Xanthogranulomatous pyelonephritis, an uncommon chronic inflammatory renal disorder of middle-aged women, is rarely seen in childhood. A 10 year-old boy with focal type of this disease in upper and lower pole was experienced. Patient had a intermittent fever and right flank pain without palpable mass. The blood analysis only revealed ESR increase but no anemia, no leukocytosis. There was no history or signs of urinary tract infection or calculi. The urine analysis and culture showed nothing abnormal. An intravenous pyelogram, ultrasonogram, abdominal CT and selective renal arteriography only demonstrated a non functioning upper pole of right kidney. During operation, a gross finding and frozen section strongly showed xanthogranulomatous pyelonephritis and diagnosis was made on histological examination, After nephrectomy, there had been no evidence of disease recurrence during 2 years follow-up period.
Anemia ; Angiography ; Calculi ; Child* ; Diagnosis ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Frozen Sections ; Humans ; Kidney ; Leukocytosis ; Male ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Tract Infections

Congenital lymphedema is a rare disorder of unknown etiology which affects the extremities, preponderantly the lower extremities, at or immediately after birth. We experienced a case of congenital lymphedema in a newborn with generalized edema on the left lower extremity. We performed lymphangioscintigraphy and MRI for diagnosis. Microlymphaticovenous anastomosis was done on 16 days after birth and the patient showed clinical improvement. We report this case with brief review of the related literature.
Diagnosis ; Edema ; Extremities ; Humans ; Infant, Newborn ; Lower Extremity ; Lymphedema* ; Magnetic Resonance Imaging ; Parturition

PURPOSE: Simple instructional systems design (ISD) model is based on a fast development, usability test, and continuos feedback, which are necessary for educational program development in medical school. This study aims to figure out the usability of Simple ISD model for a medical ethics education program by describing a developmental details of each phase and its evaluation results. METHODS: Research has been conducted in two steps. First, while researchers participated in the program development by using Simple ISD model, we collected empirical data of each development activities. Second, the developed program was evaluated by students' web-based usability test, a 8-students' focus group interview and 5 faculty members' individual interviews in 4 domains; learning contents, instructional methods and strategies, achievement evaluation, and self-evaluation. RESULTS: Following the circular process of analysis, design, development, and usability test of Simple ISD model, a 10-week medical ethics program covering 9 instructional topics was developed. The average points of response on the developed medical ethics program in 2008 and 2009 are increased from 3.96 to 4.59 and 4.41, respectively. The prospects and limitations of the program are discussed. CONCLUSION: From a development study of the medical ethics program by using Simple ISD model, we could implement a more usable medical ethics program, and found 4 different usability of the Simple ISD model; the rapid development of educational program, program improvement by continuous feedback, faculty members' engagement in instructional design, and professional development of the faculty members.
Achievement ; Ethics, Medical ; Focus Groups ; Learning ; Program Development ; Schools, Medical

Heart transplantation (HTx) has become standard treatment for selected patients with end-stage heart failure. Improvements in immunosuppressant, donor procurement, surgical techniques, and post-HTx care have resulted in a substantial decrease in acute allograft rejection, which had previously significantly limited survival of HTx recipients. However, limitations to long-term allograft survival exist, including rejection, infection, coronary allograft vasculopathy, and malignancy. Careful balance of immunosuppressive therapy and vigilant surveillance for complications can further improve long-term outcomes of HTx recipients.
Allografts ; Forecasting ; Heart Failure ; Heart Transplantation ; Heart ; Humans ; Tissue Donors

Heart transplantation (HTx) has become standard treatment for selected patients with end-stage heart failure. Improvements in immunosuppressant, donor procurement, surgical techniques, and post-HTx care have resulted in a substantial decrease in acute allograft rejection, which had previously significantly limited survival of HTx recipients. However, limitations to long-term allograft survival exist, including rejection, infection, coronary allograft vasculopathy, and malignancy. Careful balance of immunosuppressive therapy and vigilant surveillance for complications can further improve long-term outcomes of HTx recipients.

PURPOSE: This study aimed to explore the relationship between students' seating preferences and academic achievement in medical school. METHODS: The subjects of this study were 109 second-year students in C medical school. The pattern of seat selection of 109 students was surveyed by participant observation for 48 days, and a questionnaire was administered to determine the factors that were considered by students. Using SPSS version 12.0, we analyzed the factors that students considered with regard to seat selection and seat preference and the frequency of seat movements between areas. We performed one-way ANOVA to analyze the differences in academic achievement between students who moved seats versus those who did not. RESULTS: The most common reasons for seat selection were to focus better on the lecture (60 students), to focus better on lecture, and to feel familiar with the same seat (60 students). Students' preferred seats were in rows A4, A7, A5, and A3 (in descending order), which are primarily the central sections, and columns B15, B1, B14, B19 (in descending order), which are primarily both ends of the division. The difference in academic achievement between students who moved seats and those who did not was not significant (p>0.05). Among students who did not move seats, the difference in academic achievement between 9 seating areas was not significant in 6 subjects (p>0.05). CONCLUSION: The results of this study suggest that we should reconsider a professor's general perception regarding academic achievement according to seat location.
Achievement ; Humans ; Schools, Medical ; Surveys and Questionnaires

