Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.
Botulinum Toxins ; Botulinum Toxins, Type A ; Frustration ; Ganglion Cysts ; Humans ; Muscle Relaxation ; Nerve Block ; Neurotransmitter Agents ; Pain Perception ; Urinary Bladder

PURPOSE: This study was conducted to evaluate successful aging (SA) in elderly individuals and to determine the factors that influence SA. METHODS: The subjects included 207 elderly individuals from D city, Korea. The data were obtained between July 1 and August 30, 2008. The participants were assured of anonymity and confidentiality. For the evaluation, Kim & Shin's SA scale, Lawton's instrumental activities of daily living (IADL) scale, Jon's self-esteem scale, Kee's geriatric depression scale short form-Korean (GDSSF-K), and Hong's productive activities scale were used. The data were analyzed using descriptive statistics, the t-test, analysis of variance (ANOVA), and Pearson correlation coefficients; multiple regression analysis was performed using the SPSS/WIN 10.0 program. RESULTS: The maximum score for SA was 34, and the mean score was 22.62. It was found that SA was significantly correlated to IADL, self-esteem, depression, and productive activity. Depression was the most powerful predictor of SA and it accounted for 40.6% of the total variance in SA. Self-esteem, productive activity, living situation, economic status, and age together accounted for 62.1% of the total variation in SA. CONCLUSION: Depression, self-esteem, and productive activity were identified as variables that influence SA. On the basis of these results, we conclude that nurses should assist elderly individuals in order to facilitate SA. Moreover, individualized nursing management strategies must be developed in order to facilitate SA.
Activities of Daily Living ; Aged ; Aging ; Anonyms and Pseudonyms ; Confidentiality ; Depression ; Humans ; Korea

The purpose of the present study lied in examining the incidence, treatment and failure causes of peri-implantitis by analyzing medical charts of those patients who underwent implant placement for the past 2 years. The subjects included those patients who underwent implant placement at the present hospital from January 2001 to December 2002. 3i implants were used for the analysis for the comparison of significance. A total of 301 patients were examined, among whom 102 were females and 199, males. Implants were placed in a total of 578 cases. The number of peri-implantitis was present in a total of 29 cases (21 males and 8 females), giving the incidence at 9.6%. The evidence of peri-implantitis was seen in 60 cases, which was in 10.4% of the patients. Among those cases with peri-implantitis, 28 cases (47%) underwent bone graft and 22 cases (43%) underwent maxillary sinus lift. Furthermore, 4 of these patients had systemic diseases such as diabetes or hypertension. Regular management is important for the preven ion of peri-implantitis. In other words, early prevention through regular follow-ups to check the status of surrounding soft tissue would be needed to maintain implants.
Female ; Humans ; Hypertension ; Incidence ; Male ; Maxillary Sinus ; Peri-Implantitis* ; Retrospective Studies* ; Transplants

In order to investigate the occurrence characteristics of cancer in terms of industry in Kwangju-Chonnam area, medical utilization records of industrial medical insurance corporations during the period of 1987 to 1988 were reviewed for the identification of neoplastic disease. The cases obtained from the medical records were followed up for the verification and to get additional information. Standardized incidence data were compared by occupational characteristics. Multiple logistic regression analysis was applied to analyze the difference of incidence or distribution of cancer as a whole or of some selected cancer. Total cases of cancer identified were 242 during the study period. Annual incidence rate was calculated as 123.1 per 100,000 person. The frequent types of cancer were cancers of stomach, liver, lung, colon and rectum, bladder and lymphoma in descending order. Employees of mine and other sand handling industries showed significantly higher risks for cancer of stomach and cancer as a whole. Employees of the transportation industry showed the higher risk for cancer of liver. Workers in small-sized industry (< or = 100) had a higher risk for cancer than who in large-sized industry (>100). These findings suggested the effect of occupational environmental exposure to cancer development.
Colon ; Environmental Exposure ; Humans ; Incidence ; Insurance* ; Liver ; Liver Neoplasms ; Logistic Models ; Lung ; Lymphoma ; Medical Records ; Occupations ; Rectum ; Silicon Dioxide ; Stomach ; Stomach Neoplasms ; Transportation ; Urinary Bladder

BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

PURPOSE: Protein tyrosine kinase(PTK), protein kinase C(PKC), oxidase, as a mediator, have been known to take a role in signal transduction pathway of angiogenesis. The authors confirmed that PKC is the most noticeable mediator for abnormal proliferation of vascular endothelial cells through in vitro study model using the inhibitors, targeting the formation of three co-enzymes. In this study, we would investigate which isoform of PKC play an important role in abnormal angiogenesis of vascular endothelial cell. METHODS: In 96 well plates, 10(4) HUVECs(human umbilical vein endothelial cells) were evenly distributed. Two groups were established; the control group without administration of DMH(1,2-dimethylhydrazine) and the DMH group with administration of 7.5x10(-9)M DMH. RNA was extracted from vascular endothelial cell of each group and expression of the PKC isoform was analyzed by RT-PCR(reverse transcriptase-polymerase chain reaction) method. RESULTS: RT-PCR analysis showed that PKCalpha, -betaI, -betaII, -eta, -micron and -zeta were expressed in vascular endothelial cells of each group. DMH incresed the expression of PKCalpha and PKCmicron, and decreased PKCbetaI, PKCbetaII expression dominantly. CONCLUSION: Based on the result of this study, it was suggested that PKCalpha and PKCmicron may have significant role in abnormal proliferation of vascular endothelial cell.
1,2-Dimethylhydrazine* ; Cell Proliferation ; Dimenhydrinate ; Endothelial Cells* ; Oxidoreductases ; Protein Kinase C* ; Protein Kinases* ; RNA ; Signal Transduction ; Tyrosine ; Umbilical Veins

