• Title/Summary/Keyword: perineal

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Surgical Repair of Atresia Ani with Rectovaginal Fistula in an African Buffalo (Syncerus caffer)

  • Ryu, Jisook;Kang, Shin Geun;Yun, Jungsang;Yeo, Yonggu
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.111-113
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    • 2018
  • A three-month-old female African buffalo born at Seoul Zoo showed signs of abdominal distension, bulging of the perineal skin, and small stool volume compared to feed intake. Upon physical examination, atresia ani with rectovaginal fistula was diagnosed. This case was subjected to surgery under inhalation anesthesia after injecting a sedative. Surgery was performed in two steps: anal reconstruction and closing the rectovaginal fistula. First, a circular skin incision was made at the end of the rectal pouch to create an anus, and then the skin of the anus and the mucous membrane of the rectum were brought into apposition by simple interrupted sutures. Second, the rectovaginal fistula was ligated on both vulval and anal side. Antibiotics were administered on every alternate day and the sutures were removed at ten days surgery under sedation. The rectovaginal communication was closed and the calf was able to urinate and defecate normally. The animal grew to become a normal adult without any complications. This is the first case report of atresia ani with rectovaginal fistula in an African buffalo, that was successfully treated by surgical intervention.

A Study on Urinary Incontinence Related Health Problems in Women above Middle Age in Rural Areas and Their Coping with the Problems (농촌 지역 중년기 이후 여성들의 요실금 관련 건강문제와 대처)

  • Kim, Chunmi;Lee, Hung Sa;Kim, Eun Man
    • Research in Community and Public Health Nursing
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    • v.24 no.3
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    • pp.368-376
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    • 2013
  • Purpose: The purpose of this study was to identify the current urinary incontinence states in women above middle age dwelling in rural areas and their coping with the problems. Methods: The participants were 261 women above middle age. Data were collected from February to May, 2012 using a structured questionnaire. The data were analyzed with the SPSS/WIN 20 program. Results: The frequency of urinary incontinence in women above middle age was 45.4%. There were significant differences in urinary incontinence due to age, education, job status, frequency of delivery, and menstrual status. And, there were significant relations among urinary symptoms, difficulty of ADL, incontinence stress and depression. Frequently used coping-methods with urinary incontinence were washing frequently in order to avoid awful smell, paying attention to perineal cleaning, and going to restroom frequently. Conclusion: Community nurses who are in charge of primary health care ought to assess urinary incontinence and develop a urinary incontinence program that includes psychological and social factors.

Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons

  • Sapino, Gianluca;Deglise, Sebastien;Raffoul, Wassim;di Summa, Pietro G.
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.543-546
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    • 2021
  • Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.

Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve

  • Kim, Young Je;Kim, Du Hwan
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.148-151
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    • 2021
  • Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

A Case Report of San-syndrome (疝症) Patient Diagnosed as Soeumin Greater Yang Disease Reverting Yin Pattern (소음인 태양병 궐음증으로 진단한 산증(疝症) 환자 치험 1례)

  • Jang, Halim;Lee, Hyeri;Oh, Jiwon;Lee, Euiju
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.96-106
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    • 2020
  • Objectives The purpose of this case study was to report that San-syndrome patient was treated by diagnosing as Greater Yang Disease Reverting Yin Pattern. Methods The patient was administered with Insamosuyu-tang. Numeral Rating Scale (NRS) and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to assess the improvements of symptoms. Results and Conclusions The perineal region discomfort was reduced from NRS 4 to NRS 1. NIH-CPSI score was reduced from 23 to 11, which means symptom relief. Nocturia and sleep disorder were resolved, and general weakness was relieved accordingly.

Clinical study of acupuncture treatment 1 Case of pruritus ani (항문소양증환자(肛門搔痒症患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Kang, Mi-Suk;Byun, Im-Jeoung;Song, Ho-Sueb;Lim, Jeung-Eun;Kwon, Soon-Jung;Lee, Seong-No;Hwang, Hyeun-Seo;Kim, Kee-Hyun
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.201-204
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    • 2001
  • Objective : This study was to report a clinical trial in which acupuncture treatmnt on 會陰(Huiyin, CV1) was effectively applied to a patient who had suffered from teasing pruritus ani for 38 years. pruritus ani was thought to be initiated by dystonia. Methods : The acupoint, 會陰(Huiyin, CV1) was selected, because needling on perineal muscles was mainly used to alleviate pelvic pain or pruritus ani in the light of MPS(Myofascial Pain Syndrome) theory, on which 會陰(Huiyin, CV1) was located and also had pelvic pain and pruritus ani in its indications. On the acupoint, the following maneuver was used. (1) Make a patient stand and bend forward (2) Insert a needle on 會陰(Huiyin, CV1) (3) Repeat lifting and pushing (4) Draw a needle immediately without retaining needle on the acupoint Results : The patient with Pruritus ani recovered after above treatment two times and had no recurrence up to Feb. 2001. Conclusion : In this study, Needling on 會陰(Huiyin, CV1) proved to be effective in the aspect of MPS and acupuncture treatment as well, but more clinical trials are expected to follow this study.

