Pudendal neuralgia is a painful neuropathy of the pudendal nerve, which contains sensory and motor fibers that innervate the anal, perineal, and genital regions. Secondary pudendal neuralgia may occur after injuries sustained during gynecological or urological surgery; however, cases caused by tumors involving the pudendal nerve are extremely rare. Although schwannomas involving the pudendal nerve have been reported, ganglioneuromas (GN) have not. GN are uncommon tumors composed of mature ganglion cells within a Schwannian stroma and typically arise along the sympathetic plexus or in the adrenal medulla. We present the case of a 41-year-old female patient with perineal neuralgic pain caused by a GN involving the perineal branch of the pudendal nerve for 8 years. The tumor was initially diagnosed as a GN on excisional biopsy but was not completely resected and subsequently recurred. Because of its location below the inferior pubic ramus, complete resection was performed using an anterior approach. Given the potential for recurrence and the risk of malignant transformation to neuroblastoma, complete resection is essential.

Perihepatic capsulitis is associated with various diseases, such as Fitz-Hugh-Curtis syndrome, systemic lupus erythematosus, perforated cholecystitis, perforated hepatic abscess, and tuberculous peritonitis. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and is characterized by the widespread millet-like hematogenous dissemination of Mycobacterium tuberculosis. We describe a 24-year-old virgin patient presenting with right upper quadrant and costovertebral angle pain. Diffuse perihepatic capsular enhancement was observed in abdominal computed tomography scans. Chest radiography showed miliary tuberculosis, and a polymerase chain reaction hybridization assay of sputum revealed the presence of M. tuberculosis. Symptoms improved after administering anti-tuberculosis medications. This report describes a rare case of miliary tuberculosis accompanying perihepatitis.
Cholecystitis ; Humans ; Liver Abscess ; Lupus Erythematosus, Systemic ; Mycobacterium tuberculosis ; Peritonitis, Tuberculous ; Polymerase Chain Reaction ; Radiography ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Miliary ; Young Adult

BACKGROUND: Mg++ is an important control factor for transport of K+, Na+, Ca++ and also has been known for having an antiarrhythmic and inotropic action on the heart. Orthotopic liver transplantation is a complex surgical procedure with significant physiologic alterations resulting in electrolyte imbalances. Therefore, the goal of this study was to evaluate the effects of prophylactic MgSO4 administration on intraoperative serum magnesium concentration and its related clinical outcomes. METHODS: 19 patients receiving liver transplants were divided into two groups. Both groups received normal saline (300 ml/3 hr) right after anesthetic induction. MgSO4 (35 mg/kg) was mixed with saline in the experimental group but not in the control group. Serum magnesium concentration was measured four times during surgery. We also checked the total transfused units of packed cells and CaCl2 requirement, the severity of postreperfusion syndrome and base deficit. RESULTS: Serum magnesium concentration significantly decreased in the control group at the postanhepatic stage. The experimental group showed less prominent symptoms of postreperfusion syndrome and less need for potassium supply, but both groups did not reveal any differences in the amount of transfusion and CaCl2 requirement. CONCLUSIONS: We confirmed that our prophylactic administration of MgSO4 (35 mg/kg) may be considered a safe dose showing not only prevention of hypomagnesemia but also a decrease in the potassium requirement and in the severity of postreperfusion syndrome. However, routine administration of MgSO4 might cause disadvantageous effects, so more appropriate indications can be prepared after further clinical research.
Heart ; Humans ; Liver Transplantation* ; Liver* ; Magnesium* ; Potassium

No abstract available.
Humans

OBJECTIVE: In accordance with the increasing number of elderly people in our society, the incidence of pedicle screw fixation which is a technically demanding procedure and requires a lengthy operation time has increased in the patients with lumbars instability over 60 years old. To ascertain the outcome and efficacy of the pedicle screw fixation in patients over 60 years old, we analyzed the surgical results including complications. PATIENTS AND METHOD: From May, 1994 to September, 1997, we assessed 30 patients over 60 years of age and 159 patients under the age of 60 with lumbar spinal instability who underwent surgery of pedicle screw fixation and compared with the results of surgery between two groups. RESULTS: For the elderly, the average operation time was 244 minutes and the transfusion amount was 3.3 pints. For younger patient the average operation time was 246 minutes and the transfusion amount was 3.2 pints. Four surgical complications occurred; two patients with voiding difficulty, one patient with heart problem, and a patient with DIC(Disseminated Intravascular Coagulation). However, all complications were controlled without further problems. The success rate in the elderly was 60%, which was lower than the success rate of 76% among younger patients. CONCLUSION: Considering the condition of the diseases in the elderly and the fact that the operations were performed without any major problems, these results are acceptable. Based on our analysis, it is our view that advanced age per se should not be regarded as a contraindication for pedicle screw fixation.
Aged ; Follow-Up Studies* ; Heart ; Humans ; Incidence ; Middle Aged*

The incidence of spine trauma has been increasing. To investigate the incidence, characteristics, and difficulty in management of the acute spine-injuried patients in suburban area we analyzed 50 cases treated conservatively or by operative fusion over a recent one-year period. This study comprised of 26 females and 24 males, between 23 and 83 years old patients with injury of whole column of spine. The most frequent cause of injury was traffic accident. The most common lesion was the compression fracture of the first lumbar spine. Most patients complained neck or back pain on admission. In 3 cases, neurological deficits were noted. For six patients, surgical treatment were performed and 44 patients has been conservatively managed with halo brace, neck collars, and thoracolumbar orthoses. The average period of admi-ssion and immobilzation for the conservatively treated patients was 6 weeks. During which time a few complications such as progressive kyphosis, hypoalbuminemia, thrombophlebitis, urinary tract infection, paralytic ileus, bed sore, and alcohol withdrawal syndrome were aroused. In most cases, good outcomes were achieved. Most of geriatric patients, concomitant systemic diseases with cardiovascular and pulmonary dysfunction were usually present and absence of the insight on spine injury made difficulties in managment. On the basis of these results we concluded that most elderly patients with spine fracture coulde be effectively treated by conservative methods, and also careful and systemic management with adequate education for patients and their families were required.
Accidents, Traffic ; Aged ; Aged, 80 and over ; Back Pain ; Braces ; Education ; Female ; Fractures, Compression ; Humans ; Hypoalbuminemia ; Incidence ; Intestinal Pseudo-Obstruction ; Kyphosis ; Male ; Neck ; Orthotic Devices ; Pressure Ulcer ; Spine ; Thrombophlebitis ; Urinary Tract Infections

Compared to the lumbar region, it is very rare to encounter far lateral disc herniation in the cervical spine, and because of this, correct diagnosis before surgery is difficult: the condition can, however, be identified through the use of advanced MRI imaging techniques. In this case, far lateral disc herniation at C7-T1 was effectivery removed through posterior laminoforaminotomy, and soon after surgery, the patient's symptoms showed complete remission.
Diagnosis ; Lumbosacral Region ; Magnetic Resonance Imaging ; Spine

No abstract available.
Female ; Ovulation*