Herrmann And Desfosses, the Two Men "Behind the Anal Glands": A Brief History of a Notable Page in the History of Proctology.

UuPGRP, a peptidoglycan recognition protein of Urechis unicinctus, promotes immune defense against bacterial infection.

Perianal fistula is a common, miserable, and often embarrassing condition that tends to recur. Most cases result from chronic infection of the anal glands (cryptoglandular), leading to an internal opening in the anal canal and an external opening that discharges fluid. Pelvic MRI has become essential for its management because it helps accurately classify the type and extent of the fistula, enabling optimized preoperative planning before surgery. It is particularly useful for perianal fistulas in patients with Crohn disease, in whom infections are often extensive. Examination involves imaging in three planes aligned with the anal canal axis, using T2-weighted sequences without fat saturation and at least one T2-weighted sequence with fat saturation; intravenous contrast material can also be used. Easy-to-use imaging criteria have been proposed to assess treatment response and healing in daily practice, while disease activity scores are primarily used for clinical research. Radiologists should be aware of mimics, such as pilonidal sinus and hidradenitis suppurativa, and recognize that cancers can rarely develop in fistulas. Reports should be tailored to the needs of the referring clinician rather than being merely descriptive.

To describe the surgical technique, complications, and outcomes of laparoscopic iliosacral lymph node (ISLN) extirpation in dogs with apocrine gland anal sac adenocarcinoma (AGASACA), with or without intraoperative lymphangiography. 18 client-owned dogs underwent laparoscopic ISLN extirpation (19 procedures) between March 2012 and May 2024. Dogs were included if medical records were complete, the dogs were diagnosed with AGASACA, and an attempted laparoscopic ISLN extirpation was performed. Dogs were evaluated for staging and/or management of suspected metastasis to ISLNs. The study population included 11 male castrated and 7 female spayed dogs with a mean age of 9.95 ± 1.8 years (range, 7 to 14 years). Pertinent physical examination abnormalities included firm, irregular, or nodular masses involving one or both anal sacs, perianal subcutaneous tissues, or prior anal sacculectomy sites. 16 of 19 procedures (84.2%) were completed totally laparoscopically, while 3 of 19 (15.8%) required reactive conversion to open celiotomy. Intraoperative lymphangiography was attempted in 6 of 19 procedures (31.6%) using indocyanine green, methylene blue, or both. Indocyanine green was successful in 2 of 3 cases (66.7%), whereas methylene blue was unsuccessful in all attempts. Intraoperative surgical complications occurred in 9 of 19 procedures (47.3%), and most were mild and self-limiting. Histopathology confirmed metastatic ISLN(s) in 14 of 19 cases (73.7%). All dogs survived to discharge, and 18 of 19 cases (94.7%) survived beyond 14 days postoperatively. Laparoscopic ISLN extirpation, with or without intraoperative lymphangiography, is a viable diagnostic and treatment approach for dogs with AGASACA, supporting the increasing role of minimally invasive surgery in veterinary surgery including oncologic staging.

IntroductionFibroblast activation protein (FAP) is involved in the extracellular matrix (ECM) remodeling and wound healing. Absent in most adult tissues, it is overexpressed by neoplastic cells and/or cancer-associated fibroblasts (CAFs) in several human malignancies. The extra Domain-B of fibronectin (EDB+FN) is a splice variant of fibronectin involved in angiogenesis and tissue remodeling, overexpressed by CAFs and cancer-associated vessels (CAVs) in many aggressive human tumors. This study aims to investigate FAP and EDB+FN expressions in canine tumors and assess their potential as druggable targets in animal patients.MethodsFAP and EDB+FN expression was assessed by immunohistochemistry on 88 canine tumors, including Soft Tissue Sarcomas [STS], Osteosarcomas [OSA], Hemangiosarcomas [HSA], Apocrine Gland Anal Sac Adenocarcinomas [AGASAC], Mast Cell Tumors [MCT], Lymphomas, and Melanomas, using polyclonal and monoclonal anti-FAP and the L19 anti-EDB antibodies. Expression distribution and intensity were semi-quantitatively scored in neoplastic cells, CAFs, CAVs, and stroma.ResultsFAP was variably expressed in neoplastic cells (79/88), CAFs (79/88), and CAVs (82/88) across all tumor types, but mostly in AGASACs, STSs, and MCTs. The monoclonal antibody presented greater specificity. EDB+FN expression was less present across tumor types, mostly with a vascular staining pattern. Labelling was most intense and consistent in the neoplastic cells, CAFs, and CAVs of melanomas, and to a lesser extent in AGASAC and STS.DiscussionSTS, AGASAC, and MCT could be candidates for FAP-targeted strategies; melanomas are the most promising for EDB+FN-directed therapies. These results support FAP and EDB+FN as targets worth investigating for clinical applications in animal patients.

