No abstract available.

PURPOSE: Pelvic floor muscles play an important role in female sexual function. Urinary incontinence is one of the complex symptoms of pelvic floor relaxation. The purpose of the present study was to evaluate the effects of behavioral treatment on the sexual life variables and quality of life in stress urinary incontinent women. MATERIALS AND METHODS: Fifty women with clinically and urodynamically proven stress urinary incontinence were randomly selected, and treated with functional electrical stimulation (FES) -Biofeedback. The FES-Biofeedback treatment was performed for 20 min per session, 2 sessions a week, for 6 weeks. The treatment consisted of electrical stimulation (35Hz and 50Hz, simultaneously) for 24 seconds, and the biofeedback, composed of 3 phases of contraction, lasted for 32 seconds. The outcome measures on the sexual life variables and quality of life scales were assessed by the Bristol Female Lower Urinary Tract Symptoms questionnaire and a self-developed questionnaire, based on the Brief index of sexual Functioning for women (BISF-W). RESULTS: The general quality of life scores were significantly improved after 6 weeks of FES-Biofeedback (p<0.05). The quality of orgasms, sexual interest, sexual activity and sexual anxiety were significantly improved after the FES-Biofeedback (p<0.05). Changes in the scores for the degree of satisfaction in those variables also showed statistical significance (p<0.05). CONCLUSIONS: Women with incontinence were dissatisfied with their sexual life due to various symptoms associated with their urinary symptoms or symptoms that result from pelvic floor relaxation. The FES-Biofeedback therapy showed positive effects on improving, not only stress incontinence, but also sexual life variables and the life quality.
Anxiety ; Biofeedback, Psychology* ; Electric Stimulation ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Muscles ; Orgasm ; Outcome Assessment (Health Care) ; Pelvic Floor ; Quality of Life* ; Surveys and Questionnaires ; Relaxation ; Sexual Behavior* ; Sexuality ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Weights and Measures

In female sexual dysfunction (FSD), psychological and contextual factors significantly influence organic components of sexual response and behavior. The hormonal environment also affects FSD. Therefore, a tailored medical approach to each individual's sexual symptom is inevitable. This paper reviews currently available pharmacological treatment of FSD including the most recent advances and future targets in pharmacotherapy. In hormonal therapies for FSD, efficacy of estrogens and androgens on the treatment of vaginal atrophy, low sexual desire, and small subsets of genital arousal disorder, respectively, have been demonstrated. However, we need more data regarding long-term safety. There are two non-hormonal agents approved by the US Food and Drug Administration. Flibanserin has shown marginal benefit over placebo for the treatment of hypoactive sexual desire disorder. Ospemifen has shown beneficial effect on vulvovaginal pain from hormone related atrophy although it requires a longer period data to assess safety in other female genital organs, such as uterus and ovaries. Controversies still remain regarding hormonal therapies for FSD. Besides, some of the developing drugs still require more reliable safety and efficacy data. However, pharmacologic treatment of FSD is a promising field yet to be explored.
Androgens ; Arousal ; Atrophy ; Drug Therapy ; Estrogens ; Female* ; Genitalia, Female ; Humans ; Ovary ; Sexual Dysfunctions, Psychological ; United States Food and Drug Administration ; Uterus

High blood pressure is a serious health problem and a primary risk factor for both stroke and heart disease. Many studies have strongly assessed short-term effects as well as long-term effects of bariatric surgery on type2 diabetes mellitus, whereas little attention has been paid to the effect on hypertension. This review study was designed to evaluate the impact of Bariatric Surgery and weight loss on obese patients with hypertension, and whether the hypertension improved or resolved post-surgery. Relevant papers were searched using MEDLINE, Science Citation Index, Pub Med, and Clinical Evidence, by using the searched terms (Hypertension, Bariatric, Obesity, and Surgery). The association between weight reduction and Hypertension control is hard to analyze. And well-organized studies with a long term follow up are required to determine the effect of Bariatric Surgery and Hypertension control.
Bariatric Surgery* ; Diabetes Mellitus ; Follow-Up Studies ; Heart Diseases ; Humans ; Hypertension* ; Obesity ; Risk Factors ; Stroke ; Weight Loss

PURPOSE: The aim of this study was to evaluate the effectiveness of interventions for workplace bullying among nurses. METHODS: First, risk factors of workplace bullying were categorized in order to create analysis criteria. A search of 8 databases, and manual searching resulted in the identification of 3,096 relevant articles. Three of the authors did article selection, data extraction, and quality assessment using the Risk of Bias (RoB) and the Risk of Bias for Nonrandomized studies (ROBANS). RESULTS: Interventions in workplace bullying were classified as individual, interactions, and organizational approach. Twelve intervention studies (10 individual interventions, 1 team approach, 1 multi-level approach) were selected. Four of the individual interventions decreased bullying, but three had no effect. One multi-level intervention reported that bullying did not occur. Individual interventions improved bullying awareness in four articles, decreased turnover intention in two articles, and increased skill and knowledge of bullying management in five articles. One team approach increased nurse interactions and group cohesion. The quality of selected articles was low overall. CONCLUSION: Individual interventions have a possibility to improve awareness and knowledge about bullying, but there is a lack of evidence on preventing bullying. Further research is required on multi-levels interventions with well-designed controlled trials.
Bias (Epidemiology) ; Bullying ; Intention ; Risk Factors

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR −14.7; systemic beta-agonist, −5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.
Humans ; Korea ; Patient Safety ; Safety Management ; Surveys and Questionnaires

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*

PURPOSE: Current treatment of glioblastoma after surgery consists of a combination of fractionated radiotherapy and temozolomide. However, it is difficult to completely remove glioblastoma because it has uncertain boundaries with surrounding tissues. Moreover, combination therapy is not always successful because glioblastoma has diverse resistances. To overcome these limitations, we examined the combined effects of chemotherapy and knockdown of mitogen-activated protein kinase phosphatase-1 (MKP-1). MATERIALS AND METHODS: We used ten different anti-cancer drugs (cisplatin, cyclophosphoamide, doxorubicin, epirubicin, etoposide, 5-fluorouracil, gemcitabine, irinotecan, mitomycin C, and vincristine) to treat glioblastoma multiforme (GBM) cells. Knockdown of MKP-1 was performed using siRNA and lipofectamine. The basal level of MKP-1 in GBM was analyzed based on cDNA microarray data obtained from the Gene Expression Omnibus (GEO) databases. RESULTS: Anti-cancer drug-induced cell death was significantly enhanced by knockdown of MKP-1, and this effect was most prominent in cells treated with irinotecan and etoposide. Treatment with these two drugs led to significantly increased phosphorylation of c-Jun N-terminal kinase (JNK) in a time-dependent manner, while pharmacological inhibition of JNK partially inhibited drug-induced cell death. Knockdown of MKP-1 also enhanced drug-induced phosphorylation of JNK. CONCLUSION: Increased MKP-1 expression levels could be the cause of the high resistance to conventional chemotherapeutics in human GBM. Therefore, MKP-1 is an attractive target for overcoming drug resistance in this highly refractory malignancy.
Apoptosis ; Camptothecin ; Cell Death ; Dacarbazine ; Deoxycytidine ; Doxorubicin ; Drug Resistance ; Drug Resistance, Multiple ; Dual Specificity Phosphatase 1 ; Epirubicin ; Etoposide ; Fluorouracil ; Gene Expression ; Glioblastoma ; Humans ; JNK Mitogen-Activated Protein Kinases ; Lipids ; Mitomycin ; Oligonucleotide Array Sequence Analysis ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; RNA, Small Interfering

We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.
Adhesives ; Amenorrhea ; Cicatrix ; Constriction, Pathologic* ; Female ; Hematocolpos ; Hemorrhage ; Humans ; Hypopituitarism ; Postpartum Period ; Uterine Hemorrhage