• Archives of Plastic Surgery
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• 제41권6호
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• pp.753-758
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• 2014

Background Extramammary Paget's disease (EMPD) is an intraepithelial carcinoma usually occurring on the skin or mucosa of the perineum. Clinically, it resembles eczema or dermatitis, and misdiagnosis and treatment delays are common. The treatment of choice for EMPD is a wide excision with adequate margins. Wide excision with intraoperative frozen biopsy and Mohs micrographic surgery are common methods; however, these are associated with a high recurrence rate and long operation time, respectively. Methods Between January 2010 and June 2013, 21 patients diagnosed with EMPD underwent mapping biopsy. Biopsy specimens were collected from at least 10 areas, 2 cm from the tumor margin. When the specimens were positive for malignancy, additional mapping biopsy was performed around the biopsy site of the positive result, and continued until no cancer cells were found. Based on the results, excision margins and reconstruction plans were established preoperatively. Results The patients (18 male, 3 female) had a mean age of 66.5 years (range, 50-82 years). Almost all cases involved in the perineal area, except one case of axillary involvement. Permanent biopsy revealed one case (4.8%) of positive cancer cells on the resection margin, in which additional mapping biopsy and re-operation was performed. At the latest follow-up (mean, 27.4 months; range, 12-53 months), recurrence had not occurred. Conclusions Preoperative mapping biopsy enables accurate resection margins and a preoperative reconstructing plan. Additionally, it reduces the operation time and risk of recurrence. Accordingly, it represents an effective alternative to Mohs micrographic surgery and wide excision with intraoperative frozen biopsy.

• 여성건강간호학회지
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• 제2권1호
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• pp.125-137
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• 1996

This study was conducted to identify the educational need of pregnant women, and to evaluate the effect of the 2-hour childbirth class provided by researchers. The subjects were composed of 183 pregnant women who participated voluntarily in the 2-hour childbirth class, and the data were collected by self reporting structured questionnaire designed by researchers. The data were analyzed with descriptive statistics, paired t test, and McNemar test by SPSS pc program. The results were as follows ; 1. Mean age of th subjects was 27 and most subjects graduated from the high school and the college. 80.3% of the subjects had nuclear family. 82.5% of the subjects were full time housewives. 2. 85.8% of the subjects were ipara. Though 71.6% of the subjects might have antepartal care in the clinic, 67.2% of the subjects had no chance to participate in the childbirth class before this study. 3. Subject's health and lifestyle, especially related to eating habits, were changed in the antepartum period. We found that the pregnancy affected positively on health and lifestyle of the women. Over 75% of the subjects became to understand the progress of labor, breath methods during the labor, and perineal exercise. Most subjects changed to think that they could control their body more actively and positively during the labor after participating in the childbirth class. 93.4% answered that 'childbirth class was necessary and important'. Most subjects wanted to be taught the contents, such as postpartum care, breast feeding, and infant care in the childbirth class. In conclusion, pregnant women to attend the childbirth educational program with their husband, and the 2-hour childbirth class provided by the researchers very effective in many aspects. Therefore we anticipated that the childbirth class on basis of pregnant women's needs will contribute to improvement of pregnant women's health and well-being during the labor.

• Toxicological Research
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• 제25권3호
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• pp.132-139
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• 2009

The toxicity test of ammonium persulfate was conducted to ensure of its potential toxic effects according to the single-dose acute oral toxicity study (OECD Guideline 423) and 90-day repeated dose sub-chronic oral toxicity study guideline (OECD Guideline 408) for establishing national chemical management system, and matching in the Globally Harmonized Classification System (GHS) category. In acute oral toxicity study, pasty stool, perineal contamination and temporary body weight decrease were observed after dosing 1st and 2nd challenge (300 mg/kg body weight). All test animals were dead within 6 hours after dosing at 3rd challenge (2000 mg/kg body weight). Therefore, the GHS class of test substance is considered class 4. In sub-chronic toxicity study, body weight changes, food consumptions, hematological, biochemical and pathological examination did not show any noticeable and significant differences between the administered (5, 20, 80 mg/kg body weight) and control (vehicle only) group animals. Based on these results, the no observed adverse effect level (NOAEL) is considered above 80 mg/kg body weight.

