No abstract available.

No abstract available.
Amebiasis* ; Skin*

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*

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

No abstract available.
Appendicitis* ; Humans

No abstract available.
Humans ; Urinary Retention*

Fecal incontinence is a common problem that is underreported, underdiagnosed and poorly managed. It profoundly affects the quality of life and psychological function. It is widely known that the diversity of causes of fecal incontinence and different modes of action of various treatment modalities mandates a tailored approach in each case. Currently, several diagnostic tests are available that can provide useful insights regarding the pathophysiology of fecal incontinence, and also several advanced treatment modalities which make it possible to rehabilitate most of these patients become recently available. Strictly speaking, however, no specific test can tell the exact etiology of fecal incontinence and the modes of action in various treatment modalities are still not well-defined. In this sense, policy of approach to patients with fecal incontinence can rather be straightforward. Patients with endosonographically proven sphincteric defect should be treated with sphincteroplasty. But for patients without such defect, less invasive procedures among recently available modalities should be the first consideration and then more invasive ones next in case of failure.
Diagnosis* ; Diagnostic Tests, Routine ; Fecal Incontinence* ; Humans ; Quality of Life

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*

PURPOSE: Defecography is known to be a sensitive and specific measurement of pelvic floor dyssynergia (PFD). However, its standardized parameter for diagnostic analysis is still incomplete. We attempted to determine which defecographic findings are most significant for PFD, and how closely they match other physiologic tests and clinical symptoms of functional pelvic outlet obstruction. METHODS: Ninety-six patients with constipation who completed work-up of their symptoms with defecography, anorectal manometry and electromyography (EMG) were included in the study. Internal consistency of defecographic findings, and agreements between defecographic findings and results of other tests were statistically analyzed (Crohnbach's alpha, Cohen's kappa, respectively). RESULTS: Of the 96 patients evaluated, obstructive symptoms of constipation were obvious in 35 (36.5%) by obstructive symptom score. As known defecographic findings for PFD, poor opening of the anal canal was found in 33 (34.4%), persistent posterior angulation of the rectum in 33 (34.4%), and poor emptying of the rectum in 61 (63.5%). Manometric defecation index, manometric evacuation index, and EMG findings compatible with PFD were in 81 (84.4%), 72 (75%), and 73 (76%), respectively. Internal consistency of three defecographic findings was good (alpha = 0.78). Agreements between each defecographic findings and each result of other tests were all poor. CONCLUSION: Among known defecographic findings for PFD, one specific finding cannot be considered more important than the others for its diagnosis. It is hard to expect consistent results of various diagnostic tests and to predict the presence of defecographic PFD by use of anorectal manometry, EMG, or even by clinical symptoms.
Anal Canal ; Ataxia ; Constipation ; Defecation ; Defecography ; Diagnostic Tests, Routine ; Electromyography ; Humans ; Manometry ; Pelvic Floor ; Rectum