• Title/Summary/Keyword: rectum

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Rectal perforation caused by a sharp pig backbone in a middle-aged patient with mild depression (경도의 우울증이 있는 중년 남자에서 날카로운 돼지 척추뼈에 의한 직장천공)

  • Sun, Hyeong Ju;Lee, Jeonghun;Kim, Dong Min;Chu, Myeong-Su;Park, Kyoung Sun;Choi, Dong Jin
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.31-34
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    • 2015
  • In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.

Variation of optimization techniques for high dose rate brachytherapy in cervical cancer treatment

  • Azahari, Ahmad Naqiuddin;Ghani, Ahmad Tirmizi;Abdullah, Reduan;Jayamani, Jayapramila;Appalanaido, Gokula Kumar;Jalil, Jasmin;Aziz, Mohd Zahri Abdul
    • Nuclear Engineering and Technology
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    • v.54 no.4
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    • pp.1414-1420
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    • 2022
  • High dose rate (HDR) brachytherapy treatment planning usually involves optimization methods to deliver uniform dose to the target volume and minimize dose to the healthy tissues. Four optimizations were used to evaluate the high-risk clinical target volume (HRCTV) coverage and organ at risk (OAR). Dose-volume histogram (DVH) and dosimetric parameters were analyzed and evaluated. Better coverage was achieved with PGO (mean CI = 0.95), but there were no significant mean CI differences than GrO (p = 0.03322). Mean EQD2 doses to HRCTV (D90) were also superior for PGO with no significant mean EQD2 doses than GrO (p = 0.9410). The mean EQD2 doses to bladder, rectum, and sigmoid were significantly higher for NO plan than PO, GrO, and PGO. PO significantly reduced the mean EQD2 doses to bladder, rectum, and sigmoid but compromising the conformity index to HRCTV. PGO was superior in conformity index (CI) and mean EQD2 doses to HRCTV compared with the GrO plan but not statistically significant. The mean EQD2 doses to the rectum by PGO plan slightly exceeded the limit from ABS recommendation (mean EQD2 dose = 78.08 Gy EQD2). However, PGO can shorten the treatment planning process without compromising the CI and keeping the OARs dose below the tolerance limit.

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.

The Impact of Tissue Inhomogeneity Corrections in the Treatment of Prostate Cancer with Intensity-Modulated Radiation Therapy (전립선암의 세기조절 방사선 치료시 밀도보정의 효과)

  • Han Youngyih;Park Won;Huh Seung Jae
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.149-155
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    • 2004
  • Purpose: To investigate the effects of tissue inhomogeneity corrections on the dose delivered to prostate cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT). Methods and Materials: For five prostate cancer patients, IMRT treatment plans were generated using 6 MV or 10 MV X-rays. In each plan, seven equally spaced ports of photon beams were directed to the isocenter, neglecting the tissue heterogeneity in the body. The dose at the isocenter, mean dose, maximum dose, minimum dose and volume that received more than 95% of the isocenter dose in the planning target volume ( $V_{p>95%}$) were measured. The maximum doses to the rectum and the bladder, and the volumes that received more than 50, 75 and 90% of the prescribed dose were measured. Treatment plans were then recomputed using tissue inhomogeneity correction maintaining the intensity profiles and monitor units of each port. The prescription point dose and other dosimetric parameters were remeasured. Results: The inhomogeneity correction reduced the prescription point dose by an average 4.9 and 4.0% with 6 and 10 MV X-rays, respectively. The average reductions of the $V_{p>95%}$ were 0.8 and 0.9% with the 6 and 10 MV X-rays, respectively. The mean doses in the PTV were reduced by an average of 4.2 and 3.4% with the 6 and 10 MV X-rays, respectively. The irradiated volume parameters in the rectum and bladder were less decreased; less than 2.1 % (1.2%) of the reduction in the rectum (bladder). The average reductions in the mean dose were 1.0 and 0.5% in the rectum and bladder, respectively. Conclusions: Neglect of tissue inhomogeneity in the IMRT treatment of prostate cancer gives rise to a notable overestimation of the dose delivered to the target, whereas the impact of tissue inhomogeneity correction to the surrounding critical organs is less significant.