BACKGROUNDAnorectal abscess and cryptoglandular anal fistula are common conditions with high recurrence rates, reflecting an incomplete understanding of their pathophysiology. A classic, yet unproven hypothesis proposes that high androgen levels increase infection risk by stimulating anal gland secretion, potentially explaining the male predominance. However, direct evidence regarding sex hormone levels in patients remains scarce. We hypothesized that active perianal infection is associated with significantly altered testosterone (T) levels.AIMTo investigate the association between perianal diseases and sex hormone levels and to identify factors associated with T levels.METHODSThis cross-sectional study included 249 men: 64 with hemorrhoids, 64 with anorectal abscess, and 121 with anal fistula. Preoperative serum sex hormone levels were measured. Multivariate linear regression identified factors associated with T levels.RESULTSThere were no significant differences in age among the three groups at baseline. T levels differed significantly among the groups (P < 0.001). Multivariate regression analysis revealed that in the overall study population, anorectal abscess (B = -2.999, P < 0.001) and body mass index (BMI; B = -0.368, P < 0.001) negatively correlated with T levels. In the abscess group, white blood cell count (B = -0.565, P < 0.001) and BMI (B = -0.298, P = 0.011) negatively correlated with T levels. In the fistula group, BMI (B = -3.866 P < 0.001) and internal opening above the dentate line (B = -4.479, P = 0.048) were associated with lower T levels.CONCLUSIONPatients with active perianal infections exhibited a significantly lower T level compared to those with hemorrhoids or fistulas, which is independently associated with systemic inflammation severity and obesity.

In this study, the anal glands of 10 adult Anatolian ground squirrels (Spermophilus xanthophrymnus) were examined through dissection, scanning electron microscopy (SEM), and light microscopy. The anal glands consist of three independent complexes positioned ventrolaterally to the anus. These glandular complexes were connected with the anal canal, the rectum, and with each other through muscular and connective tissue layers coursing in multiple directions. Each anal gland complex consisted of a glandular component and a sac-like structure. The sac structures of the anal gland complexes, which can evert, were visualized for the first time in this study using SEM. At the basal regions of the anal sacs, two distinct types of glandular clusters were identified. Type I apocrine glands, characterized by short excretory ducts, were located adjacent to the sac base, whereas Type II holocrine glands, with longer tubular ducts, were situated more distally. The study identified the presence of numerous interconnected sinusoidal vascular structures in both the glandular region of the anal complex and in the inner portions of the muscle bundles surrounding the anal complexes. These sinusoidal capillaries, previously unreported in the anal glands, likely represent erectile structures that engorge with blood and generate pressure to facilitate anal complex function.

An anal abscess is a painful and common condition that can significantly disrupt daily activities. It is most often caused by an infection of the anal glands, with about 95% of cases linked to cryptoglandular disease. These abscesses are more frequently seen in individuals with diabetes or weakened immune systems. Common types include perianal (60%), ischiorectal (30%), and submucosal abscesses (5%). If left untreated, approximately 40% of cases may develop into fistulas. In Ayurveda, this condition is known as Guda Vidradhi (Perianal abscess). Acharya Sushruta explained that imbalanced Doshas affect tissues such as skin, blood, muscle, fat, and bone, leading to abscess formation. He recommended Bhedana (incision) and Vishravana (drainage) as key treatments. His contributions, including the Shashti Upakramas (60 treatment methods), offer detailed wound and abscess management strategies. This case report presents the successful Ayurvedic management of Guda Vidradhi (Perianal abscess) demonstrating an effective alternative to modern surgical approaches.

