• Advances in pediatric surgery
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• 제5권1호
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• pp.69-74
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• 1999

Condyloma acuminata, an uncommon disease m the pediatric patients, is being reported with increasing frequency in both adults and children. During the last 10 years, we managed 11 children with condyloma acuminata of the anogenital area. The patients' age at presentation varied from 9 months to 11 years, and boys outnumbered girls by a ratio of 2 : 1. The lesions were found in the perianal area in 9 patients and the genital area in 2. No history of sexual contact or abuse could be elicited. Although the exact mode of transmission of human papillomavirus(HPV) couldn't be defined, maternal-infant transmission at birth and close nonsexual family contact were the main possible causes of HPV infection in our patients. Our experience suggest that fulguration of the warts and concomitant excision with scissors of the larger lesions are the most satisfactory method of treatment in children. However, condyloma acuminata have high recurrence rate despite these treatments. Viral typing and careful epidemiological investigation on a larger series of patients may clarify the causative factors and effective modalities of treatment in childhood anogenital condyloma acuminata.

• The Korean Journal of Pain
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• 제12권2호
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• pp.268-271
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• 1999

Intrathecal phenol-glycerin block is a potent tool in stepwise approach to intractable perineal pain. At outpatient clinic, intrathecal phenol-glycerin block have been frequently used to control the cancer pain, as this procedure does not require special equipment. However, undesirable effects may occur with any given intrathecal injection. Although most side effects do not last long, they deserve well to prevent. Recently, we have been controlled the perineal and perianal cancer pain with intrathecal phenol-glycerin block without any specific complications. However, one patient we managed experienced that one patient, with this procedure for chronic non-malignant perineal pain control experience gait disturbance and one-week of voiding and defication difficulties. This research reports these practices, including the review of literature.

• Archives of Reconstructive Microsurgery
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• 제12권1호
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• pp.13-18
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• 2003

Fournier's gangrene is a synergistic necrotizing fasciitis of the perineal, perirectal and urogenital area and can be fatal unless treated in early stage. Perianal and urogenital infections are common causes of the disease but it can occur after artificial procedure on perineal area using by surgical instruments. It is mixed aerobic and anaerobic infection and E. coli is the most common causative bacteria. Untill now many investigators have focused on early diagnosis, preserving hemodynamic stability, broad-spectrum systemic antibiotics and treatment of underlying disease in management of Fournier's gangrene. The authors have experienced five patients of chronic liver disease whose necrotizing perineal infections developed spontaneously and treated them aggressively as described above and reconstructed perineal soft tissue defects using by various surgical methods, then we got good results both functionary and cosmetically. From now on, we would better reconstruct soft tissue defect of perineum with skin graft or pedicled flap in early stage when treat Fournier's gangrene, thereafter we can get an ultimate increase in patient's life quality.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.461-465
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• 2016

Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction.

• Parasites, Hosts and Diseases
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• 제49권2호
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• pp.183-185
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• 2011

The present study was performed to determine the prevalence of Enterobius vermicularis among preschool children in Gimhae-si, Korea. A total of 6,921 preschool children in 76 kindergartens were examined using the cellotape perianal swab method. The overall egg positive rate (EPR) was 10.5%. The EPR in boys was higher than that in girls (adjusted odds ratio (AOR): 1.5, P<0.001), and it was higher in rural than in urban children (AOR: 1.2, P=0.022). The present study confirmed that the prevalence of E. vermicularis infection is fairly high among preschool children in Gimhae-si. Therefore, systematic control and preventive measures should be adopted to reduce morbidity associated with this nematode infection.

• 한국임상수의학회지
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• 제32권1호
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• pp.120-122
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• 2015

Hepatoid gland tumors in dogs usually occur in the perianal region, but arise occasionally from other areas such as the tail, back, and thigh. This report describes two cases of ectopic hepatoid gland adenomas in dogs. The tumors have been observed in the lumbar area of the back and in the axillary region, respectively. The cytological and histopathological features were consistent with hepatoid gland adenoma. Although ectopic hepatoid gland tumors have been described previously in literatures, this is the first report of ectopic hepatoid gland adenoma cases in dogs in South Korea.

• The Korean Journal of Pain
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• 제1권1호
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• pp.98-102
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• 1988

In order to control the pain after hemorrhoidectomy and anal fistulectomy, 6 mg of 0.5% hyperbaric tetracaine without(control, group I) or wilt 0.3 mg(group II) or 0.5 mg (group III) of 0.1% morphine was injected with a 22 gauge spinal needle into the subarachnoid space through L 3-4 interspace of patients in lateral position. About 30 minutes in Fowler' sposition after injection, operation was performed in lithotomy position. All the patients who ha4 morphine showed remarkable relief of postoperative pain for an average of 27 hours. However, the dosage(0.3 or 0.5 mg) of morphine administered did not affect the duration of pain relief. Blood pressure, pulse rate and pupil size were unchanged in all patients. Dysuria after block developed for on average of 5,6, 13.2 and 14.6 hours in group I, II and III respectively. Most of these cases required urethral catheterization. Minor complications such as nausea, vomiting, itching, fever, burning sensation and paresthesia were observed 16.7, 20 and 20% of cases in group I, II and III respectively; however, no treatment was required.

• Advances in pediatric surgery
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• 제8권1호
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• pp.6-10
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• 2002

To clarify the necessity of surgery for fistula-in-ano (FIA) in infant, a retrospective analysis of 82 cases FIA in infant were performed for 11 years period from 1987 to 1998. Group A included 44 cases in the period of surgery oriented treatment to 1992, and group B contained 38, period of feeding control oriented management (FC) after 1993. FC, that was indicated in case with loose stool and eczematoid perianal skin (LSES), composed of quit breast feeding, change of cow milk or complete weaning. Surgical decision was made after improvement of stool condition. Fistulectomy was performed in 29 cases (65.9 %) of group A. However, in group B, only 15 cases (39.5 %) required surgery (p=0.0036). Thirty-four cases in B had the history of LSES, and Fe was applied in 25, and was effective in 24. Among 24 cases, 21 showed complete healing with FC, 3 had surgery because of the persistent FIA, and 1 got operation due to no improvement of stool condition. In conclusion, Fe has to be applied to FIA in infant before surgery, particularly in cases with history of LSES. As one of the etiologic factors for FIA, LSES could be considered to this particular age group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.41-49
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• 2019

Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Several genetic defects that disturb intestinal epithelial barrier function or affect immune function have been noted in these patients from the young age groups. In incidence of pediatric IBD in Korea has been increasing since the early 2000s. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with "neonatal IBD" or "infantile-onset IBD" have higher rates of affected first-degree relatives, severe disease course, and a high rate of resistance to immunosuppressive treatment. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.

• Parasites, Hosts and Diseases
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• 제59권6호
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• pp.635-638
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• 2021

In this study, we intended to describe a human case of lumbosacral canal sparganosis in People's Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1-S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1-S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.