PURPOSE: In small portion of patients with Hirschsprung's disease, the aganglionic stagment extends only up to the mid-rectum. This report describes an innovative and effective posterior sagittal anorectal myectomy for curative repair of ultrashort segment Hirschsprung's disease in neonates. METHODS: The procedure was performed on ten patients with ultrashort segment Hirschsprung's disease between 1995 to 1998. The procedure was performed by making a sagittal incision in midline posterior perineum to expose the posterior rectum.4 longitudinal strip of muscular layer is removed from the aganglionic portion of the anorectum from the upper rectum to the internal sphincter. The patients were followed postoperatively to determine the effectiveness of the procedure and to observe the presence of any complications. RESULTS: Seven patients (70.0%) were under three months old. Operative biopsy showed that four patients had aganglionosis in the upper rectum, three patients in the middle rectum and three patients in the lower rectum. The posterior sagittal anorectal myectomy was successful in the treatment of ultrashort segment Hirschsprung's disease- symptom recurred for one patient due to total aganglionosis and for another patients due to rectosigmoid aganglionosis. These two patients received the staplingprocedure after colostomy. Some transient complications included mucosal perforation during surgery (30.0%) and incisional wound infection (20.0%). CONCLUSION: For those neonates with ultrashort segment Hirschsprung's disease, the posterior sagittal autorectal myectomy should be considered a safe and effective method for treatment and confirmatory diagnosis. In addition, preliminary colostomy is not required prior to this procedure.
Biopsy ; Colostomy ; Diagnosis ; Hirschsprung Disease* ; Humans ; Infant, Newborn ; Perineum ; Rectum ; Wound Infection

No abstract available.

No abstract available.
Abdominal Pain* ; Peptic Ulcer*

Congenital M llerian anomalies of uterus are so infrequently encountered and endometriosis, primary infertility, hematometra, and urinary tract anomalies are claimed to be common complaints in women with unicornuate uterus. We report one case of rudimentary horn associated with agenesis of right kidney and pelvic endometriosis which is presented with brief review of literature about anomaly of the female genital tract.
Animals ; Endometriosis* ; Female ; Hematometra ; Horns* ; Humans ; Infertility ; Kidney* ; Urinary Tract ; Uterus

No abstract available.
Inhalation* ; Lung Injury* ; Lung*

The aim of this study was to analyze the effect of age at beginning of treatment on the results of anisometropic amblyopia in twenty-two consecutive children. The children who had strabismus or any other ocular disease affecting visual acuity was excluded. Two age groups were defined, according to the age at which treatment was started : 7 years or less(group I. N=10), 8 years or more(group II. N=12). Mean age of group I was 5.3 years old(4.1-7.9), while group II was 10.2 years old(8.0-13.2). Six patients were treated with occlusion therapy, 11 patients with atropine penalization, 1 patient with occlusion therapy and atropine penalization alternatively and 4 patients with spectacle correction only. All children had cycloplegic refraction before treatment and at each visit the corrected visual acuity was assessed. The difference in refractive errors between two eyes before treatment was 2.58D(1-9D) in group I and 2.75D in group II. The mean initial corrected visual acuity of amblyopic eyes was 0.43 in group I and 0.46 in group II. There was no significant difference in initial visual acuity between the two groups. The range of follow up times was from 5 to 60 months, with an average of 18 months. There was no significant difference in final visual outcome of amblyopic eye between the two groups. For patients aged 7 years or less, 80%(8/10) of patients achieved a final visual acuity of 0.8 or better and 90%(9/10) achieved the same final visual acuity as in the sound eye. For patients aged 8 years or more, 83%(11/12) of patients achieved a final visual acuity of 0.8 or better and 83%(10/12) achieved the same final visual acuity as in the sound eye. The initial visual acuity, the methods of therapy did not affect the final visual outcome. In pure anisometropic amblyopia, the patients older than 8 years of age have been treated as effectively as the patients 7 years or less.
Age Factors ; Amblyopia* ; Anisometropia ; Atropine ; Child ; Follow-Up Studies ; Humans ; Refractive Errors ; Strabismus ; Treatment Outcome ; Visual Acuity

PURPOSE: Peptide YY is composed of 36 amino acids, and its functions are suppression of gastric acid secretion, delay of gastric emptying, increase of intestinal motility, inhibition of pancreatic exocrine secretion, and enhanced postprandial colonic absorption of water and electrolyte. PYY is released from PYY cells, which are mainly distributed in the ileum and colon, in response to the presence of intraluminal lipids. This study was designed to determine the regional distribution of PYY in the normal human ileum, colon, rectum, and anal canal by studying mucosal concentrations. METHODS: Fresh tissues were obtained from specimens of segmental resections of the small bowel, colectomies, ileostomies, and abdominoperineal resections for the management of colonic or rectal carcinomas or benign diseases of the bowel. Only specimens devoid of advanced luminal obstruction were included. Mucosa was separately recruited by microdissection of frozen sections. Radioimmunoassays were performed using the methods of Adrian et al. RESULTS: The concentration of PYY was highest at 25 cm proximal to the ileocecal valve in the ileum (307.6 pmol/ g) and in the upper rectum at the colon (653.1 pmol/g). The concentration of PYY was 27.3 pmol/g in the anal canal distal to the dentate line. A clear differential distribution of PYY was shown in the ileum and colon. CONCLUSIONS: This study showed PYY was present in large amounts in the mucosa of the ileum and colon, with high concentrations in locations 25 cm proximal to ileocecal valve and in the upper rectum, respectively. The trend of regional differences in PYY in the colonic mucosa probably reflects local differences in functions, such as absorption and storage. Also, the peak concentration in the ileum at 25 cm proximal to ileocecel valve suggests that this region is the most abundant production site of PYY in the ileum.
Absorption ; Amino Acids ; Anal Canal ; Colectomy ; Colon ; Frozen Sections ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans* ; Ileocecal Valve ; Ileostomy ; Ileum ; Microdissection ; Mucous Membrane* ; Peptide YY* ; Phenobarbital ; Radioimmunoassay ; Rectum

PURPOSE: This study was conducted to evaluate the functional results of an anterior extrasphincteric anorectoplasty (AEA) guided by an illuminating intrarectal indicator, in which a transperineal positioning of the anal canal was performed without cutting the perineal sphincter muscle. METHODS: Point A which would be a anal orifice in future was designated 0.3 mm anterior to the anal dimpling site. A semicircular incision was made in the front of the anus. The flap, which included from the anal skin to the upper margin of the external anal sphincter, was everted posteriorly. A quarter of the frontal upper rim of the external anal sphincter was exposed, and the center of the uppermost portion was designated as point B. From point A toward point B, a spinal needle was inserted through the anal sphincter, and needle's tract was dilated under direct identification of the sphincter muscle by electronic stimulation. An illuminating intrarectal indicator with a laparoscopic light source was pushed through the distal stoma of a sigmoid colostomy toward its distal lumen so that the blind rectal pouch was perineally exposured. On the blind pouch, a cruciate incision was made, and it was anastomosed to the anus. RESULTS: From 1991 to 2000, 11 patients with imperforate anus of high and intermediate type were operated by our method. In one case, the urethral injury was found intraoperatively and was immediately repaired. One case of anal stenosis was improved after serial Hegar dilatation. The postoperative bowel function in the Kirwan's clinical assessment at 12 th month was grade I in 9 cases and grade II in 2 case. Conclusion: This AEA with an illuminating intrarectal indicator shows acceptable clinical results and could be considered to be an effective surgical option for anorectal malformations.
Anal Canal ; Anus, Imperforate ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Dilatation ; Humans ; Needles ; Skin

No abstract available.
Cervix Uteri* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Follicular Fluid* ; Humans* ; Spermatozoa* ; Spouses*

Wrestlers has frequently injured on his ear by friction or hitting. If the ear injury like hematoma did not treat appropriately, it should be deform to disfigured outer shape. We analyzed the incidence and characteristics of ear deformity with elite wrestlers. We took the photo with elite 58 male wrestlers' ears. We surveyed the carrier of elite player, duration of training time, ear injury history, treatment history and satisfactory scale of his ear shape. The characteristics of ear shape were classified by Yotuyanagi classification. 44 wrestlers has deformity of his ear in elite wrestlers (76%, 44/58). Right side ear deformity is 50 cases, bilaterally involvement is one case. Microtia was 11 (24%), ear protrusion was 15 (33%) cases. Yotuyanagi type IB was 13 (29%) cases that deformity extending from helix to antihelix. Type IIA was 12 (27%) cases that deformity with a substantial change with good structural integrity in outline of the ear. Acute ear injury was treated with simple icing (33 cases, 56%), aspiration and compression (6 cases, 10%). 34 wrestlers (77%) dissatisfied his own ear shape. 10% of acute ear injuries treat appropriately in domestic elite male wrestlers. 76% of the wrestlers has an ear deformity and dissatisfaction.
Classification ; Congenital Abnormalities* ; Ear Deformities, Acquired ; Ear* ; Friction ; Hematoma* ; Humans ; Incidence ; Male ; Prevalence*