Epithelial components of the rectum and anal canal comprise the rectal mucosa, anal canal mucosa, and anal glands. The clinicopathological characteristics of 111 cases of canine epithelial tumors in these regions were reviewed. Histopathological examination was performed on normal rectal and anal canal tissues and on 64 tumors. All signet-ring cell carcinomas and anal gland adenomas, as well as approximately half of the adenomas, were classified as anal canal tumors and were located within 1.5 cm of the anus. Acinar adenocarcinomas, papillary adenocarcinomas, and mucinous adenocarcinomas were predominantly classified as rectal tumors. Immunohistochemically, rectal adenomas, acinar adenocarcinomas, papillary adenocarcinomas, and mucinous adenocarcinomas frequently exhibited a CDX2+CK20+SOX2-CK7- immunophenotype, consistent with that of the proximal rectal mucosa. In contrast, adenomas in the anal canal frequently showed a CDX2-CK20-SOX2+CK7± immunophenotype, consistent with that of the rectal mucosa at the recto-anal junction. Signet-ring cell carcinomas and anal gland adenomas exhibited a CDX2-CK20-SOX2+CK7+ immunophenotype, consistent with that of the anal glands. In a hierarchical cluster analysis of tumor immunophenotypes, Group 1 (mostly anal canal adenomas) and Group 2 (rectal adenomas, acinar adenocarcinomas, papillary adenocarcinomas, and mucinous adenocarcinomas) formed one cluster, whereas Group 3 (signet-ring cell carcinomas) and Group 4 (anal gland adenomas) formed another distinct cluster. Based on these results, canine epithelial tumors in the rectum and anal canal may be categorized into a rectal mucosa-like immunophenotype (including adenomas, acinar adenocarcinomas, papillary adenocarcinomas, and mucinous adenocarcinomas) and anal gland-like immunophenotype (including signet-ring cell carcinomas and anal gland adenomas).

An anal fistula also called fistula-in-ano is a tract that develops between the inside of the anus and the outside skin around the anus. most anal fistulas are the result of an infection that starts in an anal gland,the infection causes an abscess develop around the anus that drains on its own or is drained surgically through the skin next to the anus. This drainage track remains open and connects the infected anal gland or the anal canal to a hole in the outside skin around the anus. Surgery is usually needed to treat an anal fistula. Sometimes nonsurgical treatments may be an option. presents challenges because to its recurrence, particularly in high-level and remote communications. In India, ksharasutra therapy, also known as medicated seton therapy is used to treat difficult anal fistulas with a high success rate (recurrence rate of 3.33%). in the present article detail description about A- 35 year male patient diagnosed with anterior fistula in ano at 1clock position treated well with Apamarga ksharasutra treatment is given.

The hallmarks of cancer describe stepwise changes in cellular functions and molecular pathways of tumour cells that undergo malignant progression. Although 14 hallmarks have been proposed, their manifestation at the molecular level across different tumour types remains incompletely understood. Here, we hypothesised that hallmark-associated transcriptomic signatures reflect the contrasting biological behaviours of a pair of a benign and a malignant tumour. To this end, we compared the two most common canine perianal tumours, the highly malignant apocrine gland anal sac adenocarcinoma (AGASAC) and the benign hepatoid gland adenoma (HGA). Spontaneous primary tumours were analysed using RNA-Seq (AGASAC n = 11, HGA n = 10) and a direct mRNA hybridisation panel (AGASAC n = 28, HGA n = 12). Large transcriptomic differences were observed in both the number of differentially expressed genes and enriched pathways. Surprisingly, transcriptomic differences based on the hallmarks of cancer were less pronounced that anticipated, particularly for "activating invasion and metastasis" and "inducing or accessing vasculature". Only the HGAs showed a significant enrichment for "deregulating cellular energetics". However, our data point towards a contrasting immune landscape between the compared tumours and a subgrouping of AGASACs associated with the inflammatory landscape. Overall, the transcriptomes of these two benign-malignant tumour extremes on the tumour spectrum contrasted each other in select aspects of the hallmarks. Still, their malignant or benign behaviours could not generally be mirrored on the mRNA level.

