-based cohort study was conducted using the Danish National Patient Registry and the Danish Cancer Registry (DCR). We identified all patients with a first-time hospital contact or procedure for HIV infection, solid organ transplantation or autoimmune disease or a first-time record of haematologic malignancy in the DCR, 1978-2005, and followed these for a subsequent anal SCC, starting follow-up 1 year after diagnosis of the index disease. Standardised incidence ratios (SIRs) were computed as the ratio of observed to expected numbers of anal SCCs, based on national age-, sex- and period-specific rates. Among 4,488 patients with HIV, we observed 21 anal SCCs with 0.3 expected (SIR: 81.1 (95% confidence interval (CI): 51.6-121.9)). Risk of anal SCC was markedly increased among 5,113 solid organ recipients (SIR: 14.4 (CI: 7.0-26.4)) and 30,165 patients with haematologic malignancies (SIR: 2.3 (CI: 1.1-4.2)) but only moderately increased among 242,114 patients with autoimmune diseases (SIR: 1.3 (CI: 1.0-1.6)). SIRs varied according to type of autoimmune disease and were high in patients with Crohn's disease (SIR: 3.1 (CI: 1.2-6.4)), psoriasis (SIR: 3.1 (CI: 1.8-5.1)), polyarteritis nodosa (SIR: 8.8 (CI: 1.5-29.0)) and Wegener's granulomatosis (SIR: 12.4 (CI: 2.1-40.8)). In conclusion, we found HIV infection, solid organ transplantation, haematologic malignancies and a range of specific autoimmune diseases strongly associated with increased risk of anal SCC. PMID:19960431

  15. Double-porosity models for a fissured groundwater reservoir with fracture skin.

    USGS Publications Warehouse

    Moench, A.F.

    1984-01-01

    Theories of flow to a well in a double-porosity groundwater reservoir are modified to incorporate effects of a thin layer of low-permeability material or fracture skin that may be present at fracture-block interfaces as a result of mineral deposition or alteration. The commonly used theory for flow in double-porosity formations that is based upon the assumption of pseudo-steady state block-to-fissure flow is shown to be a special case of the theory presented in this paper. The latter is based on the assumption of transient block-to-fissure flow with fracture skin.-from Author

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

    PubMed

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

    2015-01-01

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

  17. 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

  18. Comparison between anal endosonography and digital examination in the evaluation of anal fistulae.

    PubMed

    Choen, S; Burnett, S; Bartram, C I; Nicholls, R J

    1991-04-01

    A prospective trial was performed comparing the accuracy of digital examination and anal endosonography in defining the anatomy of anal fistulae. Before operation 38 consecutive patients were assessed by the consultant in charge of the case, by a research fellow and by anal endosonography involving two radiologists. These findings were compared with the operative findings. Consultants correctly identified 26 of 33 internal openings, 29 of 34 primary tracks and 15 of 21 secondary tracks. The research fellow correctly identified 26 internal openings, 24 primary tracks and 10 secondary tracks. There was no significant difference between the accuracy of consultants and the research fellow. Anal endosonography identified 10 internal openings based on initial criteria. This rose to 24 when revised ultrasonographic criteria were applied. There was no statistical difference between consultant assessment and anal ultrasonography in correctly identifying intersphincteric and transphincteric tracks. Ultrasonography is unable to assess primary superficial, suprasphincteric and extrasphincteric tracks or secondary supralevator and infralevator tracks. Consultant assessment of secondary supralevator and infralevator tracks was correct in 78 per cent of cases. PMID:2032103

  19. 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.

  20. 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 (...

  1. The Fissure Tolbachik Basalt Eruption, Kamchatka (2012-2013): main results of its studying

    NASA Astrophysics Data System (ADS)

    Muravyev, Y. D.; Gordeev, E.; Droznin, V. A.; Volynets, A. O.

    2013-12-01

    There is a large volcanic center in the south part of the Klyuchevskaya group of volcanoes, for which fissure eruptions of mafic lavas are typical in historic times. The latest large effusion of lavas in this zone occurred over the period 1975-1976 and was called the Great Tolbachik fissure eruption (GTFE 1975-76). After 37 years of rest, in the evening of November 27, 2012 liquid basalts star ted to effuse extensively to the south of Plosky Tolbachik Volcano. One day prior to the eruption, a swarm of ear thquakes was recorded beneath the volcano. Seismic data showed that the fissure opened at 17h45m local time at an altitude of about 2.5 km on the souther n flank of Plosky Tolbachik. The fissure stretched 6 km from nor th to south. Local residents repor ted three areas of eruptions late at night. The eruption was obviously explosive in the upper part of the fissure. At this stage the fissure produced the most powerful ash emissions resulting in ash deposits as far as several tens of kilometers from the volcano. In its lower part the fissure star ted to produce extremely fluid basaltic lava. A small lava flow from the central area of eruption traveled to the west and descended 9 km along the valley of Vodopadny creek to a height of 650 m a.s.l. and destroyed Vodopadnaya base camp, which had been built during the 1975-1976 Great Tolbachik fissure eruption. By November 30, the movement of Vodopadny lava flow had ceased. The main lava flow resulted from the central part of the fissure. Gradually, the main eruptive center with up to three vents was formed above the upper fissure. The vents activity varies in time. By mid January 2013 a crater with a lava lake had been formed above the upper fissure. The crater is continuously fountaining hot material. Over the period of two months the erupted lava had covered an area of 30 km2. New portions of lava are coming to the surface along the lava channels increasing the thickness of the lava field. Sometimes lava bursts out of

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

    PubMed

    Cao, Jiansheng; Liu, Changming; Zhang, Wanjun

    2013-01-01

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

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

    PubMed Central

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

    2012-01-01

    Aim: The aim of this study is to compare the occurrence of enamel fractures, sealant fractures and marginal fissures after placement of three sealants: Helioseal F, Conseal F and Clinpro. Materials and Methods: Thirty individuals between 13 and 15 years of age, diagnosed with pit and fissure caries by visual and DIAGNOdent examination, were chosen for sealant placement on their mandibular molars. The sealants were placed at random, after which, impressions were made with polyvinyl siloxane and casts were fabricated. Dies were prepared, each of which were sputter coated with gold in order to be examined under a scanning electron microscope. The following morphologies were analyzed from dies from each of the sealant groups: Continuous margins, sealant fractures, marginal fissures and enamel fractures. After six months, they were recalled for impression making. Dies were prepared and microscopically analyzed as mentioned. Based on the time of evaluation, there were two groups: Initial group (soon after placement) and final group (after six months). Statistical analysis was done using the paired ‘t’ test and One-way analysis of variance (ANOVA). Results and Conclusions: Clinpro had the greatest fracture resistance, followed by Conseal F and Helioseal F. The occurrence of marginal fissure was found to be least with Clinpro. PMID:22557813

  4. 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.

  5. 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.

  6. 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.…

  7. Anatomy of the Inferior Orbital Fissure: Implications for Endoscopic Cranial Base Surgery

    PubMed Central

    De Battista, Juan Carlos; Zimmer, Lee A.; Theodosopoulos, Philip V.; Froelich, Sebastien C.; Keller, Jeffrey T.

    2012-01-01

    Considering many approaches to the skull base confront the inferior orbital fissure (IOF) or sphenomaxillary fissure, the authors examine this anatomy as an important endoscopic surgical landmark. In morphometric analyses of 50 adult human dry skulls from both sexes, we divided the length of the IOF into three segments (anterolateral, middle, posteromedial). Hemotoxylin- and eosin-stained sections were analyzed. Dissections were performed using transnasal endoscopy in four formalin-fixed cadaveric cranial specimens (eight sides); three endoscopic approaches to the IOF were performed. IOF length ranged from 25 to 35 mm (mean 29 mm). Length/width of the individual anterolateral, middle, and posteromedial segments averaged 6.46/5, 4.95/3.2, and 17.6/ 2.4 mm, respectively. Smooth muscle within the IOF had a consistent relationship with several important anatomical landmarks. The maxillary antrostomy, total ethmoidectomy approach allowed access to the posteromedial segment of the fissure. The endoscopic modified, medial maxillectomy approach allowed access to the middle and posterior-medial segment. The Caldwell-Luc approach allowed complete exposure of the IOF. The IOF serves as an important anatomic landmark during endonasal endoscopic approaches to the skull base and orbit. Each of the three segments provides a characteristic endoscopic corridor, unique to the orbit and different fossas surrounding the fissure. PMID:23542710

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

    PubMed

    Cao, Jiansheng; Liu, Changming; Zhang, Wanjun

    2013-01-01

    The complex physiographic and hydrogeological systems of mountain terrains facilitate intense rock-fissure seepages and multi-functional ecological interactions. As mountain eco-hydrological terrains are the common water sources of river basins across the globe, it is critical to build sufficient understanding into the hydrological processes in this unique ecosystem. This study analyzes infiltration and soil/rock-fissure seepage processes from a 65 mm snowfall/melt in November 2009 in the typical granitic gneiss slope catchment in the Taihang Mountains. The snowfall, snowmelt and melt-water processes are monitored using soil-water time-domain reflectometry (TDR) probes and tipping bucket flowmeters. The results suggest that snowmelt infiltration significantly influences soil/rock water seepage in the 0-100 cm soil depth of the slope-catchment. It is not only air temperature that influences snowmelt, but also snowmelt infiltration and rock-fissure seepage. Diurnal variations in rock-fissure seepage are in close correlation with air temperature (R(2) > 0.7). Temperature also varies with soil/rock water viscosity, which element in turn influences soil/rock water flow. Invariably, water dynamics in the study area is not only a critical water supply element for domestic, industrial and agricultural uses, but also for food security and social stability. PMID:23128629

  9. 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 ...

  10. 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 ...

  11. 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

  12. 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

  13. Californium-252 brachytherapy for anal and ano-rectal carcinoma

    SciTech Connect

    Cross, B.; Maruyama, Y.; Proudfoot, W.; Malcolm, A.

    1986-01-01

    Surgery has historically been the standard treatment for anal, ano-rectal and rectal carcinoma but is prone to local or regional failure. Over the past 15 years there has been increasing interest in and success with radiation therapy and combined chemoradiotherapy for treatment of anal and ano-rectal cancers. Cf-252 brachytherapy combined with external beam teletherapy has been investigated for anal and ano-rectal lesions at the Univ. of Kentucky with encouraging results.

  14. Anal squamous cell carcinoma: An evolution in disease and management

    PubMed Central

    Osborne, Marc C; Maykel, Justin; Johnson, Eric K; Steele, Scott R

    2014-01-01

    Anal cancer represents less than 1% of all new cancers diagnosed annually in the United States. Yet, despite the relative paucity of cases, the incidence of anal cancer has seen a steady about 2% rise each year over the last decade. As such, all healthcare providers need to be cognizant of the evaluation and treatment of anal squamous cell carcinoma. While chemoradiation remains the mainstay of therapy for most patients with anal cancer, surgery may still be required in recurrent, recalcitrant and palliative disease. In this manuscript, we will explore the diagnosis and management of squamous cell carcinoma of the anus. PMID:25278699

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

    SciTech Connect

    Cummings, B.J.

    1983-09-01

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

  16. Risk of Anal Cancer in People Living with HIV: Addressing Anal Health in the HIV Primary Care Setting.

    PubMed

    Walker, Crystal Martin; Likes, Wendy; Bernard, Marye; Kedia, Satish; Tolley, Elizabeth

    2016-01-01

    Anal health and anal cancer are rarely addressed in HIV primary care. We sought to understand factors that impeded or promoted addressing anal health in HIV primary care from providers' perspectives. In this exploratory study, HIV primary care providers from the Mid-South region of the United States participated in brief individual interviews. We analyzed transcribed data to identify barriers and facilitators to addressing anal health. Our study sample included five physicians and four nurse practitioners. The data revealed a number of barriers such as perception of patient embarrassment, provider embarrassment, external issues such as time constraints, demand of other priorities, lack of anal complaints, lack of resources, and gender discordance. Facilitators included awareness, advantageous circumstances, and the patient-provider relationship. Anal health education should be prioritized for HIV primary care providers. Preventive health visits should be considered to mitigate time constraints, demands for other priorities, and unequal gender opportunities. PMID:27080925

  17. [Treatment of anorectal diseases].

    PubMed

    Herold, A

    2007-02-14

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

  18. 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.

  19. 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

  20. Adenocarcinoma of the anal canal: A report of two cases with review of literature.

    PubMed

    Kulkarni, Medha Pradip; Momin, Yasmin Altaf; Pandav, Amitkumar Bapuso; Sulhyan, Kalpana Ranjitsingh

    2016-01-01

    Adenocarcinoma of the anal canal accounts for about 20% of all anal canal cancers. It is subclassified into two types. (1) Colorectal type, which arises from the mucosa above dentate line and (2) extramucosal type, which includes adenocarcinoma arising in anorectal fistulae and adenocarcinoma arising from anal glands. Anal gland adenocarcinomas are extremely rare. In this article, we present two cases of anal adenocarcinoma, one colorectal type, and other anal gland carcinoma along with review of literature. PMID:27510691

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

    PubMed Central

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

    2015-01-01

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

  2. [The anal incontinence-- study on 20 operated cases].

    PubMed

    Iusuf, T; Sârbu, V; Grasa, C; Cristache, C; Botea, F

    2001-01-01

    The authors present 20 cases operated for anal incontinence. Two techniques were performed: direct repair (18 cases) and Musset-Cottrell procedure (2 cases). The results were excellent in 12 cases, good in 5 cases and satisfactory in 3 cases. The method of choice seems to be the direct repair of the anal sphincter after a proper local and general preparation. PMID:12731180

  3. Controversies in the treatment of common anal problems

    PubMed Central

    Sagap, Ismail; Remzi, Feza H

    2006-01-01

    Treating common benign anal diseases has evolved towards more outpatient procedures with better outcome. However, minimizing post-procedure morbidities such as pain and the avoidance incontinence remain the most significant concerns. We introduce some controversies and highlight the developments in current surgical practice for the treatment of common anal problems. PMID:16718832

  4. Anal cancer and intraepithelial neoplasia screening: A review

    PubMed Central

    Leeds, Ira L; Fang, Sandy H

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations. PMID:26843912

  5. Spontaneous variation of anal "resting" pressure in healthy humans.

    PubMed

    Enck, P; Eggers, E; Koletzko, S; Erckenbrecht, J F

    1991-11-01

    To investigate anal sphincter performance during sleep and after a meal, a two-channel micro-transducer probe was used for 12-h stationary recording of basal anal pressure overnight in eight healthy male volunteers. It was shown that the basal anal pressure ("resting" pressure) exhibits three distinct patterns of cyclic activity changes in all subjects: a long-term rhythm with a prominent decrease of pressure during which sleep was approximately circadian, an ultradian rhythm of approximately 20 to 40 min in length that was more prominent at night, and spontaneous relaxations of the sphincter tone occurring between 3 and 20 times per hour with the maximum frequency after breakfast. These data indicate that the anal sphincter is a dynamic structure not often at rest. Long-term anorectal manometry may be supplementary to short-term clinical evaluation of anal sphincter performance in healthy subjects as well as in patients with defecation disorders.

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

    PubMed Central

    Tabry, Helena; Farrands, Paul A

    2011-01-01

    Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands. For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgical treatments include setons, fibrin glue, collagen plugs and flaps to cover the internal fistula opening. These have achieved varying degrees of success, as will be discussed. The present review also discusses anal fistulae in light of much recently published literature. Currently, anal fistulae remain challenging and require specialist expertise; however, new treatment options are on the horizon. PMID:22175058

  7. A case of focal lung infarction following right upper lobectomy in case of undeveloped lung fissure.

    PubMed

    Parissis, Haralabos; Booth, Karen; Al-Alao, Bassel

    2015-09-01

    We present a case of infarction of residual upper lobe tissue during right upper lobectomy. We believe that although the blood supply to the upper lobe had been isolated and divided in order to perform the right upper lobectomy, residual right upper lobe had been left behind secondary to "poorly estimated" staple separation of the upper from the middle lobe in a patient with non-developed oblique fissure. We suggest that in this situation the upper lobe bronchus should be identified and clamped and the lung re-inflated in order to accurately demarcate the borders of the upper and middle lobe prior to the application of the stapler to prevent infarction of residual upper lobe tissue. Therefore, this case emphasises that routine lung inflation during fissure development in right upper lobectomy may prevent unpredictable complications.

  8. Painful ophthalmoplegia secondary to a mucocele involving the sella turcica, superior orbital fissure, and sphenoid sinus.

    PubMed

    Clarke, H; Clarke, V; Gill, J; St John, A; Lashley, M

    1992-03-01

    A case of painful ophthalmoplegia associated with an extensive lesion involving the sella turcica, superior orbital fissure, and sphenoid sinus in a 57-year-old man is reported. Even though nasal and ocular symptoms and signs represent the usual features of sphenoidal mucoceles, extension to the intracranial cavity as seen in this lesion is rare. Surgical exploration via a sublabial, transseptal approach revealed a mucocele of the sphenoid sinus. This case exhibited extensive and aggressive behavior simulating a malignant neoplasm.

  9. 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.

  10. Evaluation of different types of enamel conditioning before application of a fissure sealant.

    PubMed

    Ciucchi, Philip; Neuhaus, Klaus W; Emerich, Marta; Peutzfeldt, Anne; Lussi, Adrian

    2015-01-01

    The aim of the study was to compare fissure sealant quality after mechanical conditioning of erbium-doped yttrium aluminium garnet (Er:YAG) laser or air abrasion prior to chemical conditioning of phosphoric acid etching or of a self-etch adhesive. Twenty-five permanent molars were initially divided into three groups: control group (n = 5), phosphoric acid etching; test group 1 (n = 10), air abrasion; and test group 2, (n = 10) Er:YAG laser. After mechanical conditioning, the test group teeth were sectioned buccolingually and the occlusal surface of one half tooth (equal to one sample) was acid etched, while a self-etch adhesive was applied on the other half. The fissure system of each sample was sealed, thermo-cycled and immersed in 5% methylene dye for 24 h. Each sample was sectioned buccolingually, and one slice was analysed microscopically. Using specialized software microleakage, unfilled margin, sealant failure and unfilled area proportions were calculated. A nonparametric ANOVA model was applied to compare the Er:YAG treatment with that of air abrasion and the self-etch adhesive with phosphoric acid (α = 0.05). Test groups were compared to the control group using Wilcoxon rank sum tests (α = 0.05). The control group displayed significantly lower microleakage but higher unfilled area proportions than the Er:YAG laser + self-etch adhesive group and displayed significantly higher unfilled margin and unfilled area proportions than the air-abrasion + self-etch adhesive group. There was no statistically significant difference in the quality of sealants applied in fissures treated with either Er:YAG laser or air abrasion prior to phosphoric acid etching, nor in the quality of sealants applied in fissures treated with either self-etch adhesive or phosphoric acid following Er:YAG or air-abrasion treatment.

  11. 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

  12. 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.

  13. 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)

  14. 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.

  15. 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.

  16. 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.

  17. Resin infiltration of fissure caries with various techniques of pretreatment in vitro.

    PubMed

    Lausch, Julian; Paris, Sebastian; Selje, Timo; Dörfer, Christof E; Meyer-Lueckel, Hendrik

    2015-01-01

    The resin infiltration technique might be used for occlusal caries lesions in order to arrest their progression. This in vitro study evaluated the influence of various modifications of the infiltration technique on the penetration abilities of the infiltrant into occlusal lesions. Extracted human molars and premolars (n = 140) with non-cavitated white spot lesions were randomly allocated to 7 groups. As control, specimens were etched with 15% hydrochloric acid (HCl) gel for 120 s and resin infiltrated for 180 s (Icon; DMG). As modification HCl gel reduced in surface tension and viscosity with and without abrasives was applied using 3 different types of brushes either to oscillate or rub the HCl gel onto the enamel surface. The median maximum lesion depth was 1,232 µm (interquartile range 882-1,513). Compared with the control procedure [23% (16/50)] a higher percentage penetration was observed if the HCl gel was mixed with a small amount of abrasives were rubbed into the fissures using a modified brush with stiff bristles that were adjusted to the fissure relief for either 120 s [100% (64/100)] or 30 s [98% (61/100); p < 0.05; Mann-Whitney test]. All other experimental treatments resulted in penetration results in-between. It can be concluded that the use of an abrasive HCl gel in conjunction with a modified brush mostly enhances resin infiltration into fissure caries lesions. PMID:25427531

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  19. 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.

  20. 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

  1. Chronic pancreatitis

    MedlinePlus

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

  2. Ultrasound imaging of the anal sphincter complex: a review.

    PubMed

    Abdool, Z; Sultan, A H; Thakar, R

    2012-07-01

    Endoanal ultrasound is now regarded as the gold standard for evaluating anal sphincter pathology in the investigation of anal incontinence. The advent of three-dimensional ultrasound has further improved our understanding of the two-dimensional technique. Endoanal ultrasound requires specialised equipment and its relative invasiveness has prompted clinicians to explore alternative imaging techniques. Transvaginal and transperineal ultrasound have been recently evaluated as alternative imaging modalities. However, the need for technique standardisation, validation and reporting is of paramount importance. We conducted a MEDLINE search (1950 to February 2010) and critically reviewed studies using the three imaging techniques in evaluating anal sphincter integrity.

  3. What Are the Risk Factors for Anal Cancer?

    MedlinePlus

    ... have few or no known risk factors. Human papilloma virus (HPV) infection Most squamous cell anal cancers ... to be linked to infection by the human papilloma virus (HPV), the same virus that causes cervical ...

  4. Anal Cancer Rates Rising in Many Parts of The World

    MedlinePlus

    ... Services, or federal policy. More Health News on: Health Disparities HPV Recent Health News Related MedlinePlus Health Topics Anal Cancer Health Disparities HPV About MedlinePlus Site Map FAQs Contact Us ...

  5. Changes in anal sphincter tone at induction of anaesthesia.

    PubMed Central

    Harrison, M. J.; Tomlinson, P. A.; Ubhi, C. S.; Wright, J.; Hardcastle, J. D.

