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Abdominal Radiology (New York) Apr 2017Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this...
PURPOSE
Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this study was to evaluate MR imaging differences of perianal fistulas in patients with and without Crohn's disease.
METHODS
Our retrospective search from January 2012 to December 2015 of the Radiology database for perianal fistula yielded 207 patients. Only patients with dedicated MR fistula protocol studies were included, whereas patients with previous anal surgery or anastomosis, anorectal tumors, and equivocal findings that could not be definitely assessed as a fistula were excluded. The following features were assessed: anatomic type of fistula (Parks Classification), luminal origin (hour clock position), anal verge distance, signs of acute inflammation, circumference of anus involved by inflammation, presence of rectal inflammation. and abscess.
RESULTS
One hundred and twenty six of 207 patients met inclusion criteria. Of these, 96 (76.2%) had Crohn's disease and 30 (23.8%) did not. The most common fistulas identified were transphincteric (38.5% of Crohn's and 50% of non-Crohn's) and intersphincteric (33.3% of Crohn's and 35.4% of non-Crohn's). An abscess was associated in 41 cases, 32 (33.3%) in the Crohn's group and 9 (30.0%) in the non-Crohn's group. Rectal inflammation was present in 29 patients with Crohn's disease (29.2%) and in 2 without Crohn's (6.7%). This finding was statistically significant (p = 0.0009).
CONCLUSIONS
Our study demonstrates that while both groups can have similar MR imaging features, accompanying rectal inflammation was more commonly seen in Crohn's disease.
Topics: Adult; Aged; Crohn Disease; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Rectal Fistula; Retrospective Studies
PubMed: 27885389
DOI: 10.1007/s00261-016-0989-z -
Pediatric Surgery International May 2017Perianal fistulous disease is present in 10-15% of children with Crohn's disease (CD) and is frequently complex and refractory to treatment, with one-third of patients... (Review)
Review
PURPOSE
Perianal fistulous disease is present in 10-15% of children with Crohn's disease (CD) and is frequently complex and refractory to treatment, with one-third of patients having recurrent lesions. We conducted a systematic review of the literature to examine the best surgical strategy or strategies for pediatric complex perianal fistulous disease (CPFD) in CD.
METHODS
We searched CENTRAL, MEDLINE, EMBASE, and CINAHL for studies discussing at least one surgical strategy for the treatment of pediatric CPFD in CD. Reference lists of included studies were hand-searched. Two researchers screened all studies for inclusion, quality assessed each relevant study, and extracted data.
RESULTS
One non-randomized prospective and two retrospective studies met our inclusion criteria. Combined use of setons and infliximab therapy shows promise as a first-line treatment. A specific form of fistulectomy, "cone-like resection," also shows promise when combined with biologics. Endoscopic ultrasound to guide medical and surgical management is feasible in the pediatric population, though it is unclear if it improves outcomes.
CONCLUSION
There is a paucity of evidence regarding the treatment of CPFD in the pediatric population, and further research is required before recommendations can be made as to what, if any, surgical management is optimal.
Topics: Adolescent; Animals; Child; Crohn Disease; Female; Humans; Male; Perianal Glands; Prospective Studies; Rectal Fistula; Retrospective Studies
PubMed: 28138950
DOI: 10.1007/s00383-017-4067-6 -
In Vivo (Athens, Greece) 2018Neoplastic lesions of perianal glands account for approximately 10% of all skin cancer cases in dogs. They occur in many dog breeds, usually in male animals aged over 6...
BACKGROUND/AIM
Neoplastic lesions of perianal glands account for approximately 10% of all skin cancer cases in dogs. They occur in many dog breeds, usually in male animals aged over 6 years. Due to their hormone-dependency, tamoxifen can be used in antineoplastic treatment. The aim of the study was to measure epidermal growth factor (EGF) levels in the serum of dogs with perianal tumours after tamoxifen treatment and to use it as a prognostic factor for further treatment.
MATERIALS AND METHODS
The study was performed on 19 male dogs aged between 6 and 14 years, diagnosed with neoplastic hyperplasia in the perianal region. The control group comprised 10 healthy dogs brought in for routine castration. The research material comprised blood drawn from the animals and tumour specimens for histopathology. The study group received 1-month treatment with tamoxifen. Blood serum was then tested for 17-β oestradiol level, and for EGF level on the first day of the therapy and 6 months after treatment completion.
