PURPOSE: We investigated how the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) are correlated with the sexual activity of these patients. MATERIALS AND METHODS: A total of 87 patients were included in this study; 18 patients were diagnosed with IC and the other 69 had PBS. The diagnosis was made on the basis of the concept of IC/PBS proposed by the ICS in 2002. Patients were asked to fill in a Bristol female lower urinary tract symptom questionnaire, and symptoms were rated on a scale of from 1 to 4 or 5. Pearson's correlation coefficient was used to analyze the correlation of pain and urinary symptoms with quality of life and sexual activity. RESULTS: The average age of the patients was 51+/-14.7 years (range, 28-74 years). Age and vulvodynia were positively correlated with one another (r=0.232), and there was a negative correlation between age and dyspareunia (r=-0.302). Among the items regarding IC/PBS and sexual activity, frequency showed a positive correlation with vulvodynia (r=0.258) in addition to an inhibited sex life (r=0.403). Urgency showed a positive correlation with an inhibited sex life (r=0.346). Vulvodynia showed a positive correlation with an inhibited sex life (r=0.259) and dyspareunia (r=0.401). The main symptoms of IC/PBS (frequency, urgency, and pelvic pain) showed a positive correlation with almost all items related to quality of life (p<0.05). CONCLUSIONS: Frequency, urgency, and various types of pain are negatively correlated with the sexual activity of patients. This suggests that physicians should consider sexual function in the management of patients with IC/PBS.
Cystitis, Interstitial ; Dyspareunia ; Female ; Humans ; Quality of Life ; Sexual Behavior ; Urinary Bladder ; Urinary Tract ; Vulvodynia

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

PURPOSE: This study was designed to examine the effect of stress on the pathophysiology of bladder stability via the Rho-kinase and nitric oxide synthase activity, which are required for muscle contraction and relaxation within the bladder. MATERIALS AND METHODS: Animal testing was conducted in two separate sessions. In the first experiment, 36 female Sprague-Dawley rats weighing about 230-270g each were employed. 18 rats were placed in the control group and 18 rats were placed in the test group. The second testing was conducted using metabolic cages. Six rats were placed in the control group and six rats were placed in the test group under a stressful environment. RESULTS: The results showed that the frequency of urination was significantly increased with time in the test group(p<0.05). However, the volume of voided urine decreased, thereby suggesting stress was a cause of overactive bladder. Analysis of bladder tissue for nitric oxide synthase (NOS) and RhoA-binding kinase(ROKalpha), important components of contraction and relaxation of bladder muscle, revealed that the levels of iNOS and ROKalpha were significantly increased with continued application of stress. This suggests that stress affects the levels of NOS and ROKalpha in an overactive bladder to influence contraction and relaxation of the bladder muscle. CONCLUSIONS: An increase in the ROKalpha expression and changes of the NOS expressions in the rats with chronic stress pathophysiologicaly support that stress contributes to the clinical symptoms of overactive bladder.
Animals ; Female ; Humans ; Muscle Contraction ; Nitric Oxide Synthase ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urination

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

Benign paroxysmal positional vertigo (BPPV) of anterior semicircular canal (ASC) is the rarest variant of BPPV, which is thought to be due to the anatomically superior position of ASC during most activities. This type of BPPV is currently diagnosed by detecting positional down-beating nystagmus in the Dix-Hallpike test. A 62-year-old female presented with positional vertigo, especially when sitting up. No nystagmus was induced by both Dix-Hallpike tests, however, positional down-beating nystagmus was observed with the left torsional component when sitting up from both Dix-Hallpike positions and supine position. After the reverse Epley maneuver, up-beating nystagmus was newly observed in the left Dix-Hallpike test, which was compatible with BPPV of the left posterior semicircular canal. This patient was thought to suffer from canalithiasis of the left ASC.
Female ; Humans ; Middle Aged ; Semicircular Canals ; Supine Position ; Vertigo

PURPOSE: Sexual activity is a highly personal matter and uneasy to measure their problems objectively in view of clinical field. Many investigators have been continued to rely on self-report measures of sexual function. However, there have been few report measuring female sexual function in general population in Korea. This study was aimed to investigate function by self-report measures. MATERIALS AND METHODS: 347 married women was randomly selected and asked to fill the Brief Index of Sexual Function for Women (BISF-W) which was translated into Korean and modified by authors. Three factors-interest/desire, sexual activity, and satisfaction were analyzed. RESULTS: Women were grouped by age at 10-year intervals. 21.5% of women reported to be sexually active during the past moth, and 78.5% was inactive. Most common coital frequency in all age groups pas one-two times per month. 76.1% of women showed passive response in their initiation of sexual activities. Mostly they reach orgasm only by the vaginal intercourse, and overall satisfaction rate was 55.2% including only 25% of fifties groups followed by pain. CONCLUSIONS: In general, Korean women showed less active in their sexual lives, however, they were relatively satisfied to their sexual lives. A larger study and more sophisticated, modified questionnaire, which is more considering specific social, psychological interpersonal factors would be required.
Coitus ; Female ; Humans ; Korea ; Moths ; Orgasm ; Surveys and Questionnaires* ; Research Personnel ; Sexual Behavior*

Epithelial myoepithelial carcinoma is a rare tumor with slightly less than one percent of salivary gland neoplasm. Histologically, the carcinomas are characterized by a mixture of trabecular structure with outer myoepithelial cells and inner ductal cells, which are confirmed by electron microscopy and immunohistochemistry. Although this neoplasm exhibits high degree of cellular differentiation histologically, it is classified into low grade carcinoma because of its locally infiltrative, destructive growth pattern, and tendency to metastasize. We report a 45-year-old woman with epithelial-myoepithelial carcinoma arising from a submandubular gland, one of the most unusual locations.
Female ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Salivary Gland Neoplasms ; Submandibular Gland

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke