Clinical efficacy of procedure for prolapse and hemorrhoids for treatment of rectal mucosa prolapse / 局解手术学杂志

Objective To observe the clinical efficacy of procedure for prolapse and hemorrhoids ( PPH) for treatment of rectal mucosa prolapse.Methods The 100 patients who suffered from rectal mucosa prolapse and were planning to take surgical treatment for the first time in our hospital from June 2013 to June 2015 were randomly divided into the treatment group and the control group .Patients in the treatment group(n=50) underwent PPH while patients in the control group (n=50) underwent traditional simplified mucosal plication technique .To observe the therapeutic effect of the two groups ,the average operation time ,average length of stay in hospital ,postoperative pain within 72 hours,postoperative anal function and postoperative complications of the two groups .Results There was no significant difference in the over-all treatment effect between the two groups(P>0.05).The average operation time, average length of stay in hospital,postoperative pain with-in 72 hours and postoperative anal function of the treatment group were lower than those of the control group ,and the differences were significant (P0.05).Conclusion Compare to the traditional simplified mucosal plication technique ,PPH technique has more advantages such as shorter operation time ,less anguish of patients,less complication,shorter hospitalization time,and higher security, which indicates PPH could become the preferred method for treatment of rectal mucosa prolapse .

Effect of repeated rectal exposure of low-dose simian immunodeficiency virus on the systemic cellular immunity in monkeys / 中国比较医学杂志

Objective To study the effect of repeated rectal exposure of low -dose simian immunodeficiency virus on the systemic cellular immunity in monkeys .Methods Eight 3-to 4-year old rhesus macaques ( Macaca mulatta) (male:female 1:1) were used in this study.The monkeys were inoculated with 10 TCID50 SIVmac239 virus through rectum twice a week for consecutive 6 weeks to establish a multiple rectal exposure model of SIVmac 239 virus infection.Then, plasma viral load, CD4+ T cell count, T cell subsets and IFN-γsecretion of the experiment monkeys were determined . Results Low-dose SIVmac239 virus induced some changes in the immune system through the rectal mucosa , but didn’t induce typical infection.Repeated rectal mucosal low-dose virus exposure can activate the cellular immune system . Conclusions This study defines the effect of repeated low -dose simian immunodeficiency virus exposure on the systemic cellular immunity, and provided basic information for HIV-1 vaccine research.

Stapled Mucosectomy: An Alternative Technique for the Removal of Retained Rectal Mucosa after Ileal Pouch-Anal Anastomosis

Restorative proctocolectomy (RPC), when performed with a stapled ileal pouch-anal anastomosis (IPAA), allows the retention of the rectal mucosa above the dentate line and can result in disease persistence or recurrence, as well as neoplastic lesions in patients with ulcerative colitis (UC). We report the case of a patient with chronic UC who underwent staple mucosectomy, which is an alternative technique that evolved from stapled hemorrhoidopexy, rather than more traditional procedures. The patient had undergone laparoscopic RPC with a stapled IPAA 2 cm above the dentate line and a temporary loop ileostomy. Because the histopathology showed low-grade dysplasia in the proximal rectum, stapled mucosectomy with a 33-mm circular stapler kit at the time of ileostomy closure was scheduled. Following the application of a purse-string suture 1 cm above the dentate line, the stapler was inserted with its anvil beyond the purse-string and was fired. The excised rectal tissue was checked to ensure that it was a complete cylindrical doughnut. Histopathology of the excised tissue showed chronic inflammation. There were no complications during a follow-up period of 5 months. Because it preserves the normal rectal mucosal architecture and avoids a complex mucosectomy surgery, stapled mucosectomy seems to be a technically feasible and clinically acceptable alternative to the removal of rectal mucosa retained after RPC.

Effects of Adriamycin or CP-2 to the Rectal Mucosae of Mouse Implanted with Ehrlich Carcinoma Cells: An Autoradiographic Study / 대한해부학회지

This experiment was performed to evaluate the morphological responses of the rectal intestinal glands of the mouse, inoculated with Ehrlich carcinoma cells, following administration of adriamycin or composition of the extracts of the Croton tiglium and Coptis chinensis rhizome (CP-2, Institute of Experimental Tumor Research, Seoul, Korea). Healthy adult ICR mice weighing 25 gm each were divided into normal and experimental groups (tumor control group, adriamycin treated group, and CP-2 treated group). In the experimental groups, each mouse was inoculated with 1 x 10(7) Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day, 0.2 mL of saline, adriamycin (2 mg/kg) or CP-2 (30 mg/kg) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of anticancer drugs, each mouse was injected with a single dose of 0.7 microCi/gm of methyl- 3H-thymidine through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed. and rectal tissues were collected and fixed in 10% neutral formalin. Deparaffinized sections were coated with autoradiographic emulsion EM-1 (Amersham Lab., England) in the dark room and dried. The number of the labeled epithelial cells of the rectal crypts (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. On histological study, in the rectum of adriamycin treated groups, length of the intestinal crypts is shorter than those of the normal control ones. Disrupted intestinal crypts and epithelial cells were observed. But in the CP-2 treated group, morphological changes of the rectum were not observed. On autoradiographic study, number of the labeled cells of normal control, rumor control, adriamycin-treated, CP-2-treated groups were 263.1 (+/-38.65), 395.7 (+/-52.52), 73.3 (+/-22.54), 96.3 (+/-28.36), respectively. In the adriamycin and CP-2 treated groups., poorly-labeled cells containing only a few silver grains of 3H-thymidine were observed more frequently than in those of the normal and tumor control groups. But in the tumor control group, number of the heavy labeled cells were observed more frequently than in those of the normal control group. From the above results, adriamycin and CP-2 may suppress the DNA synthesis of the cells of the rectal crypts. But CP-2 does not result any histological defect on the rectal mucosa. These results suggest that CP-2 is expected as one of most effective anticancer drugs.

Plication Method of the Redundant Rectal Mucosa by Longitudinal over and over Suture (overlaping suture)

This report is a review of experience with 45 patients plication methods of redundant rectal mucosa by longitudinal over and over suture who were admitted in department of surgery at Dongsan sacred Heart Hospital during 1997. This new technique was indicated by incomplete rectal prolapse, first degree complete rectal prolapse (internal rectal intussusception), 3rd degree hemorrhoids, redundant rectal mucosa in operation field, anal prolapse and severe external anal skin tag. At first, entire hemorrhoid-bearing area was dissected by excision and ligation methods. Within upward 1cm from ligationpoint, No.3 chromic catgut suture was done including rectal submucosa. Starting from this, linear continueous overlapping locking suture was done until redundant mucosa was tented by Chromic suture traction in range of 1 to 1.5 cm widths. If there is wide redundant mucosa not corrected one time, another linear continuous overlapping locking suture especially not circular may be done. This method is very easy and few complication-bleeding, pain, infection, mucosa loss, etc. The patients who have incomplete defecation sensation, rectocele and skin tag were satisfied with operation. This method may be an easy, effective new technique in patients who have anal prolapse, skin tag, rectocele and constipation etc.