Arteriovenous malformation (AVM) of the scrotum is a rare vascular lesion, which is distinguished histologically by ambiguous vessels displaying both arterial and venous characteristics and abnormal muscularization of variable sized ectatic vessels. Complete excision is recommended as a definitive treatment. Here, a case of arteriovenous malformation involving the scrotal vessels is reported.
Arteriovenous Malformations* ; Scrotum

This study was designed to establish norms of hand function, and to identify developmental characteristics of hand function among the Korean children. 712 elementary school children participated in measurement of grip strength, three kinds of pinch strength, and dexterity. The hand strength of the Korean children appeared to be weaker than that of western children. The grip strength of boys was significantly stronger than that of girls in all ages for both hands. The order of magnitude of three kinds of pinch strength was, in descending order, lateral pinch, palmar pinch and tip pinch for both boys and girls. There was no significant difference of hand function according to the type of hand dominance in boys. However, girls with left hand dominance showed weakness of bilateral grip, right tip pinch, and bilateral lateral pinch strength compared with girls with right hand dominance. In conclusion, this study provided normative data of hand functions including dexterity, and enabled us to identify some developmental characteristics of hand functions for the Korean elementary school children.
Age Factors ; Child ; Comparative Study ; Female ; Hand/*physiology ; *Hand Strength ; Human ; Korea ; Laterality ; Male ; Motor Skills ; Schools ; Sex Factors ; Students

OBJECTIVE: The aim of this study was to investigate the efficacy of capsaicin, a neurotoxin for C-fiber afferents, applied intravesically in the treatment of neurogenic bladder with detrusor hyperreflexia (DH). METHOD: Six subjects, three women and three men with traumatic spinal cord injury who had neurogenic bladder manifested with DH and urinary incontinence resistant to oral and intravesical anticholinergic instillation treatment were tried with intravesical administration of capsaicin (1 mmol/l 100 ml) for 30 minutes. Single instillation was given in five subjects and two instillations in one. Maximal detrusor pressure and maximal bladder volume were monitored by the portable cystometer. Follow-up monitor of pressure and volume was recorded after 1 week and every 3 weeks afterwards for 21 weeks, with one exception (31 weeks). RESULTS: Average maximal detrusor pressure decreased by 50.8% and average bladder capacity at maximal detrusor pressure increased by 68% in five subjects after single instillation of capsaicin. Clinical benefit from single instillation lasted over 21 weeks and same as the subject with two instillations. Maximal effect on detrusor pressure appears during 6~9 weeks period and bladder capacity during 9~15 weeks period. Although autonomic dysreflexia in 5 of 6 subjects during instillation and macroscopic hematuria in 2 subjects during the 1st two days were noted, they were resolved spontaneously. CONCLUSION: Single and repeated intravesical instillation of capsaicin were safe and effective in the management of neurogenic bladder with DH in traumatic spinal cord injured patients.
Administration, Intravesical ; Autonomic Dysreflexia ; Capsaicin* ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Male ; Reflex, Abnormal ; Spinal Cord ; Spinal Cord Injuries ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Incontinence

OBJECTIVE: The purpose of this study is to evaluate the psychosocial factors and outcomes in young adult stroke patients. METHOD: The study group consisted of 59 stroke patients under the age of 45. Retrospective chart reviews of demographic findings, functional status, primary caregiver, marital and child status, discharge destination, employment and psychological difficulties were recorded by rehabilitation team during hospitalization. Telephone and mail surveys were carried out for the functional status, marital status, employment and social factors of the study group after discharge. RESULTS: The proportion of young adult stroke was 13.7% of all stroke patients. Young adult stroke were 20 cases (34%) of cerebral infarction and 39 cases (66%) of cerebral hemorrhage. Of the 39 married patients, 2 couples were separated. The marital adjustment skill was significantly lower in these couples than ordinary couples under age of 45. Forty-two of 51 patients were able to return to their premorbid residence. Of the 39 patients employed at the time of stroke, only 4 (10.3%) were able to return to work after discharge. Two of the 4 patients returned to school after discharge. CONCLUSION: Rehabilitation of young adult stroke patients is associated with variety of social factors including marital adjustment and returning to work.
Caregivers ; Cerebral Hemorrhage ; Cerebral Infarction ; Child ; Employment ; Family Characteristics ; Hospitalization ; Humans ; Marital Status ; Postal Service ; Psychology ; Rehabilitation ; Retrospective Studies ; Return to Work ; Stroke* ; Telephone ; Young Adult*