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Systematic Review on Complementary and Alternative Medicine for Female Sexual Dysfunction (여성 성기능장애의 보완대체의학적 치료에 관한 논문 연구)

  • Jeong, Young-Min;Kim, Song-Baek;Choi, Chang-Min;Seo, Yun-Jung;Cho, Han-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.2
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    • pp.66-87
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    • 2013
  • Objectives: The aim of this study was to review systemically clinical trials on the trends of studies for Complementary and Alternative Medicine in the treatment of female sexual dysfunction and provide basic resource for future treatment and suggestions for improving research methods. Methods: Through medical website 'Pubmed', foreign clinical literatures about female sexual dysfunction were searched and domestic clinical literatures about female sexual dysfunction were searched using internet websites 'National assembly library', 'KISS', 'RISS', 'Korean traditional knowledge portal'. Results: Total 19 literatures were selected from January 2000 to June 2012. 15 foreign literatures were selected through medical website and 4 domestic literatures were chosen using internet websites or hand-searching. 5 literatures were published in 2008 and 13 literatures mentioned about age group of patients. FSFI is most common tool for female sexual dysfunction. 9 of 19 literatures were using Herbal medicine for treatment. 5 literatures were about CBT, 6 literatures were about Biofeedback and other one literatures are about Perineal massage. There were 14 Randomized controlled trials and 5 Non-randomized controlled trials. And randomized controlled trials were relatively low in risk of bias than non-randomized controlled trials. Conclusions: Upon these results, in similar future more clinical trials should be done and accumulate Evidence-based literatures.

Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa (중환자실내 병원성 요로감염 실태와 전파경로: Imipenem Resistant P. aeruginosa[IRPA]의 분자역학적 특성을 중심으로)

  • Yu, Seong-Mi;Jeon, Seong-Sook;Kang, In-Soon;An, Hye-Gyung
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1204-1214
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    • 2006
  • Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

Treatment Results of Preoperative Radiotherapy Alone vs. Preoperative Radiotherapy and Chemotherapy in Locally Advanced Rectal Cancer (국소진행된 직장암에서의 수술전 방사선치료 단독군과 방사선치료와 항암제 병용치료군의 치료성적)

  • Kim Jae Sung;Park Seoung Ho;Cho Moon June;Yoon Wan Hee;Bae Jin Sun;Jeong Hyun Yong;Song Kyu Sang
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.33-40
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    • 1995
  • Purpose : To assess the efficacy and toxicity of the preoperative radiotherapy with or without chemotherapy in locally advanced rectal cancer Methods : Forty three patients (clinically diagnosed stages above or equal to Astler-Coiler stage B2 without distant metastasis) were assigned to preoperative radiotherapy alone arm (n=16) or combined preoperative radiotherapy and chemotherapy arm (n=27). Preoperative radiotherapy of 4500 cGy to whole pel-vis +/-540 cGy boost to primary site and concurrent chemotherapy of 2 cycles of 5-FU (500 mg/$m^2$) and leucovorin (20 mg/$m^2$) were used. Fifteen patients of preoperative radiotherapy alone arm and 19 of combined arm received surgical resection after preoperative treatment. Results : During the preoperative treatment, no significant complication was developed in both groups. Pathologic results were as follows; complete remission 1, Bl 1, B2 6, C1 2, C2, 5 in preoperative radiotherapy alone arm and complete remission 2, Bl 8, B2 4, C2 3, D 2 in combined arm. Postoperative complications were delayed perineal wound healing in three patients, intestinal obstruction in three patients (one managed by conservative medical treatment, two by surgical treatment). Conclusion : The combined preoperative radiotherapy and chemotherapy arm was more effective in pathological response and lymph node negativity rate than the preoperative radiotherapy alone arm. Both the preoperative radiotherapy alone arm and the combined arm were generally well tolerated and did not result in an increased postoperative morbidity.

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Single Oral Dose Toxicity Study of the Methylcyclohexane in Female Rats (암컷 랫드에서 Methylcyclohexane의 단회 경구투여 독성시험)

  • Kim, Sung-Hwan;Lim, Jeong-Hyeon;Shin, In-Sik;Moon, Changjong;Kim, Sung-Ho;Shin, Dong-Ho;Kim, Jong-Choon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.21 no.1
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    • pp.33-39
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    • 2011
  • The present study was carried out to investigate the potential acute toxicity of methylcyclohexane (MCH) by a single oral dose in female rats. The test chemical was administered once by gavage to female rats at dose levels 0, 1,250, 2,500, and 5,000 mg/kg. Mortalities, clinical findings, and body weight changes were monitored for the 14-day period following the administration. At the end of 14-day observation period, all animals were sacrificed and complete gross postmortem and histopathological examinations were performed. Treatment-related clinical signs, as evidenced by depression, soft feces, decreased locomotion activity, solid perineal region, crouching position, and anorexia were observed in all treatment groups in a dose-dependent manner. At the dose level of 5,000 mg/kg, decreased or suppressed body weight gain was found during the study period. At the scheduled necropsy, one case of congestion of the intestine and an increase in the weights of liver and kidney were observed in the 5,000 mg/kg group. Histopathological examinations exhibited an increased incidence of glomerular atrophy, congestion/hemorrhage, and focal degeneration/necrosis in the liver and an increased incidence of congestion, and inflammatory cell infiltration in the kidney. On the basis of the results, it was concluded that a single oral administration of MCH resulted in some adverse effects on clinical sign, body weight gain, and organ weight and histopathology in the liver and kidney in female rats. In the experimental conditions, the minimal lethal dose ($LD_{10}$) of MCH was greater than 5,000 mg/kg.