    1988-01-01

    Changes in anal pressure have been monitored during the induction of anaesthesia. Falls in pressure accompany loss of consciousness following bolus doses of commonly used intravenous and inhalational anaesthetic agents. Subsequent rises in pressure towards pre-anaesthetic levels are usually associated with the time taken to correct responses and initial recovery. Premedication, including anticholinergic drugs in conventional dosage, does not affect anal pressure. PMID:3408160

  6. Anal Cancer Incidence and Mortality in Puerto Rico

    PubMed Central

    Colón-López, Vivian; Ortiz, Ana P.; Soto-Salgado, Marievelisse; Torres-Cintrón, Mariela; Mercado-Acosta, Juan José; Suárez, Erick

    2013-01-01

    Objective Anal cancer is a rare tumor that is associated with oncogenic HPV genotypes. This study aims to compare the age-standardized rates (ASRs) of anal cancer incidence and mortality in men and women living in Puerto Rico (PR) with those of non-Hispanic whites (NHW), non-Hispanic blacks (NHB), and Hispanics (USH) living in the continental United States (US). Methods ASRs were calculated based on cancer data that came from the PR Cancer Central Registry and from the Surveillance, Epidemiology, and End Results (SEER) program. The age-specific relative risks (RR) and 95% Confidence Interval (95% CI) were estimated using Poisson regression models. Results Comparing the period of 2001 to 2004 to that of 1992 to 1996, the incidence of anal cancer increased among NHW, NHB, and PR men. In females, an increase in the incidence was observed for all racial groups except for Puerto Rican women. When evaluating findings by age groups, Puerto Rican men younger than 60 years old had a 20% higher incidence of anal cancer than did USH men of the same age strata (RR: 2.20; 95% CI = 1.48–3.29). However, Puerto Rican females had a lower incidence of anal cancer than NHW and NHB women. An increased percent change in mortality was observed only in NHW and NHB men. A decreasing trend was observed in all racial/ethnic groups except for NHW women. Conclusion Our results support the notion that there are racial/ethnic differences in anal cancer incidence and mortality, with potential disparities among men and women in PR compared with USH men and women. Given the increasing incidence trends in anal cancer, particularly among PR, NHW, and NHB men, further investigation is needed to better elucidate screening practices that can aid in the prevention of anal cancer. PMID:23781623

  7. Unprotected anal Intercourse among Iranian Intra-Venous Drug Users

    PubMed Central

    Mirabi, Parvaneh; Yarmohmmadi Vasel, Mosaieb; Moazen, Babak; Sehat, Mahmoud; Rezazadeh, Majid; Ahmadi, Khodabakhsh

    2013-01-01

    Purpose: To assess the prevalence and associated factors of unprotected anal intercourse among Iranian male heterosexual Intra-Venous Drug Users (IDUs). Methods: In a cross-sectional study 360 male heterosexual IDUs were sampled from streets of eight different geographical parts of Iran. Variables such as socio-demographics, HIV knowledge (10 items), and HIV attitude (16 items) were entered to a logistic regression to determine the predictors of unprotected anal intercourse during the past month. Results: From all, 20.8% reported unprotected anal intercourse during the past month. HIV knowledge was not significantly different among IDUs with and without unprotected anal intercourse. High age [odds ratio (OR) = 0.954, 95% confidence intervals (CI) = 0.916–0.992] was associated with a lower likelihood of unprotected anal intercourse, while being not married (OR = 2.301, 95% CI = 1.151–4.601), and high perceived HIV risk (OR = 1.776, 95% CI = 1.376–2.290) were associated with a higher likelihood of unprotected anal intercourse. Conclusion: Although the results might not be generalizable to all Iranian IDUs, this study findings may still be helpful for design and implementation of public health programs in Iran to prevent sexual transmission of HIV through IDUs. PMID:24350203

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

    NASA Astrophysics Data System (ADS)

    Conway, Brian D.

    2016-05-01

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

  9. Ability of Pit and Fissure Sealant-containing Amorphous Calcium Phosphate to inhibit Enamel Demineralization

    PubMed Central

    Owais, Arwa I; Kawaja, Wasan

    2016-01-01

    ABSTRACT Aim: To evaluate the effect of amorphous calcium phosphate (ACP)-containing pit and fissure sealant on inhibition of enamel demineralization in vitro. Materials and methods: Enamel specimens (n = 75) were prepared using freshly extracted noncarious human third molars. Box-shaped cavities (8 × 2 × 2 mm) on the buccal or lingual surfaces were prepared and restored with resin-based sealant (Concise™), ACP-containing sealant (Aegis®) or fluoride-containing sealant (Conseal-F™). The samples were acid challenged in a demineralizing solution of 50 mmol/l lactic acid at pH 5.0 for 4 days. The change in enamel microhardness (ASuH) was calculated. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey’s post hoc test. Results: The mean SuH0 (±SD) (in Vicker’s unit) prior to the acid challenge was: Concise™ (318.83 ± 33.86), Aegis® (331.03 ± 21.52), Conseal-F™ (310.12 ± 34.31). Following the acid challenge, the values dropped in all groups and ASuH (±SD) values were 269.17 ± 47.49, 151.39 ± 23.96 and 175.79 ± 32.39 respectively. Conclusion: The ACP-containing pit and fissure sealant has the potential to inhibit enamel demineralization. How to cite this article: Zawaideh FI, Owais AI, Kawaja W. Ability of pit and fissure sealant-containing amorphous calcium phosphate to inhibit enamel demineralization. Int J Clin Pediatr Dent 2016;9(1):10-14. PMID:27274148

  10. 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.

  11. 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.

  12. Fissured Tongue

    MedlinePlus

    ... Executive Committee Board of Trustees Governance Past Presidents Staff/Contact History Awards Our Partners Membership Membership Categories Renew Your Membership Login Fellowship Academic Fellowship Affiliate Fellowship (AFAOM) Application Process Fellowship Study ...

  13. Addition of fluoride to pit and fissure sealants--a feasibility study.

    PubMed

    Swartz, M L; Phillips, R W; Norman, R D; Elliason, S; Rhodes, B F; Clark, H E

    1976-01-01

    The data obtained in this in vitro study indicate that contact with pit and fissure sealants to which NaF has been added in amounts ranging from 2 to 5% substantially increases the fluoride content of the enamel and reduces its solubility in acid. The properties of the materials do not seem to be impaired by the addition of fluoride in these amounts. It thus appears that this approach to providing a backup anticariogenic mechanism may, indeed, be feasible. However, further investigation must be done to confirm the anticariogenic effect and to establish the most efficacious means of fluoride incorporation in the materials.

  14. Treating pit-and-fissure caries: a systematic review and network meta-analysis.

    PubMed

    Schwendicke, F; Jäger, A M; Paris, S; Hsu, L Y; Tu, Y K

    2015-04-01

    For shallow or moderately deep pit-and-fissure lesions, various treatment options are available: (1) noninvasive treatments (e.g., fluoride application, antibacterial treatments, oral hygiene advice) avoid any dental hard tissue removal; (2) microinvasive treatments (e.g., sealing) remove only a few micrometers of hard tissues by etching; and minimally invasive methods (e.g., "preventive" resin/sealant restoration) remove carious dentin but avoid sacrificing sound tissues. We aimed at systematically reviewing and comparing these strategies for treating pit-and-fissure lesions in permanent teeth using network meta-analysis. Randomized or nonrandomized clinical trials investigating shallow or moderately deep primary caries lesions in fissured or pitted surfaces were included. We compared the risk of requiring invasive treatments or any retreatments in noninvasive, microinvasive, and minimally invasive treated lesions; untreated lesions were used as controls. Five electronic databases were systematically screened up to September 2013 and cross-referencing performed. Pairwise and network meta-analyses were performed and odds ratios and 95% confidence intervals (CI) calculated. Certainty of estimates was evaluated via GRADE criteria. From a total of 2,214 identified records, 14 studies representing 1,440 patients with 3,551 treated lesions were included. Pairwise meta-analysis found microinvasive and minimally invasive treated lesions to require less invasive retreatments than control lesions (odds ratios [95% confidence intervals]: 0.13 [0.07 to 0.26], 0.13 [0.03 to 0.50], respectively), whereas the estimate for noninvasively treated lesions remained nonsignificant (0.64 [0.39 to 1.06]). These findings were reflected in the strategy ranking stemming from network meta-analysis (first, minimally invasive; second, microinvasive; third, noninvasive). However, microinvasive treatment required significantly more total retreatments (including resealing) than minimally or

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

    PubMed

    Lambrecht, W; Kluth, D; Lierse, W

    1989-02-01

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

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

    NASA Astrophysics Data System (ADS)

    Zhao, C.; Zhang, Q.; Yang, C.; Zhang, J.; Zhu, W.; Qu, F.; Liu, Y.

    2015-11-01

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

  17. One-year clinical evaluation of a Glass Carbomer fissure sealant, a preliminary study.

    PubMed

    Gorseta, K; Glavina, D; Borzabadi-Farahani, A; Van Duinen, R N; Skrinjaric, I; Hill, R G; Lynch, E

    2014-06-01

    Glass Carbomer is a new generation of restorative material developed from glass-ionomer cements with possibility of gradual mineralization into fluorapatite. The aim of this clinical trial was to investigate the retention of Glass Carbomer fissure sealant after 12 months, in comparison to a commonly used conventional resin-based sealant. Forty-eight teeth in 24 patients [mean (SD) = 8 (2.3) years] with well-delineated fissure morphology were randomly divided into two equal groups and sealed with Bis-GMA resin-based Helioseal F (group A, Ivoclar Vivadent, Liechtenstein) and Glass Carbomer (group B, Glass Carbomer Sealant, Glass Carbomer Products, Leiden, Netherlands) using the split mouth design. Materials were placed and set according to the manufacturer's instructions using a polymerization unit Bluephase 16i (Vivadent, Liechtenstein). Complete sealant retentions in both groups were 100% and 75% after 6 and 12 months of clinical service, respectively. There were there were no secondary caries lesions in both groups after 6 months; two new carious lesions were detected in both groups after 12 months. The Mann-Whitney U test revealed no significant difference between the two groups at both evaluations points (P > 0.05). Glass Carbomer material showed a similar retention rate when compared with a resin-based sealant. Future studies are required to examine the long-term performance of Glass Carbomer sealants. PMID:25134364

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. JC Virus T-Antigen Expression in Anal Carcinoma

    PubMed Central

    Ramamoorthy, Sonia; Deveraj, Bikash; Miyai, Katsumi; Luo, Linda; Liu, Yu-Tsueng; Boland, C. Richard; Goel, Ajay; Carethers, John M.

    2010-01-01

    Background & Aims Anal carcinoma is thought driven by HPV infection through interrupting function of cell regulatory proteins such as p53 and pRb. JCV expresses a T-antigen (T-Ag) that causes malignant transformation through development of aneuploidy and interaction with some of the same regulatory proteins as HPV. JCV T-Ag is present in brain, gastric and colon malignancies, but has not been evaluated in anal cancers. We examined a cohort of anal cancers for JCV T-Ag and correlated this with clinicopathologic data. Methods Archived anal carcinomas were analyzed for JCV T-Ag expression. DNA from tumor and normal tissue was sequenced for JCV with viral copies determined by qPCR and Southern blotting. HPV and MSI status was correlated with JCV T-Ag expression. Results Of 21 cases of anal cancer (mean age 49 years, 38% female), 12 (57%) were in HIV-positive individuals. All 21 cancers expressed JCV T-Ag, including 9 HPV-negative specimens. More JCV copies were present in cancer vs. surrounding normal tissue (mean 32.54 copies/μg DNA vs. 2.98 copies/μg DNA, P=0.0267). There was no correlation between disease stage and viral copies, nor between viral copies and HIV-positive or -negative status (28.7 vs. 36.34 copies/μg DNA, respectively, P=0.7804). In subset analysis, we found no association between JCV T-Ag expression and HPV or MSI status. Conclusions Anal carcinomas uniformly express JCV T-Ag and contain more viral copies compared to surrounding normal tissue. JCV and its T-Ag oncogenic protein, presumably through interruption of cell regulatory proteins, may play a role in anal cancer pathogenesis. PMID:24048785

  5. 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

  6. 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.

  7. 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. ?? Springer-Verlag 2008.

  8. The gonyautoxin 2/3 epimers reduces anal tone when injected in the anal sphincter of healthy adults.

    PubMed

    Garrido, Rogelio; Lagos, Néstor; Lattes, Karinna; Azolas, Carlos García Rodrigo; Bocic, Gunther; Cuneo, Aldo; Chiong, Hector; Jensen, Cristian; Henríquez, Ana I; Fernández, Cristian

    2004-01-01

    The primary clinical symptom of Paralytic Shellfish Poisoning is acute paralytic illness produced by paralyzing toxins. Paralytic shellfish poison is formed by a mixture of phycotoxins and their toxicity is due to its reversible binding to a receptor site on the voltage-gated sodium channel on excitable cells, thus blocking neuronal transmission. We studied the effect of the gonyautoxin 2/3 epimers by local infiltration in the anal internal sphincter of healthy voluntary adults in order to reduce anal tone. The toxin was injected after prior clinical evaluation, anoscopy and anorectal manometry. Post injection clinical examination, electromyography and anorectal manometry were performed. Resting and voluntary contraction pressures were measured and the anorectal inhibitory and anocortical reflexes were tested by manometry. Blood and urine samples were obtained from each participant, and hemogram, basic metabolic panel, and urinalysis were done both before and one week after the injection. This study shows, for the first time, that gonyautoxin 2/3 reduces the anal tone by relaxing the anal sphincters in 100 % of the participants. Manometric recordings showed a significant decrease in anal maximal voluntary contraction pressure after the toxin injection, dropping to 55.2+/-6.2 % and 47.0+/-6.8% (Mean Value+/-Std.Dev.) of the baseline values at 2 minutes and at 24 hours respectively after the injection. Post-injection electromyography showed that activity of the muscle was abolished. We conclude that local administration of gonyautoxin 2/3 to the anal sphincter produces immediate relaxation and a statistically significant decrease in the anal tone (p <0.001). PMID:15515965

  9. 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.

  10. Nicorandil associated anal ulcers: an estimate of incidence

    PubMed Central

    Colvin, HS; Barakat, T; Moussa, O; Babu, H; Slaughter, T; Palmer, JG; Hinson, FL

    2012-01-01

    INTRODUCTION Nicorandil is a commonly prescribed antianginal medication that has been found to be associated with painful anal ulceration. The incidence of this complication is unknown. We have used the best data available to us to make an estimate of this figure in a health district with a remarkably stable population of approximately 200,000 people. METHODS Using an electronic search of all letters generated from colorectal and gastroenterology clinics as well as endoscopy reports from January 2004 to November 2010, patients with anal ulceration who were taking nicorandil were identified. Other causes of ulceration were excluded by biopsy in the majority of cases. The central hospital and community pharmacy database was interrogated to estimate the number of patients who were prescribed nicorandil over a six-year period (2004-2010). RESULTS A total of 30 patients (24 men, 6 women) with a median age of 79.5 years were identified who fulfilled the criteria of: taking nicorandil; having no other identified cause for anal ulceration; and achieving eventual healing after withdrawal of nicorandil. In the six-year period an estimated mean of 1,379 patients were prescribed nicorandil each year. The mean annual incidence of anal ulcers among nicorandil users is therefore calculated to be in the region of 0.37%. CONCLUSIONS Anal ulceration appears to occur in approximately four in every thousand patients prescribed nicorandil each year. Prescribing physicians should explain the risk of this unpleasant complication to their patients. PMID:22507720

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

    PubMed

    Fischer, R E; Juni, S

    1982-02-01

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

  12. 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...

  13. Anal encirclement with polypropylene mesh for rectal prolapse and incontinence.

    PubMed

    Sainio, A P; Halme, L E; Husa, A I

    1991-10-01

    Seventeen selected patients (mean age, 74 years)--14 with rectal prolapse and 3 with persisting anal incontinence after previous operations--underwent high anal encirclement with polypropylene mesh. There was no operative mortality. Prolapse recurred in 2 (15 percent) of the 13 patients followed up for 6 months or more (mean, 3.5 years). Three (27 percent) of the 11 patients with associated anal incontinence improved functionally, as did the three operated on for persisting incontinence, but only one patient regained normal continence. No breakage, cutting out, or infection related to the mesh was observed. Because of the risk of fecal impaction encountered in three of our patients, the procedure is not advocated for severely constipated patients. Despite the somewhat disappointing results regarding restoration of continence, we find this method useful in patients with rectal prolapse who are unfit for more extensive surgery, in controlling the prolapse to an acceptable degree. PMID:1914725

  14. 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?

  15. MRI of anal cancer: assessing response to definitive chemoradiotherapy.

    PubMed

    Gourtsoyianni, S; Goh, V

    2014-02-01

    Anal cancer is an uncommon malignancy of the gastrointestinal tract but has a relatively good prognosis with an 80% 5-year overall survival. In this article, we review the role of MRI for assessing treatment response in anal cancer after completion of definitive chemoradiotherapy. New generation MRI scanners with optimal-phased array body coils, resulting in better signal to noise and improved contrast and spatial resolution, have contributed to high-resolution imaging in clinical practice enabling visualization of relevant anatomy including the sphincter complex, adjacent structures, mesorectal and pelvic lymph nodes with a diameter down to 2 mm. Multiplanar, high-resolution T2-weighted and diffusion-weighted sequences have a role in initial locoregional staging of anal SCC, assisting radiotherapy planning, as well as in assessing response to treatment and treatment-related complications. PMID:24072381

  16. A case of langerhans cell histiocytosis with anal fistula.

    PubMed

    Akbayram, Sinan; Akgun, Cihangir; Ozen, Suleyman; Kaya, Avni; Tuncer, Oguz; Yuca, Sevil Ari; Caksen, Huseyin; Oner, Ahmet Faik

    2009-01-01

    Langerhans cell histiocytosis (LCH) is an uncommon clinically heterogeneous disorder characterized by the proliferation and accumulation of Langerhans cells with local infiltration of tissues and organ destruction. LCH takes many clinical forms, affecting different systems and different sites in the same system with variable outcomes. Bone, skin, lymph node, pituitary, liver, lung, bone marrow and spleen involvement can be seen in patients with LCH. Involvement of the perianal site is rare. In this article, a 16-month-old boy with multiple organ involvement including skin, liver, lung, and bone is presented. Aside from these systemic involvements, he also had a simple anal fistula. According to our best knowledge, this case of LCH with anal fistula is only the second to be reported in childhood. We would like to emphasize that LCH may be associated with anal fistula; therefore, we suggest that patients with LCH should be examined for this condition. PMID:20505285

  17. 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

  18. Human anal motility while fasting, after feeding, and during sleep.

    PubMed

    Orkin, B A; Hanson, R B; Kelly, K A; Phillips, S F; Dent, J

    1991-04-01

    The aim of this study was to determine whether the human anal sphincter responds dynamically to changing physiological states. In 19 healthy human subjects, intraluminal anal canal pressure was measured with a 5-cm perfused sleeve sensor during the day while fasting (3 hours) and after feeding (3 hours) and at night during sleep (8 hours). Daytime mean anal canal pressures (+/- SEM) while fasting (50 +/- 3 mm Hg) were similar to those after feeding (49 +/- 3 mm Hg) and to those at night during sleep (49 +/- 3 mm Hg). Marked minute-to-minute variations in mean pressure occurred in all three periods, however, as did large phasic increases and decreases in pressure (greater than 20 mm Hg) and small phasic changes in pressure less than 20 mm Hg (anal slow waves). The minute-to-minute variations in mean pressure were greater during the awake fed state (4 +/- 1 mm Hg/min) than at night during sleep (2 +/- 1 mm Hg/min; P less than 0.03), as were the number of large phasic waves per minute (increases in pressure: awake, fed = 0.5 +/- 1 waves/min, night = 0.3 +/- 0.1 waves/min, P less than 0.05; decreases in pressure: awake, fed = 0.4 +/- 0.1 waves/min, night = 0.2 +/- 0.1 waves/min, P less than 0.05). Anal small waves had a similar frequency of about 17 waves/min in all three states. In conclusion, the anal sphincter maintains a continuous pressure barrier to rectal outflow both during the day and at night during sleep. However, marked minute-to-minute variations in mean pressure and large phasic increases and decreases in pressure do occur. Both are fewer at night during sleep.

  19. Herpes zoster ophthalmicus presenting as orbital abscess along with superior orbital fissure syndrome: A case report.

    PubMed

    Lavaju, Poonam; Badhu, Badri Prasad; Shah, Sangeeta

    2015-09-01

    Orbital abscess and superior orbital fissure syndrome (SOFS) are rare manifestations of herpes zoster ophthalmicus. Herein, we report a case of orbital abscess along with SOFS in a 2.5-year-old-male child secondary to herpes zoster infection. He presented with a 5-day history of proptosis and ptosis of the right eye that had been preceded by vesicular eruptions on the right forehead and scalp. Computed tomography scan of the head and orbit showed orbital abscess and right cavernous sinus thrombosis. A diagnosis of orbital abscess with SOFS secondary to herpes infection was made. The condition subsequently improved following antiviral therapy, intravenous vancomycin and amikacin, and oral corticosteroids. PMID:26632131

  20. Purkinje cell age-distribution in fissures and in foliar crowns: a comparative study in the weaver cerebellum.

    PubMed

    Martí, Joaquín; Santa-Cruz, M C; Bayer, Shirley A; Ghetti, Bernardino; Hervás, José P

    2007-12-01

    Generation and settling of Purkinje cells (PCs) are investigated in the weaver mouse cerebellum in order to determine possible relationships with the fissuration pattern. Tritiated thymidine was supplied to pregnant females at the time that these neurons were being produced. Autoradiography was then applied on brain sections obtained from control and weaver offspring at postnatal (P) day 90. This makes it possible to assess the differential survival of neurons born at distinct embryonic times on the basis of the proportion of labeled cells located at the two foliar compartments: fissures and foliar crowns. Our data show that throughout the surface contour of the vermal lobes, generative programs of PCs were close between wild type and homozygous weaver. Similar data were found in the lobules of the lateral hemisphere. On the other hand, the loss of PCs in weaver cerebella can be related to foliar concavities or convexities depending on the vermal lobe or the hemispheric lobule studied. Lastly, we have obtained evidence that late-generated PCs of both normal and mutant mice were preferentially located in fissures. These quantitative relationships lead us to propose a model in which the final distribution of PCs through the vermal contour would be coupled to two factors: the cortical fissuration patterning and a "time-sequential effect" of weaver mutation.

  1. 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

  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. 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

  4. [Evaluation of surgical treatment of anal fistula].

    PubMed

    Fall, B; Mbengue, M; Diouf, M L; Ndiaye, A; Diarra, O; Ba, M

    2001-01-01

    Second reason for consultations in proctology in our department after hemorroïds-linked illnesses, fistulas in ano constitute a chronic disease which causes therapeutic difficulties linked mainly to the futur functionning of the sphincter, especially in its most complex types. In our group of 43 patients in whom surgical exploration with stylet was the key of the diagnosis, the anorectoscopy and even less chirurgical examination were not often contributive, the fear of post-operative incontinence forced us to prefer ligation-section with rubber every time that the sphincter was involved. With our results, the majority of patients (41/43) healed in normal periods with a sufficient functionning of the anus. This result confirmed our attitude towards the sphincter: that is to save if possible.

  5. Rhizomelia with anal atresia and anophthalmia: a new syndrome?

    PubMed

    Ozlem, Giray; Elçin, Bora; Ayfer, Ulgenalp; Oguz, Ateş; Erdener, Ozer; Derya, Erçal

    2008-01-01

    We report a newborn who presented with an unreported combination of anophthalmia, anal atresia, rhizomelia, dextrocardia and corpus callosum agenesis. Clinical and postmortem findings did not match any previously described syndromes with the type of anomalies seen in this patient. We suggested that this combination of congenital malformations might represent a new syndrome.

  6. Carcinoma of the anal canal and flow cytometric DNA analysis.

    PubMed Central

    Scott, N. A.; Beart, R. W.; Weiland, L. H.; Cha, S. S.; Lieber, M. M.

    1989-01-01

    Using flow cytometric DNA analysis of paraffin embedded tissue, DNA histograms were successfully obtained from the anal cancers of 117 patients. DNA diploid patterns were given by 82 cancers (70%) and DNA non-diploid patterns by 35 cancers (30%): 15 DNA aneuploid, 20 DNA tetraploid. Well differentiated squamous cell cancers were mainly DNA diploid, while a larger proportion of poorly differentiated and small cell cancers were DNA non-diploid. The large majority of stage A cancers were DNA diploid. A greater proportion of tumours that had invaded through the anal sphincter or had lymph node metastases or distant spread were DNA non-diploid. Prognosis was slightly poorer for patients with DNA non-diploid cancers when compared to patients with DNA diploid tumours (P = 0.08) and significantly poorer for individuals with DNA aneuploid anal cancers (P = 0.037). However, in a multivariate analysis model, the DNA ploidy pattern of an anal cancer was not of independent prognostic significance alongside tumour histology and tumour stage. PMID:2803916

  7. Spectinomycin in the treatment of anal gonorrhea: a retrospective study.

    PubMed

    Felman, Y M; William, D C; Corsaro, M C

    1978-01-01

    The authors conducted a retrospective study of 125 male patients treated for anal gonorrhea with 4 g of spectinomycin in a social hygiene clinic. Of those treated, nine (7.2%) still had cultures positive for Neisseria gonorrhoeae when tested again five to 14 days after treatment.

