Factors Affecting Health-Related Quality of Life in Persons with Stroke Using SF-6D

BACKGROUND: The SF-6D, derived from the SF-36, is a preference-based instrument measuring health-related quality of life (HRQOL). Using this tool, we measured the HRQOL of persons disabled by stroke dwelling in Gyeongju city and identified factors affecting the HRQOL. METHODS: As of March 2008, 991 persons who had had a stroke and were aged 50 and over were identified on the Gyeongju city disabled registry. Interviewers specifically trained for this face-to-face survey gathered pertinent information including general and clinical characteristics from June to October 2008. In addition, the health status was measured using the Modified Rankin Scale, the Barthel ADL index, and the SF-36. The SF-6D index was derived from the SF-36. We analyzed the known-group construct validity and convergent validity. Finally, we performed multiple regression analyses to identify factors affecting the HRQOL. RESULTS: Of the 991 potential subjects, 498 persons participated in the interviews (response rate: 50.3%). The SF-6D indices for females and those aged 70 and over were lower than indices for males and those aged 60 and less. Correlation coefficients between the Modified Rankin Scale, the Barthel index, and the SF-6D index were relatively high (-0.533 and 0.555, respectively) and statistically significant (P<0.001). Multiple regression analyses showed that sex, age, smoking, alcohol use, comorbidity, the Modified Rankin Scale, and the Barthel index had an effect on the SF-6D index of persons with stroke, and the Barthel index was the most important factor. CONCLUSIONS: Our results indicate that the SF-6D can be a valid tool for evaluating health states of persons disabled by stroke, and functional limitation was the main factor affecting the HRQOL.

Rocuronium bromide induced anaphylaxis in a child: A case report / 대한마취과학회지

Anaphylaxis or anaphylactoid reaction in pediatric patient during anesthesia is rare. We report a rocuronium induced anaphylactic reaction in a 33-month-old female. The patient was scheduled to undergo escharectomy due to injuries suffered from a major burn. Shortly after administration of rocuronium, the patient developed severe hypotension, tachycardia, and hypoxia. A similar reaction occurred after administration of rocuronium on subsequent anesthesia. She underwent uneventful anesthesia with volatile induction and maintenance of anesthesia with sevoflurane on her next 7 operations without using of muscle relaxant.

The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis / 대한흉부외과학회지

BACKGROUND: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. MATERIAL AND METHOD: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. RESULT: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. CONCLUSION: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

Primary Pyogenic Psoas Abscess in Child / 대한정형외과학회잡지

Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.

Effect of intraperitoneal injection of single chemotherapeutic agent on rat bladder carcinogenesis induced by N-butyl-N-(4-hydroxybutyl) nitrosamine / 대한비뇨기과학회지

Chemotherapeutic agents were evaluated for their effect on the development of urinary bladder tumors, induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female Sprague-Dawley rats. For 16 weeks, 0.05% BBN was administered orally, and then chemotherapeutic agents (adriamycin and cisplatin) were injected intraperitoneally for 12 weeks. In our preliminary experimental series, an experimental bladder tumor model induced by BBN was useful in evaluating the effectiveness of chemotherapeutic agents. Cisplatin appears to be effective in inhibiting precancerous histologic changes and carcinoma in rat urinary bladder mucosa by BBN. However, the effectiveness of adriamycin was inconclusive.

Spectrum of Multicystic Dysplastic Kidney / 대한비뇨기과학회지

Multicystic dysplastic kidney is the most frequent cause of abdominal mass in the neonate, but its presentation is variable depending on the size of cystic kidney, state of the opposite kidney and associated anomalies. multicystic dysplastic kidney also represents a spectrum of pathology from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Herein we report 5 cases of MCK with different presentation and histology, a bilateral MCK associated with horseshoe kidney, a large MCK with uremia, a focal segmental MCK with contralateral UPJ obstruction, a small focal segmental MCK with contralateral megaureter and a small MCK detected by ultrasonogram for localization of impalpable testis.

