• Title/Summary/Keyword: Rectal

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Management of a traumatic anorectal full-thickness laceration: a case report

  • Fortuna, Laura;Bottari, Andrea;Somigli, Riccardo;Giannessi, Sandro
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.215-218
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    • 2022
  • The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

LC-MS/MS-based Proteomic Analysis of Locally Advanced Rectal Tumors to Identify Biomarkers for Predicting Tumor Response to Neoadjuvant Chemoradiotherapy

  • Kim, Kyung-Ok;Duong, Van-An;Han, Na-Young;Park, Jong-Moon;Kim, Jung Ho;Lee, Hookeun;Baek, Jeong-Heum
    • Mass Spectrometry Letters
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    • v.13 no.3
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    • pp.84-94
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    • 2022
  • Neoadjuvant chemoradiotherapy (nCRT) is a standard therapy used for locally advanced rectal cancer prior to surgery, which can more effectively reduce the locoregional recurrence rate and radiation toxicity compared to postoperative chemoradiotherapy. The response of patients to nCRT varies, and thus, robust biomarkers for predicting a pathological complete response are necessary. This study aimed to identify possible biomarkers involved in the complete response/non-response of rectal cancer patients to nCRT. Comparative proteomic analysis was performed on rectal tissue samples before and after nCRT. Proteins were extracted for label-free proteomic analysis. Western blot and real-time PCR were performed using rectal cancer cell line SNU-503 and radiation-resistant rectal cancer cell line SNU-503R80Gy. A total of 135 up- and 93 down-regulated proteins were identified in the complete response group. Six possible biomarkers were selected to evaluate the expression of proteins and mRNA in SNU-503 and SNU-503R80Gy cell lines. Lyso-phosphatidylcholine acyltransferase 2, annexin A13, aldo-ketose reductase family 1 member B1, and cathelicidin antimicrobial peptide appeared to be potential biomarkers for predicting a pathological complete response to nCRT. This study identified differentially expressed proteins and some potential biomarkers in the complete response group, which would be further validated in future studies.

Feasibility of Simultaneous Multislice Acceleration Technique in Diffusion-Weighted Magnetic Resonance Imaging of the Rectum

  • Jae Hyon Park;Nieun Seo;Joon Seok Lim;Jongmoon Hahm;Myeong-Jin Kim
    • Korean Journal of Radiology
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    • v.21 no.1
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    • pp.77-87
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    • 2020
  • Objective: To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients. Materials and Methods: This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance. Results: Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI. Conclusion: SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.

Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?

  • Hwang, Jin-Bok;Hong, Jeana
    • Clinical and Experimental Pediatrics
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    • v.56 no.12
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    • pp.514-518
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    • 2013
  • The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.

Controlled Release of Propranolol.HCI from Hollow Type Suppositories Inserted Polyvinyl Alcohol Hydrogel Capsule (폴리비닐알코올 하이드로겔 캅셀을 삽입한 중공좌제로부터 염산프로프라놀롤의 조절 방출)

  • 진선경;문이렌;구영순
    • YAKHAK HOEJI
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    • v.43 no.2
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    • pp.150-159
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    • 1999
  • Hollow type suppositories inserted polyvinyl alcohol (PVA) hydrogel capsule containing propranolol·HCI (PPH) were prepared using different bases, polyethylene glycol (PEG), Witepsol H-15 (WH-15) and Witepsol W-35 (WW-35) to improve the controlled release of PPH. The release of PPH from the hollow type suppository inserted PVA hydrogel capsule was retarded than that from PEG, WH-15, or WW-35 hollow type suppositories in rat rectal cavity. When the suppositories were administered to rats, the controlled release of PPH was proved by the plasma concentration-time-profiles of PPH. No significant difference (p〈0.05) among the three different hollow type suppositories was observed in terms of AUC and MRT of PPH. WH-15 hollow type suppository inserted 12% of PVA hydrogel capsule caused irritation to rat rectal mucosa. However, the WH-15 hollow type suppository inserted PVA hydrogel capsule caused no severe irritation on rectal mucosa. The application of the hollow type suppositories using PVA in sustained rectal delivery of drugs might be feasible.

