OBJECTIVES: To analyze the findings of rectal intussusception and to find the other accompanied functional anorectal diseases. MATERIALS AND METHODS: We analyzed defecograms in 25 patients with rectal intussusception among 77 patients taken with obstructed defecatory symptom. Females were 16 (64%), males were 9 (36%), and the mean age was 55 years old. The changes of anorectal angle (ARA) and movement of anorectal junction were measured, and the morphologic changes of rectal wall during defecation were analyzed. RESULTS: ARAs measured by central axis method (CAM), the mean angles were 114.6, 102.2, and 119.8 degree, respectively in resting, squeezing, and straining period. By posterior wall methods (PWM), those were 86.7, 72.0, 93.3 degree. The differences of ARA between resting and straining period were 5.2, 6.6 degree, respectively by CAM and PWM. The mean descent of anorectal junction during defecation was 0.83 cm. The most frequent finding associated with rectal intussusception was rectocele (12 cases;48%). The other accompanied findings were 9 spastic pelvic floor syndrome (36%) and 4 fecal incontinence (16%). Total 18 patients out of 25 patients were accompanied with other functional anorectal diseases (72%). CONCLUSIONS: Recognition of rectal intussusception with accompanied diseases would be important for the proper treatment planning.
Axis, Cervical Vertebra ; Defecation ; Fecal Incontinence ; Female ; Humans ; Intussusception* ; Male ; Middle Aged ; Muscle Spasticity ; Pelvic Floor ; Rectocele

OBJECTIVES: To analyze the findings of rectal intussusception and to find the other accompanied functional anorectal diseases. MATERIALS AND METHODS: We analyzed defecograms in 25 patients with rectal intussusception among 77 patients taken with obstructed defecatory symptom. Females were 16 (64%), males were 9 (36%), and the mean age was 55 years old. The changes of anorectal angle (ARA) and movement of anorectal junction were measured, and the morphologic changes of rectal wall during defecation were analyzed. RESULTS: ARAs measured by central axis method (CAM), the mean angles were 114.6, 102.2, and 119.8 degree, respectively in resting, squeezing, and straining period. By posterior wall methods (PWM), those were 86.7, 72.0, 93.3 degree. The differences of ARA between resting and straining period were 5.2, 6.6 degree, respectively by CAM and PWM. The mean descent of anorectal junction during defecation was 0.83 cm. The most frequent finding associated with rectal intussusception was rectocele (12 cases;48%). The other accompanied findings were 9 spastic pelvic floor syndrome (36%) and 4 fecal incontinence (16%). Total 18 patients out of 25 patients were accompanied with other functional anorectal diseases (72%). CONCLUSIONS: Recognition of rectal intussusception with accompanied diseases would be important for the proper treatment planning.
Axis, Cervical Vertebra ; Defecation ; Fecal Incontinence ; Female ; Humans ; Intussusception* ; Male ; Middle Aged ; Muscle Spasticity ; Pelvic Floor ; Rectocele

Aspergillosis is the most common fungal infection of the paranasal sinuses and usually appears as a chronic disease in an otherwise healthy person. The number of reported cases of aspergillosis in the nose and paranasal sinuses has increased: while previously reported cases have involved the maxillary sinus alone in the majority of cases, reports of the isolated frontal sinus aspergillosis is rare. We present a case of frontal sinus aspergillosis which was successfully treated by endoscopic sinus surgery with a review of literature.
Aspergillosis* ; Chronic Disease ; Frontal Sinus* ; Humans ; Maxillary Sinus ; Nose ; Paranasal Sinuses

Abdominal cocoon is a rare disease of the peritoneum and almost invariably presents as an acute or subacute intestinal obstruction with or without a mass. The etiology of this disease is largely unknown and abdominal cocoon of unknown etiology has been limited to the tropical and subtropical zones and primarily affects young adolescent females. In the temperate zone, only one case has been reported from the United Kingdom, but the patient was also born in Pakistan. No case of abdominal cocoon purely developed in the temperate zone has been reported. Recently, we experienced a case of abdominal cocoon in a 34-year-old female patient(Korean) who had never been abroad. The diagnosis was made postoperatively by reviewing the literature. We herein report this rare condition developed in an unusual geographical location with a brief review of the literature.
Adolescent ; Adult ; Case Report ; Female ; Human ; Intestinal Obstruction/*etiology ; Male ; Peritoneal Diseases/complications/*etiology

BACKGROUND: Vasodilators including angiotensin converting enzyme inhibitor(ACEI) have been suggested to reduce left ventricular volume and to improve left ventricular performance in patients with moderate to severe regurgitant valvular heart diseases. However, long-term effects of angiotensin converting enzyme inhibitor upon left ventricular size and function in asymptomatic or minimally symptomatic patients with chronic mitral regurgitation remain to be elucidated. MATERIALS AND METHOD: Forty five patients with moderate to severe chromic mitral regurgitation on echocardiography and mild or no symptoms were studied. Serial changes of left ventricular dimension and ejection fraction were analyzed retrospectively using M-mode echocardiography in patients treated with ACEI(ACEI group, n=21) and in patients treated with other medications except ACEI or with no medication(non-ACEI group, n=24). RESULTS: The mean duration of follow-up was 30+/-15 months. ACEI group showed trends of decreasing left ventricular end-systolic dimension(LVESD) and left ventricular end-diastolic dimension(LVEDD) and a trend of increasing ejection fraction(EF), though statistically insignificant when compared to those of before-treatment or non-ACEI group. In patients with larger initial LVESD(>35mm), LVEDD was reduced(the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.2# and -4.4%) that was significantly different from those of non-ACEI group(+3.4% and +3.4% each)(p<0.05). In patients with larger initial LVEDD(>60mm), the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.9% and -5.8%, and in patients with initial EF less than 60%, the percent change of LVEDD 2 years after ACEI treatment was -0.57%. Those changes were also statistically significant compared to those of non-ACEI group(p<0.05 each). CONCLUSION: In mildly symptomatic chronic mitral regurgitation patients, especially whose left ventricular dimension is increase, long-term ACEI therapy seems to be effective in preventing left ventricular dilatation or in reducing left ventricular volume and such therapy may have a beneficial effect on the natural history of such patients.
Angiotensins* ; Dilatation ; Echocardiography ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Mitral Valve Insufficiency* ; Natural History ; Peptidyl-Dipeptidase A* ; Retrospective Studies ; Vasodilator Agents

Purpose: To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera. Methods: After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age. Results: The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669). Conclusions In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.