• Radiation Oncology Journal
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• 제34권3호
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• pp.186-192
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• 2016

Purpose: To determine whether large rectal volume on planning computed tomography (CT) results in lower tumor regression grade (TRG) after neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer patients. Materials and Methods: We reviewed medical records of 113 patients treated with surgery following neoadjuvant CCRT for rectal cancer between January and December 2012. Rectal volume was contoured on axial images in which gross tumor volume was included. Average axial rectal area (ARA) was defined as rectal volume divided by longitudinal tumor length. The impact of rectal volume and ARA on TRG was assessed. Results: Average rectal volume and ARA were 11.3 mL and $2.9cm^2$. After completion of neoadjuvant CCRT in 113 patients, pathologic results revealed total regression (TRG 4) in 28 patients (25%), good regression (TRG 3) in 25 patients (22%), moderate regression (TRG 2) in 34 patients (30%), minor regression (TRG 1) in 24 patients (21%), and no regression (TRG0) in 2 patients (2%). No difference of rectal volume and ARA was found between each TRG groups. Linear correlation existed between rectal volume and TRG (p = 0.036) but not between ARA and TRG (p = 0.058). Conclusion: Rectal volume on planning CT has no significance on TRG in patients receiving neoadjuvant CCRT for rectal cancer. These results indicate that maintaining minimal rectal volume before each treatment may not be necessary.

• Annals of Surgical Treatment and Research
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• 제96권2호
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• pp.78-85
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• 2019

Purpose: Insistence that total regression of primary tumor would not represent long-term oncologic outcomes has been raised. Therefore, this study aimed to evaluate the outcomes of these patients after preoperative chemoradiotherapy (PCRT) and radical surgery and to evaluate the associated risk factors. Methods: We included 189 patients with rectal cancer who showed total regression of the primary tumor after PCRT, followed by radical resection, between 2001 and 2012. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the results were compared with 77 patients with Tis rectal cancer who received only radical resection. Factors associated with RFS were evaluated using Cox regression analysis. Results: Sphincter-saving resection was performed for 146 patients (77.2%). Adjuvant chemotherapy was administered to 168 patients (88.9%). During the follow-up period, recurrence occurred in 17 patients (9%). The 5-year RFS was 91.3%, which was significantly lower than that of patients with Tis rectal cancer without PCRT (P = 0.005). In univariate analysis, preoperative CEA and histologic differentiation were associated with RFS. However, no factors were found to be associated with RFS. Conclusion: RFS was lower in patients with total regression of primary rectal cancer after PCRT than in those with Tis rectal cancer without PCRT, and it would not be considered as the same entity with early rectal cancer or "disappeared tumor" status.

• 대한간호학회지
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• 제29권4호
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• pp.903-916
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• 1999

The purpose of this study was to compare the ear-based rectal temperature measured with a tympanic thermometer with the rectal temperature measured with a glass mercury thermometer in order to test the accuracy of tympanic thermometer and to determine relationship among rectal, axilla, and abdominal temperature in neonates. The samples consisted of thirty four neonates admitted to the neonatal intensive care unit and nursery at an university affiliated hospital. The mean age of the subjects was 4.9 days. The ear-based rectal temperatures were taken with a tympanic thermometer in rectal mode (First Temp Genius 3000). Rectal and axilla temperatures were taken with a glass mercury thermometer, Abdominal temperature was continuously monitored with the probe connected to the servo controller of incubator. The results of the study can be summarized as follows : 1. Intrarater comparison : Agreement between the first and the second ear-based rectal temperature was 97% within 0.1$^{\circ}C$. 2. Comparison of ear-based rectal temperature and the rectal temperature from a glass mercury thermometer : ear-based rectal temperature ranged from 36.95$^{\circ}C$d to 37.95$^{\circ}C$, with a mean of 37.58$^{\circ}C$(SD＝0.22$^{\circ}C$). Rectal temperature from a glass mercury thermometer ranged from 36.2$0^{\circ}C$ to 37.2$0^{\circ}C$, with a mean 36.75$^{\circ}C$(SD＝0.29). The mean difference between both temperatures was 0.84$^{\circ}C$. The correlation coefficient between both temperatures was r＝0.77(p＝0.00). 3. Comparison of rectal and axilla temperature : Axilla temperature ranged from 35.8$0^{\circ}C$ to 37.1$0^{\circ}C$, with a mean of 36.55$^{\circ}C$. The mean absolute difference between the rectal and axilla temperature was 0.23$^{\circ}C$. The correlation coefficient between rectal and axilla was r＝0.67. 4. Comparison of axilla and abdominal temperature : Abdominal temperature ranged from 36.2$0^{\circ}C$ to 37.0$0^{\circ}C$, with a mean of 36.58$^{\circ}C$. The mean absolute difference between axilla and abdominal temperature was only -0.03$^{\circ}C$. Findings of this study suggest that ear-based rectal temperature overestimates the actual rectal temperatures in neonates. Therefore, the interchangeble use of both temperatures in clinics seems problematic. The site offset(adjustment value) programmed in rectal mode of the tympanic thermometer needs to be readjusted. Choosing one optimal site for temperature measurement for each patient, and using the specific site consistently would result in more consistent measurements of changes in body temperature, and thus can be more effective in diagnosing fever or hypothermia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.15-22
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• 2008