Anal gland adenocarcinoma is an extremely rare malignancy, with squamous cell carcinoma being the most common type of anal canal cancer. Due to its rarity, there are no well-defined diagnostic criteria or standardized treatment protocols for this condition. This study describes a rare instance of adenocarcinoma in the anal canal, which initially manifested as an anal fistula. The patient received a multifaceted treatment plan encompassing surgical intervention, chemotherapy, and radiotherapy. The study investigates the methods of diagnosis, characteristics of tumours, and the selected treatment approach. This case highlights the challenges in diagnosing and managing anal canal adenocarcinoma. Given its rarity, further studies are needed to establish standardized diagnostic and treatment guidelines.

Echiurids, as nonsegmented annelids, have an excretory system of a special organization. The excretory system of the echiuran worms is known to consist of ultrafiltration zones on blood vessels and anal sacs. Prior to this study, the fine structure of the anal sacs had been described in detail only for Thalassema thalassemum (Thalassematinae). In contrast, the more complex anal sacs of Bonelliinae, which contain additional structural elements such as tubules, remained unexplored. This study describes the anatomy, histology, and ultrastructure of the anal sacs of Bonellia viridis Rolando, 1822 (Bonelliinae) using a set of modern morphological methods: computer microtomography, araldite histology, scanning and transmission electron microscopy. New data suggest functional implications for structural elements of the anal sacs: the conical part and the neck of the funnel, the tubules, and the end sac. The ciliary funnels are responsible for collecting filtrate to their conical parts and can close at their base, thus preventing reverse flow. According to the ultrastructural data, the inner epithelium of the tubules and the end sac modifies the incoming filtrate in two ways. The inner epithelium of the tubules carries out pinocytosis and accumulates electron-dense granules. The inner epithelium of the end sac has a basal labyrinth consisting of basal processes with numerous mitochondria extending deep into the extracellular matrix and indicates active ion transport. Additional zones responsible for ultrafiltration were identified in the outer epithelium of the anal sac-specifically within the tubule and at the base of the funnel. The origin of the echiurid anal sacs as a result of fusion and multiplication of the metanephridia at the posterior growth zone of metameric annelid-like ancestor is suggested.

Canine apocrine gland anal sac adenocarcinoma (AGASAC) is an aggressive malignancy with a high incidence of regional lymph node metastasis at diagnosis. Platelet-derived growth factor receptor beta (PDGFRβ) is a receptor tyrosine kinase involved in oncogenic signaling and angiogenesis, representing a potential therapeutic target. Its expression in different AGASAC histotypes has not been fully defined. This study evaluated microscopic patterns and PDGFRβ immunohistochemical expression in three normal anal gland sacs, 51 primary AGASACs (12 non-metastatic, 39 metastatic), and 33 corresponding nodal metastases. PDGFRβ expression was semi-quantitatively scored and statistically analyzed. Histotypes included 26 mixed with solid prevalence, 11 pure solid (including 1 comedo-carcinoma), 9 mixed with tubular prevalence, 4 tubular, and 1 neuroendocrine-like. PDGFRβ was expressed in normal anal sac glands and in 43/51 tumors (5-100% positive cells): 19/26 mixed with solid prevalence, 10/11 solid, 9/9 mixed with tubular prevalence, 4/4 tubular, and 1 neuroendocrine-like. PDGFRβ labeled 27/33 nodal metastases. PDGFRβ expression was highest and more intense in tumors with a tubular pattern. The statistical trend indicated a correlation of AGASAC dedifferentiation to reduced PDGFRβ expression, but no statistical significance was found. Rare AGASAC variants (solid comedo-carcinoma and neuroendocrine-like) were described for the first time. PDGFRβ expression was higher in tubular tumors and commonly detected in primary and metastatic lesions. These findings support exploring TKI therapy for specific AGASAC histotypes. Further studies integrating receptor activation and treatment outcomes are warranted to clarify predictive and prognostic relevance.

