- Anal metastasis of rectal cancer-adenocarcinoma of squamous cells: a case report and literature review. [Journal Article]
- SCSurg Case Rep 2017; 3(1):55
- Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case...
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy. Biopsy of both tumors revealed a similar histology of well- to moderately differentiated adenocarcinoma. There was no sign of metastases in lymph nodes or other organs. For the purpose of diagnosis and treatment, transperineal local resection of the anal tumor was performed, and it was histologically identified as adenocarcinoma of squamous cells with no invasion to muscles, lymph ducts, or microvessels. The pathological margin was free. Then, to achieve radical cure, laparoscopic low anterior resection (LAR) with D3 lymphadenectomy was performed. The histological diagnosis of the anal tumor was adenocarcinoma of squamous cells without invasion to muscles, lymph ducts, or vessels. The surgical margin was completely free. Immunohistochemical analysis of both tumors revealed similar staining patterns, and the final diagnosis was rectal cancer with metastasis to the anal skin. The patient received no postoperative therapy, and no recurrences have been observed 12 months after surgery. We expect that our sphincter-preserving surgical strategy provided a good prognosis for the synchronous rectal cancer and anal metastasis. This is a rare report of a case with an anal metastasis of colorectal cancer on perianal squamous cells without a history of anal disease that was resected while preserving anal function.
- Treatments for achalasia in 2017: how to choose among them. [Journal Article]
- COCurr Opin Gastroenterol 2017 Apr 19
- CONCLUSIONS: Emerging data support the concept that optimal management of achalasia is phenotype-specific, guided by high-resolution manometry, and, in some instance, functional luminal imaging probe studies. This opinion article reviews the varied characteristic and treatment considerations of achalasia syndromes as currently understood.
- Wnt-β Catenin Signaling Pathway: A Major Player in the Injury Induced Fibrosis and Dysfunction of the External Anal Sphincter. [Journal Article]
- SRSci Rep 2017 Apr 19; 7(1):963
- Wnt-β catenin is an important signaling pathway in the genesis of fibrosis in many organ systems. Our goal was to examine the role of Wnt pathway in the external anal sphincter (EAS) injury-related f...
Wnt-β catenin is an important signaling pathway in the genesis of fibrosis in many organ systems. Our goal was to examine the role of Wnt pathway in the external anal sphincter (EAS) injury-related fibrosis and muscle dysfunction. New Zealand White female rabbits were subjected to surgical EAS myotomy and administered local injections of either a Wnt antagonist (sFRP-2; daily for 7 days) or saline. Anal canal pressure and EAS length-tension (L-T) were measured for 15 weeks after which the animals were sacrificed. Anal canal was harvested and processed for histochemical studies (Masson trichrome stain), molecular markers of fibrosis (collagen and transforming growth factor-β) and immunostaining for β catenin. Surgical myotomy of the EAS resulted in significant impairment in anal canal pressure and EAS muscle L-T function. Following myotomy, the EAS muscle was replaced with fibrous tissue. Immunostaining revealed β catenin activation and molecular studies revealed 1.5-2 fold increase in the levels of markers of fibrosis. Local injection of sFRP-2 attenuated the β catenin activation and fibrosis. EAS muscle content and function was significantly improved following sFRP-2 treatment. Our studies suggest that upregulation of Wnt signaling is an important molecular mechanism of injury related EAS muscle fibrosis and sphincter dysfunction.
- Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults. [Review]
- NUNeurourol Urodyn 2017 Apr 18
- CONCLUSIONS: Currently EMG methods rarely play a decision making role in selecting proper treatment of lower urinary tract dysfunction. With the current efforts to improve phenotyping of these patients in order to provide individualized treatment, the role of EMG could increase.
- Clinical characteristics of neurogenic dysphagia in adult patients with Chiari malformation type I. [Journal Article]
- BDBeijing Da Xue Xue Bao 2017 Apr 18; 49(2):315-321
- CONCLUSIONS: CMI was usually accompanied by symptoms caused by posterior cranial nerve damage, ataxia, and positive pyramidal signs. Location of the syringomyelia affecting specifically the bulbar or upper cervical region was associated with dysphagia in CMI patients. These findings suggest that the mechanism of dysphagia in CMI may be due to a dysfunction in the neurological pathway of pharyngeal muscle movement. Dysphagia etiology work-up should include CMI in the differential diagnosis.
- Female striated urogenital sphincter contraction measured by shear wave elastography during pelvic floor muscle activation: Proof of concept and validation. [Journal Article]
- NUNeurourol Urodyn 2017 Apr 13
- CONCLUSIONS: Stiffness increased within the anatomical region of the SUS during voluntary pelvic floor muscle contractions with predictable response to changes in contraction intensity. These observations support the potential for ultrasound SWE to study SUS function non-invasively.
- Office-based Electromyography-guided Botulinum Toxin Injection to the Cricopharyngeus Muscle: Optimal Patient Selection and Technique. [Journal Article]
- AOAnn Otol Rhinol Laryngol 2017; 126(5):349-356
- CONCLUSIONS: This procedure can be a simple, safe, and effective tool in patients with cricopharyngeal dysfunction after swallowing rehabilitation, especially for cranial nerve IX or X palsy.
- Open vs. endoscopic cricopharyngeal myotomy; Is there a difference? [Journal Article]
- AJAm J Otolaryngol 2017 Mar 31
- CONCLUSIONS: Endoscopic CPM is a safe and effective alternative to the open approach. Patients undergoing endoscopic CPM have shorter operative times and improved outcomes when compared to the open approach.
- Variation of pressure from cervical to distal end of oesophagus during swallowing: Study of a mathematical model. [Journal Article]
- MBMath Biosci 2017 Apr 05; 288:149-158
- The investigation is an attempt to explore the cause that generates high pressure in the distal oesophagus compared to that in the proximal part. We observe through computer simulation that peristalt...
The investigation is an attempt to explore the cause that generates high pressure in the distal oesophagus compared to that in the proximal part. We observe through computer simulation that peristaltic waves of even slightly but progressively increasing amplitude can generate high pressure near the distal end. This is illustrated through exponential growth in the wave amplitude, which represents the dependence of the rate of growth of amplitude on its current magnitude. This may be physically interpreted that the generation of high pressure in the lower oesophagus ensures complete bolus delivery to the stomach through the cardiac sphincter. This finding may prove to be a very prominent result towards creating a prosthetic oesophagus. Some more conclusions with regard to progressive exponential increase in amplitude are also drawn. The pressure falls to zero invariably in the proximal half of every bolus, whereas for constant amplitude, zero pressure is located exactly at the midpoints of the boluses for Newtonian flows. Backward flow of fluid takes place in a smaller region if amplitude increases. Circular muscles contract more in the lower oesophagus to generate higher pressure in the distal oesophagus. In a sharp contrast to the case of constant-amplitude, pressure is neither uniformly distributed in a wave, nor is of identical shape for all boluses in the case of train wave propagation. Pressure distribution along the axis of the oesophagus differs in shape and magnitude both when a single wave propagates.
New Search Next
- Associated factors to urinary incontinence in women undergoing urodynamic testing. [Journal Article]
- RERev Esc Enferm USP 2017 Apr 03; 51:e03209
- CONCLUSIONS: Interventions and guidance on preventing UI and strengthening pelvic muscles should be directed at women who present weight changes, who are sedentary menopausal women, and those who have undergone hysterectomy or other gynecological surgery. Studies on pelvic strengthening methods are needed in order to take into account the profile of the needs presented by women.