Urodynamically Studied Neurogenic Bladder / 대한비뇨기과학회지

Urodynamics is a neurourolgic diagnostic tool concerned with identification and measurement of physiologic and pathologic factors involved in the storage, transportation, and evacuation of urine. It plays an important role in the diagnosis, management of neurogenic bladder and its use has gradually increased. But a disparity between clinical and urodynamic findings is commonly found and its application to the clinical management of neurogenic bladder is practically as well embarrassing as its reading. We analyzed the results of 81 cases of neurogenic bladder with urodynamic study. Urodynamically, there were 18 cases showing D. hyperreflexia with DSD, 10 cases D. Hyperreflexia without DSD, 36 cases D. areflexia without low compliance, and 17 case D. areflexia with low compliance. A disparity between the clinical and urodynamic :assessment was noted in 28 cases( 35%). Clinically severe symptom with complication was particularly common in D. hyperreflexia with DSD, D. areflexia with low compliance and catheter indwelling patients.

Functional Analysis of Anti-Refluxing Augmentation Cystoplasty / 대한비뇨기과학회지

Augmentation cystoplasty using bowel is effective method for the functional enlargement of bladder capacity in contracted bladder due to various causes. Prevention of vesicoureteral reflux after augmentation cystoplasty is still controversial but generally accepted that prevention of reflux is essential for good long term result. Therefore, antireflux augmentation cystoplasty including the use of ileocecal valve and hemi-Kock intussuscepted ileal nipple valve has been used recently for this purpose. Herein, we report the result of 3 cases of ileocecal cystoplasty and 6 cases of hemi-Kock ileocystoplasty. Hemi-Kock ileocystoplasty is better than ileocecal cystoplasty in a viewpoint of reflux prevention and continence, but complication is more common and serious in hemi-Kock ileocystoplasty than ileocecal cystoplasty. It is considered that azotemia is not contraindication for these procedures, and renal function deterioration has not been observed postoperatively.

Influence of Age on the Remnant Kidney in Uninephrectomized Rats / 대한비뇨기과학회지

To investigate the influence of age on the remnant kidney, unilateral nephrectomy was performed in rats at 1week(group N-1), 3weeks(group N-3), 5weeks(group N-5), 7weeks(group N-7). 9weeks(group N-9), and 10weeks(group N-10) of age and sham operation was performed in the control group of rats at the same ages. Proteinuria in spot urine, serum BUN/creatinine, compensatory renal growth and histologic changes were compared with in each group at 32weeks after uninephrectomy. The results were as follows : 1. A compensatory renal growth in nephrectomy group was significantly greater than that in sham operated groups(p <0.001 ) and a compensatory renal growth in prepubertal groups( N-1, 3, 5. 7) was significantly greater than that in postpubertal groups ( N-9, IO) between the nephrectomy groups. 2. In histologic changes, visceral glomerular epithelial proliferation, mesangeal widening and proliferation, obliteration of capillary lumen were more marked in nephrectomy group than sham operated group and group N-1, N-3, N-5, N-7 than in groups N-9, N-10 at week 32. 3. The proteinuria in spot urine was more marked in nephrectomy groups than sham operated groups at week 32 and there was no significant difference in serum BUN/creatinine between nephrectomy group and sham operated groups. It is concluded that in rat, uninephrectomy at young ages leads to more marked compensatory renal growth and histologic change than uninephrectomy in the adult and functionally, proteinuria precedes change of serum BUN and creatinine.

A Primary Carcinoma of Female Urethra Treated by Radiation / 대한비뇨기과학회지

Primary carcinoma of the female urethra is a relatively rare disease that accounts for less than 0.02% of all malignancies in women. The rarity with which the neoplasm is encountered has prevented unanimity of opinion with regard to its proper management. Herein we report one case of female urethral carcinoma treated by radiation therapy alone external beam 4,500 cGy followed by interstitial implant. 1,000 cGy).

A Primary Carcinoma of Female Urethra Treated by Radiation / 대한비뇨기과학회지

Primary carcinoma of the female urethra is a relatively rare disease that accounts for less than 0.02% of all malignancies in women. The rarity with which the neoplasm is encountered has prevented unanimity of opinion with regard to its proper management. Herein we report one case of female urethral carcinoma treated by radiation therapy alone external beam 4,500 cGy followed by interstitial implant. 1,000 cGy).

Pyogenic Adrenal Cyst in Newborn / 대한비뇨기과학회지

Cysts of the adrenal gland are often misinterpreted and misdiagnosed because of their rarity. There are few reports in the literature of adrenal cyst in children, especially in the newborn. Adrenal cysts in the newborn are usually of the pseudocyst due to adrenal hemorrhage and have tendency to become adherent to surrounding structure, mimicking malignant tumor. We report a cases of pyogenic adrenal cyst in the newborn which was suspected malignancy because of adherence to adjacent organ.