The perineum refers to the anatomical area immediately below the pelvis, and is comprised of diverse anatomic and somatic innervation. Although various interventions have been proposed for the management of intractable cancer-related perineal pain, their efficacy are limited because the target of nerve blocks has focused on somatic rather than sympathetic components. Recently, blockade of the ganglion impar has been introduced as an alternative means of managing intractable neoplastic perineal pain of sympathetic origin. We successfully treated a patient who had suffered from cancer-related intractable perineal pain with ganglion impar block.
Ganglion Cysts* ; Humans ; Nerve Block ; Pelvis ; Perineum ; Rectal Neoplasms

No abstract available.
Animals ; Heart* ; Rats* ; Wisconsin*

Fibrous hamartoma of infancy (FHI) is an uncommon, benign, solitary intradermal or subcutaneous tumor. It occurs typically in the axillary or shoulder region. The histopathologic examination of affected lesion shows the characteristic elements: dense fibrous tissue, adipose tissue, and primitive mesenchymal tissues. A 15 month-old girl had the multiple, asymptomatic, discrete, and skin-colored tumors that scattered on the scalp. These were present at birth. We report a rare case of FHI occurred on the scalp with multiple and congenital characteristics.
Adipose Tissue ; Female ; Hamartoma* ; Humans ; Parturition ; Scalp ; Shoulder

Cutaneous chromomycosis is a slow growing verrucous skin infection caused by five species, identified as Philadophara verruscosa, Fonsecaea dermatitidis, Fonsecaea pedrosoi, Fonsecaea compactum, Cladosporium, carionii. We report a case of chromomycosis of the skin causing by Cladosporium genus, in view of its rarity and unique light microscopic and ultrastructural features. This 65-year-old female had suffered from eczematous and lichenified skin lesion for the last two years since she burned her dorsum of the left hand by boiling oil. The lesion was slowly progressed, and ended up to the brownish hardening of the skin covered with crusts. Skin punch biopsy was done. Histologically, the sections revealed typical features of chronic granulomatous inflammation along with the heavy infiltration of the lymphocytes, plasma cells and histiocytes. Pseudocarcinomatous downgrowth of the epidermis and microabscesses in the upper dermis were also found. Numerous thick walled fungal organisms were noted within the giant cells and freely in the dermis, which were positive ant PAS stain, and diastase resistant. Thick mucous capsule is not observed. The organisms showed very faint yellowish walls with a few buddings and a few short elongated hyphae were also noted. Ultrastructurally, the fungus wall was multilayered and inner organelles were sparse. There is no evidence of systemic involvement, especially brain.
Female ; Humans ; Biopsy

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.

PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.
Arthrography ; Arthroscopy ; Diagnosis, Differential ; Female ; Head* ; Humans ; Middle Aged ; Radiography ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Tendinopathy*

No abstract available.
Brain Stem* ; Evoked Potentials* ; Hallucinations* ; Humans

A 47-years old korean farmer was first visited our department in Nov. 19, 1969 with complaining of proptosis, lateral deviation of eye ball and visual disturbance of 5 years duration. The onset was insidious. Past and family history were not contributory. On examination, right eye was within normal limit. The left eye was markedly proptotic (aoout 10 mm of exophthalmos) and displaced out-and downward. The vision of the left eye was L.P.. The ocular motility was slightly limited to all direction. Pupil was normal size and poorly reacted to light. Funduscopic examination revealed pale and slightly excavated in disc. X-ray of chest, skull and optic foramen showed normal. On Nov. 22. 1969 author adopted the Kronlein's approach and exceed well capsulated oval mass situated within the muscle cone, which attached to optic nerve. The tumor mass showed soft, dark reddish color of surface measuring 2 X 2 X 15 cm and its cut surface disclosed sponge like appearance. Histologically the section from tumorous mass showed many large cavernous spaces separated by connective tissue. The newly formed cavernouus space was for the most part lined by a single layer of endothelium and in part contained with red cell. We confirmed adiagnosis of cavernous hemangioma of the orbit in pathologic study. It was suggested that early loss of vision was caused by optic atrophy due to direct pressure of optic nerve by the tumor mass. A review of literature of recent years related to cavernous hemangioma of orbit was added.
Connective Tissue ; Endothelium ; Exophthalmos ; Hemangioma, Cavernous* ; Humans ; Middle Aged ; Optic Atrophy ; Optic Nerve ; Orbit* ; Porifera ; Pupil ; Skull ; Thorax