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  9. 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

  10. 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

  11. 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

  12. 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

  13. Overview of the 2012-13 basaltic fissure eruption of Tolbachik, Kamchatka, Russia

    NASA Astrophysics Data System (ADS)

    Belousov, Alexander; Belousova, Marina; Edwards, Benjamin; Volynetz, Anna; Melnikov, Dmitry; Senyukov, Sergey

    2014-05-01

    On 27 November 2012 a short-lived swarm of shallow (<10 km) earthquakes marked the onset of a new eruption from the Tolbachik volcanic complex, in east-central Kamchatka, Russia. The 3.5-km-long radial eruptive fissure opened on the south flank between 1500-2000 m a.s.l. Lava fountaining from multiple small vents ceased after several days and the eruption continued from vents at the southern end of the fissure. Almost continuous lava fountains up to 200 m high issued from a small lava lake located inside the broad, open crater of the largest cinder cone. While explosive activity was rather mild, initial discharge of lava was very high (up to 400 m3/s) and by the end of December 'a'a lava flows had travelled up to 17 km from the vent. SiO2 concentrations for the plagioclase-phyric lava were 54 wt.%, but then decreased to 52 wt.%. In January 2013 lava was transported through a system of lava tubes 1 km long and up to 5 m wide. From tube exit points it propagated in the form of channelized lava streams (velocities 1-3 m/s; discharge rates 30-50 m3/s); on lower slopes of the volcano it propagated mostly as 'a'a flows. Lava channels were frequently dammed by floating clinker and accretionary lava balls, which caused flooding of proximal areas by ropy/shelly/slabby pahoehoe lavas. Locally small volumes of lava were extruded through the upper surfaces and lateral levees of 'a'a lava to form very slowly inflating entrail pahoehoe lava lobes. Starting in mid-February the average intensity of the eruption gradually declined, with sporadic bursts in February and April. By May discharge rates of lava had decreased to approximately 15 m3/s and most of lava started to flow as entrail pahoehoe. By the beginning of June the volume of erupted products (dominantly lavas) reached 0.52km3. The effusion of lava continued until the end of August, when the lava lake in the crater of the active cinder cone became inactive. Weak strombolian outbursts from 1-3 small vents on the bottom of

  14. Nervous control of the internal anal sphincter of the cat.

    PubMed Central

    Bouvier, M; Gonella, J

    1981-01-01

    1. The effects of sympathetic and parasympathetic efferent nerve stimulation on the activity of longitudinal and circular coats of th anal sphincteric area have been studied on acute animals using extracellular electrical recordings. In addition, the effect of intramural sympathetic nerves stimulation has been investigated on anal sphincteric circular muscle, with the sucrose gap technique. 2. Hypogastric nerve stimulation elicited in anal sphincteric circular muscle slow time course depolarization responses (latency 200-400 msec) which were abolished by alpha-adrenergic blockers (dihydroergotamine, phentolamine). 3. Stimulation of the parasympathetic outflow to the internal anal sphincter (second ventral sacral root: VS2) inhibited spontaneous electrical activity of the circular muscle. Pharmacological arguments lead to the conclusion that the inhibition induced by VS2 stimulation is mediated through intramural non-adrenergic non-cholinergic (purinergic) inhibitory neurones. 4. Rectal distension caused an inhibition of the anal sphincteric circular muscle activity which persisted in the presence of atropine, phentolamine and propranolol, indicating that this inhibition was produced by non-adrenergic non-cholinergic intramural neurones. 5. VS2 stimulation produced only an activation of the longitudinal muscle of the sphincteric area, which was abolished by hexamethonium and atropine; in contrast, hypogastric nerve stimulation gave rise to an inhibition which was blocked by propranolol. These results indicate that the longitudinal muscle receives (1) an excitatory innervation from preganglionic parasympathetic nerves connected with intramural cholinergic neurones, and (2) an inhibitory sympathetic innervation from noradrenergic axons running in the hypogastric nerves. No inhibitory no-adrenergic non-cholinergic innervation was observed in the longitudinal muscle in response to VS2 stimulation. 6. The results obtained from simultaneous stimulation of VS2 and

  15. Tumors and Tumorlike Conditions of the Anal Canal and Perianal Region: MR Imaging Findings.

    PubMed

    Surabhi, Venkateswar R; Menias, Christine O; Amer, Ahmed M; Elshikh, Mohamed; Katabathina, Venkata S; Hara, Amy K; Baughman, William C; Kielar, Ania; Elsayes, Khaled M; Siegel, Cary L

    2016-01-01

    Tumors and tumorlike conditions of the anus and perianal region originate from the anal canal and anal margin or result from direct extension of tumors from adjacent organs. The anatomy of the anal canal is complex, and its different histologic characteristics can lead to diverse pathologic conditions. The anal canal extends from the anorectal junction to the anal verge. The World Health Organization classification of anal canal tumors includes (a) anal intraepithelial neoplasia, the precursor of squamous cell carcinoma (SCC), and (b) invasive tumors. Invasive tumors are further classified on the basis of cell type as epithelial tumors (SCC, adenocarcinoma, mucinous adenocarcinoma, small cell carcinoma, and undifferentiated carcinoma), nonepithelial tumors, carcinoid tumors, melanoma, and secondary tumors (direct spread from rectal, cervical, or prostate carcinoma). The anal margin, or perianal skin, lies outside the anal verge and encompasses a radius of 5 cm from the anal verge. Tumors in the anal margin are classified according to the World Health Organization classification of skin tumors. Anal margin tumors include SCC, anal intraepithelial neoplasia, also known as Bowen disease, adenocarcinoma and its precursor Paget disease, basal cell carcinoma, and verrucous carcinoma (Buschke-Löwenstein tumor), which is a rare variant of SCC. Imaging plays an important role in the evaluation, staging, and follow-up of patients with anal and perianal tumors. However, because of the overlap in imaging features among these diverse entities, a definitive diagnosis is best established at histopathologic examination. Nevertheless, familiarity with the pathogenesis, imaging features, and treatment of these tumors can aid radiologic diagnosis and guide appropriate patient treatment. (©)RSNA, 2016. PMID:27618320

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

    SciTech Connect

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

    2012-01-01

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

  17. Location of seismic events and eruptive fissures on the Piton de la Fournaise volcano using seismic amplitudes

    USGS Publications Warehouse

    Battaglia, J.; Aki, K.

    2003-01-01

    We present a method for locating the source of seismic events on Piton de la Fournaise. The method is based on seismic amplitudes corrected for station site effects using coda site amplification factors. Once corrected, the spatial distribution of amplitudes shows smooth and simple contours for many types of events, including rockfalls, long-period events and eruption tremor. On the basis of the simplicity of these distributions we develop inversion methods for locating their origins. To achieve this, the decrease of the amplitude as a function of the distance to the source is approximated by the decay either of surface or body waves in a homogeneous medium. The method is effective for locating rockfalls, long-period events, and eruption tremor sources. The sources of eruption tremor are usually found to be located at shallow depth and close to the eruptive fissures. Because of this, our method is a useful tool for locating fissures at the beginning of eruptions.

  18. The 'Jack Stone' or 'Mercedes Benz' sign--anew theory to explain the presence of gas within fissures in gallstones.

    PubMed

    Wright, F W

    1977-07-01

    Gas within clefts of fissures in gallstones is not a very common finding, but when it occurs is, characteristic and indicates the presence of one or more calculi. It closely resembles the appearance of a 'Jack Stone' but has previously been termed the 'Mercedes Benz' sign. Only a few cases have previously been recognised in the U.K. Most reported cases have been associated with biliary colic or cholecystitis. Various theories have been put forward to explain the presence of gas, but the author believes that the gas is released from solution by negative pressure within cholesterol stones undergoing internal fissuring due to their crystalline structure, i.e. the gas is released from solution from the small amount of fluid trapped in the calculus, in the same way that gas may be 'pulled' out of solution in a joint, a degenerate intervertebral disc or the fibro-cartilage of the symphysis pubis.

  19. The 'Jack Stone' or 'Mercedes Benz' sign--anew theory to explain the presence of gas within fissures in gallstones.

    PubMed

    Wright, F W

    1977-07-01

    Gas within clefts of fissures in gallstones is not a very common finding, but when it occurs is, characteristic and indicates the presence of one or more calculi. It closely resembles the appearance of a 'Jack Stone' but has previously been termed the 'Mercedes Benz' sign. Only a few cases have previously been recognised in the U.K. Most reported cases have been associated with biliary colic or cholecystitis. Various theories have been put forward to explain the presence of gas, but the author believes that the gas is released from solution by negative pressure within cholesterol stones undergoing internal fissuring due to their crystalline structure, i.e. the gas is released from solution from the small amount of fluid trapped in the calculus, in the same way that gas may be 'pulled' out of solution in a joint, a degenerate intervertebral disc or the fibro-cartilage of the symphysis pubis. PMID:872516

  20. Measurement of kinetic energy dissipation with gelatine fissure formation with special reference to gelatine validation.

    PubMed

    Jussila, Jorma

    2005-05-28

    Various methods for calculating the amount of kinetic energy dissipated by a bullet into ballistic gelatine have been suggested in literature. These methods were compared using the results of thirteen 9 mmx19 mm pistol and five 7.62 mmx 39 mm rifle bullets shot into 10% ballistic gelatine. The Wound Profile Method gave the highest correlation, 0.89, with the measured amounts of dissipated kinetic energy. The Fissure surface area and total crack length method gained 0.51 and 0.52, respectively. The experimental results were also compared with those from pig tests with the same bullet types. Using the z-test at 95% level of confidence no difference between impact velocity normalized bullet decelerations could be determined for the 9 mm bullet used. The same test showed significant difference for 7.62 mm bullets. That, however, can be considered to be the result of the bullet's tendency to tumble in non-homogenous living tissue causing significant dispersion of observed deceleration values. The results add further evidence supporting the validity of 10% gelatine at +4 degrees C as wound ballistic tissue simulant. The study also introduces the use of an elastic "shroud" to hold the gelatine in place, to some extent reduce the effects of asymmetric expansion of the gelatine and to simulate the expansion suppression effect of surrounding tissues. PMID:15837008

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

    NASA Astrophysics Data System (ADS)

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

    2012-07-01

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

  2. Modeling the hydraulical behavior of a fissured-karstic aquifer in exploitation conditions

    NASA Astrophysics Data System (ADS)

    Debieche, T. H.; Guglielmi, Y.; Mudry, J.

    2002-02-01

    A 5-year daily measurement of the dynamic level in a borehole was plotted versus cumulative yield since the beginning of exploitation. Eighty percent of the experimental curve is explained by a linear function ( h= aQc+ h0) by intervals. Only floods, which follow heavy storms and non-pumping cannot be taken into account. The slopes of the straight lines are spread around two constant values of the slope: a r=+0.35×10 -3 m m -3, which characterizes the part which is controlled by recharge, and a p=-0.14× 10 -3 m m -3, which characterizes the draining part of the aquifer fractures. This linear fitting demonstrates that the borehole-aquifer system can be considered as an equivalent continuous medium, where the linear relationship between dynamic head and pumped yield are defined by the values of ar and ap. Thus the hydraulic behavior of the aquifer differs according to the pumping rate: equivalent continuous medium for a low rate, dual permeability for a high one. This work demonstrates that the long-term behavior of an exploited fissured aquifer can be described by a simple model, if the duration of the aquifer test is long enough (1-3 months). It also shows that the production phase must include repetitive head measurements in order to refine the exploitation yield and the management conditions.

  3. 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.

  4. A randomized control clinical trial of fissure sealant retention: Self etch adhesive versus total etch adhesive

    PubMed Central

    Aman, Nadia; Khan, Farhan Reza; Salim, Aisha; Farid, Huma

    2015-01-01

    Context: There are limited studies on comparison of Total etch (TE) and Self etch (SE) adhesive for placement of sealants. Aims: The aim of the study was to compare the retention of fissure sealants placed using TE adhesive to those sealants placed using SE (seventh generation) adhesive. Settings and Design: The study was conducted in the dental section, Aga Khan University Hospital. This study was a randomized single blinded trial with a split mouth design. Materials and Methods: The study included 37 patients, 101 teeth were included in both study groups. The intervention arm was treated with SE Adhesive (Adper Easy One, 3M ESPE, US). Control arm received TE adhesive (Adper Single Bond 2, 3M ESPE, US) before sealant application. The patients were followed after 6 months for assessment of sealant retention. Statistical analysis used: Interexaminer agreement for outcome assessment was assessed by Kappa Statistics and outcome in intervention group was assessed by McNemar's test. Results: Ninety-one pairs of molar (90%) were reevaluated for sealant retention. Complete retention was 56% in TE arm and 28% in SE arm with an odds ratio (OR) of 3.7. Conclusions: Sealants applied with TE adhesives show higher rate of complete sealant retention than SE adhesive. PMID:25657521

  5. Sylvian fissure and parietal anatomy in children with autism spectrum disorder.

    PubMed

    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

  6. Chabazite in spodumene-bearing Alpine-type fissure veins from Hiddenite, North Carolina, USA

    NASA Astrophysics Data System (ADS)

    Wise, Michael A.

    2009-07-01

    Alpine-type fissure vein mineralization in the Hiddenite area of western North Carolina, USA consists mostly of quartz, but locally contains Cr-bearing beryl (emerald) or Cr-bearing spodumene (hiddenite). These gem minerals occur in mineral-lined cavities and may be accompanied by euhedral crystals of quartz, calcite, muscovite, rutile, albite, pyrite, siderite and dolomite. Chabazite-Ca occurs as a late stage phase in spodumene-bearing veins, but is absent in emerald-bearing veins. Chabazite-Ca occurs as simple penetrating twins of pseudocubic rhombohedra and as the lens-shaped variety, phacolite. Chabazite-Ca from Hiddenite contains minor amounts of Na, Mg, Fe and K. Phacolitic chabazite-Ca shows Fe-enriched but Mg-depleted cores relative to the rims. Chemical zoning is absent in rhombohedral chabazite. The Hiddenite chabazite apparently precipitated under low temperature (< 250°C) and low pressure (< 2 kbar) conditions during the waning stages of crystallization of an alkaline hydrothermal fluid.

  7. Clinical evaluation of the retention and wear of a light-cured pit and fissure glass ionomer sealant.

    PubMed

    Aranda, M; Garcia-Godoy, F

    1995-01-01

    The purpose of this study was to evaluate the 12-month retention and wear of an experimental light-cured glass ionomer for pit and fissure sealing. A total of 25 patients 7-14 years-old were selected from the Pediatric Dentistry Clinic at the University of Texas Health Science Center at San Antonio. The patients resided in areas without fluoridated water. Each tooth was isolated with cotton rolls, dried with oil-free compressed air and GC Dentin Conditioner applied with a small disposable brush to the pits and fissures for 20 seconds. The teeth were rinsed with water and gently air dried using an air/water syringe. The teeth were not desiccated. GC experimental glass ionomer for pit and fissures was used. The powder/liquid ratio was dispensed at 1.4 gm/1.0 gm (one level spoonful of powder to one drop of liquid). The powder was mixed for 15-20 seconds. An explorer was used to apply the mixed sealant to the tooth and teased into all pits and fissures. The sealant was then cured for 20 seconds. Occlusion was corrected after the sealant was light-cured. Immediately, a color slide and a vinyl polysiloxane impressions were taken. The impressions were poured in epoxy resin. Color slides, impressions and epoxy models were also made at 3, 6, 9 and 12-month recalls. A total of 95 sealants were placed and follow-up for 12 months. The results showed that with the clinical visual inspection all sealants were present at 3 and 6 months postoperatively. At 12 months, only 20% of the sealants were clinically evident.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7547485

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

    NASA Astrophysics Data System (ADS)

    Thomas, R.

    2012-09-01

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

  9. Challenges faced in the clinical application of artificial anal sphincters.

    PubMed

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

    2015-09-01

    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

  10. Anal cancer treatment: Current status and future perspectives

    PubMed Central

    Ghosn, Marwan; Kourie, Hampig Raphael; Abdayem, Pamela; Antoun, Joelle; Nasr, Dolly

    2015-01-01

    Anal cancers (AC) are relatively rare tumors. Their incidence is increasing, particularly among men who have sex with other men due to widespread infection by human papilloma virus. The majority of anal cancers are squamous cell carcinomas, and they are treated according to stage. In local and locally advanced AC, concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil (5-FU) is the current best treatment, while metastatic AC, chemotherapy with 5-FU and cisplatin remains the gold standard. There are no indications for induction or maintenance therapies in locally advanced tumors. Many novel strategies, such as targeted therapies, vaccination, immunotherapy and photodynamic therapy are in clinical trials for the treatment of AC, with promising results in some indications. PMID:25741135

  11. Challenges faced in the clinical application of artificial anal sphincters.

    PubMed

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

    2015-09-01

    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.

  12. An anatomical structure which results in puffiness of the upper eyelid and a narrow palpebral fissure in the Mongoloid eye.

    PubMed

    Yuzuriha, S; Matsuo, K; Kushima, H

    2000-09-01

    The typical Mongoloid eye differs from the Occidental one in puffiness of the upper eyelid and narrowness of the palpebral fissure. We surmised that an anatomical structure might exist in the preaponeurotic fat space, which determines the features of the Mongoloid eye. The upper eyelids of 720 Japanese patients and eight Japanese cadavers were macroscopically investigated, and sagittal slices of the central upper eyelid of one patient and nine cadavers were microscopically analysed. Another, lower-positioned transverse ligament different from the higher-positioned Whitnall's one was identified just above the fusional line between the orbital septum and the levator aponeurosis in almost every upper eyelid. A robust ligamentous structure was observed in 331 patients (46%) with puffier eyelids and a narrower palpebral fissure, a diaphanous retinaculum in 381 patients (53%) and no transverse ligamentous tissue in eight patients (1%). Histological evaluation demonstrated that this ligament was composed of tight bundles of collagen fibres containing few elastic fibres. Examination of the preaponeurotic fat space indicated that the superficial expansion of the levator aponeurosis turned up around this transverse ligament to become the orbital septum. When the levator muscle contracts, the deep expansion of the levator aponeurosis retracts the tarsus, the middle expansion retracts the pretarsal orbicularis oculi muscle and skin, and the superficial expansion retracts the preaponeurotic fat against this ligament. This structure thus determines the low position of the preaponeurotic fat and restricts the vertical width of the palpebral fissure, causing the features of the Mongoloid eye.

  13. 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.

  14. Management of obstetric anal sphincter injuries (OASIS) in subsequent pregnancy.

    PubMed

    Evans, C; Archer, R; Forrest, A; Barrington, J

    2014-08-01

    Obstetric anal sphincter injuries (OASIS) are common and may greatly affect a patient's quality of life. There is very little information regarding optimum management in future pregnancies. Based upon anecdotal experience, this study describes the recommendations of a cohort of consultant obstetricians in the UK, in this clinical situation. There is limited adherence to the available national guidelines due to the absence of available equipment and expertise to perform endo-anal ultrasound and manometry. Elective episiotomy is still recommended by a small number of obstetricians but the majority of patients are routinely followed-up. Caesarean section is only advised for asymptomatic patients with a previous stage 4 tear, and for any symptomatic patient with a previous stage 3 or 4 tear, irrespective of subgrade. A request for elective caesarean section is likely to be granted, irrespective of OASIS grade. The use of postpartum endo-anal ultrasound would help identify those women in whom a further vaginal delivery is unlikely to exacerbate any symptoms of faecal incontinence. PMID:24800795

  15. [Hemorrhoidal disease accompanied by anal prolapsus and its treatment methods].

    PubMed

    Dzhavalov, É A; Khalilova, L F

    2014-01-01

    The objective of this research is to evaluate specifications of the surgery, its post-operative period and complications in patients with traditional hemorrhoidectomy which is a procedure performed by using a linear stapler along with a circular resection of prolapsed mucosal and sub-mucosal layers of lower rectal ampulla with the utilization of Longo technique. The study was conducted with the participation of 398 patients with the hemorrhoidal disease accompanied by anal prolapsus of which 338 (84%) were composed of males and 65 (16%) of females. Out of 398 patients, 308 (77%) underwent stapler hemorrohidectomy using linear stapler, 74 (19%) patients had conventional hemorrhoidectomy with the utilization of electric coagulation and 16 (4%) of them received circular hemorroidopexy using Longo technique. According to the data obtained during this research linear stapler use in the treatment of hemorroidal desease, accompanied by anal prolapses is an effective and technically simple solution to the problem. This method is implemented quickly, allows to cover greater part of abnormally changed cavernous tissue and conduct persist lifting of anal canal mucosal layer. It is also a safe method without any disease relapses.

  16. [Hemorrhoidal disease accompanied by anal prolapsus and its treatment methods].

    PubMed

    Dzhavalov, É A; Khalilova, L F

    2014-01-01

    The objective of this research is to evaluate specifications of the surgery, its post-operative period and complications in patients with traditional hemorrhoidectomy which is a procedure performed by using a linear stapler along with a circular resection of prolapsed mucosal and sub-mucosal layers of lower rectal ampulla with the utilization of Longo technique. The study was conducted with the participation of 398 patients with the hemorrhoidal disease accompanied by anal prolapsus of which 338 (84%) were composed of males and 65 (16%) of females. Out of 398 patients, 308 (77%) underwent stapler hemorrohidectomy using linear stapler, 74 (19%) patients had conventional hemorrhoidectomy with the utilization of electric coagulation and 16 (4%) of them received circular hemorroidopexy using Longo technique. According to the data obtained during this research linear stapler use in the treatment of hemorroidal desease, accompanied by anal prolapses is an effective and technically simple solution to the problem. This method is implemented quickly, allows to cover greater part of abnormally changed cavernous tissue and conduct persist lifting of anal canal mucosal layer. It is also a safe method without any disease relapses. PMID:24781070

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

    PubMed

    Hadlow, W J

    1985-05-01

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

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

    PubMed

    Duby, Zoe; Colvin, Christopher

    2014-01-01

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

  19. 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).

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

    PubMed

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

    1994-04-01

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

  1. 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

  2. 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

  3. 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

  4. Chronic Bronchitis

    MedlinePlus

    ... chronic. Chronic bronchitis is one type of COPD (chronic obstructive pulmonary disease). The inflamed bronchial tubes produce a lot of mucus. This leads to coughing and difficulty breathing. Cigarette smoking is the most ... diagnose chronic bronchitis, your doctor will look at your signs ...

  5. 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

  6. Stratigraphy, paleoenvironment and emplacement mechanisms of the Koko fissure craters, O'ahu, Hawai'i

    NASA Astrophysics Data System (ADS)

    Skilling, I. P.; Bluth, J.; Simoneau, E.

