Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

Purpose: The purpose of the study was to identify degrees of symptoms, self-efficacy, fear of cancer recurrence, anti-hormone therapy beliefs, and medication adherence, and to pinpoint factors influencing medication adherence among patients with breast cancer who were undergoing hormone therapy. Methods: The data of 144 breast cancer patients who had breast cancer surgery and were undergoing anti-hormone therapy were collected from July to August 2022. The collected data were analyzed using the descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and hierarchy multiple regression analysis. Results: Medication adherence significantly differed according to the breast cancer stage (F=3.35, p=.38) and presence of comorbidities other than breast cancer (t=-2.26, p=.025). Medication adherence was explained by breast cancer stage (β=.15), the presence of comorbidities other than breast cancer (β=.16), symptom (β=.17), and Anti-Hormone Therapy Beliefs (β=-.44)(F=11.47, p<.001). The model explained 34% of the variance. Conclusion The results of the study suggest that share the patient’s symptom experiences among medical staff, and educate about the importance of anti-hormone therapy beliefs and prior methods. The findings of this study highlight the need to develop and implement education or interventions to enhance medication adherence among breast cancer patients who are undergoing anti-hormone therapy.

BACKGROUND: Since the herniorrhaphy was performed by Bassini, that method has been the standard for herniorrhaphy for over a hundred year, although it has been modified by other surgeons. During recent decades, biomaterials were introduced to the medical field, and polypropylene mesh was applied to reconstruct the defective abdominal wall of an inguinal hernia in an adult. The Lichtenstein Hernia Institute is regarded as the leading group for the tension-free herniorrhaphy using Marlex mesh under local anesthesia. METHODS: We designed this study prospectively to investigate the characteristics of groin hernias and the results, including complications and recurrence after surgery. The primary method of surgery was a Lichtenstein's tension-free herniorrhaphy using Prolene mesh. We performed 196 hernioplasties in 180 patients having a groin hernia, which included 16 bilateral hernias. RESULTS: 139 indirect hernias, 51 direct hernias, and 3 femoral hernias were included; there were 15 recurrent hernias. A Lichtenstein's tension-free herniorrhaphy was performed in 84.2% of the cases, a preperitoneal mesh graft in 10.2%, and a Bassini's method in 4.6%. There were four recurrences; three were through the femoral canal after the repair of a direct hernia in a female, and one was a recurrent direct hernia in a male patient. CONCLUSIONS: With the use of a mesh prosthesis, a tension-free herniorrhaphy is possible with neither distortion of the normal anatomy nor suture-line tension. However, it should be carefully applied to a direct hernia only after thorough exploration of the groin through the retroinguinal space of Bogros to rule out coexisting intraparietal or femoral hernias. It is necessary to provide enough laxity for the mesh because prolene mesh can shrink up to 20%, and recurrence might be caused by the tension in the applied mesh.
Abdominal Wall ; Adult* ; Anesthesia, Local ; Biocompatible Materials ; Female ; Groin ; Hernia ; Hernia, Femoral ; Hernia, Inguinal* ; Herniorrhaphy* ; Humans ; Male ; Polypropylenes ; Prospective Studies ; Prostheses and Implants ; Recurrence ; Transplants

PURPOSE: Cystatin C has been proposed for the assessment of glomerular filtration rate, being more accurate than creatinine determination. We measured serum cystatin C concentrations in the pediatric population, and analysed the correlation between cystatin C and glomerular filtration rate. METHODS: Cystatin C and creatinine were measured by the particle enhanced nephelometric immunoassay and Jaff'e method, respectively, in 276 children and adolescents without evidence of kidney disease. The glomerular filtration rate was estimated by Schwartz's formula. RESULTS: The mean serum cystatin C concentration was significantly higher in infants under the age of 12 months than in older population. There was a negative correlation between cystatin C and age under 12 months, but not a significant change of cystatin C with age in children older than 12 months For children older than 12 months, the reference range of cystatin C was 0.46-1.05 mg/L. On the other hand, there was a positive correlation between creatinine and age in the whole population. We also observed a positive correlation between estimated glomerular filtration rate and 1/ cystatin C. CONCLUSION: The measurement of cystatin C is more practical than creatinine for estimating glomerular filtration rate in the pediatric population.
Adolescent* ; Child* ; Creatinine ; Cystatin C* ; Glomerular Filtration Rate* ; Hand ; Humans ; Immunoassay ; Infant ; Kidney Diseases ; Reference Values

Extraskeletal chondromas are relatively uncommon benign cartilaginous tumors of the soft tissue and well known to pose a considerable diagnostic problem because of histological variations including the immature appearance of their tumor cells. Recently, we have experienced a case of extraskeletal chondroma mimicking benign chondroblastoma. The patient was a 47-year-old woman who complained of a painful subcutaneous swelling on the radial aspect of 4th proximal interphalangeal (PIP) joint in the left hand for 6 months. Radiologic examination of the 4th finger revealed a 1cm-sized soft tissue mass. Histologically, the tumor was characterized by a lobulated mass which was composed of dense proliferation of chondroblast-like cells admixed with a few multinucleated giant cells of osteoclastic type. However, there were focal areas of typical chondroma which showed lace-like intense calcification around the differentiated chondrocytes.
Chondroblastoma ; Chondrocytes ; Chondroma* ; Female ; Fingers ; Giant Cells ; Hand ; Humans ; Joints ; Middle Aged ; Osteoclasts

Higenamine was isolated originally from Aconiti tuber from Aconitum species and recently Higenamine was synthesized. The purpose of this study is to investigate the adrenergic effect of Higenamine on rabbit cardiovascular system. Blood pressure, cardic output, systemic vascular resistance and heart rate were measured after intravenous injection of Higenamine(2-100microg/kg/min). The effects of Higenamine were compared with those of other sympathomimetic drugs. The changes in the cardiovascular systems after pretreatment with Propranolol, Atenolol and Hexamethonium were also studied. The following results were obtained. 1) Higenamine increased the cardic output and the heart rate and decreased the blood pressure and the systemic vascular resistance. Those changes were dose-dependent. The duration of action of Higenamine was 5 to 8 minutes. 2) The effects of Higenamine were similar to those of Isoproterenol. The amount of Higenamine was more than 100 times the required amount of Isoproterenol in order to obtain the same casdiovascular effects. 3) The effects of Higenamine were blocked by Propranolol, The increase of cardic output and heart rate were blocked by Hexamethonium. Higenamine has stimulating action on beta1 and beta2 receptors. But Higenamine is much less potent than Isoproterenol.
Aconitum ; Adrenergic Agents* ; Atenolol ; Blood Pressure ; Cardiovascular System* ; Heart Rate ; Hexamethonium ; Injections, Intravenous ; Isoproterenol ; Propranolol ; Sympathomimetics ; Vascular Resistance

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