Significance of rectosigmoid polyp as a predictor of proximal colonic polyp

The association between rectosigmoid polyps and polyps in the more proximal colon is still a matter of debate, and the need for colonoscopy in patients with rectosigmoid polyps that are detected by flexible sigmoidoscopy is controversial. The aim of this study was to determine whether or not certain characteristics of rectosigmoid polyps are associated with the presence and characteristics of proximal colonic polyps. Seven hundred and twenty-eight patients who underwent total colonoscopy between October 1995 and June 1998 and who had colorectal polyps were retrospectively analyzed. Patients with inflammatory bowel diseases, familial adenomatous polyposis, or any advanced cancer were excluded. The odds ratio (OR) and 95% confidence interval (CI) of prevalence of proximal colonic polyps according to the patients age and sex, as well as the characteristics of rectosigmoid polyps, were calculated. Advanced adenoma was defined as an adenoma larger than 10 mm or an adenoma of any size with villous component, high-grade dysplasia or invasive carcinoma. Among 728 patients with colorectal polyps, 356 patients (48.9%) had polyps only in the rectosigmoid region, 193 patients (26.5%) had polyps only in the proximal colon, and 179 patients (24.6%) had polyps in both the rectosigmoid and proximal colon. In 535 patients with rectosigmoid polyps, the prevalence of proximal colonic polyps, neoplastic polyps and advanced adenomas were 33.4%, 27.3% and 2.9%, respectively. The prevalence of proximal colonic polyps in patients with rectosigmoid polyps was found to be significantly related to the male gender and elderly patients, in addition to the neoplastic histology of the rectosigmoid polyps. However, the prevalence of the proximal colonic polyps was not related to the size, number and shape of rectosigmoid polyps. In 179 patients with both rectosigmoid and proximal colonic polyps, the characteristics of proximal colonic polyps such as size, number and shape were similar to those of rectosigmoid polyps. We recommend total colonoscopic examination in all patients with rectosigmoid adenomas, regardless of the size, number, and shape, especially in elderly males.

A Study on Mitomycin C Induced Damage to the Iris and Ciliary Body of Cats

This study was performed to investigate the toxicity of mitomycin C(MMC) on the iris and ciliary body of the cat. After anesthesia, MMC in 0.1, 0.2, or 0.4 mg/ml concenration was injected intracamerally and the equal volume of balanced salt solution(BSS) was injected intracamerally to the contralateral eye as a control. There were no significant difference between 0.1 mg/ml of MMC and BBS injection except for the enlargement of endoplasmic reticulum and destruction of cristae of ciliary body 14 days after MMC injection. Iris vessel was congested and mitochondria of ciliary body was enlarged and cristae was disrupted 7 days after 0.4 mg/ml of MMC injection. There were infiltration of inflammatory cell on the iris and increased cellular damage at the nonpigmented epithelium of ciliary body 21 days after 0.4 mg/ml of MMC injection. These results suggest that the caution is necessary to prevent high concentration of MMC from getting into the anterior chamber at the time of glaucoma filtering surgery in human.

The Neuromuscular blocking Effect of Subcutaneous Administration of Succinylcholine / 대한마취과학회지

Succinylcholine is commonly administered intravenously, however sometimes it can be administered intramuscularly or sublingually when an intravenous line is not available. We investigated the neuromuscular blocking effect of subcutaneous injection of succinylcholine. The 60 adult patients (ASA 1 or 2) were randomly divided into two groups. After intravenous administration of propofol 3 mg/kg, succinylcholine 1 mg/kg was administered intravenously in one group (IV group, n=10) and subcutaneously in another (SQ group, n=50). Neuromuscular transmission was monitered continuously by the train-of-four (TOF) from response stimulated the ulnar nerve with 2Hz at wrist and the evoked compound action potential of hypothenar muscles was measured with Relaxograph (Datex Co.). We determined the maximum depressed the twitch height (T(TXD)), onset time from injection of succinylcholine to T(MXD), recovery time from T(MXD) to the recovery of 75%, and duration of action from injection of succinylcholine to the recovery of 75%. In the results, T(MXD) of SQ group varied from O% to over 75% compared with 0% in IV group. The onset time of SQ group were more delayed between 7.78+/-2.80 to 13.08+/-3.51 minutes compared with 1.08+/-0.16 minutes in IV group. The recovery time of SQ group were faster between 15.67+/-10.40 to 2.59+/-1.75 minutes compared with 18.68+/-3.68 minutes in IV group. The duration of action of SQ group were not significantly different compared with IV group. And in the SQ group, the lesser depression of twitch height the slower onset time and the faster recovery time was revealed. Conclusively, the subcutaneous administration of succinylcholine 1 mg/kg resulted that the magnitudes of neuromuscular blockade was variable and incomplete, and onset time were slower but recovery were faster than intravenous injection.