Rationale:Anal fistulas typically result from infected anal glands, presenting with symptoms like recurrent purulent discharge, pain, and itching around the anus. Infections are commonly located in the skin, soft tissues, or spaces surrounding the rectum and anal canal. Notably, extensive subcutaneous tissue infections in the buttocks are exceedingly uncommon. Distinguishing this condition from anal fistulas associated with Crohn disease poses a significant diagnostic challenge.Patient concerns:A 27-year-old female patient presented with pain, swelling, and purulent discharge in the buttocks persisting for 6 months, with a recent exacerbation over the last 2 days.Diagnoses:The diagnoses were established through a comprehensive medical history assessment, physical examination, enhanced magnetic resonance imaging of the anal canal, and electronic colonoscopy, revealing: complex anal fistula, infected sinus in the buttock area, constipation, and mild anemia.Interventions:The surgical intervention involving complete fistula dissection, excision of the affected area’s apex in the buttocks, removal of necrotic material, fibrous tissue debridement, and thread-draped drainage facilitated fistula tract healing and markedly enhanced patients’ quality of life.Outcomes:After treatment, the patient showed no purulent discharge, swelling, or pain in the buttocks, and there was no bleeding or fluid leakage. The patient was followed up for 18 months after the treatment, and the wound healed well, with a satisfactory treatment outcome.Lessons:In the context of diagnosing and treating anal fistulas, it is crucial to abandon the notion that infection is limited to the perianal region. Utilizing advanced magnetic resonance imaging of the anal canal is essential for precise localization, while employing a combination of diagnostic examinations is warranted for accurate differential diagnosis. Postsurgical follow-up of anal fistula patients for a minimum of 1 year is advisable to monitor recurrence and address predisposing factors like constipation. In instances of uncommon variants, it is advisable to engage in multidisciplinary cooperation to synthesize insights from various specialties, thereby enhancing the scientific rigor of diagnostic and therapeutic approaches.

Abstract Chemical communication is the most ancient and widespread form of communication. In many species, specialised structures called scent glands have evolved to facilitate this communication. These glands vary considerably among species in structure, size, body location and the composition of their secretions. Histological analysis is therefore required to confirm the presence of scent glands, identify secretion types and assess potential roles of the immune system and microbiota in modifying secretions. Here, we investigated the distribution and structure of scent glands in the banded mongoose ( Mungos mungo ), a cooperatively breeding, group‐living mammal. We found that individuals possess two large (1.5 cm diameter) anal glands, each consisting of a central sac surrounded by glandular tissue. This in turn is surrounded by a layer of striated muscle, which likely facilitates the deposition of relatively large quantities of odorous chemicals when engaging in deliberate scent marking behaviour. The glands are lined by two different types of epithelia (keratinised and non‐keratinised) which may impact how immune genes such as the major histocompatibility complex (MHC) affect the microbiome of the glands, and therefore, the chemicals that are secreted during scent marking. Additionally, we reveal a previously unidentified small (0.75 mm in length) scent gland in the cheek, which may be used for scent marking. We provide evidence that banded mongooses may use their chin and abdomen for scent rubbing, as these regions are often rubbed in odorous substances, but we found no evidence of specialised scent glands in these areas. Our findings highlight the importance of integrating anatomical, behavioural and biochemical approaches to understand the mechanisms and purposes of scent communication. This study serves as a foundation for future research on the interplay between scent marking and rubbing behaviours, and the role of immune genes and microbiota in shaping chemical communication in banded mongooses and other mammalian species.

