Review of Intersphincteric Resections for Rectal Cancer Treatment

Colorectal cancer is the third most common cancer, second most common cancer in women, and the fourth leading cause of death in the world. Radical surgical treatment with Total Mesorectal Excision (TME) is considered the best treatment for cancer found in the lower third of the rectum and has benefits of complete tumor removal to reduce risk of recurrence and to improve survival. Advances in preoperative chemoradiation therapy have increased chances of achieving a 1 cm distal margin and allowed successful sphincter-preserving surgery by intersphincteric resection (ISR) and Coloanal Anastomosis (CAA) that allows normal defecation. MRI is particularly useful in evaluating localization of the tumor, involvement of anal sphincter (internal and external sphincters), levator ani muscles, and adjacent structures to the anus, with an accuracy of 85%, sensitivity of 87%, and specificity of 75%. Performing ISR with TME oncologic principles achieves similar results to Low Anterior Resection (LAR), but depends on the presence of sufficient Distal Rectal Margin (DRM); if a sufficient DRM cannot be achieved, then patients are offered an Abdominoperineal Resection (APR) with permanent colostomy and poor quality-of-life results.

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Role of Imaging in Rectal Cancer

JMS SKIMS ◽

10.33883/jms.v15i1.102 ◽

2012 ◽

Vol 15 (1) ◽

pp. 4-6

Author(s):

Ajaz Ahmad Malik

Keyword(s):

Rectal Cancer ◽

Rectal Wall ◽

Preoperative Staging ◽

Positron Emission ◽

Adjacent Structures ◽

Tumor Involvement ◽

Magnetic Resonance Imaging Mri ◽

Optimal Treatment Strategy

THIS ARTICLE HAS NO ABSTRACT (FIRST 100 WORDS OF THE ARTICLE ARE DISPLAYED): Staging of rectal cancer is necessary to provide the optimal treatment strategy although proctoscopy or sigmoidoscopy with biopsy are diagnostic. This is achieved by locoregional assessment of the disease by various available radiological investigations. Staging information includes extent of tumor involvement of the rectal wall and adjacent structures, presence or absence of adjacent lymphadenopathy, and determination of distant metastasis. Several modalities exist for the preoperative staging of rectal cancer, like computed tomography (CT); magnetic resonance imaging (MRI) with traditional body, endorectal, or phasedarray coils; endorectal ultrasonography (ERUS) with rigid or flexible probes; and positron emission tomography (PET) with and without. JMS 2012;15(1):4-6.

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Clinicopathological Analysis of Distal Margin for Rectal Cancer after Preoperative Chemoradiation Therapy

Hepatogastroenterology ◽

10.5754/hge11840 ◽

2012 ◽

Author(s):

Masanori Nishioka ◽

Mitsuo Shimada ◽

Nobuhiro Kurita ◽

Takashi Iwata ◽

Shinya Morimoto ◽

...

Keyword(s):

Rectal Cancer ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Distal Margin ◽

Clinicopathological Analysis ◽

Preoperative Chemoradiation Therapy

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Carcinomatous degeneration of pilonidal cyst with sacrum destruction and invasion of the rectum

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20132140 ◽

2013 ◽

Vol 88 (6 suppl 1) ◽

pp. 59-62 ◽

Cited By ~ 9

Author(s):

Luiz Fernando Nunes ◽

Antonio Kneipp Pitta de Castro Neto ◽

Roberto André Torres Vasconcelos ◽

Flávio Cajaraville ◽

Juliana Castilho ◽

...

Keyword(s):

Inflammatory Process ◽

Multiple Organ ◽

Malignant Degeneration ◽

Histologic Type ◽

Extended Resection ◽

Permanent Colostomy ◽

Bulky Disease ◽

Pilonidal Cyst ◽

Appropriate Treatment ◽

Adjacent Structures

Malignant degeneration of pilonidal cysts is rare. The most common histologic type is the squamous cell carcinoma, triggered by the chronic inflammatory process. The growth of the lesion is typically slow. The diagnosis must be early and the appropriate treatment is ample surgical resection, including the presacral fascia. In some cases, as the present one, the diagnosis is made at a stage when the disease has progressed and invaded adjacent structures. In these cases the surgery involves multiple organ resection. We report the case of a patient with carcinomatous degeneration of pilonidal cyst, with bulky disease that extended up to the wall of the rectum. The treatment was extended resection, sacrectomy and abominoperineal resection of the rectosigmoid with permanent colostomy.

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Neuroblastoma

10.1093/med/9780190685157.003.0033 ◽

2018 ◽

Author(s):

Christina Brown ◽

Meredith Kato

Keyword(s):

Neoadjuvant Chemotherapy ◽

Solid Tumor ◽

Primary Treatment ◽

Infants And Toddlers ◽

Older Children ◽

Childhood Malignancy ◽

Common Cancer ◽

Primary Treatment Modality ◽

Adjacent Structures ◽

Worse Prognosis

Neuroblastoma is a solid tumor that arises from neural crest cells. It is a common cancer of childhood, accounting for 7.8% of all childhood malignancy. It affects primarily infants and toddlers with older children carrying a worse prognosis. While surgery is a primary treatment modality, these tumors are not well encapsulated and tend to invade adjacent structures making resection more difficult. As such, patients often come to the operating room after neoadjuvant chemotherapy and the surgeries can be long with large blood losses. Anesthesia for the resection for neuroblastoma must take into account the effect of ongoing treatment on the patients as well as the surgical challenges inherent in this disease.

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3-D imaging of cells using a confocal laser scanning microscope and digital image processing

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100102560 ◽

1988 ◽

Vol 46 ◽

pp. 96-97

Author(s):

Thomas M. Jovin ◽

Michel Robert-Nicoud ◽

Donna J. Arndt-Jovin ◽

Thorsten Schormann

Keyword(s):

Laser Scanning ◽

Confocal Laser Scanning Microscope ◽

Laser Scanning Microscopy ◽

Confocal Laser Scanning ◽

Confocal Laser ◽

Scanning Microscope ◽

Laser Scanning Microscope ◽

Biochemical Processes ◽

Adjacent Structures

Light microscopic techniques for visualizing biomolecules and biochemical processes in situ have become indispensable in studies concerning the structural organization of supramolecular assemblies in cells and of processes during the cell cycle, transformation, differentiation, and development. Confocal laser scanning microscopy offers a number of advantages for the in situ localization and quantitation of fluorescence labeled targets and probes: (i) rejection of interfering signals emanating from out-of-focus and adjacent structures, allowing the “optical sectioning” of the specimen and 3-D reconstruction without time consuming deconvolution; (ii) increased spatial resolution; (iii) electronic control of contrast and magnification; (iv) simultanous imaging of the specimen by optical phenomena based on incident, scattered, emitted, and transmitted light; and (v) simultanous use of different fluorescent probes and types of detectors.We currently use a confocal laser scanning microscope CLSM (Zeiss, Oberkochen) equipped with 3-laser excitation (u.v - visible) and confocal optics in the fluorescence mode, as well as a computer-controlled X-Y-Z scanning stage with 0.1 μ resolution.

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Parasite defense mechanisms in bees: behavior, immunity, antimicrobials, and symbionts

Emerging Topics in Life Sciences ◽

10.1042/etls20190069 ◽

2019 ◽

Vol 4 (1) ◽

pp. 59-76 ◽

Cited By ~ 2

Author(s):

Alison E. Fowler ◽

Rebecca E. Irwin ◽

Lynn S. Adler

Keyword(s):

Defense Mechanisms ◽

Poor Quality ◽

Future Research ◽

Immune Priming ◽

Social Bees ◽

Bee Health ◽

Landscape Scales ◽

And Function ◽

Solitary Species

Parasites are linked to the decline of some bee populations; thus, understanding defense mechanisms has important implications for bee health. Recent advances have improved our understanding of factors mediating bee health ranging from molecular to landscape scales, but often as disparate literatures. Here, we bring together these fields and summarize our current understanding of bee defense mechanisms including immunity, immunization, and transgenerational immune priming in social and solitary species. Additionally, the characterization of microbial diversity and function in some bee taxa has shed light on the importance of microbes for bee health, but we lack information that links microbial communities to parasite infection in most bee species. Studies are beginning to identify how bee defense mechanisms are affected by stressors such as poor-quality diets and pesticides, but further research on this topic is needed. We discuss how integrating research on host traits, microbial partners, and nutrition, as well as improving our knowledge base on wild and semi-social bees, will help inform future research, conservation efforts, and management.

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Der akute anale Schmerz

Therapeutische Umschau ◽

10.1024/0040-5930/a000424 ◽

2013 ◽

Vol 70 (7) ◽

pp. 399-402

Author(s):

Olivier Pittet ◽

Nicolas Demartines ◽

Dieter Hahnloser

Keyword(s):

Levator Ani ◽

Klinische Untersuchung ◽

Proctalgia Fugax ◽

Chronische Analfissur ◽

Levator Ani Syndrome

Anale Schmerzen sind häufig in der Proktologie. Eine detaillierte Anamnese der Schmerzen und die klinische Untersuchung führen meistens zur Diagnose und damit zur unmittelbaren Therapie. Die akute Perianalvenenthrombose soll innerhalb 72 Stunden exzidiert werden. Akute Analfissuren werden konservativ mit Stuhlregulation und sphinktertonus-senkender Medikation sehr erfolgreich therapiert. Die chronische Analfissur muss meistens operiert werden. Perinalabaszesse können häufig in Lokalanästhesie abgedeckelt werden. Die proctalgia fugax und das levator ani syndrome sind Auschlussdiagnosen und werden symptomatisch therapiert.

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The Impact of Missing and Error-Prone Auxiliary Information on Sparse-Matrix Sub-Population Parameter Estimates

Methodology ◽

10.1027/1614-2241/a000095 ◽

2015 ◽

Vol 11 (3) ◽

pp. 89-99 ◽

Cited By ~ 1

Author(s):

Leslie Rutkowski ◽

Yan Zhou

Keyword(s):

Sparse Matrix ◽

Small Body ◽

Auxiliary Information ◽

Poor Quality ◽

Quality Data ◽

Estimation Methods ◽

Parameter Estimates ◽

Population Parameter ◽

Conditioning Model ◽

The Impact

Abstract. Given a consistent interest in comparing achievement across sub-populations in international assessments such as TIMSS, PIRLS, and PISA, it is critical that sub-population achievement is estimated reliably and with sufficient precision. As such, we systematically examine the limitations to current estimation methods used by these programs. Using a simulation study along with empirical results from the 2007 cycle of TIMSS, we show that a combination of missing and misclassified data in the conditioning model induces biases in sub-population achievement estimates, the magnitude and degree to which can be readily explained by data quality. Importantly, estimated biases in sub-population achievement are limited to the conditioning variable with poor-quality data while other sub-population achievement estimates are unaffected. Findings are generally in line with theory on missing and error-prone covariates. The current research adds to a small body of literature that has noted some of the limitations to sub-population estimation.

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