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Effect of Suppository Bases on Absorption of Lithium Carbonate (좌제기제가 탄산리튬의 흡수에 미치는 영향)

  • Kim, Yong-Hyun
    • Journal of Pharmaceutical Investigation
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    • v.16 no.4
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    • pp.148-151
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    • 1986
  • This paper was designed to investigate the influence of different suppository bases on both the rectal absorption and dissolution rate of lithium carbonate, and to compare bioavailability from rectal administration with that from oral administration. The dissolution rates were in such order as PEG 4000, surfactant A (Witepsol 15+sodium lauryl sulfate), surfactant B (Witepsol 15+cholic acid), Witepsol 15 and cacao butter. Among various suppository bases, the blood level of lithium carbonate after rectal administration was increased in the following order: surfactant A>surfactant B>PEG 4000>Witepsol 15>cacao butter. When it comes to compare oral with rectal administration in AUC values, surfactants and PEG 4000 showed similar blood levels to oral administration, but lipophilic bases such as Witepsol 15 and cacao butter showed far lower blood level than oral administration. Peak time in oral administration was 2 hrs, but those in rectal administration using various suppository bases were $6{\sim}8$ hrs.

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Rectal stricture in a finishing swine : Case

  • Seol, Min-Sug;Hur, Boo-Hong;Kiku Matsuda;Lim, Chae-Woong;Song, Hee-Jong
    • Korean Journal of Veterinary Service
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    • v.24 no.4
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    • pp.375-377
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    • 2001
  • Rectal stricture occurred in 2 finishing pigs submitted for necropsy from Moguchon, the meat processing plant, chonbuk. Grossly, the wall of the rectum was harden and thickened by fibrous tissue. Anteriro to the stricture, the descending colon was dilated up to 30cm in diameter, filled with gas and pasty green fluidal feces. Histologically, the epithelia of rectal mucosa were necrotized. The mucosa and submucosa of rectum were infiltrated by macrophages, eosinophils and lymphocytes. This infiltration was the most extensive in the deeper layer of submucosa and intensive fibrosis was observed in deeper submucosa layer. This case is report for rectal stricture of finishing pig.

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Lumbar Sympathectomy in the Management of Rectal Tenesmoid Pain (항문 이급후중의 치료에 있어 요부 교감 신경절 차단)

  • Yoon, Keon-Jung;Kim, Jong-Lul;Park, Kyu-Ho
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.354-356
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    • 1995
  • Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. Lumbar sympathectomy was performed in patient whose main complaint was rectal tenesmoid pain resulting from hemorrhoid operation, and in whom analgesic or psychotropic drugs had failed in controlling the symptom. After chemical lumbar sympathectomy, patient was free from the rectal tenesmoid pain. It is concluded that lumbar sympathectomy is a safe and effective treatment for rectal tenesmus.

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Management of T1 Rectal NEN (T1 직장 신경내분비종양의 치료)

  • Kim, Ji Hyun;Nam, Seung-Joo
    • Journal of Digestive Cancer Research
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    • v.7 no.2
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    • pp.45-50
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    • 2019
  • Incidence of rectal neuroendocrine neoplasms (NEN) has increased tremendously over the decades due to disease awareness and widespread use of screening colonoscopy. Although NEN has been recognized as malignant disease, most rectal NENs are initially found as small mass confined to the submucosa, which can be removed completely through various endoscopic treatments with good prognosis. In this review, we summarize the treatment options focusing on localized T1 rectal NEN by comparing representative international guidelines and discuss current controversies on the management. We also discuss various resection techniques focusing on endoscopic resection.

Effects of Berberis koreana Palibin on Sleep Duration and Rectal Temperature in Mouse (매자나무성분이 마우스 수면 및 체온에 미치는 영향)

  • Cho Sun-Hee;Kim Chung-Il
    • The Korean Journal of Pharmacology
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    • v.10 no.1 s.15
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    • pp.61-65
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    • 1974
  • Berberis koreana Palibin belonging to Berberidaceae family, a common herb in Korea, has been contained some quantity of Berberine analogue and other ingredients. Authors therefore paid attention to its pharmacological actions and examined the effects on sleep duration and rectal temperature in mouse with crystal (A) from Berberis koreana Palibin in Korean native plans. The experiment searching for the effect on sleep duration was performed with pretreatment of Berberis Koreana Palibin crystal (A) 30 min before the administration of 25 % ethanol, and its crystal were also administered intraperitoneally with the intention to examine the effect on rectal temperature in mouse. The results of the experiment were as follows; 1. Crystal (A) from Berberis koreana Palibin was made by extraction with ethanol and HCI. 2. Crystal (A) enhanced the hypnotic activity of alcohol in concentratins of 0.1 mg/10g or 0.15 mg/10g. 3. Rectal temperatures in mice were significantly reduced with administration of crystal (A) in concentrations of 0.1 mg/10g or 0.15 mg/10g. 4. The maximal reduction of rectal temperature and potentiation of the hypnotic activity were observed at 30 min after its administration. From the above results, it is clear that crystal (A) from Berberis koreana Palibin exerts the potentiation of hypnotic action of alcohol and reduction of rectal temperature in normal mouse. Its pharmacological effects are probably derived from the action upon the central nervous system.

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