Perineal trauma with anal avulsion: case report.

Anorectal avulsion is an exceptional rectal trauma. In this kind of lesions, the anus and the sphincter no longer join the perineum and are pulled upward. We present a case of 34-years-old patient who was admitted because of a pelvic-perineal trauma, presenting a partial anorectal avulsion, exposed femoral fracture with thigh's lacerated-contused wound. Our treatment included primary plastic of the internal anal sphincter with replanting of the rectum on the anal canal and a diverting loop sigmoid colostomy (SCS), so as to prevent sepsis. Closure of the protective SCS was performed four months after the trauma.

Elective Treatment of Large-Bowel Obstruction in Asymptomatic Sigmoid Volvulus.

BACKGROUND: Sigmoid volvulus is an uncommon cause of intestinal obstruction representing the 5% of all Western cases, associated with old age and a history of neurological and psychiatric condition. Generally, its diagnosis is established by clinical and radiologic findings. It often represents an emergency and it is commonly associated with pain, vomit and abdominal tenderness. CASE PRESENTATION: We present a case of a 59 years old man, admitted to our emergency department, showing an abdominal X-Ray reporting a distention of large bowel,which was required due to presence of multiple diarrhea episodes during the previous 7 days. He had no significant past medical history and did not report constipation or subocclusive episode. CONCLUSIONS: Volvulus should be considered in the differential diagnosis in adult and healthy patients with bowel obstructions. Surgery is, in all cases, the radical and definitive treatment since there is a higher mortality in case of recurrent volvulus. Despite the massive bowel distention, our choice was the elective open surgery. Primary anastomosis is feasible and safe and did not lead to any complications. In case of unsuccessful colonic decompression, evidence to support or refute the safety and effectiveness of laparoscopic surgical resection for treatment of patients with sigmoid volvulus disease is not yet proven.

The effects of pattern shape, subliminal stimulation, and voluntary control on multistable visual perception.

Spontaneous figure reversal of ambiguous patterns was analyzed in humans. A) With Necker-"cube"-like, or "drum"-like figures, having square or round shaped "front" and "rear" surfaces, and either large or small "depth", the perceptual intervals corresponding to both interpretations of "drum" were longer than those of "cube"; the perceived "depth" of the figures was less relevant for reversal timing (inter-reversal intervals were only slightly longer for the "deeper" figures). Although the shape of "front" and "rear" surfaces is not a crucial geometrical feature for figure reversal, it did influence its timing. More, or longer information-processing steps should probably be needed for perceptual representations of curvilinear patterns in comparison with rectangular ones. The underlying neural mechanisms are probably located at a relatively peripheral level in the visual system. B) With a modified Necker "cube"-like figure, having the two internal vertices coincident, and the long axis of the figure aligned horizontally, the effect of voluntary control on perception-reversal timing overcomes opposite effects due to either fixation-attention to pattern's focal zones, or subliminal stimulation by the pattern's biased versions, suggesting one or the other perception's possibility, while it is enhanced by concordant imagery. Voluntary control should intervene downward at a high-level processing, and should probably affect both a decision-making and a perception-stabilizing mechanism in the process of the pattern's unconscious interpretation. Results A and B are confronted with other results on both perceptual and binocular rivalry of up-to-date literature, in the frame of discussions on low-level bottom-up automatic stimulus-driven processing vs high-level top-down covert attention-driven processing.

First identification and localization of a visual pigment in Hydra (Cnidaria, Hydrozoa).

The cnidarian Hydra does not possess identified photoreceptive structures or specialized cells for light detection; nevertheless, it shows a marked photosensitivity. So far no evidence has been previously reported about the localization of the proteins involved in the photoresponse. We used polyclonal antibodies and immunofluorescence microscopy on whole-mount Hydra to identify a putative rhodopsin-like protein. Our results show an immunoreactivity in the ectodermal layer of Hydra, which corresponds in position to the nervous epidermal sensory cells. These data provide the first identification of a rhodopsin-like protein in a phylogenetically old invertebrate and give a new insight into the Hydra photoreceptive response.