    2011-12-01

    The Koko fissure craters are aligned and nested basanitic tuff cones and rings at the SE corner of O'ahu, Hawai'i. There are no published studies of their stratigraphy, emplacement mechanisms or depositional paleoenvironments. This study focuses on a tuff cone complex (Koko Crater) and a younger adjacent nested tuff ring (Hanauma Bay). A detailed stratigraphy with logged sections for both Koko Crater and the Hanauma Bay craters are presented and discussed. Koko Crater is dominated by wet fallout deposits on steep proximal slopes, commonly resedimented by hot (vesiculated) and cold (unvesiculated) debris flows, slumps and slides, but with an increasing percentage of wet (low temperature) low concentration PDC deposits preserved in the shallowly-dipping flanking apron deposits, and in the uppermost proximal deposits. At least two earlier cone or ring rims are preserved along its southern margin. The deposits of Hanauma Bay overlie the Koko deposits and are dominated by a mix of wet low concentration PDC, wet fallout and synchronous PDC, and fallout deposits in proximal settings, and by low concentration, probably drier, PDC deposits in more distal settings. The Hanauma Bay rings were emplaced before the Koko Crater tephra was consolidated, as steep-sided rills incised into Koko tephra are locally filled with tephra of mixed Koko and Hanauma sources. The onset of Hanauma Bay eruptions is marked by a horizon that is very rich in rounded coral sand clasts. Discontinuous horizons and lenses of coral block fallout are also very common in the Hanauma tephra. Coral sand is absent and coral blocks are much rarer in the Koko tephra. These observations, and probably also the dominance of wet fallout at Koko, imply that Koko was erupted in deeper water than the nearshore coral beach environment of the Hanauma rings. A faster rate of water recharge into the conduit in deeper open water is probably the most important factor in the generation of a cone rather than a ring at this

  7. Effects of sealant, viscosity, and bonding agents on microleakage of fissure sealants: An in vitro study

    PubMed Central

    Mehrabkhani, Maryam; Mazhari, Fatemeh; Sadeghi, Samaneh; Ebrahimi, Masoumeh

    2015-01-01

    Objective: The aim of this study was to evaluate the effects of enamel or dentin bonding agent (DBA) and sealant viscosity on sealant microleakage. Materials and Methods: Sixty extracted human premolars were randomly divided into two equal groups (based on sealant viscosity) and each group was divided into three subgroups of 10 teeth. Group 1 (low viscosity sealant, Seal-Rite, Pulpdent, USA with 7.7% filler): Prophylaxis, enameloplasty, etching of occlusal surfaces with 38% of phosphoric acid gel, rinsing and drying, followed by (1) enamel bonding agent (EBA) (Margin Bond, Coltène/Whaledent AG) or (2) DBA (Excite, Ivoclar Vivadent AG, Liechtenstein) or (3) no bonding (NB) prior to sealant application. In Group 2, similar procedures were performed except for applying a high viscosity sealant (Seal-Rite, Pulpdent, The USA with 34.4% filler). Specimens were thermocycled and then immersed in a 0.5% basic fuchsine solution for 24 h next, buccolingual slices of samples were scored under a stereomicroscope. The Kruskal–Wallis and Mann–Whitney U-tests were used for data analysis. Results: There was no significant difference between DBA, EBA, and NB subgroups in the microleakage scores in both groups. Low viscosity sealant had a lower microleakage than the high viscosity sealant in both DBA (P = 0.002) and NB (P = 0.041) subgroups. Conclusion: The results indicated that the use of low viscosity sealant reduced the microleakage of pit and fissure sealants. However, the use of a bonding agent before sealant placement didn’t affect the microleakage. PMID:26929696

  8. 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.

  9. 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

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

    PubMed

    Welbeck, Monique

    2016-01-01

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

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

    SciTech Connect

    Cotter, Shane E.; Grigsby, Perry W. . E-mail: pgrigsby@wustl.edu; Siegel, Barry A.

    2006-07-01

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

  13. A rare case of leiomyoma of the internal anal sphincter

    PubMed Central

    Sturiale, Alessandro; Fabiani, Bernardina; Naldini, Gabriele

    2016-01-01

    Introduction Leiomyoma is a benign tumour which derives from the smooth muscle fibres and it may occurs in every site in which this type of muscle is present. Among all benign soft tissue tumours it represents almost 3.8% and its pathogenesis remains still unknown. Presentation of case The present case is about a 62 year old woman referred to our centre complaining anal and perineal pain which increase after defecation in association with the appearance of a nodule in the perianal region fixed to the anal sphincter. A 360° tridimensional transanal ultrasound was performed and it showed an anterior nodular thickening of the internal anal sphincter. After an inconclusive preoperative biopsy and a counselling with the patient, the surgeons decided to proceed with the surgical excision. The immunohistochemical examination confirmed the preoperative suspicion of leiomyoma. At 1 year follow-up the patient had not tumour-related symptoms or fecal incontinence and any signs of local recurrence at ultrasound imaging were demonstrated. Discussion Leiomyomas are relatively insensitive to chemotherapy whereby surgery is the treatment of choice and it should be adequate to the site and dimension of the lesion achieving a complete resection with free margins. A further close follow-up is needed too. Conclusion Nowadays there is not a gold standard technique to treat such kind of lesions and the decision of the best surgical approach should depend on the dimension and site. In fact, surgery aims to the oncological outcome trying also to minimize the possible post-operative functional complications. PMID:27078867

  14. Recrystallized Granite Surface Fissures of Wasatch Range Produced Not Later Than 1/4Billion Years Ago

    NASA Astrophysics Data System (ADS)

    McDonald, Keith

    2000-11-01

    Our studies of numerous recrystallized fissures in 4 granite plutons of Wasatch Range, i.e., Mount T-W-M, (K.L. McDonald, Bul. A.P.S., 32 (4), 1124),(37 (5), 1256-7),(38 (1), 740) Bonanza Pk.-Midway,(35 (9), 2132) Little Cottonwood and Ferguson Canyon plutons, all of which formed magma chambers reaching Earth-atm. interface, estab that they resulted from high thermal gradients and not passages of earthquake waves.(33 (9), 1982-2) Magma chambers formed, solidified during Permo- Carboniferous Ice Age (roughly 1/3...1/4 billion yr ago), a time interval preceding extrusion, pf Rocky Mts., 10^8 yr ago, and while fluid, some belched lava flows(36 (9), 2466) extending over its reservoir walls to run hundreds of m. We have shown how the magma melts, dilutes and replaces overlying metamorphic rock(38 (1), 740) 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.(33 (3), 485) Recryst. fissures, reaching depths of perhaps 100 m, had initial fractures near time of solidification of top 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, rain water, stream flow over granite surface, partial coverage by ocean, etc., during P-C ice age -- when region of Wasatch Range existed at sea level, S.L. Valley being covered entrely by ocean water and region of Wasatch Boul. rising gently above Pac. Ocean to elev. of possibly 500-1000 ft, say, at a dist. of 10-15 mi to e, as implied by Chinese Wall of limestone on Grandeur Pk, another in Neff's Canyon running e from n ridge of her 9200 ft saddle-summit, as well as a dozen other ancient calcified stream beds emptying into ocean to w., in S.L. Valley. This existed prior to regional uplift (of similar topog.) of over 4000 ft. Details of how earthquake waves form an

  15. 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

  16. Unexpected anal squamous cells carcinoma after open hemorrhoidectomy.

    PubMed

    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.

  17. Malignant melanoma of the anal canal: a case report

    PubMed Central

    Barbus, Roxana; Rancea, Alin; Fetica, Bogdan; Spârchez, Zeno

    2009-01-01

    This article is one case report of 49 year-old woman diagnosed with malignant melanoma of the anal canal. The tumor was detected at early stage and initially treated with local excision, followed by adjuvant interstitial brachytherapy. Since the patient complained of painful local ulceration and atypical cells were found at biopsy, abdominoperineal resection of the rectum was performed and a sterile specimen was obtained, proving the efficacy of adjuvant brachytherapy for local control. Patient is now considered disease free for 30 months after primary treatment.

  18. Adynamic and dynamic muscle transposition techniques for anal incontinence

    PubMed Central

    Barišić, Goran; Krivokapić, Zoran

    2014-01-01

    Gracilis muscle transposition is well established in general surgery and has been the main muscle transposition technique for anal incontinence. Dynamization, through a schedule of continuous electrical stimulation, converts the fatigue-prone muscle fibres to a tonic fatigue-resistant morphology with acceptable results in those cases where there is limited sphincter muscle mass. The differences between gluteoplasty and graciloplasty, as well as the techniques and complications of both procedures, are outlined in this review. Overall, these techniques are rarely carried out in specialized units with experience, as there is a high revision and explantation rate. PMID:24759348

  19. 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.

  20. Dyke propagation mechanisms and the immediate pre- and syn-eruptive seismicity of the 2014 Holuhraun fissure eruption, Iceland

    NASA Astrophysics Data System (ADS)

    Woods, Jennifer; Ágústsdóttir, Thorbjörg; Greenfield, Tim; Green, Robert G.; White, Robert S.; Brandsdóttir, Bryndís; Steinthórsson, Sveinbjörn; Redfern, Simon

    2015-04-01

    We present data from our dense seismic array which captured the micro-seismicity associated with the propagating dyke intrusion from the subglacial Bárðarbunga volcano, during the 24 hours preceding and following the onset of effusive magmatism at the Holuhraun lava field in central Iceland. The Bárðarbunga volcano is located at the centre of the Iceland hot spot within the Eastern Rift Zone, beneath the Vatnajökull ice cap. Local magmatic intrusions can be tracked through the swarms of micro-seismicity accompanying dyke propagation, arising from crustal failure and fracture of both the country rock and solidifying magma plugs. August 2014 saw the beginning of a period of unrest of Bárðarbunga volcano during which a dyke propagated first out of the caldera and then towards the northeast. It continued north of the Dyngjujökull outlet glacier and resulted in a fissure eruption in the old Holuhraun lava field on 29 August 2014. At time of writing it has erupted ~1km3 of lava covering over 64km2, making this the largest eruption in Iceland for 150 years. Our extensive, local seismic network covers the numerous volcanic systems beneath the Vatnajökull glacier and their transecting fissure swarms (rifting units) along the divergent plate boundary. This work focusses on the immediate pre- and syn-eruptive seismicity of the 2014 Holuhraun fissure eruption. Rock fracture mechanisms are determined from fault plane solutions of these seismic events, produced as the magma migrated from beneath the surface to the eruption site.

  1. 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

  2. [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.

  3. 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

  4. 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

  5. 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

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

    NASA Astrophysics Data System (ADS)

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

    2003-04-01

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

  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. CHEMICAL TRANSPORT IN A FISSURED BOCK: VERIFICATION OF A NUMERICAL MODEL

    SciTech Connect

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

    1982-04-01

    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

  9. 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

  10. Investigation of anal motor characteristics of the sensorimotor response (SMR) using 3-D anorectal pressure topography

    PubMed Central

    Cheeney, Gregory; Remes-Troche, Jose M.; Attaluri, Ashok

    2011-01-01

    Desire to defecate is associated with a unique anal contractile response, the sensorimotor response (SMR). However, the precise muscle(s) involved is not known. We aimed to examine the role of external and internal anal sphincter and the puborectalis muscle in the genesis of SMR. Anorectal 3-D pressure topography was performed in 10 healthy subjects during graded rectal balloon distention using a novel high-definition manometry system consisting of a probe with 256 pressure sensors arranged circumferentially. The anal pressure changes before, during, and after the onset of SMR were measured at every millimeter along the length of anal canal and in 3-D by dividing the anal canal into 4 × 2.1-mm grids. Pressures were assessed in the longitudinal and anterior-posterior axis. Anal ultrasound was performed to assess puborectalis morphology. 3-D topography demonstrated that rectal distention produced an SMR coinciding with desire to defecate and predominantly induced by contraction of puborectalis. Anal ultrasound showed that the puborectalis was located at mean distance of 3.5 cm from anal verge, which corresponded with peak pressure difference between the anterior and posterior vectors observed at 3.4 cm with 3-D topography (r = 0.77). The highest absolute and percentage increases in pressure during SMR were seen in the superior-posterior portion of anal canal, reaffirming the role of puborectalis. The SMR anal pressure profile showed a peak pressure at 1.6 cm from anal verge in the anterior and posterior vectors and distinct increase in pressure only posteriorly at 3.2 cm corresponding to puborectalis. We concluded that SMR is primarily induced by the activation and contraction of the puborectalis muscle in response to a sensation of a desire to defecate. PMID:21109594

  11. Peri-anal implantation of bioengineered human internal anal sphincter constructs intrinsically innervated with human neural progenitor cells

    PubMed Central

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

    2014-01-01

    Background The internal anal sphincter (IAS) is a major contributing factor to anal canal pressure and is required for maintenance of rectoanal continence. IAS damage or weakening results in fecal incontinence. We have demonstrated that bioengineered intrinsically innervated human IAS tissue replacements possess key aspects of IAS physiology, like generation of spontaneous basal tone and contraction/relaxation in response to neurotransmitters. The objective of this study is to demonstrate the feasibility of implantation of bioengineered IAS constructs in the peri-anal region of athymic rodents. Methods Human IAS tissue constructs were bioengineered from isolated human IAS circular smooth muscle cells and human enteric neuronal progenitor cells. Upon maturation of the bioengineered constructs in culture, they were implanted surgically into the perianal region of athymic rats. Growth factor was delivered to the implanted constructs through a microosmotic pump. Implanted constructs were retrieved from the animals 4 weeks post-implantation. Results Animals tolerated the implantation well, and there were no early postoperative complications. Normal stooling was observed during the implantation period. Upon harvest, implanted constructs were adherent to the perirectal rat tissue, and appeared healthy and pink. Immunohistochemical analysis revealed neovascularization. Implanted smooth muscle cells maintained contractile phenotype. Bioengineered constructs responded to neuronally evoked relaxation in response to electrical field stimulation and vasoactive intestinal peptide, indicating the preservation of neuronal networks. Conclusions Our results indicate that bioengineered innervated IAS constructs can be used to augment IAS function in an animal model. This is a regenerative medicine based therapy for fecal incontinence that would directly address the dysfunction of the IAS muscle. PMID:24582493

  12. The temperature and width of an active fissure on Enceladus measured with Cassini VIMS during the 14 April 2012 South Pole flyover

    NASA Astrophysics Data System (ADS)

    Goguen, Jay D.; Buratti, Bonnie J.; Brown, Robert H.; Clark, Roger N.; Nicholson, Phillip D.; Hedman, Matthew M.; Howell, Robert R.; Sotin, Christophe; Cruikshank, Dale P.; Baines, Kevin H.; Lawrence, Kenneth J.; Spencer, John R.; Blackburn, David G.

    2013-09-01

    The width and temperature of the active fissures on Saturn’s satellite Enceladus provide key observable constraints on physical models of these geyser-like eruptions. We analyze a sequence of high spatial resolution near-infrared spectra acquired with VIMS at 0.025 s intervals during a 74 km altitude flyover of the South Pole of Enceladus by the Cassini spacecraft on 14 April 2012 UTC. A thermal-emission spectrum covering 3- to 5-μm wavelengths was detected as the field of view crossed one of the four major fissures, Baghdad Sulcus, within 1 km of 82.36S latitude and 28.24W longitude. We interpret this spectrum as thermal emission from a linear fissure with temperature 197 ± 20 K and width 9 m. At the above wavelengths, the spectrum is dominated by the warmest temperature component. Looking downward into the fissure at only 13° from the vertical, we conclude that our results measure the temperature of the interior fissure walls (and the H2O vapor) at depths within 40 m of the surface.

  13. Anal sphincter injuries during hemorrhoidectomy: a multi center study.

    PubMed

    Mirzaei, Rezvan; Mahjoubi, Bahar; Kadivar, Maryam; Azizi, Rasoul; Zahedi-Shoolami, Leila

    2012-01-01

    Hemorrhoidectomy is the treatment of choice for patients with third or fourth-degree hemorrhoids. Although the majority of surgeons believe that surgical hemorrhoidectomy is the most effective approach with excellent results in the management of hemorrhoid disease, but hemorrhoidectomy is not a simple procedure. One of the complications of this surgery is an injury to anal sphincters that can lead to incontinency in some patients. In this study, we aimed to reveal the percentage of external and internal anal sphincter injuries in surgical hemorrhoidectomy. We prospectively enrolled 128 patients from April 2006 to February 2007. They underwent hemorrhoidectomy in three general hospitals in Tehran. All patients were in grade III or IV and underwent open hemorrhoidectomy (Milligan-Morgan). After surgery, all resected material was histopathologically examined by two expert pathologists and the results confirmed by other one if there is any discrepancy. From all specimens which sent to the pathology department 15.8% (21 Pts.) had muscle fibers that Smooth muscle fibers were seen in 80.5% (17 Pts.) of them and striated muscle fibers were found in 19.5% (4 Pts.). Although hemorrhoidectomy is a safe and effective method for treatment of hemorrhoid, but the inadvertent removal of smooth and striated muscle during open hemorrhoidectomy had raised concerns about its effects on postoperative anorectal function.

  14. 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. PMID:22444354

  15. Comprehensive multiplatform biomarker analysis of 199 anal squamous cell carcinomas

    PubMed Central

    Smaglo, Brandon G.; Tesfaye, Anteneh; Halfdanarson, Thorvardur R.; Meyer, Joshua E.; Wang, Jue; Gatalica, Zoran; Reddy, Sandeep; Arguello, David; Boland, Patrick M.

    2015-01-01

    Anal squamous cell carcinoma (ASCC) is a rare, HPV-associated malignancy typically diagnosed in early stages and definitively treated with chemoradiation. In situations where patients exhibit metastatic or recurrent disease, treatment options are severely limited. In this study, molecular alterations were identified that could be used to aid in therapeutic decisions for patients with metastatic or recurrent anal squamous cell carcinoma. Specimens from patients with this cancer were tested via a multiplatform profiling service (Caris Life Sciences, Phoenix, AZ) consisting of gene sequencing, protein expression by immunohistochemistry, and gene amplification with in situ hybridization. Utilizing these techniques, novel treatment strategies that could be explored were identified, including potential benefit with anti-EGFR therapies, immune checkpoint inhibitors, topoisomerase inhibitors, and taxanes. The frequency of overexpression of proteins that mark resistance to chemotherapeutic drugs, such as MRP1 (chemotherapy efflux pump), ERCC1 (resistance to platinum-based chemotherapy), and thymidylate synthase (resistance to fluoropyrimidines) were also identified, suggesting a lack of benefit. This multiplatform strategy could be explored for its potential to generate a personalized treatment selection for patients with advanced ASCC, provide a guide for future therapeutic development for this cancer, and be extended to other rare cancer types as well. PMID:26498363

  16. Comprehensive multiplatform biomarker analysis of 199 anal squamous cell carcinomas.

    PubMed

    Smaglo, Brandon G; Tesfaye, Anteneh; Halfdanarson, Thorvardur R; Meyer, Joshua E; Wang, Jue; Gatalica, Zoran; Reddy, Sandeep; Arguello, David; Boland, Patrick M

    2015-12-22

    Anal squamous cell carcinoma (ASCC) is a rare, HPV-associated malignancy typically diagnosed in early stages and definitively treated with chemoradiation. In situations where patients exhibit metastatic or recurrent disease, treatment options are severely limited. In this study, molecular alterations were identified that could be used to aid in therapeutic decisions for patients with metastatic or recurrent anal squamous cell carcinoma. Specimens from patients with this cancer were tested via a multiplatform profiling service (Caris Life Sciences, Phoenix, AZ) consisting of gene sequencing, protein expression by immunohistochemistry, and gene amplification with in situ hybridization. Utilizing these techniques, novel treatment strategies that could be explored were identified, including potential benefit with anti-EGFR therapies, immune checkpoint inhibitors, topoisomerase inhibitors, and taxanes. The frequency of overexpression of proteins that mark resistance to chemotherapeutic drugs, such as MRP1 (chemotherapy efflux pump), ERCC1 (resistance to platinum-based chemotherapy), and thymidylate synthase (resistance to fluoropyrimidines) were also identified, suggesting a lack of benefit. This multiplatform strategy could be explored for its potential to generate a personalized treatment selection for patients with advanced ASCC, provide a guide for future therapeutic development for this cancer, and be extended to other rare cancer types as well. PMID:26498363

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

    PubMed

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

    2016-09-30

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

  18. Anal Intercourse and Sexual Risk Factors among College Women, 1993-2000

    ERIC Educational Resources Information Center

    Flannery, Diana; Ellingson, Lyndall; Votaw, Karen S.; Schaefer, Elizabeth Ann

    2003-01-01

    Objective: To determine trends and sexual risk behaviors associated with anal intercourse among college women over an 8-year period. Methods: A sexual activity questionnaire was used to collect data from 813 students enrolled in a women's health course. Results: Thirty-two percent of the women had engaged in anal intercourse, and this measure was…

  19. 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 sought.…

  20. 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

  1. [Radiological diagnosis of constipation and anal incontinence caused by changes in the pelvic floor and anal sphincter. Our experience with 38 patients with constipation with or without incontinence].

    PubMed

    Parrella, R E; Brizi, M G; Giannasio, T; Natale, L; Posi, G; Vulpio, C

    1987-11-01

    Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincteric apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusions: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially it allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteric apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualisation of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincteric apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter.

  2. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  4. A Modified LBM Model for Simulating Gas Seepage in Fissured Coal Considering Klinkenberg Effects and Adsorbability-Desorbability

    NASA Astrophysics Data System (ADS)

    Tan, Yun-Liang; Teng, Gui-Rong; Zhang, Ze

    2010-01-01

    A modified Lattice-Boltzmann method is proposed by considering the Klinkenberg effect and adsorbability-desorbability for the purpose of simulating methane gas seepage in fissured coal. The results show that the Klinkenberg effect has a little influence on methane gas seepage in fissured coal, so it can be neglected in engineering computations for simplicity. If both the Klinkenberg effect and the adsorbability-desorbability are considered, the Klinkenberg influence on gas pressure decreases as the Darcy coefficient increases. It is found by gas drainage simulations that near a drainage hole, the effect of adsorption and desorption cannot be neglected, and the location of the drainage hole has a great influence on drainage efficient λ when the hole is just located at the mid-zone of the coal seam, λ is 0.691808; when the hole is excursion down to 1.0 m from the mid-zone of coal seam, λ decreases to 0.668631; when the hole is excursion up or down to 2.0 m from the mid-zone of coal seam, λ decreases to 0.632917. The simulations supply an effective approach for optimizing the gas drainage hole location.

  5. Microtensile bond strength of a resin-based fissure sealant to Er,Cr:YSGG laser-etched primary enamel.

    PubMed

    Sungurtekin-Ekci, Elif; Oztas, Nurhan

    2016-05-01

    The aim of this study was to evaluate the effect of Er,Cr:YSGG laser pre-treatment alone, or associated with acid-etching, on the microtensile bond strength of a resin-based fissure sealant to primary enamel. Twenty-five human primary molars were randomly divided into five groups including (1) 35 % acid etching, (2) 2.5-W laser etching, (3) 3.5-W laser etching, (4) 2.5-W laser etching + acid etching, and (5) 3.5-W laser etching + acid etching. Er,Cr:YSGG laser was used at a wavelength of 2.780 nm and pulse duration of 140-200 μs with a repetition rate of 20 Hz. Following surface pre-treatment, the fissure sealant (ClinPro™, 3M Dental Products) was applied. Each tooth was sectioned and subjected to microtensile testing. Kruskal-Wallis test was used for statistical analysis. The level of significance was set at p < 0.05. The microtensile bond strength values of group 1 were significantly higher than those of group 2, while no statistically significant difference was detected between groups 1, 3, 4, and 5. It was concluded that 3.5-W laser etching produced results comparable to conventional acid etching technique, whereas 2.5-W laser etching was not able to yield adequate bonding performance.

