No abstract available.

No abstract available.
Amebiasis* ; Skin*

PURPOSE: Anorectal manometry has become a routine investigation for the evaluation of patients with anorectal disorders. However, the interpretation of such studies is confounded by the fact that controversial data are reported with regard to the same events. The aim of this study was to measure the reproducibility of the pressure profiles of anorectal manometry in healthy controls for standardization of their measurements. METHODS: Manometric study was performed on different days with 7 days interval in 22 male healthy subjects with the use of a pneumohydraulic capillary perfusion system. RESULTS: For resting pressures with rapid pull-through (RPT) technique, maximum pressure revealed 43.58, 19.8% and mean pressure, 16.02, 14.6% in the order of reproducibility coefficient and coefficient of variation. For resting pressures with stationary pull-through (SPT) technique, maximum pressure; 17.22, 12.2% and mean pressure; 14.66, 26.4%, respectively. For squeezing pressures with RPT technique, maximum pressure; 53.37, 14.3% and mean pressure; 66.32, 23.6%. For squeezing pressures with SPT technique, maximum pressure; 72.80, 11.9%, mean pressure; 93.10, 30.5% and coughing pressure; 69.42, 15.8%, respectively, For anal canal length (ACL) with RPT technique, at resting state; 7.10, 7.9% and at squeezing state; 14.55, 13.7%, respectively. For high pressure zone (HPZ) with RPT technique, at resting state; 6.68, 16.3% and at squeezing state; 11.06, 23.5%. For HPZ with SPT technique, at resting state; 11.28, 25.4% and at squeezing state; 10.04, 17.5%, respectively. For radial asymmetry (RA) with RPT technique, at resting state; 13.76, 42.3% and at squeezing state; 7.86, 22.9%. For RA with SPT technique, at resting state; 24.6, 58.6% and at squeezing state; 14.28, 46.7%, respectively. CONCLUSION: Measurements of resting and squeezing pressure are more reproducible by SPT technique, in which technique it seems that maximum value is more preferred as a representative value. ACL and HPZ are may well measured on resting pressure with SPT technique. Radial asymmetry shows the best reproducibility on squeezing pressure with RPT.
Anal Canal ; Capillaries ; Cough ; Humans ; Male ; Manometry ; Perfusion

PURPOSE: Measurement of colon transit time is well-known physiologic study for patients with chronic constipation. But information we get from it is frequently inconsistent with patient's complaint. This study was designed to ascertain the actual significance of that measurement. METHODS: The subjects included two groups of patients with chronic constipation. One group consists of 32 patients(group A), The other group 36 patients(group B). Colon transit time study and defecographic examinations were done using previously described methods. But the former study was a little modified in group A, in which sodium phosphate enema was given at the previous day of oral intake of radio-opaque markers. Findings of colon transit time study and their relations to the defecographic results were compared with each other. RESULTS: As for the 5th day-findings of colon transit time, 6 cases(18.7%) were abnormal in group A and 3 cases(8.4%) in group B(statistically not different). As for the 3rd day-findings, 15 cases(46.9%) were abnormal in group A and 7 cases(19.5%) in group B( statistically different, p=0.0163). Defecographic findings showed 7 cases(21.9%) of outlet obstruction pattern in group A and 9 cases(25%) in group B. Correlations between these findings and those of colonic transit time studies were not proven statistically. CONCLUSION: Colon transit time study with single marker bolus and the 5th day photography technique was considered not to reflect the actual conditions of patients with chronic constipation. But sodium phophate enema, given to patients before starting the study, seemed to enhance the accuracy of study.
Colon* ; Constipation* ; Enema ; Humans ; Photography ; Sodium ; Time and Motion Studies*

No abstract available.
Humans ; Urinary Retention*

No abstract available.
Appendicitis* ; Humans

No abstract available.
Humans ; Urinary Retention*

PURPOSE: The fatigue rate index (FRI) has been developed to access sustained voluntary contraction of the external anal sphincter. This study is designed to refine the technical aspects of measuring the FRI and to re-evaluate its clinical significance. METHODS: Thirty-eight patients with fecal incontinence (19 males, 19 females) and 37 (21 males, 16 females) controls were studied. Anal manometry was performed by using standard protocols. Fatigue was measured over a 20-sec squeeze at a high-pressure zone. The FRI was calculated from the maximum squeeze pressure (MXSP) and the fatigue rate. For the accuracy of the calculation, the mean resting pressure (MRP) was calibrated to zero before the metric procedure, representative segments of the calculation were selectively designated as those denoting sustained squeeze, and representative channels were designated from among 8 channels by using 3 or more of those showing typical sustaining-pressure curves. RESULTS: No difference in demographic factors was detected between the two groups. Basic manometric parameters were significantly different between the two groups (MRP, 29.4+/-21.3 vs. 44.4+/-17.8 mmHg, P=0.0015; MXSP, 205.9+/-98.0 vs. 274.2+/-106.5 mmHg, P=0.0051). The FRI was also significantly different (29.8+/-14.3 vs. 86.3+/-127.1 sec, P=0.0108). The areas under the receptor operating-characteristic curves for the MRP, the MXSP, and the FRI were 0.72, 0.69, and 0.84, respectively. The sensitivity and the specificity of the FRI for detecting fecal incontinence were 80% and 65% at 40 sec as a cut-off point. CONCLUSION: The FRI was proven to be more accurate than the MRP and the MXSP in detecting incontinence. With adequate modifications of the measuring method, measurement of the FRI could be done more easily and conveniently, but its cut-off point for detecting fecal incontinence was lower than previously reported.
Anal Canal ; Contracts ; Demography ; Fatigue ; Fecal Incontinence ; Humans ; Male ; Manometry ; Sensitivity and Specificity

PURPOSE: This study was undertaken to evaluate how well anorectal manometry diagnose anal sphincter injury, especially with regard to the parameter of radial asymmetry. METHODS: Anorectal manometry were performed in 27 male patients with anal fistula of transsphincteric type. The postoperative values of each manometric parameter including radial asymmetry (RA) were compared with preoperative ones. And also, the association between the sites of functional defect assessed by cross-sectional pressure data under station pull-through (SPT) technique and those of anatomical defect made by fistulotomy operation were determined. RESULTS: Under rapid pull-through (RPT) technique, maximum resting pressure (MRP); 113.1 21.3 mmHg (preoperative value) vs 68.0 18.5 mmHg (p=.000) (postoperative value), RA of MRP; 16.7 3.7% vs 24.1 7.5% (p=.002), Maximum squeeze pressures (MSP); 199.0 35.2 mmHg, 169.6 48.7 mmHg (p=.006), RA of MSP; 15.5 3.7%, 22.8 3.5% (p=.000). Under SPT technique, MRP; 100.4 39.5 mmHg vs 71.2 34.6 mmHg (p=.000), RA of MRP; 16.3 7.9% vs 24.2 10.8% (p=.026), MSP; 299.1 71.6 mmHg vs 231.4 90.3 mmHg (p=.004), RA of MSP; 13.0 6.1% vs 22.0 8.4% (p=.001). Sites of functional defects interpreted upon SPT data were coincidental with sites of anatomical defects made by fistulotomy in 88.9% (MRP) and 92.6% (MSP) of cases. CONCLUSIONS: Manometric radial asymmetry could be a useful parameter in diagnosing anal sphincter injury and locating the site of defect.
Anal Canal* ; Diagnosis* ; Humans ; Male ; Manometry ; Rectal Fistula

PURPOSE: The rectoanal reflex is a response of the anal sphincter to rectal distension, reflecting the functional nature of the anal sampling mechanism of rectal discrimination. The role of this reflex in the continence mechanism is believed to be important, but it exact role still remains to be proven, and the stratification of this reflex, along to the degree of functional impairment of the anal sphincter, is rarely performed. The aim of this study was to assess the differences between various parameters of this reflex among healthy volunteers and incontinent and constipated patients. METHODS: The rectoanal contractile and inhibitory reflexes were recorded in 20 normal controls (group A) and 25 constipated (group B) and 19 incontinent patients (group C). The latencies, areas under the reflex curves, amplitudes and recovery times of each reflex were individually estimated, and differences between the groups statistically analyzed. RESULTS: The inhibitory reflex was not detected in 2 cases from group B (8.0%) and 1 from group C (5.26%). The contractile reflex was not detected in 2 cases from group A (10.0%), 8 from group B (32.0%) and 10 from group C (52.63%). There were no significant differences in any of the parameters in a comparison of the three groups. In a two group comparison, the amplitude and area under the reflex curves of the inhibitory reflex differed significantly between groups B and C (P=0.0373, 0.0238), and the latency of the contractile reflex differed significantly between groups A and C (P=0.0476). CONCLUSION: Both the rectoanal reflexes showed significant differences between the three patient groups, although this was not the case with all parameters. An analytical assessment of the various parameters of those reflexes would, therefore, make it possible to stratify the functional impairment of anal continence.
Anal Canal ; Discrimination (Psychology) ; Healthy Volunteers ; Humans ; Reflex*