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

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