RESULTS
Hepatoid gland adenomas were diagnosed in 10 cases, and hepatoid gland epitheliomas in nine cases. Elevated 17-β oestradiol levels were observed in all dogs. On the first day of treatment with tamoxifen, the serum EGF levels in all study groups were higher than in the control group. At the 6-month follow-up, the EGF levels were significantly reduced in hepatoid gland adenoma cases compared to those taken on the first day of treatment of tamoxifen, while in animals with hepatoid gland epithelioma, it was greatly increased and was correlated with relapse.
CONCLUSION
Perianal gland tumours are characterised by EGF overexpression, which can be helpful in early-stage prognosis and treatment. An increase in EGF levels 6 months after tamoxifen therapy correlates with disease progression and may be a useful prognostic factor.
Topics: Adenoma; Anal Gland Neoplasms; Animals; Carcinoma; Dogs; Epidermal Growth Factor; Male; Tamoxifen
PubMed: 30150441
DOI: 10.21873/invivo.11361 -
Journal of Ultrasound in Medicine :... Nov 2016Magnetic resonance imaging (MRI) and transrectal sonography are the two accepted imaging modalities for evaluation of perianal fistulas and abscesses. Transperineal... (Comparative Study)
Comparative Study
OBJECTIVES
Magnetic resonance imaging (MRI) and transrectal sonography are the two accepted imaging modalities for evaluation of perianal fistulas and abscesses. Transperineal sonography is a new technique that is easy to learn and can be performed at any time. The purpose of this study was to prospectively compare the diagnostic accuracy of MRI, transrectal sonography, and transperineal sonography with surgical findings in patients with perianal Crohn disease.
METHODS
All patients with perianal Crohn disease underwent MRI, transrectal sonography, and transperineal sonography within a few days before surgery. Fistulas were classified as simple (43.8%) or complex (52.2%) based on surgical findings.
RESULTS
Twenty-three patients with active perianal Crohn disease (12 women and 11 men; mean age, 29.9 years; current therapy: antibiotics, 69.6%; azathioprine, 56.5%; and biologics, 73.9%; previous surgery, 26.1%; and proportion of smokers, 39.1%) were included. Sensitivity values for MRI, transrectal sonography, and transperineal sonography for diagnosis of fistulas were 84.6%, 84.6%, and 100%, respectively. Transperineal sonography was more sensitive for diagnosis of perianal abscesses than MRI and transrectal sonography (100%, 58.8%, and 92.8%).
CONCLUSIONS
Transperineal sonography is a very accurate diagnostic method with outstanding sensitivity compared with MRI and transrectal sonography for evaluation of complicated perianal Crohn disease. Due to its simplicity and low cost, it is recommended that transperineal sonography be the first diagnostic modality in these cases.
Topics: Adolescent; Adult; Animals; Child; Crohn Disease; Endosonography; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Perianal Glands; Perineum; Prospective Studies; Rectum; Reproducibility of Results; Ultrasonography; Young Adult
PubMed: 27629757
DOI: 10.7863/ultra.15.09043 -
Journal of Oral and Maxillofacial... 2020Hidradenoma Papilliferum (HP) is a rare, benign, cutaneous adnexal tumor of middle-aged females arising mainly in the apocrine sweat glands of perianal and genital...
Hidradenoma Papilliferum (HP) is a rare, benign, cutaneous adnexal tumor of middle-aged females arising mainly in the apocrine sweat glands of perianal and genital region. Initially, HP was considered to be an apocrine sweat gland tumor however recent research showed that it descends from the anogenital mammary-like glands, HP can be regarded theoretically as the cutaneous complement of mammary intraductal papilloma. Nongenital HP is an infrequent manifestation, ectopic forms of this entity have been defined with bulk of them occurring on the head and neck region (60%) and 85% of cases being 1.5 cm in the greatest diameter or lesser. Average age of patients with ectopic HP is 1-2 decades older than the age range of onset in patients with anogenital HP. Here, we present a 15-year-old adolescent female with an unusually large, ectopic occurrence of nodular HP on right cheek since 2 years.
