OBJECTIVE: To assess the impacts of stroke on sexual activities and functioning of patients with stroke and to study the associations of clinical and psychosocial factors with sexual changes following stroke. METHOD: Ninety-seven patients with stroke were interviewed and completed questionnaire concerning their prestroke and poststroke coital frequency, sexual satisfaction, and sexual functions such as erection, ejaculation, and vaginal lubrication. RESULTS: Sexual activities such as coital frequency and sexual satisfaction were decreased in patients after stroke. Sexual dysfunctions including impotence (68%), a decline in ejaculation (66.7%), and a decline in vaginal lubrication (89.5%) were high. Subjective reasons for decreased sexual life after stroke were denial of spouse, impotence, decreased libido, no opportunity of sexual activity due to hospitalization or no sexual partner, fear of relapse, physical discomfort due to hemiparesis and so on. Comparing sexual group with no sexual group after stroke, there were different in age (p=0.040), brain lesion site (p=0.036), prestroke coital frequency (p=0.048), erectile ability (p=0.005), and ejaculation (p<0.001). CONCLUSION: The decline in sexual activities and functioning was due to interpersonal, physical, psychological factors among patients following stroke.
Brain ; Coitus ; Denial (Psychology) ; Ejaculation ; Erectile Dysfunction ; Hospitalization ; Humans ; Libido ; Lubrication ; Male ; Paresis ; Psychology ; Surveys and Questionnaires ; Recurrence ; Sexual Behavior ; Sexual Partners ; Spouses ; Stroke

The correlation between facial pain and/or headache in patients with chronic sinusitis and localized findings on paranasal sinus omputed tomography (CT) are poorly understood. So we prospectively evaluated the relationship of paranasal sinus pain symptoms with CT imaging. Fifty eight patients with headache and/or facial pain rated their pain in 9 areas at the time of CT scanning and 2 months after endoscopic sinus surgery (ESS). We scored the degree of air-fluid level, mucosal thickening, and mucus retention cysts using a grade scale of severity. The ostiomeatal unit, middle meatus and nasofrontal duct were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' pain, that was improved after ESS and CT findings. Among 58 patients who had facial pain and/or headache at the time of CT scan, the pain improved in 51 patients after ESS. Bivariate analysis failed to show any relationship between pain symptoms and CT findings in 51 patients. This study suggests that findings on CT do not routinely correlate with the patients' symptoms of facial pain or headache. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.
Facial Pain ; Headache ; Humans ; Korea* ; Mucus ; Prospective Studies ; Sinusitis ; Tomography, X-Ray Computed

BACKGROUND: In Korea, the separation of prescribing and dispensing medicine was finally accepted as a medical policy in July, 2000, after a long period of discussion and study which was started in 1963. Now a year after the policy started, we investigated the knowledge, attitude, and practice of separation of prescribing and dispensing medicine. METHODS: Information, concerning whether the policy was effectively carried out and well understood, were gathered from 383 patients, who visited an university hospital from August 20 to September 1, 2001. RESULTS: The results revealed that 73.1% of the subjects knew the policy precisely. However, only 1.6% of them could answer all four questions on the purpose of the policy. The old-aged, the low educated, the low socioeconomic groups and the residents in agricultural area revealed poor understanding of the policy (P<0.05). Among the total, 74.9% showed negative response toward the policy. Time and cost increment were 75.7% and 75.2%, respectively. Among them 61.1% revealed negative attitude towards continuance the policy and 93.2% revealed dissatisfaction of the policy. CONCLUSION: The knowledge of the policy was relatively high. However, negative attitudes prevailed on the continuance of the policy. Therefore, more solutions and better strategies for the problems of prescribing and dispensing medicine would be needed.
Humans ; Korea

BACKGROUND: Arteriovenous fistula(AVF) has been the most important, primary mode of achieving vascular access for chronic hemodialysis by this time. In general, maturation period over 4 to 8 weeks after operation for the formation of AVF has been recommended for the long-term survival of AVF, and so insertion of central venous catheter without using AVF being matured has been primarily recommended whenever hemodialysis is needed. But not infrequently, serious complications have been reported in association with the insertion and the use of central venous catheter. So earlier use of AVF is regarded as a good method of avoiding serious complications with regard to the insertion and the use of central venous catheter. But early use of AVF has not been generally recommended, for early use of AVF has been regarded to be associated with early failure of AVF. But few studies have reported the correlation between maturation period and AVF survival. And in practice, early use of AVF has already been performed frequently by not a few nephrologists or nurses of dialysis units. So authors tried to examine the correlation between maturation period and AVF survival rate, and to find the validity of early use of AVF if it is regarded usable for the hemodialysis by experienced hemodialysis nurses and nephrologists. METHODS: A retrospective analysis using 88 AVF cases which had been created in 85 patients from Oct. 1986 through June 1996, and from which authors could get enough information for this study was done. Authors compared one year survival rates of AVF according to the maturation period, the presence of DM, and condition of AVF assessed clinically by doctors and experienced nurses in hemodialysis units. Also from the cases with AVF obstruction, authors examined the 1st, 2nd, and 3rd year survival rate of AVF according to the maturation period. RESULTS: One year survival rate of AVF with maturation period less than 4 weeks was higher than that with maturation period more than 4 weeks, but there was no statistical significance. One year survival rate, irrespective of the length of maturation period for AVFs, of AVF regarded to be usable and good for hemodialysis was higher than that of AVF regarded to be usable but not good for hemodialysis. In the study with the AVF obstruction group only, one year survival rate of AVF with maturation period less than 4 weeks was higher than that of AVF with maturation period more than 4 weeks but there was no statistical significance. And one year AVF survival rate was higher in non DM group(94.1%) than DM group(60%) regardless of maturation period of AVF(p<0.05). CONCLUSION: On the contrary to the views that longer maturation period of more than 4 weeks will be necessary for the long-term survival of AVF, our results suggest that shorter maturation period for AVF less than 4 weeks does not necessarily mean early failure of AVF once AVF is regarded to be usable for hemodialysis. So it is suggested that early use of AVF instead of inserting central venous catheter is a reasonable approach for getting an adequate vascular access for hemodialysis in chronic renal failure patients who were subjected to receive hemodialysis on waiting peroid of AVF maturation.
Arteriovenous Fistula* ; Central Venous Catheters ; Dialysis ; Humans ; Kidney Failure, Chronic ; Renal Dialysis* ; Retrospective Studies ; Survival Rate