Rectal bleeding is a common and worrisome problem in pediatric practice. The condition is usually alarming to patient and children. Although most cases are benign and self-limited, sometimes serious pathology also present in this manner. And severe rectal bleeding necessitates prompt diagnostic notice and appropriate treatment. The etiologies of rectal bleeding are somewhat specific to certain age group in children. Accurate history and through physical examination are paramount importance to help differentiate of the diverse etiologies causing rectal bleeding in children. This review describes patterns of rectal bleeding, historical and physical aspect, differentiation of clinical characteristics of rectal bleeding according to etiology, and diagnostic investigations.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6115-6120
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• 2014

Background: To compare the KKU-model rectal tube (KKU-tube) and the conventional rectal tube (CRT) for checking rectal doses during high-dose-rate intracavitary brachytherapy (HDR-ICBT) of cervical cancer. Materials and Methods: Between February 2010 and January 2011, thirty -two patients with cervical cancer were enrolled and treated with external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). The KKU-tube and CRT were applied intrarectally in the same patients at alternate sessions as references for calculation of rectal doses during ICBT. The gold standard references of rectum anatomical markers which are most proximal to radiation sources were anterior rectal walls (ARW) adjacent to the uterine cervix demonstrated by barium sulfate suspension enema. The calculated rectal doses derived from actual anterior rectal walls, CRT and the anterior surfaces of the KKU-tubes were compared by using the paired t-test. The pain caused by insertion of each type of rectal tube was assessed by the visual analogue scale (VAS). Results: The mean dose of CRT was lower than the mean dose of ARW ($Dmean_0-Dmean_1$) by $80.55{\pm}47.33cGy$ (p-value <0.05). The mean dose of the KKU-tube was lower than the mean dose of ARW ($Dmean_0-Dmean_2$) by $30.82{\pm}24.20cGy$ (p-value <0.05). The mean dose difference [($Dmean_0-Dmean_1$)-($Dmean_0-Dmean_2$)] was $49.72{\pm}51.60cGy$, which was statistically significant between 42.32 cGy -57.13 cGy with the t-value of 13.24 (p-value <0.05). The maximum rectal dose by using CRT was higher than the KKU-tube as much as 75.26 cGy and statistically significant with the t-score of 7.55 (p-value <0.05). The mean doses at the anterior rectal wall while using the CRTs and the KKU-tubes were not significantly different (p-value=0.09). The mean pain score during insertion of the CRT was significantly higher than the KKU-tube by a t-score of 6.15 (p-value <0.05) Conclusions: The KKU-model rectal tube was found to be an easily producible, applicable and reliable instrument as a reference for evaluating the rectal dose during ICBT of cervical cancer without negative effects on the patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9271-9275
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• 2014

Background: Schistosomiasis is an infectious disease that affects more than 230 million people worldwide, according to conservative estimates. Some studies published from China and Japan reported that schistosomiasis is a risk factor for colorectal cancer in Asia where the infective species is S. japonicum. Hoqwever, there have been only few reports of prognosis of patients with schistosomal rectal cancer SRC. Objectives: This study aimed to analyze differences in prognosis between SRC and non-schistosomal rectal cancer(NSRC) with current treatments. Materials and Methods: A retrospective review of 30 patients with schistosomal rectal cancer who underwent laparoscopic total mesorectal excision operation (TME) was performed. For each patient with schistosomal rectal cancer, a control group who underwent laparoscopic TME with non-schistosomal rectal cancer was matched for age, gender and tumor stage, resulting in 60 cases and controls. Results: Univariate analysis showed pathologic N stage (P=0.006) and pathologic TNM stage (P=0.047) statistically significantly correlated with disease-free survival (DFS). Pathologic N stage (P=0.014), pathologic TNM stage (P=0.002), and with/without schistosomiasis (P=0.026) were statistically significantly correlated with overall survival (OS). Schistosomiasis was the only independent prognostic factor for DFS and OS in multivariate analysis. Conclusions: The prognosis of patients with schistosomal rectal cancer is poorer than with non-schistosomal rectal cancer.

