PURPOSE: Nocturia and enuresis are common voiding problems in spinal cord injured patients despite a variety of management. The purpose of this study is to determine the efficacy of desmopressin, a synthetic analogue of antidiuretic mono, as an alternative treatment in the management of spinal cord injured(SCI) patients with neurogenic bladder dysfunction unresponsive to conventional therapy. MATERIALS AND METHODS: Fourteen SCI patients with nocturia or enuresis were included in this study. The patients received 10microgram desmopressin intranasally at bedtime once every 24 hours. RESULTS: There was a significant decrease in nocturnal urinary volume, frequency of nocturia and nocturnal enuresis during nighttime after desmopressin administration. Two patients stopped desmopressin because of side effects. 8 of 12 patients improved with desmopressin and the remainder had no effect. There was no serum abnormality, although there were side effects in three cases, such as gastro-intestinal trouble, chest discomfort or nasal congestion. CONCLUSIONS: Desmopressin is safe and effective in the management of nocturia or enuresis due to neurogenic bladder dysfunction in selected SCI patients.
Deamino Arginine Vasopressin* ; Enuresis ; Estrogens, Conjugated (USP) ; Humans ; Nocturia ; Nocturnal Enuresis ; Spinal Cord Injuries ; Spinal Cord* ; Thorax ; Urinary Bladder, Neurogenic*

Objectives: This research aimed to identify the level of perception, knowledge, preventive behavior, and factors affecting preventive behavior of patients with asthma and chronic obstructive pulmonary disease against particulate matter. Methods: This research was a descriptive survey research, and the subjects were chronic pulmonary disease patients over the age of 19 and under 80 who visited a university hospital in Daegu City. Data was collected by convenience sampling through structured self-administered questionnaire survey from December 2019 to January 2020, and a total of 212 copies were used for analysis. Results: Out of 212 total subjects, 112 were asthma patients (52.8%) and 100 were chronic obstructive pulmonary disease patients (47.2%). The average score (out of 10) of perception, knowledge and preventive behavior of patients with asthma for particulate matter was 7.92, 6.99, and 7.10, respectively, while those with chronic obstructive pulmonary disease scored 7.72, 6.24, and 6.80, respectively. The knowledge score was significantly higher in patients with asthma than those with chronic obstructive pulmonary disease (p=0.007). Factors affecting particulate matter preventive behavior were perception score, knowledge score, and age for asthma patients, and perception score for chronic obstructive pulmonary disease patients. Conclusions As a result of the above, the factors relate to the preventive behavior of patients with asthma and chronic obstructive pulmonary disease were perception score, knowledge score, and age for asthma, and perception score for chronic obstructive pulmonary disease. Raising the level of particulate matter preventive behavior can prevent the deterioration of chronic pulmonary diseases caused by particulate matter, so the development of arbitration programs considering the characteristics of the patients according to the disease and continuous and repetitive education are required.

No abstract available.
Classification* ; Humans ; Spinal Cord* ; Urodynamics*

This study investigated the effects of high amylose starch (HAS) consumption on gut functions in male Sprague-Dawley rats. Experimental animals were fed an diet containing HAS for 4 weeks (0, 125, 250, 500 g/kg diet). Stool weights, transit time, the pH of cecum, Bifidobacterium growth, short chain fatty acid production, and prostaglandin E2 production in colon mucus were measured. HAS intake did not affect body weight gain or food efficiency ratio during experimental period. There were no significant differences in kidney weight, epididymal fat pad weights or spleen weights, but the weights of the liver and thymus were significantly lower in the HAS100 group. The length of the large intestine, the weights of the cecum wall and cecum contents, and stool weights significantly increased through HAS intake. But transit time was not affected by the experimental diet. Although Bifidobacterium growth in the cecum increased through the HAS intake dose dependently, there were significant differences in the HAS50 and HAS100 groups. HAS intake increased the production of short chain fatty acid in the cecum contents. In particular, acetate and butyrate concentrations grew significantly. And the production of prostaglandin E2 in the colon mucus significantly decreased through HAS intake. These results demonstrate that high amylose starch intake significantly improves gut function.
Adipose Tissue ; Amylose* ; Animals ; Bifidobacterium ; Body Weight ; Butyrates ; Cecum ; Colon ; Diet ; Dinoprostone ; Humans ; Hydrogen-Ion Concentration ; Intestine, Large ; Kidney ; Liver ; Male ; Mucus ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Starch* ; Thymus Gland ; Weights and Measures

PURPOSE: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. METHOD: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. RESULT: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. CONCLUSION: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

Actinomycosis is a chronic suppurative and granulomatous bacterial infection most commonly presenting as an abscess, soft tissue swelling, or mass in the cervicofacial region. Although the organisms often invade soft tissues through damaged oral mucosa, actinomycosis presenting acutely as a superficial oral ulcer is extremely rare. We report a case of actinomycosis in a 6-year-old boy who presented a painful ulcer on the right buccal mucosa. Histopathologic examination showed sulfur granules and granulation tissue with mixed inflammatory infiltrate in the dermis. The granules contained numerous Gram-positive filamentous organisms consistent with actinomycosis. We propose that actinomycosis should be kept in mind in the diagnosis of oral ulcerations.
Abscess ; Actinomycosis* ; Bacterial Infections ; Child* ; Dermis ; Diagnosis ; Granulation Tissue ; Humans ; Male ; Mouth Mucosa ; Oral Ulcer* ; Sulfur ; Ulcer

A 64-year-old male patient underwent cardiac resynchronization therapy (CRT) device implantation via the axillary venous approach. Two weeks later, the patient started complaining of "electric shock-like" pain in the left axillary area. During physical examination, typical pain in the left axillary area was reproduced whenever his left shoulder was passively abducted more than 60 degrees. Fluoroscopic examination showed that the left ventricle (LV) and right atrium (RA) leads were positioned at an acute angle directing towards the left brachial plexus whenever the patient's shoulder was passively abducted. Brachial plexus irritation by the angulated CRT leads was strongly suspected. To relieve the acute angulation, we had to adjust the entry site of the LV and RA leads from the distal to the proximal axillary vein using the cut-down method. After successful lead repositioning, the neuropathic pain improved rapidly. Although transvenous pacing lead-induced nerve injury is not a frequent complication, this possibility should be kept in mind by the operators.
Axillary Vein ; Brachial Plexus* ; Cardiac Resynchronization Therapy ; Heart Atria ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Neuralgia ; Peripheral Nerve Injuries ; Physical Examination ; Shoulder

PURPOSE: Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. METHODS: Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. RESULTS: Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. CONCLUSION: This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.
Antibodies, Antinuclear ; Biopsy ; Buttocks ; Calcinosis ; Child ; Dermatomyositis* ; Diagnosis* ; Electromyography ; Exanthema ; Female ; Fructose-Bisphosphate Aldolase ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Muscle Weakness ; Myositis ; Retrospective Studies ; Seoul ; Sex Ratio

Long-term indwelling catheters constitute a risk factor for the development of bladder malignancy. Our study was designed to compare the incidence of bladder cancer and histological changes in the urinary bladder of spinal cord injury patients who had been catheterized for more than 11 years (group 1) and less than 10 years (group 2). Mean duration of catheterization was 17.7 years (range 11-38 years) and 6.5 years (range 2-10 years), respectively in both groups. Our study was performed by cystoscopic evaluation and random bladder biopsy in 23 patients in group 1 and 25 patients in group 2 followed at the Korea Veterans Hospital. The follow-up interval, mechanism, level and degree of injury for both groups were similar. The suprapubic cystostomy was the most common voiding method in both groups (73.9% and 60.0%, respectively). Transitional cell carcinoma in one patient and adenocarcinoma in two patients were found in group 1 and transitional cell carcinoma in one patient was found in group 2. Two patients in group 1 showed squamous metaplasia. 18 patients in group 1 and 24 patients in group 2 showed chronic cystitis. Microscopic hematuria (greater than 2-4 RBC/HPF) was present in all patients. IVPs demonstrated no filling defect of upper tracts in all patients. Overall, the incidences of bladder cancer were 13.0% (3/23) in group 1 and 4.0% (1/25) in group 2. But there was no significant difference in the incidence of bladder cancer between both groups (p=0.279). We suggest that any spinal cord injury patient with hematuria needs a complete bladder evaluation and should undergo cystoscopy and random bladder biopsy.
Adenocarcinoma ; Biopsy ; Carcinoma, Transitional Cell ; Catheterization ; Catheters ; Catheters, Indwelling ; Cystitis ; Cystoscopy ; Cystostomy ; Follow-Up Studies ; Hematuria ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Metaplasia ; Risk Factors ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

337 spinal cord injured patients had been followed up for urologic management in Korea Veterans Hospital. 106 spinal cord injured patients, admitted due to urologic complications from 1990 to 1995, were analyzed. The level of cord injury was cervical in 26, thoracic in 63 and lumbar in 17 patients. The voiding method was suprapubic cystostomy in 32, clean intermittent catheterization in 27, self-voiding in 25, condom catheter in 14, urethral catheter in 6 and others in 2 patients. The common urologic complications were acute pyelonephritis, bladder stone, epididymitis, vesicoureteral reflux, low vesical compliance, autonomic dysreflexia and bladder tumor. Medical treatments for urologic complications were performed for 79 cases (46%) and surgical treatments for 92 cases (54%) We conclude that periodic urologic follow-up will be needed for early detection and management of urologic complications due to spinal cord injury.
Autonomic Dysreflexia ; Catheters ; Compliance ; Condoms ; Cystostomy ; Epididymitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Intermittent Urethral Catheterization ; Korea ; Male ; Pyelonephritis ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder Calculi ; Urinary Bladder Neoplasms ; Urinary Catheters ; Vesico-Ureteral Reflux