The difference between anal fistulas involving the ischioretal space and pelvirectal space is that in the former the involvement of the anal fistula is low the levator ani muscle whereas in the latter it is above the levator ani muscle. The levator ani muscle posterior midline incision method, which is introduced here, is thought not to injure the anal sphincter; thus, it does not affect the anal function. The method also allow the surgeon to assess readily and accurately whether or not the fistula has invaded the pelvirectal space.
Fistula ; Muscles ; Rectal Fistula

No abstract available.
Fournier Gangrene*

There are many techniques for performing a hemorrhoidectomy. The author introduces the submucosal hemorrhoidal artery ligation technique and the shortening suture technique. In the author's expericence, the submucosal hemorrhoidal artery ligation technique reduces not only the secondary bleeding rate but also the hemorrhoid recurrence rate after a hemorrhoidectomy. The shortening suture technique reduces the postoperative anal stricture rate by folding skin into the anal canal and prevents a skin tag after a hemorrhoidectomy.
Anal Canal ; Arteries* ; Constriction, Pathologic ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids* ; Ligation* ; Recurrence ; Skin ; Suture Techniques* ; Sutures*

A quick hemostatic effect, as well as sclerosing and shrinkage of hemorrhoids, can be attained when internal hemorrhoids are treated by using injection therapy with aluminum potassium sulfate and tannic acid (ALTA), the outcomes of treatment may be similar to those of a hemorrhoidectomy. However, if the type of hemorrhoid or the method of injection is not appropriate for ALTA treatment, complications peculiar to ALTA or recurrence may develop. Accordingly, sufficient understanding of the treatment mechanism of ALTA injection and repeated training for injection are required for effective use of the ALTA treatment.
Alum Compounds ; Aluminum ; Hemorrhoidectomy ; Hemorrhoids ; Potassium ; Recurrence ; Tannins

PURPOSE: Postdural puncture headache is one well-known complications of spinal anesthesia. The development of postdurals puncture headaches is related to needle size, the direction of the needle bevel, the number of dural punctures and the age of the patient. However, the effect of the sitting position after spinal anesthesia (saddle block) on the incidence of postdural puncture headaches is not yet known. This study was performed to compare the incidence rates of headaches between a saddle block group (sitting position group) and a low spinal anesthesia group (supine position group). In addition, this study was performed to identify the predisposing factors influencing postdural puncture headaches (age, sex, seasonal variation, onset of headache, location of headache). METHODS: The authors analyzed 960 anal-surgery patients who were operated on using a saddle block or low spinal anesthesia at Hang Cinic from Jan. 2000 through Dec. 2000. The authors compared the incidence rates of headaches between the saddle block group (480 cases) and the low spinal anesthesia group (480 cases). RESULTS: 1) The incidence of postdural puncture headaches was not significantly different between the two groups (2.5% in the saddle block group, and 2.3% in the low spinal anesthesia group) (P>0.05). 2) The postdural puncture headache incidence rate was higher for younger patients (20~30 years) and for females. (M:F=7:16) (P<0.05). 3) The onest of postdural puncture headaches was at the postoperative 2nd day in 16 cases (70%) and at the postoperative 3rd day in 6 cases (26%). 4) The incidence rate of postdural puncture headache was higher in the summer (5 cases in June, and 3 cases in July, 4 cases in August). 5) The headache were located in the frontal region in 16 cases (70%) and in the occipital region in 3 cases (13%). CONCLUSIONS: There is no significant difference in the incidence rates of postdural puncture headaches between the saddle block group and the low spinal anesthesia group. Postdural puncture headaches had a tendency to occur more frequently in young female patients and during the summer season. In addition, a more intensive study of the use of saddle block anesthesia for ambulatory anal surgery is required.
Anesthesia ; Anesthesia, Spinal* ; Causality ; Female ; Headache ; Humans ; Incidence* ; Needles ; Post-Dural Puncture Headache* ; Punctures ; Seasons