The aim of this retrospective study was to investigate the relative frequency of R0 margin classification following excision of canine apocrine gland anal sac adenocarcinoma (AGASACA). Secondary aims were to establish if R0/R1 margins, or other dog or tumor characteristics, were prognostic. Retrospective cohort study. Seventy-four dogs that underwent AGASACA excision. Each tumor margin was classified as R0 or R1 from the histopathology report. Additional data relating to primary tumor characteristics, preoperative assessment, local recurrence, metastases and survival were collated from the medical record. The rate of R0 margin classification following AGASACA excision was 75.7%. An R1 margin classification was associated with increased risk of local recurrence (OR 23, p < .0001). Overall median survival time following surgery was 25 months (95% CI 21-33). Survival time was reduced in dogs with preoperative hypercalcemia (7.5 months, p = .012), presence of metastatic disease (17 months, p = .005) and lymphovascular invasion on histopathology (21 months, p = .021). Mitotic count (p = .0069) and absence of adjunct therapy (p = .0247) also reduced survival time. The R margin classification was clinically useful in predicting local recurrence. Preoperative hypercalcemia, lymphovascular invasion on histopathology, presence of metastatic disease, mitotic count, and absence of adjunct therapy all negatively affected survival. Achieving complete margins was feasible in most dogs undergoing AGASACA excision and reduced the risk of local recurrence. The R margin classification scheme was clinically useful when reporting histopathology of canine AGASACAs.

Platelet-derived growth factor receptor beta expression in primary and metastatic canine anal sac adenocarcinoma as a potential therapeutic target

Infection of the anal glands may manifest in anal fistula formation and thus becomes annoying for the patients because of its recurring nature. Symptomatic hemorrhoids are another most common anorectal disorder which when presented in a complicated state, become a troublesome entity. Coexistence of both the disease with supralevator extension of the fistulous tract is infuriating for the operating surgeon. Management approach in such a complex case with uncertain prognosis and outcome is a point of concern. Since the management principle is only through surgical intervention, a surgeon is expected to choose a sphincter-saving technique to preserve the sphincter mechanism. This is a clinical representation of a long-standing case of a 48-year-old male patient diagnosed as complex Fistula-in-ano with Hemorrhoids for the last five years. This case was dealt surgically with utmost care to save sphincter tissue, and the wound management was done using Ayurveda interventions. Within seven weeks of management, complete wound healing was achieved, and no recurrence has been noticed till date. Thus, the surgical approach with Ayurveda management principle showed good clinical outcomes in the management of complex case of Anal fistula with Hemorrhoids.

High perianal fistulae are complex infections often originating from anal glands, requiring sphincter-preserving surgical approaches. Elastic seton offers controlled tract closure with reduced need for postoperative adjustments compared to traditional cutting setons. Objectives: To evaluate the outcomes of elastic seton in managing high perianal fistulae, focusing on pain, healing, hospital stay, and continence preservation. Methods: This descriptive case series was conducted from February 2025 to May 2025 at the Department of Surgery, Surgical Unit III, Sir Ganga Ram Hospital, Lahore. Forty-five patients with high perianal fistulae were enrolled using consecutive non-probability sampling. An elastic seton from a latex glove was placed under spinal anesthesia. Follow-ups at 1 week, 4 weeks, 3, and 6 months assessed pain (VAS), wound healing, complications, and analgesic use. Data were analyzed with SPSS v24.0 using Chi-square and ANOVA, with p &lt; 0.05 significant. Results: Of the 45 patients (64.4% male; mean age 31.3 ± 8.4 years), the mean symptom duration was 11.8 ± 4.1 weeks, and average seton cut-through time was 6.3 ± 0.9 weeks. VAS scores significantly decreased from 5.13 (Week 1) to 0.40 (6 months) (p &lt; 0.001). Complete wound healing occurred in 82.2% of patients, while complications declined from 42.2% to 17.8%. Conclusion: Elastic cutting seton with staged fistulotomy ensured safe, effective high anal fistula management with reduced pain, rapid healing, and preserved continence.