Effect of a ''centralized intensive education system'' for clean intermittent self-catheterization in patients with voiding dysfunction who start catheterization for the first time

BACKGROUND: This study evaluated the effects of a 'centralized intensive education system' (CIES) in terms of acquiring a proper clean intermittent self-catheterization (CISC) technique by patients with voiding dysfunction. METHODS: Between March 2002 and March 2003, we prospectively and consecutively enrolled 132 hospitalized patients who learnt and started CISC for the first time due to voiding dysfunction. Patients were enrolled either of two groups (the CIES group vs the 'individualized ward education system'[IWES] group) at the time of the urologic consultation for voiding dysfunction. Out of 132 patients who enrolled in the study, 112 (45 males and 67 females, mean age 57.3 with a range of 18-81) were included in the primary analyses. The questionnaire was applied immediately before discharge. RESULTS: There were similar patient demographics and clinical parameters for the CIES (n = 62) and the IWES groups (n = 50). Of 10 items including the methodology of CISC, six items discriminated significantly in favor of the CIES (P < 0.05). The patient satisfaction with CISC education was significantly different for the two groups in terms of response to the questionnaire. The CIES group was found to be more satisfied with the education received than the IWES group (P < 0.05). Moreover, the number of trials to gain confidence to perform CISC in CIES group was significantly fewer than that of IWES group (P < 0.001). CONCLUSION: Our results demonstrate that CIES might be a superior training program for the patients with voiding dysfunction to acquire a proper CISC technique to the conventional IWES.     

Use of Three-Dimensional Mapping Systems in the Catheter Ablation of Atrial Fibrillation

The increasing clinical experience with remarkable advancement in the technology has enabled the catheter ablation of atrial fibrillation (AF) to become more effective and safe. Widespread utilization of three-dimensional (3D) mapping systems has facilitated the improvement in the outcomes after catheter ablation of AF. The purpose of this article is to review the current status, clinical role, and future directions of various 3D mapping systems in catheter ablation of AF.     

UNUSUAL MANIFESTATION OF DEMODICIDOSIS IN A CHILD

A 14-month-old male infant was brought to the Department of Dermatology, Yonsei University Wonju College of Medicine, with a scaly pruritic skin rash on the glabella area that had been present for 3 weeks. Physical examination showed a coin-sized erythematous scaly patch on the glabella (Fig. 1). There had been no response to the application of topical corticosteroid (Vaspit). The medical history and the results of physical examination were otherwise unremarkable. The diagnosis at the time was atopic dermatitis. A fungal study to rule out tinea faciei showed no fungal spores or hyphae, but many scattered Demodex mites ( D. foiiicuiorum ) were seen in a 10% potassium hydroxide preparation of skin scrapings (Fig. 2). The patient's lesion cleared with the appli-cation of crotamiton cream on three consecutive nights.     

Effect of captopril on the vascular permeability changes induced by C5a, histamine and compound 48/80

The modulating effect of captopril, an inhibitor of angiotensin-converting enzyme, on the vascular permeability changes induced by intradermal injections of C5a, histamine and compound 48/80, was evaluated in guinea-pigs. Cutaneous vascular permeability changes were measured by the extravasation of intravenously injected 125I-bovine serum albumin. Intraperitoneal injection of 12.5, 25, or 50 mg/kg of captopril 30 min prior to the injection of C5a (10(-11) mol) significantly enhanced the increase in vascular permeability induced by this agent (P less than 0.02). This may be explained by the known property of captopril as an inhibitor of carboxypeptidase. No effect was observed when captopril was injected either 2 or 4 h before the injection of C5a. In contrast, the same doses of captopril, when injected intraperitoneally 2 h before the injection of histamine (10(-8) mol) or compound 48/80 (10 micrograms), significantly suppressed the increase in vascular permeability induced by these agents (P less than 0.02). This suppressive effect occurred in a captopril dose-dependent manner. The ability of captopril to modulate the vascular permeability response induced by vasoactive agents indicates that it is a potentially useful tool to dissect the relative roles of mediators involved in inflammatory processes.     

Enterocolitis related to chemotherapy with gemcitabine and cisplatin in patient with transitional cell carcinoma of ureter

YANG Y.J., LIM J.S. & LEE H.J. (2009) European Journal of Cancer Care
Enterocolitis related to chemotherapy with gemcitabine and cisplatin in patient with transitional cell carcinoma of ureter     

Dermatitis palmaris sicca—a distinctive pattern of hand dermatitis

Fifty-seven patients with a Dry, Glazed, Erythematous, Fissured, non-pruritic or mildly pruritic palmar dermatitis are described. This condition was provisionally called dermatitis palmaris sicca. It appears unrelated to an allergic or irritant contact Dermatitis, and endogenous factors like Atopy, Xerosis, inherited susceptibility and Hormones, together with exogenous Factors, like Friction, and repeated hydration and Dessication, may be important to its aetiology. It runs a chronic course interrupted by episodes of painful fissuring. Exudation and Weeping, typical of other forms of hand Dermatitis, arc usually not seen. The histology shows features of a psoriasiform dermatitis. Response to topical corticosteroids is Poor, and simple emollients are useful For reducing its tendency to fissure. A close relationship to finger-tip Eczema, dyskeratotic eczema and juvenile plantar dermatosis (or dermatitis plantaris sicca) is postulated.     

Protective effect of peroxisome proliferator activated receptor gamma agonists on diabetic and non-diabetic renal diseases

SUMMARY:   Peroxisome proliferator activated receptor gamma (PPARγ) agonist has not only antidiabetic effect but also a protective effect against various types of injury of the kidney. The protective effects of PPARγ agonists are observed in diabetic nephropathy and non-diabetic renal diseases such as 5/6 ablation model of renal failure, experimental glomerulonephritis, ischemia-reperfusion injury, hypertensive nephropathy and cyclosporin-induced renal injury. The mechanism of renoprotection by PPARγ agonist is multifactorial. Anti-fibrotic and anti-inflammatory effects, suppression of renin-angiotensin system, vascular protective effect and antiapoptotic effect were proposed.