Continuous ambulatory peritoneal dialysis(CAPD) is now the most important and effective therapeutic modality as well as hemodialysis(HD) and renal transplantation in patients with chronic renal failure. It is frequently recommended to diabetic renal failure patients because of poor, athersclerotic vascularity of them. Hyperglycemia and obesity are not uncommon complications of CAPD therapy. But there were only few reports of very severe hyperglycemia or hyperosmolar coma in CRF patients on CAPD therapy, especially with 7% dextrose CAPD dialysate in foreign countries in the past. Moreover, no specific management for hyperosmolar coma is established in those situations yet. In Korea, only three cases of hyperosmolar coma in non diabetic renal failure patient on CAPD therapy have been reported in one case report. And only one case among them whose CAPD therapy was changed to HD survived. Authors also experienced a case of diabetic hyperosmolar coma treated successfully with conversion to HD in chronic renal failure patient on CAPD therapy. So we report this case with a review of literature. Taken together with this case and review of literature, changing CAPD therapy to HD is regarded to be an important part of treatment when hyperosmolar coma develops in chronic renal failure patients.
Coma* ; Glucose ; Humans ; Hyperglycemia ; Kidney Failure, Chronic* ; Kidney Transplantation ; Korea ; Obesity ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis* ; Renal Insufficiency

Continuous ambulatory peritoneal dialysis(CAPD) is now the most important and effective therapeutic modality as well as hemodialysis(HD) and renal transplantation in patients with chronic renal failure. It is frequently recommended to diabetic renal failure patients because of poor, athersclerotic vascularity of them. Hyperglycemia and obesity are not uncommon complications of CAPD therapy. But there were only few reports of very severe hyperglycemia or hyperosmolar coma in CRF patients on CAPD therapy, especially with 7% dextrose CAPD dialysate in foreign countries in the past. Moreover, no specific management for hyperosmolar coma is established in those situations yet. In Korea, only three cases of hyperosmolar coma in non diabetic renal failure patient on CAPD therapy have been reported in one case report. And only one case among them whose CAPD therapy was changed to HD survived. Authors also experienced a case of diabetic hyperosmolar coma treated successfully with conversion to HD in chronic renal failure patient on CAPD therapy. So we report this case with a review of literature. Taken together with this case and review of literature, changing CAPD therapy to HD is regarded to be an important part of treatment when hyperosmolar coma develops in chronic renal failure patients.
Coma* ; Glucose ; Humans ; Hyperglycemia ; Kidney Failure, Chronic* ; Kidney Transplantation ; Korea ; Obesity ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis* ; Renal Insufficiency

Emphysematous pyelonephritis is an uncommon, but life-threatening necrotizing inflammation of renal parenchyme and perinephric tissue by gas-forming organisms. This disease is encountered mainly in patients with uncontrolled diabetes mellitus and/or urinary tract obstruction etc. Though the pathogenesis of this diseases is still poorly understood, radiographic demonstration of gas shadow in renal parenchyme and peri-nephric tissue establishes the diagnosis of emphysematous pyelonephritis. The identification of this finding has been believed to consider incision and drainage or nephrectomy in addition to medical treatment, because of high mortality rate of this disease in spite of vigorous medical management. We report two cases of emphysematous pyelonephritis complicated in 62-year-old female and 48- year-old male patients with diabetes mellitus. Nephrectomies were not performed because of bilateral emphysematous pyelonephritis in one patient and of refusal of nephrectomy by the other patient. But patients were recovered completely on medical management.
Diabetes Mellitus ; Diagnosis ; Disulfiram ; Drainage ; Female ; Humans ; Inflammation ; Male ; Middle Aged ; Mortality ; Nephrectomy ; Pyelonephritis* ; Urinary Tract

The prognostic significance of the squamous cell carcinomas of the oral and oropharynx have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histologic characteristics. For determining prognostic indicators, the authors performed immunohistochemical staining of p53 and epidermal growth factor receptor(EGFR) in 29 cases of squamous cell carcinomas of the oral and oropharynx. The expression rate of p53 was 51.7%, that of EGFR was 96.6%, and overexpression rate of EGFR was 41.4%, however there were no statistical significance between the reactivity of EGFR, p53 and clinicopathological features such as primary stage, nodal stage, clinical stage, death and histologic grade.
Carcinoma, Squamous Cell* ; Epidermal Growth Factor* ; Oropharynx ; Receptor, Epidermal Growth Factor*

No abstract available.
Iron* ; Mesangial Cells* ; Perfusion*

No abstract available.
Acute Kidney Injury* ; Cardiopulmonary Bypass* ; Renal Replacement Therapy*