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Dose Distribution of Rectum and Bladder in Intracavitary Irradiation (자궁경부암 강내 방사선 조사장치에 의한 직장 및 방광의 피폭선량 평가)

  • Chu S. S.;Oh W. Y.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.261-270
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    • 1984
  • The intrauterine irradiation is essential to achieve adequate tumor dose to central tumor mass of uterine malignancy in radiotherapy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The simulation radiation and medical records of 203 patients who were treated with intrauterine irradiation from Feb. 1983 to Oct. 1983, were critically analized. The physical parameters to include distances between lateral walls of vaginal fornices, longitudinal and lateral angles of tandem applicator to the body axis, the distance from the external os of uterine cervix to the central axis of ovoids were measured for low dose rate irradiation system and high dose rate remote control afterloading system. The radiation doses and dose distributions within cervical area including interesting points and bladder, rectum, according to sources arrangement and location of applicator, were estimated with personal computer. Followings were summary of study results ; 1. In distances between lateral walls of vaginal fornices, the low dose rate system showed as $4\~7cm$ width and high dose rate system showed as $5\~6cm$. 2. In horizontal angulation of tandem to body axis, the low dose rate system revealed mid position$64.6\%$, left deviation $19.2\%$and right deviation $16.2\%$. 3. In longitudinal angulation of tandem to body axis, the mid position was $11.8\%$ and anterior angulation $88.2\%$ in low dose rate system but in high dose rate system, anterior angulation was $98.5\%$. 4. Down ward displacement of ovoids below external os was only $3\%$ in low dose rate system and $66.7\%$ in high dose rate system. 5. In radiation source arrangement, the most activities of tandem and ovoid were 35 by 30 in low dose rate system but 50 by 40 in high dose rate system. 6. In low and high dose rate system, the total doses an4 TDF were 50, 70 Gy and 141, 123, including 40 Gy external irradiation. 7. The doses and TDF in interesting points Co, B, were 93, 47 Gy and 230, 73 in high dose rate system but in low doss rate system, 123, 52 Gy and 262, 75 respectively. 8. Doses and TDF in bladder and rectum were 70, 68 Gy and 124, 120 in low dose rate system, but in high dose rate system, 58, 64 Gy 98, 110 respectively, and then grades of injuries in bladder and rectum were 25, $30\%$ and 18, $23\%$ respectively.

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The Influence of the Local Anesthetics on the Absorption of Sulfanilamide through the Rectum (국소마취제(局所麻醉劑)가 Sulfanilamide의 직장내(直腸內) 흡수(吸收)에 미치는 영향)

  • Ha, Chun-Ja;Lee, Jin-Hwan;Choi, Jun-Shik
    • The Korean Journal of Pharmacology
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    • v.9 no.1
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    • pp.53-58
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    • 1973
  • Author attempts to determine the absorption of the sulfanilamide by the various suppositorial bases contained the local anesthetics through the rectum of the rabbit. The types of bases examined are four of lipophillic, hydrophillic and emulsion types such as oil in water and water in oil, otherwise the local anesthetics are procaine and lidocaine each other 2 and 20 percent in a suppository. The results are as follows; 1. The absorption of sulfanilamide is higher when they are combined with the local anesthetics than when single drugs of them are used. 2. The promotion of absorption by the local anesthetics, both the procaine and lidocaine, are higher when they are used 20 percent than 2 percent as the concentration. 3. In excellency of the suppositorial base, the order of the blood level is polyethylene glycol, oil in water, water in oil as emulson type and cacao butter.

