Gas producing infection accompanied by evidence of subcutaneous gas usually are diagnosed as clostridial gas gangrene. The occurrence of nonclostridial gas producing infection is thought to be relatively rare. Two cases of nonclostridial gas producing infection simulating clostridial gas gangrene in diabetes occurred. Gram stains of pus at the time of admission can isolate the E-coli and streptococcus, and can distinguish these two entities. Chief conplaints were swelling, pain and tenderness of right lower extremity by infection. Multiple incisions to free the tissues of gas and pus and the administration of antibiotics are the treatment of choice.
Anti-Bacterial Agents ; Coloring Agents ; Gas Gangrene ; Lower Extremity ; Streptococcus ; Suppuration

No abstract available in English.

PURPOSE: This study was aimed at evaluating the expressions of types I and III collagen, inducible nitric oxide synthase (iNOS), hypoxic inducible factor-1alpha(HIF-1alpha), vascular endothelial growth factor (VEGF) and the hemodynamic changes of the bladder during the acute stages of a partial bladder outlet obstruction (PBOO) in adult rats. MATERIALS AND METHODS: Bladder specimens were aseptically removed from 35 Sprague-Dawley adult rats (8 week old, weight 250-300gm) of both sham and experimental groups at 6, 12 and 24 hours, and 2, 3, 5 and 7 days after establishing a partial bladder outlet obstruction. Bladder blood flow was measured at the left vesicular artery using a laser flowmeter. The expressions of types I and III collagen, iNOS, HIF-1alpha and VEGF in relation to changes of the bladder wall were evaluated by immunohistochemical staining and Western blot assay. RESULTS: There was a significant difference in the vesical blood flow between the sham and experimental groups after the establishment of a PBOO. The bladder blood flow of the experimental groups was significantly decreased after establishing a PBOO of 3 days duration. The expressions of type III collagen and iNOS from the immunohistochemical staining of the bladder were markedly increased during the acute stages of a PBOO. The expressions of HIF-1alpha and VEGF from the Western blot of the bladder increased with duration of the obstruction. CONCLUSIONS: A decreased bladder blood flow during the acute stages of PBOO generally enhanced the expressions of iNOS and type III collagen. This study suggests that hypoxia of the bladder after establishing a PBOO induces the expression of HIF-1alpha, and then enhances the production of nitric oxide (NO) due to activation of iNOS, which finally results in bladder growth and a decrease in bladder wall compliance.
Adult ; Animals ; Anoxia ; Arteries ; Blotting, Western ; Collagen ; Collagen Type III ; Compliance ; Flowmeters ; Hemodynamics ; Humans ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Vascular Endothelial Growth Factor A

PURPOSE: The objective of this study was to identify the relationships among symptom bother, physical and mental stress and health-related quality of life (HRQoL) in women with overactive bladder (OAB) syndrome. METHODS: The participants were 106 women who were diagnosed with OAB (urgency, urge urinary incontinence, frequency, and/or nocturia) at P university hospital. Data were collected from Dec 23, 2011 to Aug 31, 2012. RESULTS: The mean score for symptom bother was 43.1 points, for physical stress, 12.8 which was slightly higher than mental stress (11.8), and for HRQoL, 63.9. For symptom type, there were statistically significant differences in the symptom bother (F=8.67, p<.001) and HRQL (F=3.32, p= .023). The Symptom bother of OAB was positively correlated with physical stress (r=.23, p= .014) and mental stress (r=.33, p<.001) and negatively correlated with the subscales of HRQoL; coping (r=-.66, p<.001), concern (r=-.71, p<.001), sleep (r=-.59, p<.001), and social interaction (r=-.58, p<.001). CONCLUSION: From the results, bother symptom was associated with physical, mental stress and HRQoL. These results suggest that nursing intervention programs for OAB should be developed not only to relieve the symptoms but also to reduce stress and improve the quality of life.
Female ; Humans ; Interpersonal Relations ; Nursing ; Quality of Life* ; Symptom Assessment ; Urinary Bladder, Overactive* ; Urinary Incontinence

