Objective This study aims to determine changes in the proportions of types I and III collagen in hemorrhoids and to verify the sliding anal canal lining theory. Patients and method The study is focused on a sample of 17 patients, 9 females and 8 males (age range: 30–70 years), with grade III and grade IV hemorrhoids. Tissue from 4 fetuses (age: 16 weeks of gestation) was used as control sample. All the participants gave their informed consent. Samples were gathered in 2014. All patients underwent open hemorrhoidectomy by using the technique described by Milligan and Morgan, published in Lancet journal in 1937. The hemorrhoid samples were stained with hematoxylin–eosin for the histologic study to confirm the hemorrhoidal tissue diagnosis. The picrosirius red staining protocol was used after the histologic analysis. The method used for image processing is described in the text. Images were imported to the Image Tool for Windows software. The same process was used on the embryonic tissue. Data resulting from the analysis of images were processed using STATISTICA, a software for statistical analysis. Results When compared, it was found that the two tissues presented very different values, with hemorrhoids containing the highest type III collagen values. Conclusion Our results seem to imply that hemorrhoids have a larger proportion of type III collagen than fetal tissue. They also suggest a possible age-related deterioration of the tissue.
Objective Transanal repair of rectocele and full rectal mucosectomy with one circular stapler is a procedure designed for the treatment of Obstructive Defecation Syndrome by doctor Fco. Sergio Regadas in 2005. We compare the use of multiple instruments and their mechanical technology effect in the treatment of anorectocele. Patients and methods Female patients complaining about sensation of incomplete evacuation, ages between 40 and 55. The evaluation was made with the function of evacuation protocol: colonic transit time, colon radiology, ecodefecography, anorectal manometry and psychological test. The technique used was transanal repair of rectocele and full rectal mucosectomy with one circular stapler, using staplers CPH-34, CPH-34HV and EEA-3135-HEM, with measurement of the rectal wall resected: vertical length in centimetres, horizontal length in centimetres, weight in grams and volume in cubic centimetres; afterwards histological study of the tissue thickness, and applied the ANOVA and SPSS 12 tests for the statistical analysis. Results The results obtained by comparing the resections made with the CPH-34, the CPH-34HV and the EEA-3135-HEM in respect of vertical length, horizontal length, weight and volume, were found to have no significant differences; neither in the histological study of the tissue thickness in respect of characteristics and structure. Conclusion The effect of mechanical technology in the treatment of anorectocele with transanal repair of rectocele and full rectal mucosectomy with one circular stapler procedure using the CPH-34, the CPH-34HV and the EEA-3135-HEM, does not show any difference. Leaving the application of each to the operator competencies.
Introducción: Enfermedad por reflujo se desarrolla cuando el contenido gástrico provoca síntomas y/o complicaciones esofágicas y extra esofágicas. Las esofágicas incluyen el reflujo, esofagitis de reflujo y el esófago de Barrett. Esta última premaligna, caracterizada por una metaplasia intestinal especializada cuya importancia es el conocimiento de la displasia por su evolución a cáncer. Trabajos anteriores determinaron, displasia en esófago de Barrett 33,3%; prevalencia de enfermedad por reflujo no erosiva 82,70% y erosiva 17,30%; de esofagitis con hallazgo endoscópico e histológico 84,37%. Objetivo: Evaluar la prevalencia del esófago de Barrett por reflujo y esofagitis por reflujo en el Instituto Anatomopatológico de la Universidad Central de Venezuela. Método: Se realizó un estudio descriptivo, retrospectivo. Se estudiaron las muestras endoscópicas de biopsias esofágicas que ingresaron en el período 2005 al 2015, con diagnóstico de reflujo y esofagitis por reflujo. Se evaluó la ausencia o presencia de displasia en el esófago de Barrett, con su gradación correspondiente. Se utilizó un análisis descriptivo presentado en forma de frecuencias absolutas y relativas. Resultados: 35,85% reflujo y 64,12% esofagitis por reflujo, ambas con predominio en mujeres y edad promedio de 55,2 y 53,1 años respectivamente. Dieciocho casos (8%) con esófago de Barrett en relación a enfermedad por reflujo. Displasia de bajo grado 5,55%, indefinido para displasia 50% y negativo para displasia 44,44%. Conclusiones: La prevalencia de esófago de Barrett asociado a enfermedad por reflujo gastroesofágico fue del 8%. La mayor frecuencia fue en el sexo femenino con 66,66%, y las edades comprendidas entre 30 y 78 años con una media de 59,25 años.
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