• The Korean Journal of Pain
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• 제18권2호
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• pp.263-266
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• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

• The Korean Journal of Pain
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• 제11권1호
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• pp.165-168
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• 1998

Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at $L_5$ dermatome. Laminectomy was performed, and abscess and necrotic fat material was removed from left $L_5$ nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

• 여성건강간호학회지
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• 제18권3호
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• pp.209-222
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• 2012

Purpose: The purpose of this study was to determine whether upright position is effective in labor through systematic review in randomized controlled trials. Methods: We established the PICO (Patient-Intervention-Comparator-Outcome) strategy, and reviewed 282 literatures from national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria. We evaluated the quality of references and carried out a meta-analysis. Results: The maternal outcomes showed that the duration of their second-stage labor was 2.29 minutes shorter than that of the women in the recumbent position, and were less likely to have episiotomy. The other outcomes, including the mode of delivery, blood loss, hemoglobin level, use of oxytocin, use of analgesics, and perineal laceration, did not differ between the groups. The fetal heart rate abnormality occurred less than in the control group. The Apgar scores of the groups did not differ. Conclusion: There is evidence that an upright position in the second stage of labor reduces the duration of the second stage of labor, the incidence of episiotomy, and an abnormal fetal heart rate.

• The Korean Journal of Pain
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• 제29권1호
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• pp.23-28
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• 2016

Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

• 한국임상수의학회지
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• 제34권6호
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• pp.467-469
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• 2017

Signalment: A 7-month-old, female domestic shorthaired cat was presented for acute pelvic limb paraparesis. Results: There was no abnormality on survey radiographs and blood analysis, however neurological examination revealed proprioception positioning and hopping was absent in the pelvic limbs. Also, anal tone and perineal sensation were reduced. Magnetic resonance (MR) imaging showed nucleus pulposus dehydration and disc protrusion at T12-T13. Ill-defined diffuse lesion was found at T10-L2 level and it showed isointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. This lesion was considered as edematous lesion secondary to disc protrusion. The presumptive diagnosis was focal spinal cord edema associated with intervertebral disc protrusion. A traumatic aetiology was suspected. The cat was treated corticosteroids and analgesic and clinical sign improved following 9 days of treatment. Clinical relevance : Intervertebral disc protrusion is rare disease in a cat. However, it could be considered as a cause of paraparesis in cats.

• 한국수정란이식학회지
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• 제22권1호
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• pp.39-45
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• 2007

무발정기에 속한 Shih-tzu 견 9두를 대상으로 하여 PMSG(50IU/kg)를 10일 동안 매일 근육주사 후 마지막 10일째에 hCG(1,000IU/head)를 정맥 주사하여 인공적으로 발정을 유기 하였다. 실험견 9두 중 9두(100%)에서 발정 출혈, 회음부 반사, 외음부 종대 및 수컷 허용 등의 임상적인 발정 증상이 관찰되었으며 그중 5두(55.6%)가 임신하였고 4두는 임신되지 않았다(44.4%). 임신견 5두 중 3두(33.3%)가 자연분만하였는데 분만시 산자수는 $1.66{\pm}1.15$두 $(1{\sim}3)$이었고, 나머지 2두(40.2%) 는 PMSG 첫 투여후 38일과 41일에 조기태아사 하였다. 따라서 Shih-tzu 견에서 PMSG와 hCG 병용 투여에 의한 인공 발정 유기 효과는 발정 발현율 100%, 임신률 55.6%, 분만율이 33.3%이었다.

• 한국임상수의학회지
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• 제29권4호
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• pp.352-355
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• 2012

Hypospadias is a rare congenital malformation of the urethra reported in cattle. The urethral lumen of male indigenous Korean calf is open along the ventral aspect of the penis in the perineal region. Renal abscess and renal stone formation causing urinary tact infection has not been reported in hypospadia calves. The objective of this study was investigation for renal abscess and renal stone formation through autopsy. Histopathological examination and laboratory tests were performed. At autopsy, the pustules were formed on the right renal cortex, and the renal medulla abscess were formed on right and left part of the renal pelvis. Histopathological finding, this case was diagnosed as severe acute suppurative and necrotizing pyelonephritis, and severe chronic interstitial nephritis with fibrosis and moderate multifocal acute cystitis with edema. Milky exudate of the kidney has been identified as Actinomyces meyeri using the VITEK-2 system for identification of bacteria, and the stone has been identified as carbonate apatite using FT-IR system for quantification analysis. This case report describe the hypospadias complicated with urinary tract infection due to carbonate apatite stones and Actinomyces meyeri.