To observe the influence of kidney transplantation (KT) on erectile and endocrine function, we evaluated the PBI, penile pulse volume plethysmography, RigiScan and endocrine study before and after KT in 21 patients. We also interviewed with these patients or their sexual partners before KT. at 3 months and 6 months after KT. 7 cases (33%) were improved, 8 cases (38%) were same and 4 cases(19%) were aggravated in sexual desire and erectile function and 2 cases (10% ) had been suffered from erectile dysfunction since 19 months and 6 years prior to KT. The PBI was changed from 0.97 +/- 0.09 to 0.95 +/- 0.16 and it was not a significant difference. The penile plethysmography was not a good screening test in the evaluation of erectile function in KF. But the Rigiscan could detect all of the tested aggravated cases and it was thought to be a good screening test. In the endocrine studies, testosterone and FSH were decreased and LH and prolactin were increased before KT but testosterone and LH were significantly decreased after KT. It was thought to be the influence of KT and immunosuppressive agent (cyclosporin A). In conclusion, sexual desire and erectile function may be improved by the KT and most reliable screening test was Rigiscan. Endocrine function may be affected by the KT and cyclosporin A.
Cyclosporine ; Erectile Dysfunction ; Humans ; Kidney Transplantation* ; Kidney* ; Male ; Mass Screening ; Plethysmography ; Prolactin ; Sexual Partners ; Testosterone ; Transplantation

BACKGROUND: There were many efforts to evaluate the relationship between cholesterol and mortality. But almost all of them have been performed on male western people who have higher mean cholesterol concentration than oriental people and have different disease pattern from women's. So, upto now, the relationship of cholesterol to mortality in women with low cholesterol concentration was not well known. We carried out this study to investigate the relationship in Korea women whose mean cholesterol level was lower than that of western people and men. METHOD: Study subjects included in were 100,363 Korean women aged 30-65 years. They undertook multiphasic health examination provided by Korea Medical Insurance Corporation between March 1990 and July 1990, and had no history of cancer and no significant medical illnesses which could change blood cholesterol level. Study subjects were followed for 5.5 years until December 1995 and it was determined whether each subject was dead or alive using the mortality data from the Korea National Statistical office and the Korea Medical Insurance Corporation. Nonlinear ralationship between serum total cholesterol and mortality was investigated with the use of quadratic regression and with dummy variables using the 158-180mg/dl group as the comparison group. To analyzing the relationship between cholesterol concentra-tion and mortality with controlling for age, smoking, alcohol drinking, exercise, diastolic blood pressure, body mass index, pay level, Cox propor-tional hazard model was used. RESULT: During the follow-up period, there were 369 deaths. Mean cholesterol concentration of study subjects was 182.8mg/dl There was no significant association between serum cholesterol and total mortality, but women with cholesterol concentrations below 130mg/dl showed slightly increased risk of death(RR=1.20). Cholesterol had an inverse relationship with mortality from stroke, and women with cholesterol concentrations below 130mg/dl had higher risk of death from stroke(RR=3.28). Although there was no statistical significance,risk of mortality from hemorrhagic stroke in women with very low cholesterol concentration was markedly higher than in women with cholesterol concentrations above 130mg/dl. Mortality relationship with cholesterol. And women with cholesterol concentrations higher than 203mg/dl had abruply increased risk for death from ischemic heart disease. CONCLUSION: Through this study, we could observe an inverse J shaped relationship between cholesterol concentration and mortality in Korean women. The increased risk of mortality from hemorrhagic stroke in people with very low cholesterol concentration supports the previous report which proposed low cholesterol level as a significant risk factor of hemorrhagic stroke. In spite of the lack of statistical signi-ficance, greately increased risk of mortality from ischemic heart disease in people with cholesterol higher than 203mg/dl suggests that cholesterol concentration at the upper end of distribution can be a significant risk factor of ischemic heart disease in women.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cholesterol* ; Female ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Male ; Mortality* ; Myocardial Ischemia ; Proportional Hazards Models ; Risk Factors ; Smoke ; Smoking ; Stroke

PURPOSE: The emergency department (ED) has been considered highly stressful environment to work in. However, there has been no study evaluating the stresses endured by emergency staffs in Korea. This study aims to evaluate the cause and effect of stress, and coping methods used by doctors and nurses under stress from working in an emergency department. METHODS: Interns, residents and nurses of an emergency center were given questionnaires that included general health questionnaire (GHQ)-12 scale and modified Holmes & Rahe (HR) scale to examine the cause and effect of stress, and determine the coping methods they used to alleviate stress. A score of greater than 20 in the GHQ-12 scale and greater than 80 in the HR scale were considered as significant for stress. The stress scales were compared among the three groups using analysis of variance and chisquare test. RESULTS: A total of 111 participants consisting of 46 interns, 19 residents, and 46 nurses were surveyed. While the GHQ-12 score showed no difference between groups, the HR score showed significant differences among residents (82.4+/-23.0), nurses (73.6+/-13.2), and interns (70.1+/-17.7). Each stress score did not differ according to the age, gender, marital status, or presence of lover. Most frequently recorede effects of stress were difficulty waking up and fatigue. Most frequent coping methods employed were sleeping and smoking. CONCLUSION: This study suggests that ED staffs, especially residents, were exposed to significant amount of stress.
Adaptation, Psychological ; Emergencies ; Fatigue ; Korea ; Marital Status ; Surveys and Questionnaires ; Weights and Measures