PURPOSE: To examine how pediatricians in private practices are affected by the process of training medical students in their clinics as part of a community-based clerkship program. MATERIALS AND METHODS: In 2007, a questionnaire was sent to 35 pediatricians who had provided private clinical settings for clerkship training for the previous 3 years. The questionnaire covered a number of points, including the pediatricians' motivation to join and/or reasons to quit the program; if there were changes seen in their stress levels while supervising students; changes in their treatment procedures or attitudes because of the students' presence; responses of patients and/or their guardians in regard to have medical students treating them, and whether the doctors were inspired to grow professionally by participating in the program. RESULTS: Of the 35 pediatricians, 31 (88.5%) responded. Eighteen respondents (58%) selected 'responsibility to cooperate with medical school' as a reason to participate. Fifteen physicians (48.3%) answered that the clerkship program had a positive impact on their treatment procedures and their attitude towards patients. CONCLUSION: Based on the pediatricians' responses, the community-based clerkship program may instill intellectual inspiration and promote professional growth among the pediatricians in private practices, resulting in potentially better treatment for patients.
Attitude of Health Personnel ; *Clinical Clerkship ; Humans ; Motivation ; Pediatrics/*education ; Physicians/*psychology ; *Teaching

OBJECTIVES: Memory deficits in patients with schizophrenia have been well established, but it is still unclear how memory performance changes during verbal learning tasks. This study was designed to assess the pattem of verbal learning and memory performance to test the inefficiency of encoding processes in learning of schizophrenia. METHOD: Subjects consisted of 26 patients with schizophrenia who were unmedicated for atleast seven days and 22 normal controls who were matched for age,sex,and education. Verbal memory and learning were evaluated with computerized tasks composed of three consecutive immediate recall trials, a yes/no recognition test, and a delayed recall trial of a word list. RESULTS: Thepatients with schizophrenia showed significant learning deficits characterized by impaired immediate recall performance and poor learning of a word list. However, both verbal recognition performance and forgetting were comparable in both groups. Word clustering correlated significantly with recall performance. Clustering of patients decreased significantly over immediate and delay recall tasks and showed poor increase during consecutive recall tasks. CONCLUSION: Thest findings indicate that verbal learning and mnemonic strategy are impaired but learned information appears to be preserved in patients with schizophrenia. The results are consistent with the notion that a learning deficit is closely related with impaired encoding precesses in schizophrenia.
Education ; Humans ; Learning ; Memory Disorders ; Memory* ; Memory, Short-Term ; Schizophrenia* ; Verbal Learning

OBJECTIVE: This open prospective study was performed to investigate the long-term efficacy and safety of risperidone in the treatment-resistant patient with chronic schizophrenia who had completed a 8-week short-term trial. METHOD: Fourteen patients with treatment-resistant chronic schizophrenia(DSM-IV), who had been previously treated with at least two different kinds of typical antipsychotic drugs but with insufficient clinical effects or who experienced distressing extrapyramidal side effects, were evaluated over a 48-week risperidone treatment period. Efficacy was assessed by the PANSS and the CGI, and its safety by the ESRS and the UKU side effect rating scale. Both were assessed at 8-week intervals. RESULT: Nine(four males and five females) of the fourteen patients completed the study. Overall, PANSS score for the entire period showed an improvement when compared with the baseline state. The pronounced improvement in CGI severity was seen between the 8th and 16th week, continued until endpoint. Of fourteen patients, eleven(78.6%) patients showed at least a 20% decrease in total PANSS scores on endpoint analysis. Transiently-observed extrapyramidal side effects following medication were akathisia(n=3), bradykinesia(n=3), and sialorrhea(n=2). Early UKU side effects included; increased dream activity, sedation, amenorrhea, and concentration difficulty. These were common but transient with the exception of amenorrhea. Three of the four patients with amenorrhea did not resume menses throughout the study. CONCLUSION: These results suggest that risperidone is a safe antipsychotic drug with long-term efficacy against both the positive and negative symptoms in the treatment of treatment-resistant schizophrenia.
Amenorrhea ; Antipsychotic Agents ; Dreams ; Female ; Humans ; Male ; Prospective Studies ; Risperidone* ; Schizophrenia*

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution