Hemorrhoid and anal fissure are common diseases in Korea. It has been demonstrated that patients with hemorrhoidal disease have increased activity of the internal anal sphincter. The fissure causes increased contraction in the internal anal sphincter, thereby increasing pressure in the anal canal. Many studies have reported differences in the anal canal pressures between males and females. Moreover, some papers have shown that sphincter pressures decrease with age. But the majority of these studies were not specific for the hemorrhoid and anal fissure. Therefore, we studied the effect of age and gender on anal pressure in hemorrhoid and anal fissure. Two hundred ninety six patients with hemorrhoid and sixty eight patients with anal fissure were retrospectively assessed. Anorectal manometry using a radial eight-port catheter was performed during resting and squeezing maneuvers of the anal sphincter. In hemorrhoid reduction in maximal average resting(MARP) and squeezing pressure(MASP) were found from the sixth decade, however in anal fissure reduction in MARP and MASP were found in the third decade. In hemorrhoid significant decrease of MARP and MASP were noted in entire ages of female, however in anal fissure increase of MARP and MASP were noted in fifth and sixth decade of female. In conclusion, in hemorrhoid both resting and squeezing pressure decrease with age in female. In anal fissure both resting and squeezing pressure decrease in third decade and in male with fifth and sixth decade.
Anal Canal ; Catheters ; Female ; Fissure in Ano ; Hemorrhoids* ; Humans ; Korea ; Male ; Manometry ; Retrospective Studies

Natural cytotoxicity mediated by natural killer (NK) cells is believed to play an important role in host anticancer defense mechanisms. The aim of this study is to compare the number of NK cells in patients with colorectal cancer and hemorrhoids, and before and after surgery in patients with colorectal cancer. Twenty colorectal cancer patients and twenty hemorrhoid ones were studied. Venous blood samples were obtained preoperatively, and on the 7th, and 14th postoperative days. Mononuclear cells were isolated over Ficoll-Hypaque gradients, and T cells, B cells, and NK cells were measured with CD3 FITC (T cell), CD 19 PE (B cell), and CD56 FITC (NK cell) antibody, The number of T cell (/mm3) was 1224, 1280, and 1125 at preoperative, 7th, and 14th postoperative day in hemorrhoid patients and 1195, 901, and 1060 in colorectal cancer patients respectively. The number of B cell (/mm3) was 243, 160, and 250 in hemorrhoid patients and 147, 78, and 113 in colorectal cancer patients. The number NK cell (/mm3) was 148, 156, and 143 in hemorrhoid patients and 129, 85, and 128 in colorectal cancer patients. There was no difference among Dukes stages in the number of NK cells. In conclusion, the number of NK cells was not changed in colorectal cancer patients compared with hemorrhoid ones. Major operation changed the number of NK cells in colorectal cancer patients.
B-Lymphocytes ; Colorectal Neoplasms* ; Defense Mechanisms ; Fluorescein-5-isothiocyanate ; Hemorrhoids ; Humans ; Killer Cells, Natural* ; T-Lymphocytes

No abstract available.
Pregnancy*

No abstract available.
Colorectal Neoplasms* ; Epidermal Growth Factor* ; Humans ; Receptor, Epidermal Growth Factor*

Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

No abstract available.
Child* ; Humans ; Immunoglobulin E* ; Nephrosis, Lipoid*

Synchronous neoplams are uncommon condition but the incidence is now being increased. The situation is rare when these tumors comes from different origin. We experienced the case with synchronous sigmoid colon cancer and anal squamous cell carcinoma with rectal mucosal metastasis. The patient was 61 years old male. He complained of intermittent hematochezia since 3~4 months ago. The patient underwent anterior resection for colon cancer and wide excision for anal squamous cell carcinoma. After surgical operation, postoperative adjuvant chemotherapy (5-FU + Leucovorin) and radiotherapy were done. In this case, we could preserve the anal sphincter using combined therapy. We think that this type of management may be useful treatment in patients with colon cancer and anal squamous cell cancer simultaneously.
Adenocarcinoma* ; Anal Canal ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Colon, Sigmoid* ; Colonic Neoplasms ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Metastasis* ; Neoplasms, Squamous Cell ; Radiotherapy ; Sigmoid Neoplasms

A retrospective study of 274 patients who presented with constipation was done. The following results were obtained by recording colonic transit time. The male to female ratio was 72 : 197, and most patients were in their third and fifth decade, each age group accounting for 21% of total number. Associated symptoms were anal discomfort(33%), abdominal discomfort (25%), hematochezia (23%), reduced stool caliber (11%), and tenesmus (8%). As a result, 223 patients had normal transit time and 51 patients had abnormal transit time. Eighty-six patients with normal transit time and 51 patients with abnormal transit time underwent barium enema or colonoscopic examination. Abnormal lesions such as polyps and diverticulums were found in 10 patients with normal transit time and 7 patients with abnormal transit time. Therefore barium enema and colonoscopic examination in the patients with abnormal transit time were meaningful (P=0.024). Eighteen out of 25 patients with normal transit time and 8 (67%) of 12 patients with abnormal transit time showed abnormal defecogram results. The rectocele was the most frequent cause of abnormality in defecogram. Abnormal anal manometry results were obtained in 5 (22%) of 23 patients with normal transit time and 3 (50%) of 6 patients with abnormal transit time. Three types were classified in the patients with abnormal transit time. With type II patients, anal manometry findings were normal and 2 patients showed abnormal results in defecogram. With type III patients, 5 (43%) of 12 patients showed abnormal results in defecogram and 3 (50%) of 6 patients had abnormal anal manometry findings. Conclusively, if abnormal transit time is found in the patients with chronic consipation, further evaluations such as barium enema or colonoscopic examination are necessary. And even in the patients without any abnormality in transit time, selected performance of defecogram and anal manometry depending on clinical symptoms are preferable.
Barium ; Colon* ; Constipation* ; Diverticulum ; Enema ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Manometry ; Polyps ; Rectocele ; Retrospective Studies

The aim of this study was to determine the guideline of usage of antibiotics for anonectal suppurative disease. This study was conducted in consecutive 96 patients, who were taken surgical treatments for the anorectal abscess at the department of general surgery of Ewha Womans University Hospital, from January 1990 to December 1994. All subjects were classified in terms of age, gender, duration, history, associated disease, classification, location, and isolation of organism. The incidence of the anorectal abscess was highest in the 3rd and 4th decade of age and male in terms of gender. 80.3% of all patients were admitted within 10 days after onset. The most common past history of anorectal disease was the anorectal abscess(15 cases, 15.6%) and the associated systemic disease was tuberculosis(9 cases, 9.4%). The main type of anoreclal abscess was the perianal abscess(87.5%) and the most frequent location was posterior area(39.6%). In the pus culture and isolation test, 90.6% of all patients had colony formation and the most frequently cultured organism was E.coli(55 cases,57.3%), followed by Klebsiella species(15 cases,15.6%) and anaerobic Bacteroid species(14 cases,14.6%). In antibiotic sensitivity test, the 3rd generation of aminoglycoside was sensitive in 89 cases and resistant in 3 cases, and the 3rd generation of cephalosporin was sensitive in 87 cases and resistant in 5 cases. These results suggest that the 3rd generation of aminoglycoside or the 3rd generation of cephalosporin could be selected to treat the anorectal suppurative disease.
Abscess ; Anti-Bacterial Agents ; Classification ; Female ; Humans ; Incidence ; Klebsiella ; Male ; Suppuration

This study is a clinical review of 154 patients with fistula-in-ano, which were treated at the Department of General Surgery of Ewha Womans University Hospital from January, 1993 to December, 1996. The male to female ratio was 4:1, and the prevalent of groups were in the 3rd and 4th decade. The symptoms were anal discharge in 123 cases(79.8%), pain in 21 cases (13.6%), palpable mass in 9 cases(5.8%). 53.8% of the patients showed a duration of symtoms which were within 6 mouths. The previous or combined anal diseases were anal abscess in 62.4%, postfistulectomy in 29.0%, hemorrhoid in 4.3%, and anal fissure in 1.2%. The histopathologic etiologies were chronic non-specific inflammation in 94.8%, and tuberculosis in 3.2%. 38.8% of the patients showed an external openings in the anterior midline, 25.9% in the posterior midline, 13.0% in the left lateral, and 10.4% in the right lateral portion of the anus. In 84.4% of the patients, the interval opening was identified. The intersphincteric type was the most common. The operative procedures included fistulotomy with lay open in 129 cases(83.8%), fistulotomy with seton in 16 cases(10.4%), and fistulectomy in 8 cases(5.2%). The days of hospital stay were mostly within 14 days. The main postoperative complications were urinary retention and reccurance, which were identified in 4.6% each of the patients. The acuracy and the predictive value of fistulography, a method of identification of the internal openings showed an accuracy of 73%, the predictive value of positive tests was 95% and that of the negative test was 30%.
Abscess ; Anal Canal ; Female ; Fissure in Ano ; Hemorrhoids ; Humans ; Inflammation ; Length of Stay ; Male ; Mouth ; Postoperative Complications ; Rectal Fistula ; Surgical Procedures, Operative ; Tuberculosis ; Urinary Retention