  6. The magnetic anal sphincter: a new device in the management of severe fecal incontinence.

    PubMed

    Mantoo, Surendra; Meurette, Guillaume; Podevin, Juliette; Lehur, Paul-Antoine

    2012-09-01

    The authors aim to report the concept and technique of implantation and the first results of the clinical use of the magnetic anal sphincter (MAS) in the management of fecal incontinence (FI). The MAS device is designed to augment the native anal sphincter. The implant is a series of titanium beads with magnetic cores linked together with independent titanium wires. To defecate, the force generated by straining separates the beads to open up the anal canal. The technique of implantation is simple with no requirement of adjustments. The MAS has a role in the management of severe FI. The device has acceptable and comparable adverse effects to other therapies. FI and Fecal Incontinence Quality of Life scores are significantly improved in the short term. The MAS offers a simple and less invasive option of anal reinforcement. It is one step further in the quest for an ideal artificial anal sphincter device. PMID:23116075

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

    NASA Astrophysics Data System (ADS)

    McDonald, K. L.

    2002-04-01

    Our studies of numerous recrystallized fissures in 4 granite plutons of Wasatch Range, i.e., Mount T-W-M^1,6,7 Bonanza Pk.-Midway,^2 Little Cottonwood and Ferguson Canyon plutons, all of which formed magma chambers reaching Earth-atm. interface, estab. that they resulted from high thermal gradients and not passages of earthquake waves.^4 Magma chambers formed, solidified during Permo-Carboniferous Ice Age (roughly 1/3...1/4 billion yr ago), a time interval preceding extrusion of Rocky Mts., 10^8 yr ago, and while fluid, some belched lava flows^5 extending over its reservoir walls to run hundreds of m. 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. Recryst. fissures, reaching depths of perhaps 100 m, had initial fractures near time of solidification of top 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, rain water, stream flow over granite surface, partial coverage by ocean, etc., during P-C ice age - when region of Wasatch Range existed at sea level, S. L. Valley being covered entirely by ocean water and region east of Wasatch Boul. rising gently above Pac. Ocean to elev. of possibly 500-1000 ft, say, at a distance of 10-15 mi to e, as implied by Chinese wall of limestone on Grandeur Pk, another in Neff's Canyon running e from n ridge of her 9200 ft saddle-summit, as well as a dozen other ancient calcified stream beds emptying into ocean to w, in S.L. Valley. This existed prior to regional uplift (of similar topog.) of over 4000 ft. Details of how earthquake waves form an epicenter from which propagate 2 stress fields in diam. opp. directions to open up, by a few m, surface granite to form a

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

    PubMed Central

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

    2012-01-01

    Objective: The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). Materials and Methods: The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Results: Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. Conclusion: The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP. PMID:22529447

  9. 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

  10. 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

  11. Planar spin-transfer device with dynamical polarizer and analizer

    NASA Astrophysics Data System (ADS)

    Bazaliy, Yaroslaw; Kravchenko, Anton

    2011-03-01

    The behavior of the planar spin-transfer devices with monodomain magnetic layers can be described by the macrospin Landau-Lifshitz-Gilbert (LLG) equation with spin-transfer terms. The LLG description of a device with two layers is simplified after applying the overdamped, large easy-plane anisotropy approximation. A decrease of the magnetic layer thickness asymmetry creates a transition from the conventional polarizer-analizer (``fixed layer -- free layer'') operation regime to the regime of the nearly identical magnets. Here electric current leads to a ``Slonczewski windmill'' dynamic state, rather than producing the magnetic switching. The ``windmill'' precession state of a device with two free layers was investigated by numerical solution of the LLG equation.

  12. [Preservation of the anal sphincter in low rectal lesions].

    PubMed

    Arthur, K E; Guerra, M

    1997-01-01

    We have discussed the surgical options to save the anorectal sphincter in lesions within the lower 2/3 of the rectum. We presented four clinical cases: two villous adenomas, one adenocarcinoma and one benign tumor, probably of embryonic origin. We discussed the surgical options in order to avoid a permanent colostomy. There is not a single surgical procedure that we can count on to preserve the anal sphincter, either in benign or malignant lesions. The surgeons treating this pathology should consider all options and be able to select the most adequate, the less complicated and yet be able to preserve continence. The surgeons should remember that in treating malignant lesions "a curative resection is worth a colostomy". PMID:9805095

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  14. 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.

  15. Correlates of Heterosexual Anal Intercourse Among Substance-Using Club-Goers

    PubMed Central

    Kurtz, Steven P.; Surratt, Hilary L.; Inciardi, James A.

    2010-01-01

    Anal sexual intercourse represents the highest transmission risk for infection with the human immunodeficiency virus (HIV), yet much of what we know about anal sex is based on men who have sex with men (MSM). Less is known about heterosexual adults who practice anal sex, especially those who may be at risk for HIV such as substance users. The present study examined the demographic, sexual behaviors, substance use, and psychosocial correlates of recent anal intercourse among a heterosexual young adult sample of nightclub goers who also use substances. Data were drawn from an on-going natural history study of participants (n=597) in Miami's club scene who use club drugs, use prescription medications for non-medical reasons, and were regular attendees of nightclubs. Participants who reported anal sex (n=118) were more likely to be male, of moderate income, Latino, trade sex, have unprotected sex, and report victimization. Event-based and qualitative studies are needed to better understand the context in which anal sex occurs. Interventions that target heterosexual populations should include discussion about the risks of anal sex. PMID:20217224

  16. 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.

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

    PubMed Central

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

    2014-01-01

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the underlying complexity of obstetric injury. As prevention is not always possible, immediate recognition and adequate primary treatment is of importance. PMID:24876506

  18. Chronic kidney disease

    MedlinePlus

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... Chronic kidney disease (CKD) slowly gets worse over months or years. You may not notice any symptoms for some ...

  19. 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

  20. Mineralized deposits in pulps of incompletely developed permanent monkey incisors after pulpotomy with tungsten carbide fissure burs.

    PubMed

    Heide, S; Koppang, H S

    1994-06-01

    The exposed pulp of incompletely developed permanent incisors of nine monkeys were treated with partial pulpotomy with tungsten carbide fissure burs on an air turbine equipment. The pulps were capped with calcium hydroxide (Dycal) followed by insertion of conventional amalgam. The results were studied by conventional light microscopy after 1 and 6 months. Rod-like mineralized pulpal deposits were seen in five of the nine animals, in 9 out of 67 teeth, evenly distributed at the two observation times. Also the lengths of the deposits appeared similar, while the thickness had increased markedly after 6 months. After 1 month the presence of a central vessel lumen was observed in the deposits. The results seemed to indicate that the mechanism of formation was an initial pathologic mineralization of the vessel wall, and a growth of the deposits by the elaboration of fibrous, atubular dentin on to the outside of this wall.

  1. Assessing the atmospheric and climatic effects of basaltic fissure eruptions. A case study Nornahraun, North Iceland, 2014-2015.

    NASA Astrophysics Data System (ADS)

    Gallagher, Catherine; Burton, Kevin; Thordarson, Thorvaldur; Vye-Brown, Charlotte; Brown, Richard

    2015-04-01

    A volcanic eruption's ability to release sulphur gases into the atmosphere is one of the critical factors in assessing their climatic and environmental effects, because it is directly linked to the potential H2SO4 aerosol burden produced [1]. Basaltic fissure eruptions loft large amounts of sulphur into the atmosphere because of the efficient degassing of volatiles and halogens from the magma at the vent [2-4] coupled with the high sulphur yield of basaltic magma. The common nature of this style of eruption and its products, regardless of magnitude, means that our understanding of the exact processes which influence atmospheric chemistry and environmental impact is very important. The Nornahraun fissure eruption in North Iceland that began on the 31st August 2014, has quickly become one of the best documented eruptions of its kind, through systematic monitoring and sampling by the Institute of Earth Sciences eruption team and The Icelandic Meteorological Office. As a result it is an excellent modern analogue for historic or ancient basaltic fissure eruptions, for which the amount of degassing can only be estimated through petrological and geochemical methods. It also serves as a timely testing platform for novel geochemical proxies. This study uses the exceptional sensitivity of the 187Os-187Re radiogenic system to the presence of crustal material [5], and highly siderophile stable isotopes Cu, Zn and S to indicate the chemistry and degassing of the melt carrying S to the surface. The geochemical isotopic proxies will be tested using established petrological methods and gas emission data. This study concentrates on determining the following key parameters: (1) The source of volatiles in the magma indicated though the pressure dependence of S solubility. (2) The mechanism of aerosol and gas release into the atmosphere is dictated both by the chemistry of the melt that controls the S species (H2S, SO2 or FeS2) present [6], and by the mechanism of transfer. (3) The

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

    PubMed

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

    1984-05-01

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

  3. Chronic pancreatitis.

    PubMed

    Chari, S T; DiMagno, E P

    2001-09-01

    An increasing number of novel mutations are associated with chronic pancreatitis. Some cause a high-penetrance, autosomal dominant type of clinical picture (eg, mutations at codons 29 and 122 of the cationic trypsinogen gene), whereas others have a low penetrance or are frequent in the general population (eg, mutations in Kazal type 1 [SPINK1] and in codons 16, 22, and 23 of the cationic trypsinogen gene) and act as disease modifiers. The results of recent studies indicate that smoking adversely affects the course and complications of chronic pancreatitis (more frequent and faster rate of calcification and higher risk of development of pancreatic cancer). Thus, regardless of the cause of chronic pancreatis, patients with this condition should not smoke. Using current diagnostic criteria, the accuracy of endoscopic ultrasound for the diagnosis of chronic pancreatitis is not good. For example, 39% of dyspeptic persons without any other evidence of chronic pancreatitis fulfilled the endoscopic ultrasound criteria for chronic pancreatitis. Diabetes frequently occurs in chronic pancreatitis, but it is not prevented or increased by pancreatic surgery. Islet cell autotransplantation holds promise for the prevention of diabetes in patients requiring total pancreatectomy if the pancreas is not extensively fibrotic. Splenic vein occlusion is present in 7% of patients undergoing surgery for chronic pancreatitis, but fewer than one fifth of these patients have variceal bleeding before or after surgery.

  4. Microbial diversity in endostromatolites (cf. Fissure Calcretes) and in the surrounding permafrost landscape, Haughton impact structure region, Devon Island, Canada.

    PubMed

    Pellerin, André; Lacelle, Denis; Fortin, Danielle; Clark, Ian D; Lauriol, Bernard

    2009-11-01

    In recent years, endostromatolites, which consist of finely laminated calcite columns that grow orthogonally within millimeter- to centimeter-thick fissures in limestone bedrock outcrops, have been discovered in dolomitic outcrops in the Haughton impact structure region, Devon Island, Canada. The growth mechanism of the endostromatolites is believed to be very slow and possibly intertwined with biotic and abiotic processes. Therefore, to discern how endostromatolites form in this polar desert environment, the composition of the microbial community of endostromatolites was determined by means of molecular phylogenetic analysis and compared to the microbial communities found in the surrounding soils. The microbial community present within endostromatolites can be inferred to be (given the predominant metabolic traits of related organisms) mostly aerobic and chemoheterotrophic, and belongs in large part to the phylum Actinobacteria and the subphylum Alphaproteobacteria. The identification of these bacteria suggests that the conditions within the fissure were mostly oxidizing during the growth of endostromatolite. The DNA sequences also indicate that a number of bacteria that closely resemble Rubrobacter radiotolerans are abundant in the endostromatolites as well as other Actinobacteria and Alphaproteobacteria. Some of these taxa have been associated with calcite precipitation, which suggests that the endostromatolites might in fact be microbially mediated. Bacterial communities from nearby permanently frozen soils were more diverse and harbored all the phyla found in the endostromatolites with additional taxa. This study on the microbial communities preserved in potentially microbially mediated secondary minerals in the Arctic could help in the search for evidence of life-forms near the edge of habitability on other planetary bodies.

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

    PubMed Central

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

    2015-01-01

    Aim: A study was aimed to assess the knowledge, value, opinion, and practice regarding the use of dental sealants among private dental practitioners in Chennai, Tamil Nadu, India. Materials and Methods: A self-administrated questionnaire were distributed to 192 private dental practitioners in Chennai, Tamil Nadu, India by using simple random sampling. A convenience sampling technique was employed. The questionnaire consisted of 28 items, which included information about knowledge, value, opinion, and practice regarding dental sealants. The questionnaire was obtained from the study by San Martin et al. 2013 and Kailash Asawa et al. 2014. Frequency distribution was tabulated. For frequency distribution strongly, strongly agree, and agree were combined as “agree” and strongly disagree and disagree were combined as “disagree.” There were no changes in “neutral.” Results: Among the 196 study subjects 56.2% were males and 43.8% were females with their clinical experience of 52.1% for <5 years, 35.4% for 5–10 years, and 13.5% for >15 years. The mean scores for knowledge, value, opinion, and practice were 41.8 ± 3.7, 18.7 ± 2.8, 18.1 ± 1.4, and 12.9 ± 2.3, respectively. Conclusion: The results suggest that dental practitioners had satisfactory knowledge about pit and fissure sealant and had neutral attitudes about sealants being effective. Dental practitioners adequately used the pit and fissure sealants but they did not follow the standardized procedures and specific guidelines. PMID:26942116

  6. 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.

  7. Chronic pancreatitis.

    PubMed

    Majumder, Shounak; Chari, Suresh T

    2016-05-01

    Chronic pancreatitis describes a wide spectrum of fibro-inflammatory disorders of the exocrine pancreas that includes calcifying, obstructive, and steroid-responsive forms. Use of the term chronic pancreatitis without qualification generally refers to calcifying chronic pancreatitis. Epidemiology is poorly defined, but incidence worldwide seems to be on the rise. Smoking, drinking alcohol, and genetic predisposition are the major risk factors for chronic calcifying pancreatitis. In this Seminar, we discuss the clinical features, diagnosis, and management of chronic calcifying pancreatitis, focusing on pain management, the role of endoscopic and surgical intervention, and the use of pancreatic enzyme-replacement therapy. Management of patients is often challenging and necessitates a multidisciplinary approach. PMID:26948434

  8. 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.

  9. Microleakage and penetration depth of three types of materials in fissure sealant: self-etching primer vs etching: an in vitro study.

    PubMed

    Gillet, D; Nancy, J; Dupuis, V; Dorignac, G

    2002-01-01

    Clinical preventive procedures must be done after a risk assessment. One of the risk factors is the occlusal morphology of the posterior teeth. These caries-free fissures must be sealed. This first in vitro experimentation of the study evaluated the microleakage and the penetration depth of three types of materials by Vivadent: Helioseal F, Tetric, Tetric Flow. The teeth were etched with phosphoric acid and bonded using a one bottle bonding in order to determine the best material for the sealing of the fissure. The depth of penetration of fuschine dye as well as that of the tested material was measured with a grid. The results, compared to the depth of the fissures, are expressed in percentage of penetration. The results were as follows: penetration of fuschine dye: 0% for the 2 composites, 100% for Helioseal F; penetration of the materials: 96.90% for Helioseal F, 70.82 for Tetric and 86.10 for Tetric Flow (significant difference, Wilcoxon test = 0.0105). In this first in vitro study, Tetric Flow shows no microleakage and is more efficient when compared to Helioseal F and Tetric in obturating deep fissures of non carious bicuspids. The second experiment of the study evaluated the microleakage and the penetration depth of Tetric Flow when it is bonded by two different methods: Group 1: total etch (phosphoric acid) and Scotch-bond 1 (3M), and Group 2: self-etching primer with Prompt (Espe). There was no significant difference (p > 0.03) between classical bonding vs self-etching primer. The self-etching primer Prompt is very efficient vs phosphoric acid in obturating the fissures of non carious bicuspids with Tetric Flow. It is concluded that for prevention by sealing, using a flowable ceromer (Tetric Flow) with the self-etching (Prompt), is a really good technique.

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

    PubMed

    Dimmitt Champion, Jane; Roye, Carol F

    2014-07-01

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

  11. 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.

  12. 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.

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

    PubMed Central

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

    2015-01-01

    Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed. PMID:26495147

  14. 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. PMID:25887064

  15. 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.

  16. 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.

  17. Purse-string morphology of external anal sphincter revealed by novel imaging techniques

    PubMed Central

    Bhargava, Valmik; Sheean, Geoff; Ledgerwood, Melissa; Sinha, Shantanu

    2014-01-01

    The external anal sphincter (EAS) may be injured in 25–35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a “donut-shaped” structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest “purse-string” morphology, with “EAS muscles” crossing contralaterally in the perineal body to the contralateral transverse perineal (TP) and bulbospongiosus (BS) muscles, thus attaching the EAS to the pubic rami. Spin-tag MRI demonstrated purse-string action of the EAS muscle. Electromyography of TP/BS and EAS muscles revealed their simultaneous contraction and relaxation. Lidocaine injection into the TP/BS muscle significantly reduced anal canal pressure. These studies support purse-string morphology of the EAS to constrict/close the anal canal opening. Our findings have implications for the effect of episiotomy on anal closure function and the currently used surgical technique (overlapping sphincteroplasty) for EAS reconstructive surgery to treat anal incontinence. PMID:24458022

  18. 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. PMID:25835461

  19. 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. PMID:26630979

  20. 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

  1. Complete anal sphincter complex disruption from intercourse: A case report and literature review

    PubMed Central

    Cawich, S.O.; Samuels, L.; Bambury, I.; Cherian, C.J.; Christie, L.; Kulkarni, S.

    2012-01-01

    INTRODUCTION Anal sphincter injuries are uncommon injuries outside of obstetric practice – but they may cause disastrous complications. PRESENTATION OF CASE We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after 154 days of follow up. DISCUSSION This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations. CONCLUSION Acute post-coital sphincter injuries should be treated operatively on an emergent basis, without diversion because they are low energy injuries with minimal tissue loss and excellent blood supply. Although repair of each injury should be individualized, the majority of these injuries do not require concomitant protective colostomy creation. PMID:22940697

  2. 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

  3. Human papillomavirus in anal squamous cell carcinoma: an angel rather than a devil?

    PubMed

    Ravenda, Paola Simona; Zampino, Maria Giulia; Fazio, Nicola; Barberis, Massimo; Bottiglieri, Luca; Chiocca, Susanna

    2015-01-01

    Anal cancer is a rare disease with an increasing incidence worldwide but, unfortunately, even today the scientific community still has a limited knowledge and limited options of treatment. More than 50% of patients with anal cancer presenting at diagnosis with locoregional disease have good chances of cure with chemoradiotherapy (CT-RT). However, once patients develop metastatic spread, the prognosis is very poor. Human papillomavirus (HPV) is present in more than 80% of anal cancers and while multiple etiologic connections between HPV infection and anal cancer have already been well elucidated, its prognostic and/or predictive role is currently under investigation, especially among immunocompetent patients affected by this disease. In a single-institutional set, we have retrospectively analysed clinical data of 50 consecutive cases homogeneously treated with CT-RT for stage I-III anal squamous cell carcinoma. We found that HPV-positive anal cancers had a statistically significant improved five-year disease-free survival (DFS) compared to HPV-negative group. These findings could be explained by an increased chemo/radiosensitivity of HPV-positive tumours. Further efforts should be directed towards a better understanding of HPV-related oncogenesis and towards designing novel tailored strategies for the management of this disease both in terms of prevention and treatment. PMID:25987898

  4. 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. PMID:25502520

  5. Comparison of Hybribio GenoArray and Roche Human Papillomavirus (HPV) Linear Array for HPV Genotyping in Anal Swab Samples

    PubMed Central

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

    2014-01-01

    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 χ2 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. PMID:25502520

  6. Chronic pancreatitis.

    PubMed

    Chari, S T; DiMagno, E P

    2000-09-01

    In the past year, there has been at least one important clinical paper that sheds light on the character and natural history of painful chronic pancreatitis, which has important clinical implications. In addition, several novel mutations have been described in the cationic trypsinogen gene in patients with hereditary pancreatitis. The mechanism by which these mutations cause pancreatic disease remains speculative. The diagnosis of early chronic pancreatitis is controversial. A novel noninvasive pancreatic function test (measurement of postprandial APOB-48) was reported but is unlikely to be a sensitive test of pancreatic function. Pancreatic fibrosis is frequently seen in alcoholics without chronic pancreatitis, and this makes it difficult to interpret the findings on endoscopic ultrasonogram. Recent studies highlight the difficulty in abolishing pancreatic steatorrhea. Recently fibrosing colonopathy in adult patients has been reported. Extracorporeal shockwave lithotripsy combined with endoscopic therapy failed to benefit patients with calcific chronic pancreatitis.

  7. Chronic Pain

    MedlinePlus

    ... adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting ... Institute of Neurological Disorders and Stroke (NINDS). Low Back Pain Fact Sheet Back Pain information sheet compiled by ...

  8. Ear infection - chronic

    MedlinePlus

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. ...

  9. Oscillation of a Shallow Hydrothermal Fissure Inferred from Long-Period Seismic Events at Taal Volcano, the Philippines

    NASA Astrophysics Data System (ADS)

    Maeda, Y.; Kumagai, H.; Lacson, R.; Figueroa, M. S.; Yamashina, T.

    2012-12-01

    examine H2O gas (vapor) for simplicity. We calculated far-field waveforms generated by an oscillation of a crack containing vapor, and applied the Sompi method to estimate Q and nondimensional frequency. The estimated Q of a fundamental longitudinal mode oscillation was similar to the observation. We obtained a reasonable crack size (188 m) from a comparison of the observed peak frequency (0.8 Hz) with the calculated nondimensional frequency of the mode. In the swarm period of the LP events, other anomalies such as large volcano deformation and significant increase of gas emission from the main crater were not observed. This feature and the crack model result above suggest an active and localized vapor supply from magma at depth to the LP source. Such a localized supply may be realized by a transportation of vapor through a fissure. If we assume that the estimated crack volume (10^2 m^3) corresponds to vapor supplied to the LP source for each event, the total vapor mass supplied throughout the swarm period is ~10^7 kg. If we assume that this amount of vapor was originated by degassing from the magma and transported to the LP source through the fissure, we can estimate a magma volume of ~10^6 m^3. We thus suggest that the LP events at Taal were triggered by degassing and transportation of vapor from a deep magma to a shallow depth through a fissure.

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

    PubMed Central

    2012-01-01

    Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of

  11. 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

  12. 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

  13. IMRT treatment of anal cancer with a scrotal shield

    SciTech Connect

    Hood, Rodney C.; Wu, Q. Jackie; McMahon, Ryan; Czito, Brian; Willett, Christopher

    2012-01-01

    The risk of sterility in males undergoing radiotherapy in the pelvic region indicates the use of a shielding device, which offers protection to the testes for patients wishing to maintain fertility. The use of such devices in the realm of intensity-modulated radiotherapy (IMRT) in the pelvic region can pose many obstacles during simulation, treatment planning, and delivery of radiotherapy. This work focuses on the development and execution of an IMRT plan for the treatment of anal cancer using a scrotal shielding device on a clinical patient. An IMRT plan was developed using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA), using a wide array of gantry angles as well as fixed jaw and fluence editing techniques. When possible, the entire target volume was encompassed by the treatment field. When the beam was incident on the scrotal shield, the jaw was fixed to avoid the device and the collimator rotation optimized to irradiate as much of the target as possible. This technique maximizes genital sparing and allows minimal irradiation of the gonads. When this fixed-jaw technique was found to compromise adequate coverage of the target, manual fluence editing techniques were used to avoid the shielding device. Special procedures for simulation, imaging, and treatment verification were also developed. In vivo dosimetry was used to verify and ensure acceptable dose to the gonads. The combination of these techniques resulted in a highly conformal plan that spares organs and risk and avoids the genitals as well as entrance of primary radiation onto the shielding device.

  14. Anal Intercourse among Young Heterosexuals in Three US STD Clinics

    PubMed Central

    Gorbach, Pamina M.; Manhart, Lisa E.; Hess, Kristen L.; Stoner, Bradley P.; Martin, David H.; Holmes, King K.

    2016-01-01

    Background To examine factors associated with heterosexual anal intercourse (AI). Methods Between 2001 and 2004, 890 heterosexual adults aged 18-26 attending public STD clinics in Seattle, New Orleans and St Louis were interviewed using CASI and tested for sexually transmitted infections (STI) Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, and genital herpes (HSV-2). Characteristics associated with AI were identified using logistic regression. Results Overall 289 (32%) reported ever having had AI, 201 (26.5%) reported AI with at least one of their last three partners and 17% reported AI with their last partner. Fewer females than males reported condom use at last AI (24% vs. 47%, p<0.001). Ever having AI was associated with sex on the same day as meeting a partner (AOR 3.5 [95% CI 1.94-6.15]), receiving money for sex (AOR 3.3 [1.40-7.75]), and >3 lifetime sex partners (AOR 2.2 [1.17-4.26]) among women, and sex on the same day as meeting a partner (AOR 2.0 [1.28-3.14]) and paying for sex (AOR 1.8 [1.00-3.15]) among men. AI with the last partner was associated with sex toy use (AOR 5.3 [2.35-12.0]) and having concurrent partners (AOR 2.3 [1.18-4.26]) among men, and with sex within a week of meeting (AOR 2.7 [1.21-5.83]), believing the partner was concurrent (AOR 2.6 [1.38-4.83]), and partnership duration >3 months (AOR 3.2 [1.03-10.1]) among women. Prevalent STI was not associated with AI. Conclusions Many young heterosexuals attending STD clinics reported AI, which was associated with other sexual risk behaviors, suggesting a confluence of risks for HIV infection. PMID:19265740

  15. Felching among men who engage in barebacking (unprotected anal sex).

    PubMed

    Klein, Hugh

    2012-04-01

    Felching (sucking or eating semen out of someone's anus) is a sexual behavior about which virtually nothing has been written in the scholarly literature, despite the fact that it appears to be a not-uncommon practice among certain subpopulations of men who have sex with men (MSM). This study examined three broad research questions: (1) How common is felching? (2) How does a desire for felching relate to other HIV risk practices and risk behavior preferences? (3) What factors are associated with the desire to engage in felching? The data were from a content analysis study of one of the largest Internet websites specifically targeting MSM looking for partners for unprotected sex. A total of 1,316 profiles on the site were analyzed and selected randomly based on users' ZIP codes. Felching was mentioned as a sought-after practice in approximately one-sixth of the men's profiles. Men who wanted to find felching partners were significantly more likely than those not searching for felching partners to seek other types of risky sex, including unprotected oral and unprotected anal sex, and various enhanced risk preferences (e.g., having sex while high, multiple-partner sex, unwillingness to withdraw the penis prior to internal ejaculation). Multivariate analysis revealed several factors that were related to an interest in identifying partners online for felching, including race/ethnicity, indifference to sex partners' HIV serostatus, several sensation-seeking measures (e.g., wanting "wild" or "uninhibited" sex, self-identification as a "bug chaser"), and eroticizing ejaculatory fluids. PMID:21573705

  16. Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

    PubMed

    Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

    2014-08-01

    Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered.

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

    SciTech Connect

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

    2008-05-01

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

  18. Bougie dilators: simple, safe and cost-effective treatment for Crohn’s-related fibrotic anal strictures

    PubMed Central

    Kashkooli, Soleiman B.; Samanta, Sujon; Rouhani, Mehrdad; Akbarzadeh, Shoaleh; Saibil, Fred

    2015-01-01

    Summary Anal strictures with fibrotic induration have been shown to develop in up to 50% of all patients with Crohn’s disease (CD) with anal ulceration. We evaluate the technical feasibility, safety and long-term efficacy of bougie dilation for a subgroup of patients with symptomatic Crohn’s-related fibrotic anal strictures. Bougie dilation is simple to perform, relatively inexpensive and has a low risk of complications. PMID:26204140

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

    PubMed Central

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

    2015-01-01

    AIM: To describe the anal cushion lifting (ACL) method with preliminary clinical results. METHODS: Between January to September 2007, 127 patients who received ACL method for hemorrhoid was investigated with informed consent. In this study, three surgeons who specialized in anorectal surgery performed the procedures. Patients with grade two or more severe hemorrhoids according to Goligher’s classification were considered to be indicated for surgery. The patients were given the choice to undergo either the ACL method or the ligation and excision method. ACL method is an original technique for managing hemorrhoids without excision. After dissecting the anal cushion from the internal sphincter muscle, the anal cushion was lifted to oral side and ligated at the proper position. Clinical characteristics and outcomes of patients were recorded including complications after surgery. RESULTS: A total of 127 patients were enrolled. Their median age was 42 (19-84) years, and 74.8% were female. In addition, more than 99% of the patients had grade 3 or worse hemorrhoids. The median follow-up period was 26 (0-88) mo, and the median operative time was 15 (4-30) min. After surgery, analgesics were used for a median period of three days (0-21). Pain control was achieved using extra-oral analgesic drugs, although some patients required intravenous injections of analgesic drugs. The median duration of the patients’ postoperative hospital stay was 7 (2-13) d. A total of 10 complications (7.9%) occurred. Bleeding was observed in one patient and was successfully controlled with manual compression. Urinary retention occurred in 6 patients, but it disappeared spontaneously in all cases. Recurrent hemorrhoids developed in 3 patients after 36, 47, and 61 mo, respectively. No anal stenosis or persistent anal pain occurred. CONCLUSION: We consider that the ACL method might be better than all other current methods for managing hemorrhoids. PMID:26525139

  20. 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

  1. Chronic pain.

    PubMed

    Russo, C M; Brose, W G

    1998-01-01

    Chronic pain is an emotional experience and is defined as pain lasting greater than six months. It is important to understand the neurophysiology of pain in order to treat it. Nociceptors in the periphery travel to the substantia gelatinosa of the spinal cord while secondary and tertiary afferents transmit information from the dorsal horn to the brain. Modification of pain information may take place in these ascending pathways or in descending pathways. Treatment of chronic pain is most successful when it is approached in a multidisciplinary fashion with the focus not only on treatment of underlying etiology, but also on the secondary impacts of pain on the patient's life. The management of chronic pain requires special expertise. Most of the experts in chronic pain assessment and management organize themselves into pain treatment centers. These centers vary widely in their approach to the problem. The most sophisticated is a multidisciplinary center that is university-based and includes teaching and research. Treatment of chronic pain includes a variety of medications, psychological support, and rehabilitation. Multidisciplinary pain management is also an integral part of the palliative care and hospice concept used to treat cancer pain.

  2. 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

  3. 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

  4. 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

  5. Analysis of the dental morphology of Plio-Pleistocene hominids. II. Mandibular molars--study of cusp areas, fissure pattern and cross sectional shape of the crown.

    PubMed Central

    Wood, B A; Abbott, S A; Graham, S H

    1983-01-01

    Accurate measurements of the absolute and relative size of individual cusps, the arrangement of the primary fissure system and the shape of coronal cross sections of the tooth crown have been used to investigate the pattern of variation in Plio-Pleistocene hominid mandibular molar teeth. Teeth were either grouped into one of six taxonomic categories or considered as individual cases. Univariate analysis of relative cusp areas shows that the two taxonomic categories of 'robust' hominids from East and Southern Africa have relatively small mesial cusps, but a relatively large entoconid and hypoconulid and Principal Component plots of the data show that the 'robust' categories can be distinguished on the basis of relative cusp size. Other evidence suggests that these differences are not likely to be the result of allometric phenomena. Fissure pattern was analysed using the X/Y coordinates of defined reference points. Patterns were compared by Procrustes analysis and the relationships between teeth contained in the resulting similarity matrix were portrayed using Principal Coordinates plots and a nearest neighbours table. The positions of the posterior fovea and the mesial longitudinal fissure were important for distinguishing taxonomic categories. The shape of the coronal profiles proved difficult to quantify, but there were consistent and distinct differences between the South African 'robust' sample and teeth included within the East African Homo category. When these results are combined with those of a previous study of overall crown size and the distribution of extra cusps, they allow the affinities of isolated teeth or contentious specimens to be assessed. For example, our results show that KNM-ER 1506 and 1802 are more similar to the East African Homo group than any other category, and they indicate that though SK 1587 and 1588 are small teeth, they nonetheless are closest to the South African 'robust' category in terms of relative cusp size, fissure pattern and

  6. Influence of extended light exposure curing times on the degree of conversion of resin-based pit and fissure sealant materials

    PubMed Central

    Fatima, Nazish

    2014-01-01

    Purpose The aim of present study was to evaluate extended curing times on the degree of conversion (DC) of filled and unfilled resin-based materials used as pit and fissure sealants. Materials and methods The materials examined were a flowable composite (Filtek™ Z350 XT Flowable) and a pit and fissure sealant (Clinpro™ Sealant). Thirty disks of each material were prepared. The 30 made of the flowable composite were divided into three groups (n = 10 each) according to the three different curing times studied: 20 s (group 1), 40 s (group 2), and 60 s (group 3). Similarly, the 30 disks made of the pit and fissure sealant were divided into three groups (n = 10 each) according to the three different curing times: 20 s (group 4), 40 s (group 5), and 60 s (group 6). After polymerization, the disks were removed from the mold and stored in dry, lightproof containers in an incubator at 37 °C for 24 h. The DC was obtained using an Avatar 320 FTIR spectrometer. Then the data were analyzed using the Kruskal–Wallis test and the Fisher’s least significant difference post hoc test for multiple comparisons (alpha = 0.05). Results DC values for the flowable composite (Filtek™ Z350 XT) were higher (p = 0.002) than those for the pit and fissure sealant (Clinpro™ Sealant). Group 2 and group 5 showed significantly higher DC values than group 1 and group 4, respectively. There was no difference between groups 2 and 3 or between groups 5 and 6 (p = 2.93). Conclusion An extended curing time improves the DC to some extent for both materials. PMID:25382947

  7. [Chronic cough].

    PubMed

    Schafroth Török, Salome

    2013-09-18

    In non-smokers without intake of an ACE-inhibitor, the three most common causes of chronic cough are eosinophilic airways disease (asthma or eosinophilic bronchitis), Upper-airway-cough-syndrome (UACS) and Gastro-esophageal-reflux desease (GERD). In smokers, chronic bronchitis and COPD are common causes as well. In patients with a normal chest X-ray and lack of information on a less frequent cause in history and physical examination, it is recommended therefore to routinely look for these diseases and/or to treat them empirically. PMID:24025176

  8. 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.

  9. 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. PMID:26165783

  10. Anal Human Papillomavirus Infection among HIV-Infected Men in Korea

    PubMed Central

    Lee, Chang Hun; Lee, Sun Hee; Lee, Shinwon; Cho, Heerim; Kim, Kye-Hyung; Lee, Jung Eun; Jung, Eun ju; Lee, Su jin; Kim, Eun Jung; Kim, Ki Hyung; Moon, Eunsoo; Cho, Hong Je

    2016-01-01

    Background Little is known about the epidemiology on human papillomavirus (HPV) infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea. Methods A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour. Results A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM) and 68 from men who have sex with women (MSW). Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW (P < 0.001). High-risk HPV (HR-HPV) prevalence was higher among MSM (47.4%) than MSW (25.0%; P = 0.002). The HR-HPV types identified most frequently were HPV 16 (11%), HPV 18 (9.9%), and HPV 58 (5%) in MSM, and HPV 58(11%) and HPV 16 (8.9%) in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001). Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001). In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection. Conclusion Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age. PMID:27548632

  11. Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury

    PubMed Central

    Simó González, Marta; Porta Roda, Oriol; Perelló Capó, Josep; Gich Saladich, Ignasi; Calaf Alsina, Joaquim

    2015-01-01

    The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case. PMID:25722727

  12. 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

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

    PubMed

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

    2015-01-01

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

  14. Properties of HPV-positive and HPV-negative anal carcinomas.

    PubMed

    Williams, G R; Lu, Q L; Love, S B; Talbot, I C; Northover, J M

    1996-12-01

    Evidence of human papillomavirus (HPV) can be found in up to 85 per cent of anal carcinomas. In the vulva, a discrete subset of HPV-positive carcinomas which show koilocytic morphology and distinct clinical features has recently been identified (warty carcinoma). The morphological and prognostic features of HPV-positive and HPV-negative anal carcinomas were compared in this study of the tumour distribution of HPV DNA. Vulval and anal neoplasia are similar in many ways and we have also looked to see if their similarity extends to 'warty' morphology in relation to HPV status. Thirty-five resection specimens of anal carcinoma were examined with biotin-labelled probes for HPV 6, 11, 16, and 18 DNA, using a non-isotopic in situ hybridization (ISH) technique. No tumour was found to contain HPV 6, 11, or 18. Twenty-four (72 per cent) showed positivity for HPV 16 DNA. Staining was homogeneous and independent of local squamous, basaloid, or ductal differentiation. The majority of tumours showed staining suggestive of episomal, non-productive HPV infection. HPV-positive tumours were more likely to occur in the anal canal than perianally and to show a mixed squamous and basaloid appearance. No difference between the two groups was found in patient age, presence of adjacent dysplasia, ductal differentiation, or prognosis. There was no correlation between condylomatous tumour morphology and HPV 16 DNA positivity; thus, a subset equivalent to vulval warty carcinoma could not be identified. PMID:9014857

  15. 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

  16. Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options.

    PubMed

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

    2011-10-28

    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.

  17. Chronic Bronchitis

    MedlinePlus

    ... risk for emphysema or chronic obstructive pulmonary disease (COPD)? What medicines will help relieve my symptoms? What lifestyle changes should I make at home to help relieve my symptoms? Is it safe for me to exercise? What kind of exercise should I do? What ...

  18. Chronic gastritis

    PubMed Central

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-01-01

    Abstract 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. PMID:25901896

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

    PubMed Central

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

    2016-01-01

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

  20. 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.

  1. 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

  2. Long head of biceps femoris flap in anal fistula treatment: anatomical study and case report.

    PubMed

    Terryn, F X; Leonard, D; Chateau, F

    2015-01-01

    In case of complex anal fistulae, the treatment can include muscular flaps. The gracilis transposition flap is the gold-standard in perineal reconstructive surgery, with wide use during the past decades. However, in some cases, this flap is too short to reach difficult locations such as the posterior perineum. The long head of the biceps femoris, which has already been studied in the electrically stimulated neosphincter formation, could be more appropriate in such clinical situations. Furthermore, its potential advantages, amongst which an excellent functional outcome, would be to allow persistent prone position, during both treatment and reconstruction, as well as a more favorable intramuscular vascularisation. We report the case of a 39-year-old man with a complex recurrent transphincteric posterior anal fistula with an external orifice in the right buttock and complicated with a severe cellulitis, treated with an endo-anal flap combined with a long head of biceps femoris pediculised flap. PMID:26021955

  3. 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.

  4. 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

  5. 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.

  6. Diversity of human papillomavirus in the anal canal of men: the HIM Study.

    PubMed

    Sichero, L; Nyitray, A G; Nunes, E M; Nepal, B; Ferreira, S; Sobrinho, J S; Baggio, M L; Galan, L; Silva, R C; Lazcano-Ponce, E; Giuliano, A R; Villa, L L

    2015-05-01

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

  7. 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 ...

  8. Chronic obstructive pulmonary disease

    MedlinePlus

    COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... can do to relieve symptoms and keep the disease from getting worse. If you smoke, now is ...

  9. Chronic pain - resources

    MedlinePlus

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association -- www.theacpa.org National Fibromyalgia and Chronic Pain Association -- www.fmcpaware.org ...

  10. 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.

  11. Chronic Myeloproliferative Neoplasms Treatment

    MedlinePlus

    ... Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Chronic Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Chronic ...

  12. 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

  13. 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.

  14. 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.

  15. 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. PMID:26441844

  16. 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.

  17. Chronic urticaria.

    PubMed Central

    Burrall, B. A.; Halpern, G. M.; Huntley, A. C.

    1990-01-01

    Urticaria affects 15% to 20% of the population once or more during a lifetime. Chronic urticaria is a frequent recurrent eruption over a period greater than 6 weeks; the cause remains a mystery in more than 75% of cases. Urticaria and angioedema may be produced by immunologic or nonimmunologic means. Urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias, dermatographism, cholinergic urticaria, localized heat urticaria, cold urticaria, aquagenic urticaria, and vibratory angioedema all require specific evaluation and treatment. Chronic idiopathic urticaria is usually controlled by antihistamines; depending on the circadian rhythm of the eruption, sedative or nonsedative antihistamines are prescribed. Some patients will require a combination of H1 and H2 antagonists, or even parenteral corticosteroids. PMID:1970697

  18. Segmental and descending control of the external urethral and anal sphincters in the cat.

    PubMed Central

    Mackel, R

    1979-01-01

    1. The present work concerns the contribution of the somatic central nervous system to two viscero-somatic reflexes, micturition and defecation. Descending and segmental actions and properties of the motoneurones innervating the striated external urethral and external anal sphincters were studied with intracellular recording in male cats, under chloralose anaesthesia. 2. Motoneurones innervating the external urethral and external anal sphincters were intermingled and most strongly concentrated in the lateral part of the ventral horn in the S2 segment of the spinal cord. 3. Stimulation of the S1 to S3 ipsilateral dorsal roots or of the homonymous pudendal nerve branches showed that less than half of the sphincter motoneurons receive monosynaptic excitatory connexions from low threshold afferents. 4. The after-hyperpolarization recorded in the external urethral and external anal sphincter motoneurones was relatively short lasting, not long lasting as would have been expected for motoneurones innervating slow-twitch, tonic type muscles. 5. There was no evidence for recurrent inhibition in pudendal motoneurones innervating the external urethral and external anal sphincters. 6. Descending excitation and inhibition to the sphincter motoneurones originated in the nucleus reticularis gigantocellularis of the medullary reticular formation. The descending reticulospinal actions are comparable to those observed in hind limb motoneurones. 7. It is suggested that the segmental reflex connexions play a role in controlling bladder and rectal continence. The descending actions studied also modulate the segmental reflex actions and may provide voluntary control of the sphincter muscles. PMID:512936

  19. 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.

  20. Manitoba-oculo-tricho-anal (MOTA) syndrome is caused by mutations in FREM1

    PubMed Central

    Slavotinek, Anne M; Baranzini, Sergio E; Schanze, Denny; Labelle-Dumais, Cassandre; Short, Kieran M; Chao, Ryan; Yahyavi, Mani; Bijlsma, Emilia K; Chu, Catherine; Musone, Stacey; Wheatley, Ashleigh; Kwok, Pui-Yan; Marles, Sandra; Fryns, Jean-Pierre; Maga, A Murat; Hassan, Mohamed G; Gould, Douglas B; Madireddy, Lohith; Li, Chumei; Cox, Timothy C; Smyth, Ian; Chudley, Albert E; Zenker, Martin

    2014-01-01

    Background Manitoba-oculo-tricho-anal (MOTA) syndrome is a rare condition defined by eyelid colobomas, cryptophthalmos and anophthalmia/ microphthalmia, an aberrant hairline, a bifid or broad nasal tip, and gastrointestinal anomalies such as omphalocele and anal stenosis. Autosomal recessive inheritance had been assumed because of consanguinity in the Oji-Cre population of Manitoba and reports of affected siblings, but no locus or cytogenetic aberration had previously been described. Methods and results This study shows that MOTA syndrome is caused by mutations in FREM1, a gene previously mutated in bifid nose, renal agenesis, and anorectal malformations (BNAR) syndrome. MOTA syndrome and BNAR syndrome can therefore be considered as part of a phenotypic spectrum that is similar to, but distinct from and less severe than, Fraser syndrome. Re-examination of Frem1bat/bat mutant mice found new evidence that Frem1 is involved in anal and craniofacial development, with anal prolapse, eyelid colobomas, telecanthus, a shortened snout and reduced philtral height present in the mutant mice, similar to the human phenotype in MOTA syndrome. Conclusions The milder phenotypes associated with FREM1 deficiency in humans (MOTA syndrome and BNAR syndrome) compared to that resulting from FRAS1 and FREM2 loss of function (Fraser syndrome) are also consistent with the less severe phenotypes resulting from Frem1 loss of function in mice. Together, Fraser, BNAR and MOTA syndromes constitute a clinically overlapping group of FRAS–FREM complex diseases. PMID:21507892

  1. 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%…

  2. 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

  3. 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. PMID:27480402

  4. 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. PMID:18574114

  5. High reproducibility of histological diagnosis of human papillomavirus-related intraepithelial lesions of the anal canal.