• 대한영상의학회지
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• 제84권6호
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• pp.1290-1308
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• 2023

목적 직장암 병기결정에서 직장 CT의 진단능을 고해상도 직장 MRI 및 병리결과와 비교분석 하였다. 대상과 방법 초음파 젤을 이용하여 직장을 팽창시킨 후 얻은 직장 CT와 고해상도 직장 MRI를 촬영한 66명의 직장암 환자가 포함되었다. 두 명의 위장관 영상의학과 의사가 직장 CT와 MRI에서 항문피부선/항문직장경계까지의 거리, 직장간막근막까지의 거리, 벽외침범 깊이, 직장간막외 림프절 침범, 벽외정맥침범, 및 T/N 병기를 평가하였다. 동시화학방사선요법을 시행 받지 않고 근치적 수술을 시행한 20명의 환자의 CT 소견을 병리결과와 비교하였다. 급내상관분석 및 카파 분석을 이용하여 통계 분석하였다. 결과 항문피부선/항문직장경계까지의 거리 측정에서 두 명의 영상의학과 의사 모두 CT와 MRI 간에 높은 상관관계를 보였다. 벽외침범 깊이, 직장간막근막까지의 거리, 림프절의 유무, 직장간막외 림프절 침범, 벽외정맥침범, T 병기 결정에서 CT와 MRI 간의 높은 일치도를 보였다. 수술을 시행받은 20명의 환자에서 T 병기, 측방절제연 침범, 벽외정맥침범, 림프절 전이 결정에서 CT는 병리결과와 만족할만한 일치율을 보였다. 결론 직장암 전용 CT는 직장암 환자의 병기 결정에 중요한 정보를 제공하며, 진단능은 고해상도 직장 MRI와 유사하다.

• 대한영상의학회지
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• 제85권3호
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• pp.637-642
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• 2024

직장 매독은 매독 감염(syphilis infection)에서 드물게 발생하며 증상 및 내시경, 영상 소견이 비특이적이다. 직장 매독은 일반적으로 동심성 장벽비후, 점막 충혈, 직장간막 지방침윤, 림프절병증 등으로 나타난다. 직장암은 비대칭적 장벽비후, 림프절 괴사를 보여 두 질환 감별에 도움을 얻을 수 있다. 하지만 두 질환의 중복되는 소견이 많아 환자의 병력을 고려하지 않고 직장 매독과 직장암을 구분하기는 매우 어렵다. 직장 매독은 직장암 외에도 염증성 장 질환 등 다른 양성 질환으로 오인하여 필요 없는 검사를 하거나 치료가 지연되는 경우가 많다. 저자들은 악성 종양으로 의심되었던 직장 매독 증례를 경험하여 이 증례 보고에서 내시경 및 영상, 병리학적 소견에 대하여 자세히 보고하고자 한다.

• 약학회지
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• 제31권5호
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• pp.286-295
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• 1987

The relationship between in vitro release and in vivo bioavailability of acetaminophen from suppositories was investigated. Effect of glycyrrhizin on the drug release and rectal absorption in rats was also examined. Suppositories containing 25mg of acetaminophen were prepared with Wecobee FS (fatty base) or PEG (water-soluble base) bases. The release from the suppositories were determined with USP rotating basket dissolution apparatus and with the suppository release tester. The temperature of the dissolution medium was very critical for the dissolution of acetaminophen from Wecobee FS suppositories. The bioavailability of acetaminophen was calculated from the plasma concentration-time curve after rectal administration of the suppositories to the rats. There were no significant differences in AUC following rectal administration of Wecobee FS and PEG suppositories, but the release and absorption from the Wecobee FS suppositories were faster than those from PEG suppositories. The dissolution rate obtained by the suppository release tester was better correlated with in vivo absorption rate constant than that by the USP dissolution apparatus. It suggests that the partitioning between rectal fluid and suppository base is the rate-limiting step in the rectal absorption of acetaminophen from suppositories. Glycyrrhizin was found not to affect in vitro dissolution and rectal absorption of acetaminophen.

• 한국임상수의학회지
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• 제33권2호
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• pp.129-130
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• 2016

A 5-year-old male Laika dog was referred with chief complaint of dyschezia and tenesmus. The dog had rectal prolapse and it was corrected with rectal resection and anastomosis, a year ago. On rectal examination, the stricture of rectum was identified. The irregular scar tissues on serosal and muscular layers of rectum were noted and they were dispersed with partial thickness incision around rectum. Then, the colopexy and mechanical dilation with balloon catheter were applied. No recurrence of rectal prolapse and other complications were noted during follow up periods of 1 year. This report described a successfully corrected anastomotic rectal stricture in a dog.