Methods: This is a post hoc analysis of a prospective, controlled, randomized, unblinded study with 78 Korean hemodialysis patients receiving intravenous (n = 40) or subcutaneous (n = 38) erythropoietin therapy. We evaluated hemoglobin variability by calculating the frequency of hemoglobin measurements outside the target range during all visits. The high-frequency group was defined by those with hemoglobin variability over the median value (25%) while the low-frequency group was defined by those with hemoglobin variability of <25%. Results: In this analysis, 37 patients (51.1%) were men, and the mean age was 50.6 ± 12.5 years. Twenty-five patients (35.2%) had diabetes mellitus. The frequency of the value being outside the target hemoglobin range was higher in the subcutaneous group compared to the intravenous group (0.36 ± 0.19 vs. 0.27 ± 0.12/visit, p = 0.03). The low-frequency group required significantly lower erythropoietin doses compared to the high-frequency group. In the adjusted Cox analysis, the parameter high-frequency group was a significant independent risk factor for cardiovascular events (hazard ratio, 3.53; 95% confidence interval, 1.15–10.83; p = 0.03). Conclusion The risk of missing the target hemoglobin range increased with subcutaneous administration compared with intravenous erythropoietin administration in hemodialysis patients. An increased frequency of the value being outside the target hemoglobin range was also associated with an increased risk of cardiovascular events.

OBJECTIVE: This study was performed to investigate the energy expenditure at self-selected comfortable and fast walking speeds with or without plastic ankle-foot orthosis in hemiplegic patients. METHOD: Objects of this study were 10 ambulatory hemiplegic patients. To estimate oxygen consumption, we used K2 machine and measured gait speed, stride length, stride frequency, and heart rate energy expenditure index (EEI) with or without plastic ankle-foot orthosis. RESULTS: Stride length and gait speed of the hemiplegic patients with plastic ankle-foot orthosis significantly increased at their comfortable walking speed pattern. Oxygen consumption, oxygen cost and EEI significantly decreased in hemiplegic patients with plastic ankle-foot orthosis whether their gait speed pattern. CONCLUSION: The plastic ankle-foot orthosis is useful for the hemiplegic patients to increase walking speed and to reduce energy expenditure.
Energy Metabolism ; Gait ; Heart Rate ; Hemiplegia ; Humans ; Orthotic Devices ; Oxygen ; Oxygen Consumption ; Plastics* ; Walking*

BACKGROUND/AIMS: Hepatitis A virus (HAV) is a self-limiting infectious disease, but 1% of subjects develop fulminant hepatitis. The prevalence of the anti-HAV immunoglobulin G (IgG) antibody in hemodialysis subjects in Korea remains unknown. The purpose of this study was to describe and compare the seropositive rate of anti-HAV antibody among hemodialysis subjects in two hospitals according to age group. METHODS: A total of 170 hemodialysis subjects were evaluated for the seropositive rate of the anti-HAV IgG antibody and its titer. RESULTS: Of the 170 maintenance hemodialysis subjects in two hospitals (Kangnam 92 vs. Chuncheon 78), 79 (46.5%) were male. The mean age was 53.2 years old, and 94.1% of the subjects were over 40 years old. The median vintage of hemodialysis was 29.0 months. Anti-HAV antibody was found in 163 subjects (95.9%), with no significant difference between the two areas (Kangnam 97.8% [n = 90] vs. Chuncheon 93.6% [n = 73]). Subjects younger than 40 years old showed a seropositive rate of 50%, while the seropositive rate increased with age for subjects aged 40 or older (p for trend < 0.001). Seropositive subjects from Kangnam showed a higher anti-HAV antibody titer than those from Chuncheon (median: Kangnam 14.2 vs. Chuncheon 11.7). Only age influenced seropositivity. The only factor that influenced the antibody level was the location of hospital (p < 0.001). CONCLUSIONS The seropositive rate of the anti-HAV antibody in hemodialysis subjects was 95%, which is similar to findings in the general population. Active immunization against hepatitis A is strongly recommended for hemodialysis subjects under 40 years of age after anti-HAV testing.

OBJECTIVES: The aim of this study was to evaluate the prevalence and risk factors of hepatitis C virus(HCV) infection in patients on chronic hemodialysis. METHODS: We measured antibody to HCV using second generation enzyme immunoassay(ELISA) test or radioimmunoassay(RIA) and hepatitis B surface antigen, serum values of AST, ALT in 224 patients of six urban hemodialysis units. We also investigated some clinicai parameters such as age, sex, duration and frequency of hemodialysis, the amount of blood transfusion, and hemodialysis of infected patients on separate machines. RESULTS: 1) 33 of 224 patients(14.7%) were positive for HCV antibody. 2) The prevalence of HCV antibody were most significantly correlated with duration of hemodialysis and less significantly with frequency of hemodialysis, amount of blood transfusion but not correlated with age, sex and level of liver enzyme. 3) The prevalence of HCV antibody was significantly higher in a center which did not separate dialysis machine for HCV antibody positive patients than centers which did. CONCLUSION: Th prevalence of HCV antibody was most signficantly correlated with duration of hemodialysis. We suggest that environmental factor of hemodialysis unit may play major role in HCV infection of hemodialysis patients. So the importance of separate dialysis machine from HCV antibody positive patients should be emphasized.
Blood Transfusion ; Dialysis ; Hepacivirus* ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Humans ; Liver ; Prevalence* ; Renal Dialysis ; Risk Factors*

OBJECTIVES: Apoptosis is a physiologic or programmed cell death in contrast with necrotic cell death. Recently it has been known that apoptosis are concerned in the effects of chemotherapeutic agents or radiation therapy on tumor cells. Cyclosporine a(CsA), a potent immunosuppressant, has been effectively used in organ transplantaion, but it also has a significant toxicity in the kidneys. However the exact mechanism of CsA nephrotoxicity has not been ellucidated yet. This study was performed to investigate whether apoptosis particiates in CsA nephrotoxicity or not. METHODS: Twenty seven Sprague-Dawley rats were divided into 5 groups. 1) Vehicle group(n=7) as a control: Cremopbor 50mg/kg/day/subcutaneously (sc) for 7 days, 2) CsA4 group(n=5): CsA 50mg/kg/day/sc for 4 days, 3) CsA7 group(n=5): CsA 50mg/kg/day/sc for 7 days, 4) R4 group(n=5): 4 days after CsA 50mg/kg/day/se for 7 days, and 5) R8 group(n=5): 8 days after CsA 50mg/kg/day/sc for 6 days, Biochemical parameters including blood pressure were measured in each group and the cell count of apoptosis in rat kidney was evaluated by in situ end labelling(ISEL) method. RESULTS: 1) The increase of serum creatinine, blood pressure and decrease of creatinine clearance appeared in CsA4 and CsA7 groups. 2) The ce11 counts of apoptosis on tubular cells in CsA4 and CsA7 groups were significantly increased more than in control group(79.0 +/- 16.9, 98.4 +/- 11.4 vs 35.4 +/- 8.8, p<0.05), and the cell counts of apoptosis on tubular cells in R4 and R8 groups were not significantly different from that in control group(53.8 +/- 12.5, 65.2 +/- 7.1 vs 35.4 +/- 8.8, p>0.05), 3) The cell count of apoptosis on the interstitium in each group was not significantly different from that in control group(p>0.05). 4) The cell count of apaptosis on tubular cells was increased more than that on the interstitium in all groups. 5) The cell count of apoptosis on cortex only in CsA7 group was significantly increased more than that io control group(57.8 +/- 11.5 vs 21.8 +/- 2.6, p<0.05), 6) The cell count of apoptosis on medulla only in CsA4 group was significantly increased more than that in control group(636. +/- 17.9 vs 22.6 +/- 9.7, p<0.05). 7) Total cell counts of apoptosis only in CsA4 and CsA7 groups were significantly increased more than in contral group(96.0 +/- 21.1, 99.8 +/- 11.8 vs 46.6 +/- 11.4, p<0.05). CONCLUSION: CsA caused apoptosis mainly on tubular cells rather than the interstitial cells and apoptotic cells in CsA nephrotoxicity were not increased during the recovery phase. With the results apoptosis may play an important role in CsA nephrotoxicity.
Animals ; Apoptosis* ; Blood Pressure ; Cell Count ; Cell Death ; Creatinine ; Cyclosporine* ; Kidney ; Rats* ; Rats, Sprague-Dawley