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Pathologic changes occurred in patients with AS result in a weakened vertebral column with increased susceptibility to fractures, even though a trivial injury. Fractures usually tends to involve the lower cervical spine, but rarely, they are also occurred in thoracolumbar spine. We present our experiences of three cases of spinal fracture in patients with AS, cervical, thoracic, and lumbar spine, with a review of literatures.
Humans ; Rheumatic Diseases ; Spinal Fractures ; Spine ; Spondylitis ; Spondylitis, Ankylosing

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

PURPOSE: The aim of this study was to investigate the clinical and laboratory findings of hereditary spherocytosis comparing those of different age groups. METHODS: The clinical and laboratory findings of hereditary spherocytosis from June 1989 to August 1998 at Asan Medical Center were analyzed retrospectively according to two different age groups, Group I (9 patients diagnosed under 10 years of age) and Group II (19 patients diagnosed at or over 10 years of age). RESULTS: 1) Mean age at diagnosis was 2.4+/-1.97 and 28.2+/-18.81 years, and family history was positive in 44% and 47% in Group I and II patients respectively. 2) Splenectomy was carried out in 33% and 79% of Group I and II patients respectively, and accessory spleen was found in 100% and 20% of splenectomized patients respectively. 3) Gallstone was found in 11% and 42% of Group I and II patients respectively, and aplastic crisis developed in 0% and 10% respectively. 4) Post-splenectomy hematological parameters improved as follows: Group I; from hemoglobin at diagnosis of 8.5+/-3.59 g/dL to post-splenectomy level of 12.6+/-0.86 g/dL, hematocrit 24.5+/-10.25% to 38.1+/-4.86%, corrected reticulocyte 9.0+/-4.16% to 1.2+/-0.84%, total bilirubin 3.2+/-1.53 mg/dL to 2.2+/-1.34 mg/dL. Group II ; from hemoglobin at diagnosis of 8.9+/-2.95 g/dL to post-splenectomy level of 12.6+/-1.27 g/dL, hematocrit 24.9+/-7.85% to 37.4+/-2.89%, corrected reticulocyte 4.8+/-2.74% to 2.0+/-1.12%, total bilirubin 5.2+/-5.05 mg/dL to 1.1+/-0.49 mg/dL. CONCLUSION: There were no age related differences in hematologic findings at diagnosis and many of the patients with milder form of the disease could be detected later in adult life. The frequency of gallstone was up to 42% in patients whose diagnosis was delayed after 10 years of age, and aplastic crisis was a rare complication. Splenectomy was an effective treatment leading to normal hemoglobin concentrations in all patients. Accessory spleen was found in 33% of splenectomized patients, which emphasizes the necessity of spleen scan before splenectomy.
Adult ; Bilirubin ; Chungcheongnam-do ; Diagnosis ; Gallstones ; Hematocrit ; Humans ; Reticulocytes ; Retrospective Studies ; Spleen ; Splenectomy

Lichen planus is a chronic papulosquamous disease that affects the skin and mucous membranes. It is characterized by pruritic violaceous papules that are most commonly seen on the extremities of middle aged adults, but the elderly are rarely affected. Hypertrophic lichen planus usually occurs on the extremities and especially on the shins, and it tends to be the most pruritic variant. An 82-year-old female presented with severe pruritic multiple papules and plaques on the both the upper and lower extremities for 1 year. At first, the lesions began as small, polygonal papules that formed verrucous plaques over several months. Histopathologic examination showed marked hyperkeratosis, irregular acanthosis and wedge-shaped hypergranulosis. The vacuolar alteration and the lymphocytic inflammatory infiltrate were accentuated at the base of the rete ridge. From these findings, we diagnosed these lesions as hypertrophic lichen planus. The lesions were treated with topical steroid and intralesional injection of steroid, and they were slightly improved after 2 months of therapy.
Adult ; Aged ; Aged, 80 and over ; Extremities ; Female ; Humans ; Injections, Intralesional ; Lichen Planus ; Lichens ; Lower Extremity ; Middle Aged ; Mucous Membrane ; Skin

