ABSTRACT
The effect of sacral resection up to S-2 has been investigated in two patients with "chordomas," surgical division of the spinal roots was unilateral and bilateral, respectively. Anal manometry, electromyography of the sphincters, and the ascertaining of tactile, thermic, and painful stimuli perception in the perineum and anal canal were executed to determine the effects of denervation on anorectal continence. Vesical function was tested by vesical manometry. Results differ strongly between the two patients: the first, with unilateral loss of S-2, has perfect anorectal continence. The second, with bilateral loss of S-2, is incontinent and unable to discriminate rectal contents. It is sufficient to retain only one S-2 root for the maintenance of physiologic continence, including distinction between different types of bowel contents (gaseous or solid) passing through the anal canal. The same is true concerning bladder function.
Subject(s)
Anal Canal/innervation , Denervation/adverse effects , Fecal Incontinence/physiopathology , Rectum/innervation , Urinary Bladder/innervation , Anal Canal/physiopathology , Chordoma/surgery , Fecal Incontinence/etiology , Humans , Manometry , Myography , Rectum/physiopathology , Sacrococcygeal Region , Spinal Neoplasms/surgery , Spinal Nerve Roots/physiopathology , Spinal Nerve Roots/surgery , Urinary Bladder/physiopathology , Urinary Incontinence/etiology , Urinary Incontinence/physiopathologyABSTRACT
Gastroesophageal reflux has been showed both clinically and experimentally to be especially damaging esophageal mucosal layer when the elements which make up reflux are gastric content and bilio-pancreatic juice.
Subject(s)
Gastroesophageal Reflux/physiopathology , Duodenogastric Reflux/diagnostic imaging , Duodenogastric Reflux/physiopathology , Gastric Mucosa/pathology , Humans , Hydrogen-Ion Concentration , Pancreatic Juice/physiology , Radionuclide ImagingABSTRACT
The diagnosis of reflux esophagitis in the early stage is not easy because endoscopy rarely shows evident findings and histology of biopsy specimens still appears unclear and doubtful. Usual histopathological findings are reported and most available diagnostic criteria are discussed, on the basis of the literature and personal experience. Intraepithelial eosinophils are a possible marker of early reflux esophagitis: its diagnostic usefulness is outlined.
