• Radiation Oncology Journal
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• v.26 no.4
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• pp.222-228
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• 2008

Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.473-475
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• 2015

A 12-year-old intact male, Alaskan Malamute dog, which lives in the countryside, was presented with inflammation and pain around perineal areas. Thorough examination revealed maggots and punched-out round holes lesion around the perineal region. Complete blood counts (CBC) and serum biochemical examinations showed no remarkable findings except mild anemia and mild thrombocytosis. The diagnosis was easily done, based on clinical signs and maggots identification. Cleaning with chlorhexidine, povidone-iodine lavage and hair clipping away from the lesions were performed soon after presentation. SNAP 4Dx Test (IDEXX Laboratories, Westbrook, ME, USA) was performed to rule out other vector-borne diseases since the ticks were found on the clipped area and vector-borne pathogens. The test result was negative. The dog in this case was treated with ivermectin (300 mcg/kg SC) one time. Also, treatments with amoxicillin clavulanate (20 mg/kg PO, BID) was established to prevent secondary bacterial infections. Then, myiasis resolved with 2 weeks and the affected area was healed.

• Journal of Veterinary Clinics
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• v.26 no.4
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• pp.331-335
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• 2009

This paper was performed to investigate the propensity of the diameter of maximum distended urethra from urethra to os penis in mature male dogs of 25 male dogs of different breeds. The measured sites of urethras were divided into 7 regions, i.e. prostate, membrane, isthmus, perineum, scrotum, prescrotum and os penis. By using the inflated balloon catheter filled with contrast medium, the maximum diameter of the distended urethras of each region was recorded and compared among regions. The mean diameter of the lumen from the prostatic urethra to the os penis urethra was gradually narrowed except for the isthmus portion, with a sense of resistance for retraction being noted at the level of ischiatic arch in 22 dogs. Proposed results from this should be utilized as a predictor of a treatment plan for the removal of urethroliths using an urohydropropulsion.

• Journal of Korean Academy of Nursing
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• v.45 no.5
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• pp.713-722
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• 2015

Purpose: The purpose of this study was to investigate the effects of pelvic floor muscle exercise using electric stimulation and biofeedback on maximum pressure of vaginal contraction, vaginal contraction duration and sexual function in women who have had vaginal rejuvenation. Methods: The research design was a non-equivalent control group non-synchronized design study. Participants in this study were women who had vaginal rejuvenation at C obstetrics and gynecology hospital. The 15 participants in the experimental group were given pelvic floor muscle exercise using electric stimulation and biofeedback and the 15 participants in the control group received self pelvic floor muscle exercise. Results: For maximum pressure of vaginal contraction, the experimental group showed a statistically significant increase compared to than the control group (t=5.96, p <.001). For vaginal contraction duration, the experimental group also showed a statistically significant increase compared to the control group (t=3.23, p =.003). For women' s sexual function, the experimental group showed a significant increase when compared to the control group in total sexual function scores (t=3.41, p =.002). Conclusion: The results indicate that pelvic floor muscle exercise with electric stimulation and biofeedback after vaginal rejuvenation is effective in strengthening vaginal contraction pressure, vaginal contraction and that it also positively functions to increase women's sexual function.

• Women's Health Nursing
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• v.27 no.4
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• pp.379-387
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• 2021

Purpose: This study aimed to determine the actual state of childbirth in Korean women with natural childbirth and the degree of damage to the perineum during childbirth. Methods: This retrospective study analyzed the medical records of mothers who had natural childbirth at a hospital in Seoul, Korea in 2018. Data from 358 women with cephalic births at greater than 37 gestational weeks were analyzed. To determine natural childbirth characteristics and the degree of damage to the perineum, descriptive statistics were done. The difference in the degree of perineal injury according to obstetric characteristics was analyzed using independent t-test and one-way analysis of variance. Results: The mean age was 33.18±3.68 years, and 49.2% were primiparas, while 39% gave birth with a doula. The degree of perineal damage differed by age (F=9.15, p<.001), parity (t=19.13, p<.001), number of births in multiparity (F=3.68, p=.027), previous vaginal delivery in multiparity (F=3.00, p=.032) and birthing posture (F=7.44, p<.001). Having received therapeutic procedures (t=-4.62, p<.001), specifically fluid administration (t=-2.72, p=.007), oxygen supply (t=-2.76, p=.006) and epidural anesthesia (t=-2.77, p=.006) were statistically significant for perineal damage. There were no differences, however, by gestational period, doula use, water room use in labor, baby head circumference, or birth weight. Conclusion: Study findings suggest that support for older women, primiparas, and those who require therapeutic procedures may help to decrease the possibility of perineal damage during childbirth. As perineal damage was also associated with birthing posture, this should be considered when providing intrapartum nursing care.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.62-67
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• 2002

Purpose : This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy Plus radiotherapy versus abdominoperineal resection and Postoperative radiotherapy for anal cancer. Materials and Methods : Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy $(APR+RT{\pm}CT)$, and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil $(1,000\;mg/m^2\;bolus\;on\;D1\~5)$ and cisplatin $(60\;mg/m^2\;bolus\;on\;D1)$ followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Results : Overall five-year survival rates were $80.3\%$, 88.9 and $79.4\%$ for entire patients, $APR+RT{\pm}CT$ group, and the CRT group, respectively. No significant difference was found between the two groups (p=0.49). Anus preservation rate for the CRT group was $86.7\%$. Age (0=0.0164) and performance status (p=0.0007) were found to be significant prognostic factors by univariate analysis. Age (p=0.0426), performance status (p=0.0008), and inguinal lymph node metastasis (e=0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. Conclusion : This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of chemotherapy with a cisplatin based regimen rather than a concurrent regimen may lead to a decrease in complications.

• Journal of Veterinary Clinics
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• v.21 no.1
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• pp.58-61
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• 2004

A 5-year old female shih-tzu referred to the veterinary Teaching Hospital, College of Veterinary Medicine, Konkuk University. The patient was presented with a mass of ventral to pubic region and intraperineal region. CBC, chemistry, x-ray, fine needle aspiration, biopsy and MRI was performed. The dog was definitively diagnosed as lipoma based on cytologic and histopathologic examination. In order to remove the mass, an approach with two direction was made. First, intraperineal region was removed about 40%, and then ventral to pubic was removed the remainder. And inserted penrose drain for obliterate dead space to prevent the accumulation of serous discharge. The dog is clinically normal and being monitored for development of any abnormal signs for the time being. In this case, diagnostic MRI was very useful procedure. it revealed accurate location of a lipoma and useful manner for decision of surgical approach to remove.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.250-253
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• 1997

The perineum is comprised of diverse anatomic structures with mixed sympathetic and somatic innervation. The coccyx is innervated by the coccygeal nerves and branches of the fifth sacral root. Recently, ganglion impar block has been introduced as an alternative means of managing intractable pain of sympathetic origin, coccygodynia by trauma, tenesmus and perineal hyperhydrosis. We managed a 59-year-old female patient who had suffered from perineal pain by metastasis of cervical cancer. Approach to impar ganglion through the anococcygeal ligament was impossible because her coccyx was hyperflexed anteriorly by old fracture. But we could perform ganglion impar block successfully by approach through the separation of sacrum and coccyx.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.177-180
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• 1988

Transsacral neurolytic block with 2.5ml of phenol in glycerine or bupivacaine was performed in 6 patients with malignant diseases and a patient with sphincter spasm of bladder due to spinal cord injury. Pain relief was satisfactory in all patints except one patient with very low pain threshold. In one patient, second transsacral neurolytic block alone was not sufficient because of widespread pain along distant metastasis of the malignant disease, although the first block was satisfactory. The complications include transient motor weakness(4), voiding difficulty(1), subarachnoid puncture(1), and epidural venous puncture(1), but they were all spontaneously recovered within a sbort period of time and did not give any limitation to the block.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.286-289
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• 2009

Perineal laceration commonly occurs due to dilation of the birth canal at the time of foaling in primiparous mares. A 7-year-old Thoroughbred mare was presented with faecal contamination of the external genitalia. She was having history of constant straining three days after the mare's first foaling. Physical examination revealed the tearing extended from the deep part of vagina through muscles of the perineal body involved rectal floor and anal sphincter. Tentative diagnosed was third-degree perineal laceration therefore one-stage surgical procedure and a modified surgical procedure at three-week intervals was performed. During postoperative care for 3 weeks, soft faces was a key factor in success. After 3 weeks, the patient was recovered to normal condition completely.