PURPOSE: In the pediatric population, Rathke's cleft cysts (RCCs) are known to be an infrequent cause of headaches, visual disturbances, and pituitary dysfunction. We investigated the clinical characteristics of children in whom RCCs were incidentally discovered and evaluated whether RCCs influence the treatment response of patients with proven endocrinopathy. METHODS: A retrospective analysis was conducted in 34 patients with RCCs who were diagnosed between 2006 and 2013 at Hallym University Medical Center. Their clinical, hormonal, and imaging findings were reviewed. We evaluated the clinical outcomes of the patients with concomitant RCCs and endocrinopathy compared to matched controls. RESULTS: Twenty-six of 34 patients with radiologically proven RCCs had endocrine disorders. They were 9 boys and 17 girls, with ages ranging from 4.8 to 17.4 years at the time of the diagnosis. Of these, 7 (27%) had idiopathic short stature, 7 (27%) had growth hormone deficiency (GHD), and 12 (46%) had central precocious puberty (CPP). Nineteen of 26 patients (73.1%) showed low signal intensities on T1-weighted images (T1WI) and high signal intensities on T2-weighted images. The incidence of hypointensity on T1WI was higher in the patients with RCCs accompanied by endocrinopathy than in those without endocrinopathy (P=0.033). The treatment outcomes of the patients with CPP and GHD with and without RCCs were similar. CONCLUSION: CPP and GHD patients with a small RCC (less than 20 mm) expressing cystic magnetic resonance intensity can be managed with medical treatment, although the RCCs need to be closely monitored in radiological studies to observe their growth.
Academic Medical Centers ; Adolescent* ; Central Nervous System Cysts* ; Child* ; Diagnosis ; Dwarfism, Pituitary ; Female ; Growth Hormone ; Headache ; Humans ; Incidence ; Puberty, Precocious ; Retrospective Studies

PURPOSE: The purposes of this study were to evaluate symptom experience and quality of life (QOL) and to identify the predictors of QOL among breast cancer survivors. METHODS: A cross-sectional study was conducted on 200 disease-free breast cancer survivors at two hospitals between December 2007 and July 2008. Functional Assessment of Cancer Therapy Scale-B, Memorial Symptom Assessment Scale-short Form and The Linear Analogue Self Assessment Scale were used to assess symptom experience and QOL in these patients. Data were analyzed using the Pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. RESULTS: The mean score of QOL for breast cancer survivors was 95.81 (+/-18.02). The highest scores among physical and psychological symptoms were sexual interest and anxiety. Year since treatment completion was significantly associated with QOL in sociodemographic variables. Physical and psychological symptoms have a significant negative association with QOL. The results of the regression analyses showed that physical and psychological symptoms were statistically significant in predicting patients' QOL. CONCLUSION: Symptom experience and QOL are essential variables that should be acknowledged when delivering health care to breast cancer survivors. More attention to the reduction and management of psychological distress could improve QOL among breast cancer survivors.
Adaptation, Psychological ; Adult ; Anxiety ; Breast Neoplasms/*psychology ; Cross-Sectional Studies ; Data Interpretation, Statistical ; Disease-Free Survival ; Emotions ; Female ; Health Status ; Humans ; Middle Aged ; *Quality of Life ; Questionnaires ; Survivors/*psychology

The effects of styrene on the induction of cytochrome P-450s (P450), (P4501A1/2, P4502B1/2 and P4502El) and activities of other related enzymes were investigated in the male Sprague Dawley rats which were treated with styrene 500 (S1), 1,000 (S2) 1,500 (S3) mg/kg in olive oil intraperitoneally once a day for two days and sacrificed for the preparation of liver microsomes after 24 hrs. 1. The contents of total protein and P450 in the microsomes derived from the styrene treated groups were slightly higher than those from the control group except those from the 53 group (1,500 mg styrene/kg body weight) . The decreases in microsomal protein contents was prominent in the S3 (p<0.05), but the P450 contents was increased significantly in the S2 (p<0.05). 2. The activities of NADPH-P450 and NADH b5 reductase in hepatic microsomes derived from the treated groups were significantly increased in the treated groups(p<0.05). 3. The activities of PROD were also prominently increased with the treatment of styrene except in 53 group, but the activity of EROD was decreased by styrene treatment. The activities of pNPH in the styrene treated groups were higher than that of the control group (p<0.05). 5. Western blotting with monoclonal antibodies against P4502B1/2 isozymes showed the presence of P4502B1/2 in hepatic microsomes from the rats treated with styrene, and the increase in the densities of immunoblots were corelated with the dosages of styrene. The blot densities against P4501A1/2 and P4502El were slightly increased in the styrene treated groups compared with the control group. These results suggested that styrene could primarily induce P4502B1/2 as major and P4501A1/2 and P4502El in minor forms for the metabolism of styrene in rats.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2B1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Humans ; Isoenzymes ; Male ; Metabolism ; Microsomes ; Microsomes, Liver ; NAD ; Olea ; Oxidoreductases ; Rats* ; Rats, Sprague-Dawley ; Styrene*