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Isolation of Enterobacteriaceae from bile, urine and intestine in slaughtered pigs and its susceptibility to antibiotics (도축돈의 담즙, 뇨 및 장관에서 장내세균의 분리 및 항생물질 감수성)

  • 허부홍;서석열;엄성심;김진환;윤창용;조정곤;송희종
    • Korean Journal of Veterinary Service
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    • v.19 no.3
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    • pp.213-219
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    • 1996
  • Seventy-nine strains of Enterobacteriaceae isolated from 117 slaughtered pigs (bile, urine, small intestine, cecum and rectum) in 1995 were examined for biotypes and susceptibility to 19 antibiotics with MicroScan WalkAway 40/96. The obtained results were as follows : 1. Among the twenty-two species isolated from the samples, Proteus mirabilis, E. coli and Enterobacter cloacae were commonly encountered. 2. The distribution frequency of isolates from cecum, small intestine, rectum, bile, and urine was 31(38.8%), 25(31.3%), 18(22.8%), 3(3.7% ), and 2(2.5% ), respectively. 3. A majority of isolates were sensitive to 16 antibiotics, singly or in combination. And these isolates were commonly susceptible to various antibiotics such as Cp, Ts, Azt, Caz, To, Gm, Cfz, Crm, Am and Cfx, in order. Whereas the Salmonella spp was susceptible to Cf, Ti and Pi, and Proteus mirabilis to Imp, Tim, Cft and Cz. Meanwhile, no effect was found to Cf, Ak and Cax. 4. Among the antibiotic resistant strains, a total of 17 reistant patterns was noted End of these Ak Tim 45(57.0%), Ak Am Cf Cfx Cfz Tim 8(10.1%) and Ak Ti Tim 6(7.6% ) were frequently encountered.

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Effects of Dietary Supplementation of Lactobacillus reuteri on Performance of Swine, Fecal and Rectumal Microflora and Carcass Grade (유산균(L. reuteri)의 첨가가 돼지의 생산성, 분과 결장내 미생물균총 및 육등급에 미치는 영향)

  • Son, Jang-Ho;Kim, Sang-Ho
    • Korean Journal of Organic Agriculture
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    • v.13 no.2
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    • pp.185-195
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    • 2005
  • Two hundred [(Duroc${\times}$Yorkshire)${\times}$Landrace] pigs were used in a 117-d growth assay (including four growth stages) to determine the effects of dietary supplementation of Lactobacillus reuteri on performance of swine, fecal and rectumal microflora and carcass grade. Pig diet was divided tow types, commercial diet (Control group) and supplemention of 0.1% Lactobacillus reuteri (Treatmental group). There was tend to increased in average daily gain (ADG) and feed efficiency (Feed/gain) in treatmental group than control group during the whole experimental period. The number of Lactobacilius spp. into rectum and feaces and carcass rate tended to increase in treatmental group than control group. Ammonia emission from excreta were decrease by supplemention of 0.1% Lactobacillus reuteri in feed (P<0.05). These results indicated that the dietary Lactobacillus reuteri were effective in performance, increasing of Lactobacilius spp. into rectum and feaces, decreasing ammonia emission from excreta, and it had also effective the carcass rate in swine.

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Studies on Early Pregnancy Diagnosis in Korean Native Cattle by Ultrasonography (초음파를 이용한 한우의 조기임신진단에 관한 연구)

  • 전병준;윤기영;이은송;이우근;이병천;황우석
    • Journal of Embryo Transfer
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    • v.11 no.3
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    • pp.291-300
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    • 1996
  • Real time B-mode ultrasound was used to detect the early conceptus in 187 Korean native cattles between days 10 and 60 after last insemination. The ultrasound diagnostic findings were systemically confirmed by palpation per rectum after the 60th day of last insemination. The embryonic vesicle and the embryo proper within the veside were first visible on mean day fl and 23, respectively. The heartbeat of the embryo proper could be detected on day 26, and the limb buds, placentomes, amnion, fetal movement, umbilical cord, optic area and split hooves were first visible on day 33, 34, 34, 44.5, 45, 32 and 48, respectively. The mean length of embryo proper was 3.8mm on day 23 which later increased to 56. 6rnrn on day 60. When ultrasound was used to detect the conceptus between days 20 and 30 after insemination and palpation per rectum after the 60th day of insemination, the accuracy rates of pregnancy detection by ultrasound scanning at days 20, 22, 24, 26, 28, 30 were 44.4, 69.2, 78.6, 87.5, 90.0, 93.3%. In summary, the early pregnancy diagnosis of Korean native cattle with ultrasound appears high accuracy rates. It is considered that ultrasound can be used in veterinary practice well.

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