Leiomyoma of the rectum is a rare tumor and it usually present in 40 to 60 year-old individuals, and it is more frequent in men. It originates from either the muscularis mucosa or muscularis externa and those arising from the muscularis mucosa are typically small and they are identified incidentally in patients who are undergoing sigmoidoscopy. In contrast, the larger leiomyomas arising from the muscularis externa generally present symptoms that are consistent with rectal stenosis or a rectal mass. Endoscopic ultrasonography can help to define the tumor location, extension and size. Surgical resection is the treatment for most leiomyomas of the rectum, but endoscopic electroexcision is a safe and appropriate treatment for small polypoid rectal leiomyoma. We report here on a case of a semipedunculated rectal leiomyoma in a 59 year-old female patient. It was found incidentally during a colonoscopic examination and it was diagnosed by endoscopic ultrasonography. We performed endoscopic mucosal resection with colonoscopic snare electrocoagulation.
Constriction, Pathologic ; Electrocoagulation ; Endosonography ; Female ; Humans ; Leiomyoma ; Male ; Mucous Membrane ; Rectum ; Sigmoidoscopy ; SNARE Proteins

Primary malignant melanoma of the anorectum is rare, representing about 1% of all colorectal carcinoma and less than 1% of all melanomas. The most common symptom of malignant melanoma of the anorectum is anal bleeding and this is often misdiagnosed as hemorrhoids. A 72-year-old female patient was admitted due to intermittent anal bleeding for 6 months. Colonoscopic examination showed a large exophytic mass with an irregularly ulcerated and greenish-brown pigmentation on the anus and the examination also simultaneously showed a submucosal tumor-like lesion in the rectum that was located 5 cm from the anal verge. Light microscopy of the tumor revealed malignant melanocytes and the tumor cells reacted positively for immunohistochemical staining with S-100 protein and HMB-45. Distant metastasis to the brain was detected on brain MRI.
Aged ; Anal Canal ; Brain ; Colorectal Neoplasms ; Female ; Hemorrhage ; Hemorrhoids ; Humans ; Light ; Melanocytes ; Melanoma ; Microscopy ; Neoplasm Metastasis ; Pigmentation ; Rectum ; S100 Proteins ; Ulcer

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation