We report an unusual case of clitoral hypertrophy due to neurofibromatosis of external genitalia. The patient also had definite skin lesions and family history. The patient was treated successfully by clitorectomy. The patient seems to be the first case of clitoral neurofibromatosis reported in Korean literature.
Circumcision, Female ; Clitoris ; Female ; Genitalia ; Humans ; Hypertrophy ; Male ; Neurofibromatoses* ; Skin

PURPOSE: This questionnaire study was conducted to examine sexual problems and assess the effect of sexual rehabilitation education on the marital intimacy in patients with spinal cord injuries. MATERIALS AND METHODS: 45 male patients with spinal cord injuries were evaluated for sexual problems using a questionnaire. The patients were divided into two groups: control group (n=16) and trial group (n=16). Sexual rehabilitation education for patients, using manual and video tapes, was provided. The effect of sexual rehabilitation education on marital intimacy was assessed in the two groups. Using Student's t-test (paired), Student's t-test the scores of marital intimacy measured before and after the sexual rehabilitation education were compared. RESULTS: After one year, 80% (36/45) of the subjects recovered normal sexual desire, and 51% (23/45) recovered normal erectile function, most of who had been proved to have sustained a spinal cord injury at the cervical or thoracic level. Normal erectile function was more frequently seen in patients with incomplete spinal cord injury than in those with complete spinal cord injury. 31% (14/45) were able to ejaculate and 29% (13/45) experienced orgasm. After sustaining a spinal cord injury, 87% (39/45) were aware of sexual rehabilitation education. However, only 13% (5/45) were informed by their healthcare professionals. After sexual rehabilitation education, a significant increase in marital intimacy was found in the trial compared to the control group. CONCLUSIONS: In conclusion, our results indicate that sexual rehabilitation education is effective at increasing the marital intimacy of patients with a spinal cord injury. Moreover, these patients must receive relevant care and education from their healthcare professionals, which must also be in a persistent manner.
Delivery of Health Care ; Education* ; Humans ; Male* ; Orgasm ; Surveys and Questionnaires ; Rehabilitation* ; Spinal Cord Injuries ; Spinal Cord*

Sleep apnea occurs in approximately 50% of patients with acromegaly, and sleep apnea is associated with increased cardiovascular diseases and mortality. In view of these findings, sleep apnea may be a factor in the increased incidence of cardiovascular deaths in acromegaly patients. We experienced a case of active acromegaly patient, 54-yr-old man, associated with obstructive sleep apnea syndrome, congestive heart failure with dilated cardiomyopathy and serious cardiac arrhythmias. He was treated for obstructive sleep apnea syndrome, diagnosed by overnight polysomnography, with nasal continuous positive airway pressure(CPAP) for 4 months, which successfully controlled his loud snoring, sleep apnea, nocturnal hypoxemia and apnea-related symptoms. And also he was treated for underlying acromegaly and cardiac complications with bromocriptine and cardiogenic drugs for 4 months, but still had elevated growth hormone(GH) and insulin like growth factor-1 (IGF-1) levels and serious cardiac arrhythmias. We describe our experience about the effect of CPAP treatment in an active acromegaly patient associated with obstructive sleep apnea syndrome and cardiac complications with review of literature.
Acromegaly* ; Anoxia ; Arrhythmias, Cardiac ; Bromocriptine ; Cardiomyopathy, Dilated ; Cardiovascular Diseases ; Continuous Positive Airway Pressure* ; Heart Failure ; Humans ; Incidence ; Insulin ; Mortality ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) affects systemic blood pressure and cardiac function. The development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac rhythm, suggests that recurrent hypoxia and arousals from sleep may increase a sympathetic nervous system activity. Continuous positive airway pressure(CPAP) therapy has been found to be an effective treatment of OSAS. However, only a few studies have investigated the cardiovascular and sympathetic effects of CPAP therapy. We evaluated influences of nasal CPAP therapy on the cardiovascular system and the sympathetic activity in patients with OSAS. METHODS: Thirteen patients with OSAS underwent CPAP therapy and were monitored using polysomnography, blood pressure, heart rate, presence of arrhythmia and the concentration of plasma catecholamines, before and with CPAP therapy. RESULTS: The apnea-hypopnea index (AHI) was significantly decreased (p<0.01) and the lowest arterial oxygen saturation level was elevated significantly after applying CPAP (p<0.01). Systolic blood pressure tended to decrease after CPAP but without statistical significance. Heart rates during sleep were not significantly different after CPAP. However, the frequency and number of types of arrhythmia decreased and sinus bradytachyarrhythmia disappeared after CPAP. Although there was no significantly decreased after CPAP (p<0.05). CONCLUSION: CPAP therapy decreased the apnea-hypopnea index, hypoxic episodes and plasma norepinephrine concentration. In addition, it decreased the incidence of arrhythmia and tended to decrease the systemic blood pressure. These results indicate that CPAP may play an important role in the prevention of cardiovascular complications in patients with OSAS.
Anoxia ; Arousal ; Arrhythmias, Cardiac ; Blood Pressure* ; Cardiovascular System ; Catecholamines* ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Norepinephrine ; Oxygen ; Plasma ; Polysomnography ; Sleep Apnea, Obstructive* ; Sympathetic Nervous System

No abstract available.
Leiomyoma* ; Trachea*

No abstract available.
Sleep Apnea, Obstructive*

No abstract available.
Histamine* ; Pneumocytes*

No abstract available.
Granuloma, Plasma Cell*

No abstract available.

No abstract available.
Eosinophils* ; Histamine*