PubMed: 33967496
DOI: 10.4103/jomfp.JOMFP_126_20 -
Micron (Oxford, England : 1993) Nov 2020Stomaphis Walker is an obligatorily myrmecophilous, tree-trunk feeding aphid genus, having many peculiar features in its morphology. One poorly studied trait is its...
Stomaphis Walker is an obligatorily myrmecophilous, tree-trunk feeding aphid genus, having many peculiar features in its morphology. One poorly studied trait is its perianal anatomy, with suspected existence of trophobiotic organ and intriguing tubercles near abdominal segment VIII. Tubercles on rear end of abdomen in Stomaphis were considered to be marginal tubercles, structure typical of aphids. Only after their investigation under scanning electron microscope they revealed to possess a very rough surface, consisting of many protuberant, sclerotic scales with finger-like processes. Analysis and comparison with other aphids suggests, that these structures - perianal tubercles - may be considered remnants of abdominal sternite IX, atrophied in aphids. Due to their similarity to the surface of cauda of non myrmecophilous aphids, they are suspected to serve as sort of auxiliary caudas, protecting from sticky secretions of aphids e. g. honeydew or mucus while giving birth or ovipositing in confined space. A very well developed trophobiotic organ in this genus has been shown to exist for the first time.
Topics: Anal Canal; Animals; Aphids; Female; Microscopy, Electron, Scanning; Oviposition; Perianal Glands; Phylogeny
PubMed: 32905975
DOI: 10.1016/j.micron.2020.102930 -
Frontiers in Microbiology 2023As a typical solitary animal, adult giant pandas rely on chemical signals (sex pheromones) to transmit reproductive information during oestrous. Although researchers...
As a typical solitary animal, adult giant pandas rely on chemical signals (sex pheromones) to transmit reproductive information during oestrous. Although researchers have confirmed that the gut microbiota is related to the emission and reception of sex pheromones, there is no clear correlation between the gut microbes and the synthesis of sex pheromone of giant pandas, that is, which gut microbes and microbial metabolites are participate in the synthesis of giant panda's sex pheromone. As a mirror of gut microbiota, fecal microbiota can reflect the composition of gut microbiota and its interaction with host to some extent. The purpose of this study is to explore how the gut microbes affect the synthesis of sex pheromones in captive giant pandas by combining analysis of the fecal microbiome and metabolomics. The results of correlation and microbial function analysis show that intestinal microorganisms such as and are associated with the synthesis of short chain fatty acid (acetic acid) and volatile ester metabolites, such as 1-butanol, 3-methyl, acetate, acetic acid, hexyl ester and 3-hexen-1-ol, acetate, (Z). In summary, based on this study, we believe that volatile metabolites such as fecal acetate participate in the process of mate preference of captive giant pandas and affect their expression of natural mating behavior. The possible mechanism is that the gut microbes can promote the synthesis of key chemical signaling substances in perianal glands through mediated intermediate fecal metabolites, thus affecting the normal information exchange between giant pandas individuals. The results of this study have greatly enriched our understanding of gut microbes regulating the synthesis of sex pheromones in giant pandas.
PubMed: 37692393
DOI: 10.3389/fmicb.2023.1234676 -
The American Journal of Dermatopathology May 2016Mammary-type fibroepithelial lesions involving ectopic breast and anogenital region are rare and usually coexist with normal orthotopic breast. We present what we... (Review)
Review
Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands: A Case Report.
Mammary-type fibroepithelial lesions involving ectopic breast and anogenital region are rare and usually coexist with normal orthotopic breast. We present what we believe to be a unique case of synchronous bilateral gestational gigantomastia resembling fibrous mastopathy, synchronous rapidly growing pregnancy-associated nodular pseudoangiomatous stromal hyperplasia involving right breast and bilateral axillary ectopic breast tissue, and metachronous perianal mammary-type hamartoma involving anogenital mammary-like glands occurring in a 34-year-old patient with facioscapulohumeral muscular dystrophy. Also, we review the literature concerning these lesions.
Topics: Adult; Anal Canal; Anus Diseases; Biopsy; Breast; Choristoma; Female; Hamartoma; Humans; Hyperplasia; Hypertrophy; Magnetic Resonance Imaging; Muscular Dystrophy, Facioscapulohumeral; Pregnancy
PubMed: 26863057
DOI: 10.1097/DAD.0000000000000498 -
Casopis Lekaru Ceskych 2017Hidradenitis suppurativa is a chronic skin disorder characterized by recurrent inflammatory nodules, fistulas, abscesses, and scarring mainly in the intertriginous areas...
Hidradenitis suppurativa is a chronic skin disorder characterized by recurrent inflammatory nodules, fistulas, abscesses, and scarring mainly in the intertriginous areas with terminal hair and apocrine glands. Hidradenitis suppurativa manifests usually after puberty, in the third life decade and persists for many years. The prevalence of the disease is estimated to be 0,5 % in the Czech Republic. Women are most often affected in the axillary and inguinal parts, while men in the perianal and gluteal areas. The exact pathogenesis is still unknown. It is assumed that hyperkeratosis of the hair follicle leads to its occlusion, dilatation and further rupture when keratin and bacteria are spilled into the dermis causing a massive inflammatory reaction. Smoking and obesity belong to the main triggering factors. Without therapy, the disease is chronic and progressive. The standard therapy depends on the extension of the disorder. For not extensive lesions, treatment consists of topical antiseptics, antibiotics or long- term therapy with systemic antibiotics. In more advanced stages, systemic therapy with TNF-α antagonists is needed. Further therapeutic modality is surgical intervention and wide excision of the affected area. Nevertheless, recurrences in the adjacent tissue cannot be avoided.
Topics: Anti-Bacterial Agents; Chronic Disease; Czech Republic; Female; Hidradenitis Suppurativa; Humans; Male; Tumor Necrosis Factor-alpha
PubMed: 28722455
DOI: No ID Found -
In Vivo (Athens, Greece) 2023Extramammary Paget's disease (EMPD) is a rare, slow growing intra-epidermal malignant neoplasm that arises in areas rich in apocrine glands. Several common sites of...
BACKGROUND/AIM
Extramammary Paget's disease (EMPD) is a rare, slow growing intra-epidermal malignant neoplasm that arises in areas rich in apocrine glands. Several common sites of occurrence have been reported, including the vulva, perianal region, perineum, and scrotum. Most relevant studies rely on small data bases. Our objective was to evaluate prognostic factors of EMPD patients at a single medical center.
PATIENTS AND METHODS
We retrospectively analyzed 19 patients (8 males, 11 females) diagnosed with genital EMPD who were treated at the Taichung Veterans General Hospital between 2006/04 and 2022/08. Collected information included tumor location, margin condition in the case of surgical resection, recurrence rate, recurrence management, accompanied gastrointestinal malignancy, treatment details and survival data.
RESULTS
Among 19 cases, 4 with initial margin being positive, and 3 received second surgery (one refused surgery and another expired within a year). Tumor recurrence was found in 7 cases, with 6 of them later receiving second surgery, and the remaining one received radiation therapy. Median DFS was 7.57 years. During the 15-year follow-up, 2 patients expired. Overall survival rate was 87.5%. Among all factors we had analyzed, only those accompanied with GI tract malignancy had significantly worse survival rate (p=0.018). Frozen sections taken at surgical margin during surgery significantly reduced cancer recurrence rate (p=0.45). Permanent pathology margins appeared to affect the recurrence rate, but that was not significant when comparing with intraoperative frozen sections.
CONCLUSION
Local wide excision with skin flap reconstruction remains the major treatment option for genital EMPD. Following the standard-of-care procedure, the overall patient outcome was excellent. Among factors potentially associated with recurrence rate, intraoperative frozen biopsy was the most significant one. Performing intraoperative frozen biopsy is essential for recurrence-free rate elevation.
Topics: Male; Female; Humans; Retrospective Studies; Paget Disease, Extramammary; Prognosis; Taiwan; Neoplasm Recurrence, Local
PubMed: 37905610
DOI: 10.21873/invivo.13390