    PubMed

    Roberts, Jennifer M; Jin, Fengyi; Thurloe, Julia K; Biro, Clare; Poynten, Isobel M; Tabrizi, Sepehr N; Fairley, Christopher K; Templeton, David J; Carr, Andrew D; Garland, Suzanne M; Hillman, Richard J; Cornall, Alyssa M; Grulich, Andrew E; Farnsworth, Annabelle

    2015-06-01

    In a natural history study of anal human papillomavirus (HPV) infection and HPV-related lesions, we examined the reproducibility of histological high-grade squamous intraepithelial lesion (HSIL). Three expert anogenital pathologists share the reporting of histological specimens from the Study of the Prevention of Anal Cancer (SPANC), utilising Lower Anogenital Squamous Terminology (LAST) criteria. In total, 194 previously reported biopsies were randomly chosen within diagnostic strata [50 HSIL-anal intraepithelial neoplasia (AIN) 3; 45 HSIL-AIN 2; 49 'flat' low-grade squamous intraepithelial lesion (LSIL); 50 'exophytic' LSIL; and 50 negative for squamous intraepithelial lesion] and reviewed by each of these three pathologists. Consensus was defined as agreement between at least two review diagnoses, using a binary classification of HSIL and non-HSIL, or if consensus was not obtained in this way, it was achieved through a multiheader microscope session by the three pathologists. We found very high agreement between original and consensus diagnoses (Kappa = 0.886) and between each pathologist's review and consensus (Kappas = 0.926, 0.917 and 0.905). Intra-observer agreement for the three pathologists was 0.705, 1.000 and 0.854. This high level of diagnostic reproducibility indicates that the findings of SPANC should be robust and provide reliable information about HPV-related anal canal disease. PMID:25938361

  6. Human papillomavirus genotypes in human immunodeficiency virus-positive patients with anal pathology in Madrid, Spain

    PubMed Central

    2013-01-01

    Background We studied anal specimens to determine the distribution of human papillomavirus (HPV) genotypes and co-infection occurrence. This information will contribute to the knowledge of HPV genotype distributions and provide an estimate of the prevalence of different oncogenic HPV genotypes found in patients in Madrid (Spain). Methods We studied a total of 82 anal biopsies from the Hospital General Universitario Gregorio Marañón of Madrid. These included 4 specimens with benign lesions, 52 specimens with low-grade anal squamous intraepithelial lesion, 24 specimens with high-grade anal squamous intraepithelial lesions and 2 specimens with invasive anal carcinoma. HPV genotyping was performed with PCR amplification and reverse dot blot hybridization. Results We detected 33 different HPV genotypes, including 16 HPVs associated with a high risk of carcinogenesis, 3 HPVs associated with a highly likely risk of carcinogenesis and 14 HPVs associated with a low-risk of carcinogenesis. In two specimens, an uncharacterized HPV genotype was detected. The most frequent HPV genotypes found were HPV-16 (10.3%; 95% CI: 6.6%-15.1%), HPV-52 (8.5%; 95% CI: 5.2%-13%) and HPV-43/44 (7.6%; 95% CI: 4.5%-11.9%). HPV-18 was only detected in 0.9% (95% CI: 0.1%-3.2%) of the total viruses detected in all lesions. HPV co-infections were found in 83.9% of all types of lesions. The majority of cases (90.2%) were concomitantly infected with the human immunodeficiency virus (HIV). Conclusion The prevalence of high-risk carcinogenic genotypes in anal pathological samples was remarkable. Therefore, further studies that include a greater number of samples, particularly invasive carcinoma cases are needed to evaluate the potential influence of these HPV genotypes in the appearance of anal carcinomas. Also, the influence of other accompanying infections should be evaluated clarify the appearance of this type of carcinoma. Virtual slides The virtual slide(s) for this article can be found here

  7. Efficacy and safety of helical tomotherapy with daily image guidance in anal canal cancer patients.

    PubMed

    De Bari, Berardino; Jumeau, Raphael; Bouchaab, Hasna; Vallet, Véronique; Matzinger, Oscar; Troussier, Idriss; Mirimanoff, René-Olivier; Wagner, Anna Dorothea; Hanhloser, Dieter; Bourhis, Jean; Ozsahin, Esat Mahmut

    2016-06-01

    Background and purpose Intensity-modulated radiotherapy (IMRT), also using volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) techniques, has been only recently introduced for treating anal cancer patients. We report efficacy and safety HT, and daily image-guided RT (IGRT) for anal cancer. Materials and methods We retrospectively analyzed efficacy and toxicity of HT with or without chemotherapy for anal cancer patients. Local control (LC) and grade 3 or more toxicity rate (CTC-AE v.4.0) were the primary endpoints. Overall (OS), disease-free (DFS), and colostomy-free survival (CFS) are also reported. Results Between October 2007 and May 2014, 78 patients were treated. Fifty patients presented a stage II or stage IIIA (UICC 2002), and 33 presented a N1-3 disease. Radiotherapy consisted of 36 Gy (1.8 Gy/fraction) delivered on the pelvis and on the anal canal, with a sequential boost up to 59.4 Gy (1.8 Gy/fraction) delivered to the anal and to nodal gross tumor volumes. Concomitant chemotherapy was delivered in 73 patients, mainly using mitomycin C and 5-fluorouracil (n = 30) or mitomycin C and capecitabine combination (n = 37). After a median follow-up period of 47 months (range 3-75), the five-year LC rate was 83.8% (95% CI 76.2-91.4%). Seven patients underwent a colostomy because of local recurrence (n = 5) or pretreatment dysfunction (n = 2). Overall incidence of grade 3 acute toxicity was 24%, mainly as erythema (n = 15/19) or diarrhea (n = 7/19). Two patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Conclusions HT with daily IGRT is efficacious and safe in the treatment of anal canal cancer patients, and is considered in our department standard of care in this clinical setting. PMID:27034083

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Experience with a new prosthetic anal sphincter in three coloproctological centres

    PubMed Central

    2013-01-01

    Background Fecal incontinence is a common and severely disabling disorder. For patients with severe fecal incontinence, surgery may prove to be the only adequate treatment option. Methods This study reports on 43 patients that were treated with a prosthetic sphincter system between 2005 and 2009 in three coloproctological centres. Main Outcome Measures: complications, anal pressures before and after surgery, fecal continence score. Results The new artificial sphincter system significantly improves continence but leads to some complications in clinical practice. After implantation of the device, continence improved significantly (Keller & Jostarndt continence score 2.6 to 14.3 (P < 0.01)). With the band activated, resting pressure improved significantly as compared to baseline (10.7 mmHg vs. 66.1 mm Hg, P < 0.01). The same holds for anal sphincter squeeze pressure (32.2 mmHg versus 85.9 mm Hg, P < 0.01). Complications occurred in 21 patients (48.8%): 10 surgical and 13 technical. Two patients were affected by both technical and surgical problems. The median time of the occurrence was 3 months postop. In five patients difficulties arose within the first postoperative month leading to explantation of the device in three patients. 90% of complications occurred in the first year. Conclusions The soft anal band of AMI (AAS), a new artificial anal sphincter, improves severe anal incontinence, but it must be regarded as a last treatment option to avoid a stoma. PMID:24502440

  13. 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.

  14. Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer

    SciTech Connect

    Peeters, Stephanie T.H.; Lebesque, Joos V. . E-mail: j.lebesque@nki.nl; Heemsbergen, Wilma D.; Putten, Wim L.J. van; Slot, Annerie; Dielwart, Michel F.H.; Koper, Peter C.M.

    2006-03-15

    Purpose: To identify dosimetric parameters derived from anorectal, rectal, and anal wall dose distributions that correlate with different late gastrointestinal (GI) complications after three-dimensional conformal radiotherapy for prostate cancer. Methods and Materials: In this analysis, 641 patients from a randomized trial (68 Gy vs. 78 Gy) were included. Toxicity was scored with adapted Radiation Therapy Oncology Group/European Organization for the Research and Treatment of Cancer (RTOG/EORTC) criteria and five specific complications. The variables derived from dose-volume histogram of anorectal, rectal, and anal wall were as follows: % receiving {>=}5-70 Gy (V5-V70), maximum dose (D{sub max}), and mean dose (D{sub mean}). The anus was defined as the most caudal 3 cm of the anorectum. Statistics were done with multivariate Cox regression models. Median follow-up was 44 months. Results: Anal dosimetric variables were associated with RTOG/EORTC Grade {>=}2 (V5-V40, D{sub mean}) and incontinence (V5-V70, D{sub mean}). Bleeding correlated most strongly with anorectal V55-V65, and stool frequency with anorectal V40 and D{sub mean}. Use of steroids was weakly related to anal variables. No volume effect was seen for RTOG/EORTC Grade {>=}3 and pain/cramps/tenesmus. Conclusion: Different volume effects were found for various late GI complications. Therefore, to evaluate the risk of late GI toxicity, not only intermediate and high doses to the anorectal wall volume should be taken into account, but also the dose to the anal wall.

  15. 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

  16. Transient Source Processes Prior to the March 2011 Kamoamoa Fissure Eruption, Kīlauea Volcano, Hawaíi

    NASA Astrophysics Data System (ADS)

    Lundgren, P.; Poland, M. P.; Miklius, A.; Anderson, K. R.

    2014-12-01

    Interferometric synthetic aperture radar (InSAR) and continuous GPS observations at the summit of Kīlauea Volcano, Hawaíi, show spatially and temporally transient surface displacements in the months and weeks before the 5-9 March 2011 Kamoamoa fissure eruption. Interferograms computed from the Italian Space Agency's COSMO-SkyMed satellites and the German Aerospace Center's TerraSAR-X satellite show a distinctive triangular pattern of surface deformation that extends to the SE of Kīlauea Caldera starting approximately one month prior to the Kamoamoa eruption. GPS and electronic tilt meter time series for sites in the vicinity of this deformation show that this inflation transient is superimposed on the longer (~4-6 month) summit inflation. We examine and model the spatiotemporal evolution of the summit deformation. InSAR data from ascending and descending tracks are used to constrain models of the transient. To achieve low-levels of atmospheric phase noise required interferograms spanning four months prior to the eruption, thus involving multiple sources within the summit region (see figure). To solve for model parameters we use a Markov Chain Monte Carlo optimization approach. First, we model the co-eruption summit deflation to isolate the intra-caldera sources, consisting of a steeply dipping tensile dislocation (D) beneath the western edge of the caldera and a sub-horizontal, NE trending spheroidal pressure source (Y) in the center of the caldera at 1.5 km depth. We use these sources as starting models for the pre-eruption transient, which requires the addition of a sill (S) to explain the deformation that extends to the SE of the caldera. In a third step we add a simplified model for Kīlauea's rifts and basal detachment system to explain the coupled summit and south flank motion. Modeled at over 3 km beneath the surface, the transient sill source inflates over the month before the eruption and deflates during the four-day eruption. The sill runs parallel to

  17. 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

  18. 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

    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.

  19. Glass ionomer ART sealant and fluoride-releasing resin sealant in fissure caries prevention – results from a randomized clinical trial

    PubMed Central

    2014-01-01

    Background The relative performance of ART sealant and fluoride-releasing resin sealant in preventing fissure caries in permanent molars was compared in a randomized clinical trial conducted in southern China (ClinicalTrials.gov NCT01829334). Methods After obtaining ethical approval, healthy schoolchildren who had permanent first molars with occlusal fissures which were sound but deep or presented with only incipient caries were recruited for the study. Included molars were randomly allocated into one of four parallel study groups in units of left/right teeth per mouth. Two of the four groups adopted the methods of ART or fluoride-releasing resin sealant placement while the other two groups adopted the topical fluoride application methods. Fissure status of the molars in each group was evaluated every 6 months. Development of dentine caries and sealant retention over 24 months in the molars in the two sealant-using groups was compared in this report. Outcome on cost-effectiveness of all four groups over 36 months will be reported elsewhere. Results At baseline, a total of 280 children (383 molars) with mean age 7.8 years were involved for the two sealant groups. After 24 months, 261 children (357 molars) were followed. Proportions of molars with dentine caries were 7.3% and 3.9% in the ART sealant and fluoride-releasing resin sealant groups, respectively (chi-square test, p = 0.171). Life-table survival analysis showed that sealant retention (full and partial) rate over 24 months for the resin sealant (73%) was significantly higher than that (50%) for the ART sealant (p < 0.001). Molar survival (no development of dentine caries) rates in the ART sealant (93%) and fluoride-releasing resin sealant (96%) groups were not significantly different (p = 0.169). Multilevel logistic regression (GEE modeling) accounting for the effects of data clustering and confounding factors confirmed this finding. Conclusions Though the retention of fluoride

  20. 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.

  1. 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

  2. Papillary Immature Metaplasia of the Anal Canal: A Low-grade Lesion That Can Mimic a High-grade Lesion.

    PubMed

    Roberts, Jennifer M; Cornall, Alyssa M; Ekman, Deborah; Law, Carmella; Poynten, I Mary; Jin, Fengyi; Hillman, Richard J; Templeton, David J; Tabrizi, Sepehr N; Garland, Suzanne M; Thurloe, Julia K; Grulich, Andrew E; Farnsworth, Annabelle

    2016-03-01

    In a natural history study of anal human papillomavirus (HPV) infection and HPV-related lesions among homosexual men in Sydney, Australia, we identified 15 examples of papillary immature metaplasia (PIM) in anal biopsy samples. PIM has previously been described in the cervix, but not in the anal canal. PIM is a form of exophytic low-grade squamous intraepithelial lesion (eLSIL) also known as condyloma. In contrast to the maturing keratinocytes and koilocytosis seen in conventional eLSIL, the slender papillary structures of PIM have a surface population of immature squamous cells. In our anal samples PIM was characterized by close proximity to conventional eLSIL, was negative for p16 (p16) expression, and revealed the presence of a single low-risk HPV genotype (either 6 or 11) in laser capture microdissected lesions. The clinical significance of recognizing PIM lies in preventing misdiagnosis as high-grade squamous intraepithelial lesion, (the presumed precursor to anal cancer), due to the morphologic immaturity of the cell population. In routine practice, awareness of anal canal PIM and p16 immunostaining will prevent this. Further study of the natural history of anal canal PIM is needed. PMID:26551619

  3. Genetic Architecture of the Variation in Male-Specific Ossified Processes on the Anal Fins of Japanese Medaka.

    PubMed

    Kawajiri, Maiko; Fujimoto, Shingo; Yoshida, Kohta; Yamahira, Kazunori; Kitano, Jun

    2015-10-28

    Traits involved in reproduction evolve rapidly and show great diversity among closely related species. However, the genetic mechanisms that underlie the diversification of courtship traits are mostly unknown. Japanese medaka fishes (Oryzias latipes) use anal fins to attract females and to grasp females during courtship; the males have longer anal fins with male-specific ossified papillary processes on the fin rays. However, anal fin morphology varies between populations: the southern populations tend to have longer anal fins and more processes than the northern populations. In the present study, we conducted quantitative trait locus (QTL) mapping to investigate the genetic architecture underlying the variation in the number of papillary processes of Japanese medaka fish and compared the QTL with previously identified QTL controlling anal fin length. First, we found that only a few QTL were shared between anal fin length and papillary process number. Second, we found that the numbers of papillary processes on different fin rays often were controlled by different QTL. Finally, we produced another independent cross and found that some QTL were repeatable between the two crosses, whereas others were specific to only one cross. These results suggest that variation in the number of papillary processes is polygenic and controlled by QTL that are distinct from those controlling anal fin length. Thus, different courtship traits in Japanese medaka share a small number of QTL and have the potential for independent evolution.

  4. Genetic Architecture of the Variation in Male-Specific Ossified Processes on the Anal Fins of Japanese Medaka

    PubMed Central

    Kawajiri, Maiko; Fujimoto, Shingo; Yoshida, Kohta; Yamahira, Kazunori; Kitano, Jun

    2015-01-01

    Traits involved in reproduction evolve rapidly and show great diversity among closely related species. However, the genetic mechanisms that underlie the diversification of courtship traits are mostly unknown. Japanese medaka fishes (Oryzias latipes) use anal fins to attract females and to grasp females during courtship; the males have longer anal fins with male-specific ossified papillary processes on the fin rays. However, anal fin morphology varies between populations: the southern populations tend to have longer anal fins and more processes than the northern populations. In the present study, we conducted quantitative trait locus (QTL) mapping to investigate the genetic architecture underlying the variation in the number of papillary processes of Japanese medaka fish and compared the QTL with previously identified QTL controlling anal fin length. First, we found that only a few QTL were shared between anal fin length and papillary process number. Second, we found that the numbers of papillary processes on different fin rays often were controlled by different QTL. Finally, we produced another independent cross and found that some QTL were repeatable between the two crosses, whereas others were specific to only one cross. These results suggest that variation in the number of papillary processes is polygenic and controlled by QTL that are distinct from those controlling anal fin length. Thus, different courtship traits in Japanese medaka share a small number of QTL and have the potential for independent evolution. PMID:26511497

  5. [Chronic prostatitis with chronic pelvic pain syndrome].

    PubMed

    Balvocius, Antanas

    2002-01-01

    Almost 10% of the adult male population suffer from prostatitis. The International Prostatitis Collaborative Network has devised and validated a clinically useful classification of prostatitis that urologists and primary care clinicians will find helpful. According to this schema, chronic bacterial prostatitis is clearly an infectious disease, and patients with chronic prostatitis associated with chronic pelvic pain syndrome can have either inflammatory or noninflammatory disease. Chronic bacterial prostatitis is uncommon, chronic nonbacterial prostatitis (CPPS) is extremely common. Antibiotic therapy is indicated in management of chronic bacterial prostatitis and inflammatory chronic pelvic pain syndrome. Fluoroquinolones are safe and effective in managing chronic bacterial prostatitis. Based on literature, noninflammatory chronic pelvic pain syndrome can be treated using adrenergic blockade, analgesic, tricyclic antidepressants, benzodiazepie, physical therapy. PMID:12556633

  6. 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.

  7. 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

  8. 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

  9. 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

  10. Chronic Pain Medicines

    MedlinePlus

    ... Treatment of chronic pain usually involves medicines and therapy. Medicines used for chronic pain include pain relievers, antidepressants and anticonvulsants. Different types of medicines help ...

  11. 18O/16O studies of fossil fissure fumaroles from the Valley of Ten Thousand Smokes, Alaska

    NASA Astrophysics Data System (ADS)

    Warner Holt, Elizabeth; Taylor, Hugh

    2001-03-01

    At three sample sites where there are good exposures of the upper 15 m of the 1912 ash-flow sheet in the Valley of Ten Thousand Smokes (VTTS), Alaska, 18O/16O studies indicate that fumarolic activity produced a very wide range of δ18O values (-0.1 to +12.6; n=32) in the groundmass adjacent to fossil fissure fumaroles. This contrasts sharply with the uniformity of δ18O in the groundmass away from fumarolic conduits (δ18O=+5.9 to +7.1; n=7) and in all of the feldspar phenocrysts (δ18O=+6.11 to +7.51 for 11 samples from this study and Hildreth 1987), independent of whether these were collected from fossil fumaroles or from unaltered tuff. Only one sample contained feldspars that were even slightly 18O-enriched relative to the others (cloudy plagioclase δ18O=+8.45), and this sample also contained the most 18O-enriched groundmass of any of those analyzed (δ18O=+12.6). This preservation of primary magmatic δ18O values in the VTTS feldspar phenocrysts is clearly a consequence of the extremely short time span (i.e., 1912 to 1923) of vigorous, high-temperature, fumarolic activity in the 1912 ash-flow sheet. These 18O/16O systematics are strikingly similar to those discovered in the 2.8-Ma intracaldera Chegem Tuff (Gazis et al. 1996) and in the fossil fumaroles in the outflow sheet of the 0.76 Ma Bishop Tuff (Holt and Taylor 1998), thus confirming that a similar type of fumarolic meteoric-hydrothermal activity occurred above the zone of intense welding in all three of these ash-flow tuffs. This is particularly important, because it provides a direct linkage between the older tuffs and the actual observations at the VTTS of steam chemistry, water/rock interaction, circulation geometry, flow velocities, and fumarolic temperatures (up to 645°C). The 18O/16O effects in the VTTS can all be explained in terms of a two-stage history: (a) an early, 10- to 15-year-long, high-temperature (>450°C), fumarolic 18O-depletion event (groundmass δ18O=-0.1 to +4.8); and (b) a

  12. 18O/16O studies of fossil fissure fumaroles from the Valley of Ten Thousand Smokes, Alaska

    NASA Astrophysics Data System (ADS)

    Holt, Elizabeth Warner; Taylor, Hugh P.

    2001-06-01

    At three sample sites where there are good exposures of the upper 15 m of the 1912 ash-flow sheet in the Valley of Ten Thousand Smokes (VTTS), Alaska, 18O/16O studies indicate that fumarolic activity produced a very wide range of δ18O values (-0.1 to +12.6; n=32) in the groundmass adjacent to fossil fissure fumaroles. This contrasts sharply with the uniformity of δ18O in the groundmass away from fumarolic conduits (δ18O=+5.9 to +7.1; n=7) and in all of the feldspar phenocrysts (δ18O=+6.11 to +7.5 1 for 11 samples from this study and Hildreth 1987), independent of whether these were collected from fossil fumaroles or from unaltered tuff. Only one sample contained feldspars that were even slightly 18O-enriched relative to the others (cloudy plagioclase δ18O=+8.45). and this sample also contained the most 180-enriched groundmass of any of those analyzed (δ18O=+12.6). This preservation of primary magmatic δ18O values in the VTTS feldspar phenocrysts is clearly a consequence of the extremely short time span (i.e., 1912 to ≈1923) of vigorous, high-temperature, fumarolic activity in the 1912 ash-flow sheet. These 18O/l6O systematica are strikingly similar to those discovered in the 2.8-Ma intracaldera Chegem Tuff (Gazis et al. 1996) and in the fossil fumaroles in the outflow sheet of the 0.76 Ma Bishop Tuff (Holt and Taylor 1998), thus confirming that a similar type of fumarolic meteoric-hydro-thermal activity occurred above the zone of intense welding in all three of these ash-flow tuffs. This is particularly important, because it provides a direct linkage between the older tuffs and the actual observations at the VTTS of steam chemistry, water/rock interaction, circulation geometry, flow velocities, and fumarolic temperatures (up to 645°C). The 18O/l6O effects in the VTTS can all be explained in terms of a two-stage history: (a) an early, 10- to 15-year-long, high-temperature (τ;450°C), fumarolic 18O-depletion event (groundmass δ18O=-0.1 to +4.8); and (b) a

  13. 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

  14. Anal Cancer Screening: Barriers and Facilitators Among Ethnically Diverse Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men

    PubMed Central

    Newman, Peter A.; Roberts, Kathleen J.; Masongsong, Emmanuel; Wiley, D. J.

    2010-01-01

    Knowledge and beliefs about anal cancer screening among gay and other men who have sex with men remains unclear, despite data that suggests significant risk for intra-anal HPV-related cancers. Nevertheless, community-based screening activities may be most effective when stake-holder perspectives are addressed. We conducted four focus groups among 16 male and 3 female health care advocates experienced in working with diverse gay and other men who have sex with men in Los Angeles. Barriers to anal cancer screening included lack of awareness, stigma, psychological and physical discomfort, the anus as hidden/private, primary concern with HIV, and men's lack of healthcare seeking. Facilitators were community screening sites, novel strategies such as home testing, health care system changes and targeted educational campaigns, which may increase anal cancer awareness and screening among ethnically diverse men who have sex with men. PMID:21165164

  15. Infusing Swanson's Theory of caring into an advanced practice nursing model for an infectious diseases anal dysplasia clinic.

    PubMed

    Ahern, Richard L; Corless, Inge B; Davis, Sheila M; Kwong, Jeffrey J

    2011-01-01

    The incidence of anal cancer is increasing among HIV-infected men and women. The process of screening for anal dysplasia and the management of abnormal findings are currently and most often based on a medical model. The needs of these patients, however, go well beyond medical care. A more comprehensive and holistic approach to health care is, therefore, required. Given the scope of practice of advanced practice nurses who are involved in the diagnosis and treatment of patients with anal dysplasia, it is appropriate for them to assume leadership roles in addressing the needs of these patients. This article describes the application of a theory of caring to create an advanced practice nursing model of care for HIV-infected men and women in infectious diseases anal dysplasia clinics. PMID:22035527

  16. Of mice and men: an introduction to mouseology or, anal eroticism and Disney.

    PubMed

    Berger, A A

    1991-01-01

    This essay deals with two important comics, Walt Disney's Mickey Mouse and George Herriman's Krazy Kat, and considers the social, cultural, psychological and symbolic significance of the main characters and their creators. In the discussion of Disney and his work (based, in part on writings about him) it is suggested that he exhibited traits associated with anal eroticism, which raises an interesting question about the popularity of his work with the American public. The two dominant themes found in Krazy Kat are described as "the triumph of illusion over reality" and "anti-authoritarianism." In a comparison of the two characters, it is shown they are polar opposites: Mickey Mouse is sadistic, asexual, and anal while Ignatz Mouse, the hero of Krazy Kat, is playful, sexual, and phallic.

  17. Of mice and men: an introduction to mouseology or, anal eroticism and Disney.

    PubMed

    Berger, A A

    1991-01-01

    This essay deals with two important comics, Walt Disney's Mickey Mouse and George Herriman's Krazy Kat, and considers the social, cultural, psychological and symbolic significance of the main characters and their creators. In the discussion of Disney and his work (based, in part on writings about him) it is suggested that he exhibited traits associated with anal eroticism, which raises an interesting question about the popularity of his work with the American public. The two dominant themes found in Krazy Kat are described as "the triumph of illusion over reality" and "anti-authoritarianism." In a comparison of the two characters, it is shown they are polar opposites: Mickey Mouse is sadistic, asexual, and anal while Ignatz Mouse, the hero of Krazy Kat, is playful, sexual, and phallic. PMID:1856466

  18. 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.

  19. Partial bowel obstruction in a 2-month-old child. A delayed diagnosis of anal abuse.

    PubMed

    Aprile, Anna; Cesca, Eleonora; Cecchetto, Giovanni; Viel, Guido; Mognato, Guendalina; Gamba, Piergiorgio

    2009-11-20

    We present the case of an anal sexual abuse involving a 2-month-old boy, who was admitted to the Pediatric Surgery Unit of the University of Padua for low bowel obstruction. The infant had been already hospitalized for 3 days in a peripheral hospital and treated with daily rectal wash-outs for a fecaloma. Only after a careful interpretation of the plain abdominal radiograph, along with the performance of a rectoscopy and a laparotomy, a vegetable foreign body (about 3 cm in diameter and 7 cm in length) was discovered in the sigma. The morphology and dimensions of the foreign body, as well as its location, left no doubt about the etiology of the partial bowel obstruction, proving that it was clearly related to an anal sexual abuse. PMID:19767161

  20. 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. PMID:19733331

  1. 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

  2. Anoscopy

    MedlinePlus

    ... is a method to look at the: Anus Anal canal Lower rectum How the Test is Performed ... may be used to determine whether you have: Anal fissures Anal polyps Hemorrhoids Infection Inflammation Tumors Normal ...