Urinary tract infections are common clinical problems in children, even though lots of treatment strategies have been tried. Many studies of the application of probiotics for urinary tract infection in female adults exist, but there is a lack of studies in children. The aims of this study were to screen probiotic strains for inhibiting the uropathogens in vitro, to find candidates for in vivo study. Nine strains of E. coli were isolated from children with urinary tract infection and six uropathogens were obtained from Korean Colletion for Type Cultures and American Type Culture Collection. Also 135 lactic acid bacteria (LAB) strains were isolated from healthy children, and were identified through physiologic, biochemical methods, 16S rDNA PCR, and data analysis. And with agar disk diffusion assay technique the antimicrobial activities of these LAB strains against those uropathogens were examined. Three strains of separated LAB strains demonstrated major antimicrobial activity against all the uropathogens. In the agar disk diffusion assay technique, antimicrobial activities increased most in the 4th day culture broth with separated Lactobacillus. In summary, some LAB can be used as candidates to develop the probiotic microorganisms that inhibit uropathogens in children, and are expected to be applied to treatment and prevention of pediatric urinary tract infection.
Agar/chemistry ; Anti-Infective Agents/pharmacology ; Child ; Culture Media/metabolism ; Diffusion ; Escherichia coli/*metabolism ; Feces ; Humans ; Korea ; Lactic Acid/*metabolism ; Microbial Sensitivity Tests ; Polymerase Chain Reaction ; Probiotics/*metabolism ; RNA, Ribosomal, 16S/metabolism ; Urinary Tract Infections/*microbiology/therapy

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

PURPOSE: The anal verge is the border of the lowest part of the anal canal. However, grossly, it may be difficult to identify. Therefore, to assess the precise position of the anal verge, we performed this study. METHODS: From August 1 to 31, 2006, 40 patients having anal surgery under spinal anesthesia were selected randomly. Prior to surgery, the anal verge was marked with the patient in the Sims's position. After marking, the anus was pulled bilaterally to both sides using bandages, and the lengths of the four areas were measured with the patient in the jackknife position. RESULTS: With the patient in the jackknife position, the anal verge was moved laterally by an average of 1.09+/-0.36 cm. The shift distance of the anal verge relative to the anal area was measured; the shift distance in the posterior direction was 1.1+/-0.30 cm, that in the anterior direction was 0.85+/-0.25 cm, that in the right lateral direction was 1.22+/-0.41 cm, and that in the left lateral direction was 1.20+/-0.34 cm. The shifted distance to the posterior area was significantly longer than that to the anterior area (P<0.05). CONCLUSION: When performing anal surgery with the patient in the jackknife position, the anal verge is shifted to the lateral side of the anus compared to its position when the patient is in the normal position. Notably, the shift distance to the posterior area was significantly longer than that to the anterior area. By assessing the precise position of the anal verge, the surgeon can reduce the resection range of the anoderm and create an appropriate drainage wound.
Anal Canal ; Anesthesia, Spinal ; Bandages ; Drainage ; Humans

No abstract available.
Budd-Chiari Syndrome* ; Vena Cava, Inferior*

STATEMENT OF PROBLEM: A number of studies about the nano-treated surfaces of implants have been conducting along with micro-treated surfaces of implants. PURPOSE: The purpose of this study was to get information for the clinical use of nano-treated surfaces compared with micro-treated surfaces by measuring removal torque and analyzing histological characteristics after the placement of various surface-treated implants on femurs of dogs. MATERIAL AND METHODS: Machined surface implants were used as a control group. 4 nano-treated surface implants and 3 micro-treated surface implants [resorbable blast media surface (RBM), sandblast and acid-etched surface (SAE), anodized RBM surface] were used as experimental groups. Removal torque values of implants were measured respectively and the histological analyses were conducted on both 4weeks and 8weeks after implant surgery. The surfaces of removed implants after measuring removal torque values were observed by scanning electron microscopy (SEM) at 8 weeks. RESULTS: 1. Removal torque values of the nano-treated groups were lower than those of micro-treated groups. 2. Removal torque values were similar in the anodized RBM surface groups. 3. On the histological views, there was much of bone formation at 8 weeks, but there was no difference between 4 and 8 weeks, and between the types of implant surfaces as well. CONCLUSION: It is suggested that implant topography is more effective in removal torque test than surface chemistry. To get better clinical result, further studies should be fulfilled on the combined effect of surface topography and chemistry for the implant surface treatments.
Animals ; Dogs ; Femur ; Microscopy, Electron, Scanning ; Osteogenesis ; Titanium ; Torque