PURPOSE: As suggested by many investigators, the cause of age-related female sexual dysfunction is the decline of serum estrogen. We investigated the effects of estrogen on the nitric oxide synthase (NOS) and vascular endothelial growth factor (VEGF) expressions and the histologic composition in the uterus and proximal and distal vagina of rats. MATERIALS AND METHODS: Forty-five mature female Sprague-Dawley rats were randomly divided into three groups; the control group (C), the oophorectomy group (O), and the estrogen replacement group (E). The expression rates of neuronal NOS (nNOS), endothelial NOS (eNOS), VEGF and the changes of the collagen component in the uterus and proximal and distal vaginal tissues were investigated by immunohistochemical staining and Masson's trichrom staining. RESULTS: The expression rate of NOS was highest in the proximal vagina, and this was followed by the portion of the vagina distal to the uterus. The nNOS and eNOS expression rates were significantly decreased in the uterus and the proximal vagina of the E group (p<0.05), and they were increased in the uterus and proximal vagina of the O group (p<0.05). However, the VEGF expression rate was increased in only the uterus of E group. In all tissues, the collagen component was significantly decreased in the E group, while it was increased in the O group (p<0.05). CONCLUSIONS: These data suggest that estrogen downregulates nNOS and eNOS. In addition, estrogen deficiency induces collagen synthesis and it decreases the content of smooth muscle in the uterus and vagina, resulting in structural relaxation difficulty.
Animals ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons* ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Nitric Oxide Synthase Type III* ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Research Personnel ; Uterus* ; Vagina* ; Vascular Endothelial Growth Factor A*

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

PURPOSE: This prospective study was conducted to evaulate the effect of nebulized steroid (budesonide) and parenteral steroid (dexamethasone) on chidren with croup. METHODS: Twenty nine infants and children (6months-5years of age) admitted to hospital with croup were randomly assigned to receive either 1mg (4ml) of nebulized budesonide (17 patients) or 0.6mg/kg intramuscular injection of dexamethasone sodium phosphate (12 patients). Total croup score, heart rate and respiratory rate of patients were assessed on admission, 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours after treatment, respectively. RESULTS: 1) In total cases, total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.01) but at 2 hours after treatmetn in the group treated with dexamethasone (p<0.05). 2) In mild cases (total croup score<5), total croup score were significantly decreased at 2 hours after treatment in the both group (p<0.05). 3) In moderate to severe cases (total croup score> or =5), total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.05). But in group treated with dexamethasone, there were no statistical significance because of small cases. 4) Respiratory rate was decreased after treatment in the both group, but significantly decreased at 2 hours after treatment in the group treated with dexamethasone (p<0.05). 5) Heart rate was decreased after treatment in the both group, but significantly decreased at 30 minutes after treatment in the group treated with dexamethasone (p<0.05). 6) There were no significant side effects in the both group. CONCLUSIONS: We conclude that both nebulized budesonide and parenteral dexamethasone were effective in treatment of croup, and that nebulized budesonide leads to more rapid clinical improvement in children with croup, especially moderate to severe one.
Budesonide ; Child* ; Croup* ; Dexamethasone ; Heart Rate ; Humans ; Infant ; Injections, Intramuscular ; Prospective Studies ; Respiratory Rate ; Sodium

PURPOSE: Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses. MATERIALS AND METHODS: From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed. RESULTS: Multiloculated or multifocal abscess cavities were found on the preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient. CONCLUSIONS: Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage.
Abscess/etiology/radiography/*surgery ; Aged ; Aged, 80 and over ; Calcinosis/complications/surgery ; Drainage/methods ; Holmium ; Humans ; Lasers, Solid-State/*therapeutic use ; Male ; Middle Aged ; Prostatic Diseases/etiology/radiography/*surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Transurethral Resection of Prostate/*methods ; Treatment Outcome ; Urinary Bladder Neck Obstruction/complications/surgery

Purpose: We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audiological criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. Materials and Methods: The medical records of patients with tinnitus who visited the hospital between March 2020 and December 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative electroencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. Results: A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus.However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Conclusion Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.

Purpose: We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audiological criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. Materials and Methods: The medical records of patients with tinnitus who visited the hospital between March 2020 and December 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative electroencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. Results: A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus. However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Conclusion Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.