  3. 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

  4. 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

  5. Amines in the marking fluid and anal sac secretion of the tiger, Panthera tigris.

    PubMed

    Banks, G R; Buglass, A J; Waterhouse, J S

    1992-01-01

    Analysis of the marking fluid of two tigers (one Bengal and one Sumatran) by GC using an amine-specific column and a nitrogen-specific detector has shown the presence of the following amines: ammonia, methylamine, dimethylamine, trimethylamine, triethylamine, propylamine, and butane-1,4-diamine (putrescine). In contrast to previously published reports, we were unable to detect 2-phenylethylamine. The anal sac secretion was found to have a similar amine content.

  6. 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.

  7. 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

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

    PubMed

    Glynne-Jones, R; Nilsson, P J; Aschele, C; Goh, V; Peiffert, D; Cervantes, A; Arnold, D

    2014-10-01

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30%-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5%-8% at onset, and rates of metastatic progression after primary treatment between 10 and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80%-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer. PMID:25239441

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

    PubMed

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

    2014-06-01

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5-8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer. PMID:24947004

  10. Amines in the marking fluid and anal sac secretion of the tiger, Panthera tigris.

    PubMed

    Banks, G R; Buglass, A J; Waterhouse, J S

    1992-01-01

    Analysis of the marking fluid of two tigers (one Bengal and one Sumatran) by GC using an amine-specific column and a nitrogen-specific detector has shown the presence of the following amines: ammonia, methylamine, dimethylamine, trimethylamine, triethylamine, propylamine, and butane-1,4-diamine (putrescine). In contrast to previously published reports, we were unable to detect 2-phenylethylamine. The anal sac secretion was found to have a similar amine content. PMID:1388518

  11. Apparent lack of prognostic value of MIB-1 index in anal carcinomas treated by radiotherapy.

    PubMed Central

    Allal, A. S.; Alonso-Pentzke, L.; Remadi, S.

    1998-01-01

    This study was conducted to investigate the influence of Mib-1 index on outcome in 55 patients with T1-4 anal carcinomas treated radically by radiotherapy (RT) alone (24) or by concomitant chemo-radiotherapy (31). Median follow-up for surviving patients was 94 months (range 17-179 months). Tissue materials were obtained from pretreatment biopsies. A modified immunoperoxidase technique consisting of microwave heating of routinely processed material was employed using the Mib-1 antibody (Immunotech, 1:50). The median Mib-1 index for all patients was 53% (range 18-96%). Subgroups of patients with high vs low Mib-1 indices (separated by the median value) had statistically similar outcomes regarding 5-year overall survival (64% vs 65% P = 0.7), locoregional control (77% vs 69%, P = 0.5) and disease-free survival (73% vs 66%, P = 0.5). Moreover, no significant association was found between mean Mib-1 indices and various clinicopathological parameters studied (age, sex, circumferential tumour extent, T-stage, N-stage and histological type). In conclusion, Mib-1 index failed to predict the outcome of patients with anal carcinomas treated conservatively by radiotherapy with or without chemotherapy. It is noteworthy that the median Mib-1 index observed in anal carcinomas in this study was among the highest yet reported for cancers of epithelial origin. PMID:9579842

  12. 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

  13. 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. PMID:27648159

  14. [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. PMID:27614499

  15. 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

  16. A new approach to the management of epidermoid carcinoma of the anal canal

    SciTech Connect

    Papillon, J.; Mayer, M.; Montbarbon, J.F.; Gerard, J.P.; Chassard, J.L.; Bailly, C.

    1983-05-15

    Until recently most squamous cell carcinomas of the anal canal were treated by radical surgery. Radiation therapy was only considered for palliation in case of inoperable tumors. Important progress has been made in the knowledge of the natural history of the disease and in the field of radiotherapy. Anal canal squamous cell carcinoma should not be treated any longer by the same procedure as adenocarcinoma of the lower rectum, because both these diseases differ markedly. Multimodality therapy with radiotherapy as first approach has been considered. This series of 121 cases treated since 1971 and followed more than three years suggests that three protocols based on irradiation followed or not by surgery should be used according to the extent of the disease. Of the 72 patients with resectable tumor, the five-year survival rate was 65%. Three-quarters of the patients cured had normal anal function. The rate of death from cancer was 18%. The method requires an accurate assessment of the extent of the tumor and of its pelvic lymphatic spread. Great care must be taken in planning treatment in a close cooperation between radiotherapist and surgeon.

  17. Urinary Tract Infection In Young Healthy Women Following Heterosexual Anal Intercourse: Case Reports.

    PubMed

    Lema, Valentino M

    2015-06-01

    Urinary tract infections (UTIs) are among the most common bacterial infections in outpatient clinical settings globally. Young healthy women are at highest risk of community-acquired UTI. While uncomplicated UTI is not life-threatening, it is associated with high morbidity and treatment costs. The pathogenesis of urinary tract infection in young healthy women is complex. It is influenced by a number of host biological and behavioural factors and virulence of the uropathogen. The infecting uropathogens in community-acquired UTI originate from the fecal flora, E. coli being the most predominant, accounting for 80-90% of these UTIs. Vaginal colonization with uropathogens, a pre-requisite for bladder infection may be facilitated by sexual intercourse, which has been shown to be a strong risk factor and predictor of UTI. While majority of studies have explored the association between heterosexual vaginal intercourse and UTI in healthy young women, the possible association with heterosexual receptive anal intercourse has not received adequate attention despite evidence of high prevalence globally. This paper presents two young healthy married women who had severe UTI following heterosexual anal intercourse and discusses possible association thereof. Understanding the risk factors for UTI and identification of possible predisposing conditions in a particular individual are important in guiding therapeutic approaches and preventive strategies. Cognisant of reportedly high prevalence of various sexual practices including receptive heterosexual anal intercourse and their impact on individuals' health, details on sexual history should always be enquired into in young women presenting with genito-urinary complaints. PMID:26506666

  18. Consideration of future consequences and unprotected anal intercourse among men who have sex with men.

    PubMed

    Appleby, Paul Robert; Marks, Gary; Ayala, Armida; Miller, Lynn Carol; Murphy, Sheila; Mansergh, Gordon

    2005-01-01

    This study of men who have sex with men (MSM) examined whether tendencies to consider the future consequences of one's actions were associated with sexual behaviors that place oneself at risk for HIV infection. A total of 339 HIV-negative MSM responded to the Consideration of Future Consequences Scale (CFC; Strathman et al., 1994) and to questions about their anal intercourse practices in the past year. In bivariate analyses, men with a stronger future orientation were less likely to engage in anal intercourse unprotected by a condom (p < .05). Multivariate analyses revealed that CFC accounted for significant variance in three of four measures of unprotected anal sex after statistically controlling for demographic covariates (education, income, ethnicity, age). CFC was a better predictor of sexual behavior and accounted for more unique variance than any of the demographic factors. Additional research is needed to confirm that CFC is an antecedent of behavior and to examine the feasibility and efficacy of focusing on CFC in HIV prevention interventions. PMID:16368667

  19. 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.

  20. 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.

  1. 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

  2. Long-distance magma transport from arc volcanoes inferred from the submarine eruptive fissures offshore Izu-Oshima volcano, Izu-Bonin arc

    NASA Astrophysics Data System (ADS)

    Ishizuka, Osamu; Geshi, Nobuo; Kawanabe, Yoshihisa; Ogitsu, Itaru; Taylor, Rex N.; Tuzino, Taqumi; Sakamoto, Izumi; Arai, Kohsaku; Nakano, Shun

    2014-09-01

    Long-distance lateral magma transport away from volcanic centers in island arcs is emerging as a common phenomenon where the regional stress regime is favorable. It should also be recognized as an important factor in the construction and growth of island arcs, and a potential trigger for devastating eruptions. In this contribution, we report on recent investigations into the magma dynamics of Izu-Oshima volcano, an active basaltic volcano with an extensive fissure system. Izu-Oshima is flanked by numerous, subparallel NW-SE trending submarine ridges extending up to 22 km to the NW and the SE from the central vent. During a recent submersible survey we have identified that these ridges are fissures which erupted basaltic spatter and lava flows. Furthermore, lavas are petrographically similar along each ridge, while there are noticeable differences between ridges. The subparallel ridges are observed to transect a series of seamounts - the Izu-Tobu monogenetic volcanoes - which are dispersed across this area of the rear-arc. However, there are consistent petrographic and chemical differences between these seamounts and the ridges, indicating that they have different magma sources, yet, they are essentially bounding each other in dive tracks. The most appropriate scenario for their development is one where the Izu-Tobu Volcanoes are fed by an "in-situ" underlying source, while the NW-SE ridges are fed by lateral magma transport from Izu-Oshima. Magma erupted from each ridge is of a consistent geochemistry along its length, but has experienced crystal fractionation and some plagioclase accumulation. Compositions of the ridges are also very similar to lavas from the subaerial cones that can be traced down the flanks of Izu-Oshima. This implies that pairs of subaerial cones and submarine ridges represent the locus of magma transport events away from the storage system beneath Izu-Oshima. Hence, magma from this crustal reservoir moved upward to feed the on-edifice cones

  3. 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

  4. 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

  5. Chronic Insomnia

    PubMed Central

    Buysse, Daniel J.

    2010-01-01

    Ms. F, a 42-year-old divorced woman, presents for evaluation of chronic insomnia. She complains of difficulty falling asleep, often 30 minutes or longer, and difficulty maintaining sleep during the night, with frequent awakenings that often last 30 minutes or longer. These symptoms occur nearly every night, with only one or two “good” nights per month. She typically goes to bed around 10:00 p.m. to give herself adequate time for sleep, and she gets out of bed around 7:00 a.m. on work days and as late as 9:00 a.m. on weekends. Her nighttime sleep problems result in daytime irritability and difficulty focusing and organizing her thoughts, which subjectively impair her work as an administrative assistant, although her performance evaluations have been satisfactory. She says that she has “no energy for anything extra,” that her house is a mess, and that she routinely declines invitations to join social and even family activities. Her insomnia began approximately 5 years ago during a period of increased life stress related to a difficult divorce and a job change. At that time she was diagnosed with major depression and was started on a successful trial of escitalopram, which she continues at a dose of 10 mg/day. Her current symptoms are distinct from those that were associated with her episode of major depression. She denies pervasive sadness or loss of interest, but she is very frustrated with her inability to function more effectively, which she attributes to her insomnia. In fact, she believes that her cognitive difficulties and irritability are most noticeable after nights of particularly poor sleep. Her medical history is unremarkable other than a past history of Graves’ disease. She has been treated with levothyroxine for the past 15 years. How should Ms. F be evaluated? What medical testing, if any, would be appropriate? What factors should be considered in formulating a treatment plan? What treatments would be appropriate? PMID:18519533

  6. Observations of a substantial cloud-aerosol indirect effect during the 2014-2015 Bárðarbunga-Veiðivötn fissure eruption in Iceland

    NASA Astrophysics Data System (ADS)

    McCoy, Daniel T.; Hartmann, Dennis L.

    2015-12-01

    The Bárðarbunga-Veiðivötn fissure eruption lasted from 31 August 2014 to 28 February 2015, during which its sulfur emissions dwarfed anthropogenic emissions from Europe. This natural experiment offers an excellent opportunity to investigate the aerosol indirect effect and the effect of effusive volcanic eruptions on climate. During the eruption cloud droplet effective radius (re) over the region surrounding Iceland was at the lowest value in the 14 year Moderate Imaging Spectroradiometer data record during September and October 2014. The change in reflected solar radiation due to increased cloud reflectivity during September and October is estimated to exceed 2 W m-2 over the region surrounding Iceland, with increases of 1 W m-2 extending as far south as the Açores. The strength of the aerosol indirect effect diagnosed here reaffirms the ability of volcanic aerosols to affect cloud properties and ultimately the planetary albedo.

  7. 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. PMID:26458112

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

    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.

  9. High grade anal intraepithelial neoplasia among HIV-1-infected men screening for a multi-center clinical trial of a human papillomavirus vaccine

    PubMed Central

    Wilkin, Timothy; Lee, Jeannette Y.; Lensing, Shelly Y.; Stier, Elizabeth A.; Goldstone, Stephen E.; Berry, J. Michael; Jay, Naomi; Aboulafia, David M.; Einstein, Mark H.; Saah, Alfred; Mitsuyasu, Ronald T.; Palefsky, Joel M.

    2013-01-01

    Purpose High-grade anal intraepithelial neoplasia (HGAIN) is the precursor lesion to invasive anal cancer. HPV vaccination holds great promise for preventing anal cancer. Methods We examined 235 HIV-1-infected men screening for participation in a multi-site clinical trial of a quadrivalent HPV vaccine. All participants had anal swabs obtained for HPV testing and cytology, and high resolution anoscopy with biopsies of visible lesions to assess for HGAIN. Results HPV 16 and 18 were detected in 23% and 10%, respectively; abnormal anal cytology was found in 56% and HGAIN in 30%. HGAIN prevalence was significantly higher in those with HPV 16 detection compared to those without (38% vs. 17%, P=.01). Use of antiretroviral therapy, nadir and current CD4+ cell count were not associated with abnormal anal cytology or HGAIN. Conclusion HGAIN is highly prevalent in HIV-infected men. Further studies are needed on treatment and prevention of HGAIN. PMID:23611828

  10. A Comparative Evaluation of the Effect of Bonding Agent on the Tensile Bond Strength of Two Pit and Fissure Sealants Using Invasive and Non-invasive Techniques: An in–vitro Study

    PubMed Central

    Singh, Shamsher; Adlakha, Vivek; Babaji, Prashant; Chandna, Preetika; Thomas, Abi M.; Chopra, Saroj

    2013-01-01

    Background: Newer technologies and the development of pit and fissure sealants have shifted the treatment philosophy from ‘drill and fill’ to that of ‘seal and heal’. Aims: The purpose of this in–vitro study was to evaluate the effects of bonding agents on the tensile bond strengths of two pit and fissure sealants by using invasive and non-invasive techniques. Study Design and Methods: One hundred and twenty bicuspids were collected and teeth were divided into two groups: Group-I (Clinpro) and Group-II (Conseal f) with 60 teeth in each group. For evaluating tensile bond strengths, occlusal surfaces of all the teeth were flattened by reducing buccal and lingual cusps without disturbing fissures. Standardised polyvinyl tube was bonded to occlusal surfaces with respective materials. Sealants were applied, with or without bonding agents, in increments and they were light cured. Tensile bond strengths were determined by using Universal Testing Machine. Statistical Analysis: Data were then statistically analysed by using Student t–test for comparison. Results: A statistically significant difference was found in tensile bond strength in invasive with bonding agent group than in non-invasive with bonding agent group. Conclusion: This study revealed that invasive techniques increase the tensile bond strengths of sealants as compared to non- invasive techniques and that the use of a bonding agent as an intermediate layer between the tooth and fissure sealant is beneficial for increasing the bond strength. PMID:24298525

  11. 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.

  12. 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.

  13. 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

  14. Identification of epithelial label-retaining cells at the transition between the anal canal and the rectum in mice

    PubMed Central

    Runck, Laura A; Kramer, Megan; Ciraolo, Georgianne; Lewis, Alfor G

    2010-01-01

    In certain regions of the body, transition zones exist where stratified squamous epithelia directly abut against other types of epithelia. Certain transition zones are especially prone to tumorigenesis an example being the anorectal junction, although the reason for this is not known. One possibility is that the abrupt transition of the simple columnar epithelium of the colon to the stratified squamous epithelium of the proximal portion of the anal canal may contain a unique stem cell niche. We investigated whether the anorectal region contained cells with stem cell properties relative to the adjacent epithelium. We utilized a tetracycline-regulatable histone H2B-GFP transgenic mice model, previously used to identify hair follicle stem cells, to fluorescently label slow-cycling anal epithelial cells (e.g., prospective stem cells) in combination with a panel of putative stem cell markers. We identified a population of long-term GFP label-retaining cells concentrated at the junction between the anal canal and the rectum. These cells are BrdU-retaining cells and expressed the stem cell marker CD34. Moreover, tracking the fate of the anal label-retaining cells in vivo revealed that the slow-cycling cells only gave rise to progeny of the anal epithelium. In conclusion, we identified a unique population of cells at the anorectal junction which can be separated from the other basal anal epithelial cells based upon the expression of the stem cell marker CD34 and integrin α6, and thus represent a putative anal stem cell population. PMID:20647777

  15. The Anal Fistula Plug versus the mucosal advancement flap for the treatment of Anorectal Fistula (PLUG trial)

    PubMed Central

    van Koperen, Paul J; Bemelman, Willem A; Bossuyt, Patrick MM; Gerhards, Michael F; Eijsbouts, Quirijn AJ; van Tets, Willem F; Janssen, Lucas WM; Dijkstra, F Robert; van Dalsen, Annette D; Slors, J Frederik M

    2008-01-01

    Background Low transsphincteric fistulas less than 1/3 of the sphincter complex are easy to treat by fistulotomy with a high success rate. High transsphincteric fistulas remain a surgical challenge. Various surgical procedures are available, but recurrence rates of these techniques are disappointingly high. The mucosal flap advancement is considered the gold standard for the treatment of high perianal fistula of cryptoglandular origin by most colorectal surgeons. In the literature a recurrence rate between 0 and 63% is reported for the mucosal flap advancement. Recently Armstrong and colleagues reported on a new biologic anal fistula plug, a bioabsorbable xenograft made of lyophilized porcine intestinal submucosa. Their prospective series of 15 patients with high perianal fistula treated with the anal fistula plug showed promising results. The anal fistula plug trial is designed to compare the anal fistula plug with the mucosal flap advancement in the treatment of high perianal fistula in terms of success rate, continence, postoperative pain, and quality of life. Methods/design The PLUG trial is a randomized controlled multicenter trial. Sixty patients with high perianal fistulas of cryptoglandular origin will be randomized to either the fistula plug or the mucosal advancement flap. Study parameters will be anorectal fistula closure-rate, continence, post-operative pain, and quality of life. Patients will be followed-up at two weeks, four weeks, and 16 weeks. At the final follow-up closure rate is determined by clinical examination by a surgeon blinded for the intervention. Discussion Before broadly implementing the anal fistula plug results of randomized trials using the plug should be awaited. This randomized controlled trial comparing the anal fistula plug and the mucosal advancement flap should provide evidence regarding the effectiveness of the anal fistula plug in the treatment of high perianal fistulas. Trial registration ISRCTN: 97376902 PMID:18573198

  16. Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women

    PubMed Central

    Robison, Katina; Cronin, Beth; Bregar, Amy; Luis, Christine; DiSilvestro, Paul; Schechter, Steven; Pisharodi, Latha; Raker, Christina; Clark, Melissa

    2016-01-01

    OBJECTIVE To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. METHODS A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus–positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy. RESULTS There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (P<.001). Among women who underwent anoscopy, no anal dysplasia was detected in the low-risk group, whereas 13.4% in the high-risk group had anal dysplasia with 4.2% having anal intraepithelial neoplasia 2 or greater (P<.001). CONCLUSION Human immunodeficiency virus–negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women. PMID:26551180

  17. An animal homolog of plant Mep/Amt transporters promotes ammonia excretion by the anal papillae of the disease vector mosquito Aedes aegypti.

    PubMed

    Chasiotis, Helen; Ionescu, Adrian; Misyura, Lidiya; Bui, Phuong; Fazio, Kimberly; Wang, Jason; Patrick, Marjorie; Weihrauch, Dirk; Donini, Andrew

    2016-05-01

    The transcripts of three putative ammonia (NH3/NH4 (+)) transporters, Rhesus-like glycoproteins AeRh50-1, AeRh50-2 and Amt/Mep-like AeAmt1 were detected in the anal papillae of larval Aedes aegypti Quantitative PCR studies revealed 12-fold higher transcript levels of AeAmt1 in anal papillae relative to AeRh50-1, and levels of AeRh50-2 were even lower. Immunoblotting revealed AeAmt1 in anal papillae as a pre-protein with putative monomeric and trimeric forms. AeAmt1 was immunolocalized to the basal side of the anal papillae epithelium where it co-localized with Na(+)/K(+)-ATPase. Ammonium concentration gradients were measured adjacent to anal papillae using the scanning ion-selective electrode technique (SIET) and used to calculate ammonia efflux by the anal papillae. dsRNA-mediated reductions in AeAmt1 decreased ammonia efflux at larval anal papillae and significantly increased ammonia levels in hemolymph, indicating a principal role for AeAmt1 in ammonia excretion. Pharmacological characterization of ammonia transport mechanisms in the anal papillae suggests that, in addition to AeAmt1, the ionomotive pumps V-type H(+)-ATPase and Na(+)/K(+)-ATPase as well as NHE3 are involved in ammonia excretion at the anal papillae.

  18. 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.

  19. [The characteristics of the development of caries in human dental fissures based on microhardness data. Its diagnosis, treatment and prevention].

    PubMed

    Remizov, S M; Zvonnikova, L V; Raĭnov, N A

    1995-01-01

    Hygienic status of the teeth was assessed after Fyodorov-Volodkina and Green-Vermillion in 500 patients aged 26 to 68 consulted for caries, chronic and acute periodontitis. A good hygienic status of the teeth was observed in 70 subjects: the Fyodorov-Volodkina hygienic index was 1, the Green-Vermillion index O. The Fyodorov-Volodkina index from 1,7 to 5 in 430 patients, depending on the hygienic habits. Patients whose hygienic index was still unsatisfactory despite special training, were subjected to hygienic treatment of teeth with a drill fitted with a modified toothbrush, using water suspension of tooth powder, zink oxide, phosphate cement powder, or tooth paste. Hygienic treatment of teeth by this method proved to be highly effective. The duration of the procedure is 3 to 5 min.

  20. Sphincter Contractility After Muscle-Derived Stem Cells Autograft into the Cryoinjured Anal Sphincters of Rats

    PubMed Central

    Kang, Sung-Bum; Lee, Haet Nim; Lee, Ji Young; Park, Jun-Seok; Lee, Hye Seung

    2008-01-01

    Purpose This study was designed to determine whether the injection of muscle-derived stem cells into the anal sphincter can improve functional properties in a fecal incontinence rat model. Methods Cryoinjured rats were utilized as a fecal incontinence model. The gastrocnemius muscles of normal three-week-old female Sprague-Dawley rats were used for the purification of the muscle-derived stem cells. The experimental group was divided into three subgroups: normal control; cryoinjured; and muscle-derived stem cells (3 × 106 cells) injection group of cryoinjured rats. All groups were subsequently employed in contractility experiments using muscle strips from the anal sphincter, one week after preparation. Results Contractility in the cryoinjured group was significantly lower than in the control after treatment with acetylcholine and KCl. In the muscle-derived stem cells injection group, contraction amplitude was higher than in the cryoinjured group but not significantly (20.5 ± 21.3 vs. 17.3 ± 3.4 g per gram tissue, with acetylcholine (10−4 mol/l); 31 ± 14.2 vs. 18.4 ± 7.9 g per gram tissue, with KCl (10−4 mol/l)). PKH-26-labeled transplanted cells were detected in all of the grafted sphincters. Differentiated muscle masses stained positively for alpha smooth muscle actin and myosin heavy chain at the muscle-derived stem cells injection sites. Conclusions This is the first study reporting that autologous muscle-derived stem cell grafts may be a tool for improving anal sphincter function. PMID:18536965