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We are thrilled to present a new technique for treating chronic anal fissures using ultrasound-guided botulinum toxin injections. Our approach involves injecting botulinum toxin into the internal anal sphincter (IAS) guided by ultrasound for maximum effectiveness. We believe that our technique has significant potential to improve outcomes. We could not find any studies where ultrasound-guided TB puncture was used to treat chronic anal fissures.

Introduction: The outcomes of patients treated with colonic stents as a bridge to surgery (BTS) have recently been questioned in terms of safety and long-term oncologic outcomes. The aim of this study is to evaluate the effects on surgical and oncologic outcomes of colonic stents as a BTS for potentially resectable obstructive colorectal cancer., Methods: We conducted a retrospective analysis of patients operated on for potentially resectable obstructive colorectal cancer with or without distant disease between September 2002 and October 2015, comparing the patients treated with a colonic stent as a BTS (Stent group) with those directly operated on (Surgery group)., Results: Twenty patients underwent urgent surgery, while stent placement as a BTS was attempted in 57 patients. The Stent group had more patients treated with a laparoscopic approach (64.9 vs. 5%, P<.001), higher primary anastomosis rate (91.2 vs. 55%, P=.001), less need for stomata (10.5 vs. 50%, P=.001) and shorter postoperative hospital stay (7 vs. 12 days, P=.014). Thirty-day morbidity was reduced in the Stent group, although not significantly (29.8 vs. 50%, P=.104). However, 30-day mortality was significantly lower (1.8 vs. 20%, P=.015). Regarding the long-term oncologic outcomes, no significant differences were found when comparing overall survival, disease-free survival, local recurrence-free survival, distant recurrence-free survival or progression-free survival., Conclusions: Colonic stenting as a BTS for potentially resectable obstructive colorectal cancer seems to offer better surgical and equal long-term oncologic outcomes when compared to those of patients directly operated on., (Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Amyand's hernia is an inguinal hernia containing the caecal appendix. It is usually an intraoperative finding, although it can be diagnosed preoperatively with radiologic examinations, which would show a tubular structure inside the inguinal canal., Presentation of Case: A male patient presented to the emergency department complaining of abdominal pain in the right lower quadrant. He had been orchidectomized during his childhood due to cryptorchidism, and had been under antibiotic treatment a week before due to a suspected gonorrhoea. A small irreductible mass was found in the right groin. Blood tests showed leucocytosis and elevated CRP. A CT-scan was performed, reporting a tubular structure with a blind end entering the inguinal canal that seemed to be the appendix. Single-port laparoscopic exploration was indicated, and a right vasitis was found instead of an Amyand's hernia. After the operation, the patient explained that he had not taken the antibiotics for the gonorrhoea., Discussion: Untreated gonorrhoea causes ascendant vasitis and orchyepididimitis. In the present case, since the patient did not have testicles, the inflamed vas deferens mimicked the Appendix inside the inguinal canal. If the patient had told the truth about the untreated gonorrhoea, maybe the condition would have been suspected and no radiological examinations would have been performed, which subsequently lead to an unnecessary operation., Conclusion: Presently, Amyand's hernia is more frequently diagnosed preoperatively than intraoperatively. However when an Amyand's hernia is preoperatively suspected, the possibility of a vasitis should always be ruled out in order to avoid unnecessary operations., (Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

It is difficult to measure the energy spectrum of X-ray tubes due to the pile up effect produced by the high fluence of photons. Using attenuating materials, appropriate detector devices and the Monte Carlo method, primary X-ray spectrum of these devices can be estimated. In this work, a flat panel detector with a PMMA wedge has been used to obtain a dose curve corresponding to certain working conditions of a radiodiagnostic X-ray tube. The relation between the dose curve recorded by the flat panel and the primary X-ray spectrum is defined by a response function. Normally this function can be approximated by a matrix, which can be obtained by means of the Monte Carlo method. Knowing the measured dose curve and the response matrix, the primary X-ray spectrum can be unfolded. However, there are some problems that strongly affect the applicability of this method: i.e. technical features of the flat panel and inherent characteristics of the involved radiation physics (ill-posed problem). Both aspects are analyzed in this work, concluding that the proposed method can be applied with an acceptable accuracy for spectra without characteristic lines, for instance, tungsten anode in the 50-70 kVp range.

An inverse technique has been designed to unfold the x-ray tube spectrum from the measurement of the photons scattered by a target interposed in the path of the beam. A special strategy is necessary to circumvent the ill-conditioning of the forward transport algebraic problem. The proposed method is based on the calculation of both, the forward and adjoint analytical solutions of the Boltzmann transport equation. After testing the method with numerical simulations, a simple prototype built at the Operational Unit of Health Physics of the University of Bologna was used to test the method experimentally. The reconstructed spectrum was validated by comparison with a straightforward measurement of the X-ray beam. The influence of the detector was corrected in both cases using standard unfolding techniques. The method is capable to accurately characterize the intensity distribution of an X-ray tube spectrum, even at low energies where other methods fail., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Control rods are activated by neutron reactions into the reactor. The activation is produced mainly in stainless steel and its impurities. The dose produced by this activity is not important inside the reactor, but it has to be taken into account when the rod is withdrawn from the reactor. Activation reactions produced have been modelled by the MCNP5 code based on the Monte Carlo method. The code gives the number of reactions that can be converted into activity., (Copyright 2009 Elsevier Ltd. All rights reserved.)