Abscess ; Anti-Bacterial Agents ; Cavernous Sinus Thrombosis ; Disseminated Intravascular Coagulation ; Drainage ; Humans ; Mediastinitis ; Middle Aged ; Multiple Organ Failure ; Resuscitation ; Sepsis

Immunoglobulin G4-related disease (IgG4-RD) is an emerging immune-mediated fibro-inflammatory disorder which can involve any organ. The main characteristics of IgG4-RD are increased serum IgG4 concentration, abundant IgG4+ plasma cells in affected tissues, and painless swollen organs often without general symptoms. Typical pathology features of IgG4-RD are lymphoplasmacytic infiltration, dense storiform fibrosis, and obliterative pheblitis. The pathogenesis of IgG4-RD remains elusive, but involvement of excess production of type 2 T helper cells, regulatory T-cell cytokines, and B-cell activating factor in the development of IgG4-RD has been suggested. Diagnosis of IgG4-RD can be made on the basis of serological, imaging, particularly histopathological findings. Glucocorticoid is the first-line therapy for patients with multiple organ dysfunction and clinical symptoms. Drugs such as azathioprine, mycophenolate mofetil, methotrexate, and cyclophosphamide can be used as steroid-sparing agents. Rituximab is reported to be an effective therapy for treatment of IgG4-RD, even without concomitant glucocorticoid therapy. This review summarizes current concepts on pathophysiology, clinical manifestations, and treatment of IgG4-RD.
Azathioprine ; B-Cell Activating Factor ; Cyclophosphamide ; Cytokines ; Diagnosis ; Fibrosis ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Methotrexate ; Pathology ; Plasma Cells ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Rituximab

Malignant hyperthermia is a recently described and drmatic syndrome which rarely occurs during anesthesia, but when & dose occur is still fatal in the majority of cases with unknown etiology. It si a rypermetabolic condition characterized by tachycardia, tachypnea, skeletal muscle rigidity, respiratory and metabolic acidosis and cyanosis etc. A case is presented of a 20 year old gerveralcy healthy female with a family history of congenital eye-ild ptosis in herself as well as in all her brothers and sisters( male 2, female 4) and a generalized muscle weakness of unknown origin for several years in her father. She underwent a minor operation for correction of the congenital eyelid ptosis under N2O-O2-tachycardia developed followed by severe arrhythmia with unstable BP, minutes after induction tachycardia developed followed by sever arrhythmia with unstable BP, muscle rigiditiy and hyperpyrexia. 15 minutes after induction anesthesia was stopped and aggressive emergency treatment was atlemted. Unfortunately, she died postoperatively on the 8th day after anesthesia. Possible etiologic factors, the clinical features and management of malignant hyperthermia are discussed.
Acidosis ; Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac ; Blepharoptosis ; Cyanosis ; Emergency Treatment ; Fathers ; Female ; Humans ; Male ; Malignant Hyperthermia* ; Muscle Weakness ; Muscle, Skeletal ; Siblings ; Tachycardia ; Tachypnea ; Young Adult

A clinical observation was made with particular attention to radiologic diagnosis, complication and management on 69 patients of renal injury admitted to the Catholic Medical Center during the last 10 years. The results were as follows: 1. Minor renal injury was in 49 cases (71%), major renal injury in 19 cases (27.5%) and pedicle injury in 1 case (1.5%) according to Scott's classification. 2. IVU was performed in 68 cases for initial diagnostic study and 18 cases (31%) needed additional radiologic study for accurate staging. 3. CT was performed in 14 cases and its diagnostic accuracy was 93%. 4. Renal angiography was performed in 6 cases. Angioinfarction was performed in 1 case due to continuous bleeding and the other 5 cases showed localized parenchymal infarction or normal finding. 5. Sonography was performed in 6 cases for initial diagnostic study and in 3 cases for follow up study. 6. In major renal injury patients, the group which decided treatment after CT study revealed 16 7% of complication rate but the group which decided treatment without CT study revealed 38 5% of complication rate. 7. In major renal injury or pedicle injury patients, initial operative treatment group resulted in kidney loss in 70% of cases without complication but initial conservative treatment group resulted in kidney loss in 60% of cases and the delay of operation resulted in 70% of complication rate.From these results, CT is the choice of additional staging technique after initial IVU and initial surgical operation is adequate treatment procedure in major renal injury or pedicle injury patients.
Angiography ; Classification ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Kidney