In the 88 cases of biliary disease, which was proven in Seoul Red Cross Hospital from Jan. 1980 to Dec. 1981,comparative studies were made with oral and IV cholecystocholangiographic findings and ultrasonographic findings.The resuslts were ; 1. In the 18 cases of GB stones, there are 17 cases (94.4%) of positive findings incholecysto-cholangiography with detection of stone in 7 cases (38.9%), while in sonographic study, 16 cases(88.9%) are shown positive findings with detection of stones in 11 cases (61.1%). 2. In the 17 cases of acalculouscholecystitis, the diagnostic accuracy is 88.2% in cholecystocholangiography and 64.7% in sonography. 3. In the 7cases of CBD stones, all cases are shown positive findings in cholecystocholangiography with detection of stone inonly one case (14.3%), while 6 cases (85.7%) of positive findings are shown in sonography with detection stone inall cases. 4. I.V. cholanagiography is more accurate diagnsotic procedure rather than oral GB study in the casesof poor or non-functioning GB. 5. Sonography is the choice of procedure in the diagnosis of stones, while in thecases of colecystitis, cholecystocholangiography is more useful diagnostic procedure.
Diagnosis ; Red Cross ; Seoul ; Ultrasonography

BACKGROUND: The described clinical characteristics of early-onset Alzheimer's disease (EOAD) are distinct from that of late-onset AD. We reported a patient with atypical EOAD. CASE REPORT: A 54-year-old, truck driver developed gradual visuospatial, language and calculation deficits for 3 months. The neuropsychological impairments were extensive. Brain MRI revealed asymmetric atrophy in left medial temporal lobe along with distinct widening of sylvian fissure. (18)F-florbetapir-positron emission tomography (PET) showed a high uptake in the cortex. Further, the profiles of cerebrospinal fluid (CSF) biomarker were compatible with AD. CONCLUSIONS: We diagnosed the patient as EOAD based on the result of biomarker study. Increased Abeta burden was identified through amyloid PET imaging and decreased CSF Abeta level. The high rise of CSF Tau proteins was in agreement with the patient's extensive and rapid cognitive decline. This case report demonstrates the importance of AD biomarker study in confronting early-onset dementia with atypical clinical presentation.
Alzheimer Disease* ; Amyloid ; Atrophy ; Brain ; Cerebrospinal Fluid ; Dementia* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Motor Vehicles ; Positron-Emission Tomography ; tau Proteins ; Temporal Lobe

Central pontine myelinolysis (CPM) is well-recognized osmotic demyelination syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Acute ataxia as a sole clinical sign in CPM is rare. We report a case of a 59-year-old man with dysarthria, intention tremor, and a significant gait ataxia starting after alcohol withdrawal, with radiological evidence of CPM. CPM should be included in the differential diagnosis of alcoholic patients who develop a sudden ataxia. Chronic alcohol abuse is one of the most commonly encountered predisposing factors. Alcohol withdrawal represents an additional vulnerability factor, being responsible for electrolyte imbalances which are not always demonstrable but are certainly involved in the development of CPM.
Alcoholics* ; Alcoholism ; Ataxia ; Causality ; Demyelinating Diseases ; Diagnosis, Differential ; Dysarthria ; Gait Ataxia ; Humans ; Hyponatremia ; Middle Aged ; Myelinolysis, Central Pontine* ; Tremor

Treatment-induced neuropathy in diabetes (also referred to as insulin neuritis) is considered a rare iatrogenic small fiber neuropathy caused by an abrupt improvement in glycemic control in the setting of chronic hyperglycemia. The prevalence and risk factors are unknown. It presents with neuropathic pain, symptoms of autonomic dysfunction, or a combination of both. We present a case that illustrates the range of presentations of the acute treatment-induced small fiber neuropathy in a patient with diabetes mellitus.
Acute Pain* ; Blood Glucose* ; Diabetes Mellitus ; Diabetic Neuropathies ; Erythromelalgia ; Humans ; Hyperglycemia ; Insulin ; Neuralgia ; Prevalence ; Risk Factors

Eight cases of chondroblastoma were studied by analyzing the clinical and pathologic findings. The age of eight cases ranged from 17 to 38 years old(median age, 22.7 years old). The tumors developed in the femur (3 cases), patella (2 cases), tibia( 1 case), fibula (1 case), and ulna (1 case). The mean diameter of tumors was 4.0 cm (range, 1.5 to 8.0 cm). Grossly, tumors showed grayish brown solid area with foci of secondary aneurysmal bone cyst. Histologically, the tumor cells were round or polygonal in shape with nuclear groove. And there were chondroid differentiation(7 cases), mitosis(3 cases), calcific deposits(3 cases), secondary aneurysmal bone cyst(4 cases), hemosiderin deposits(4 cases), necrosis(3 cases), vascular invasion(1 caes) and foamy histiocytes and cholesterol cleft(1 cases). All cases showed no metastasis to lymph node and distant organ. Seven cases (87.5 %) were immunoreactive for S-100 protein. None were immunoreactive for cytokeratin.
Aneurysm ; Bone Cysts ; Cholesterol ; Chondroblastoma* ; Femur ; Fibula ; Hemosiderin ; Histiocytes ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Patella ; S100 Proteins ; Ulna

BACKGROUND: Communication skill training during medical education, once considered a minor subject, is now ranked as a core clinical skill. OBJECTIVES: The purpose of this study is to evaluate the effectiveness of role play as a method for improving physician-patient communication during the dermatological clerkship. METHODS: Ninety eight senior medical students undergoing dermatological clerkship were included in this study. Initially, the students were briefly lectured on communication skills from a dermatologic professor and two students were randomly allocated for role play. The student in the patient's role was shown the history of the patient with common dermatological problems just before the role play. After the first role play, the patient and physician roles were interchanged and the new student in the patient's role was shown another patient's medical history for the same role play as mentioned above. Two other students were allocated for the third role play with another dermatological problem. A questionnaire survey was used by observing students and the professors to assess the communication skills of the students playing the physician roles in various aspects. After the role plays, the students were allocated to the dermatologic outpatient clinic and with patient consent, they saw real patients as true doctors and the professors evaluated their communication skills using the same questionnaires. RESULTS: As the role plays proceeded, the communication skills of the students were improved. In the outpatient clinic, the students showed better physician-patient communication than ever before. The improvement of communication skills in the outpatient clinic was clearly shown both in the students who had observed the role plays and in those who had performed the physicians' or patients'roles. CONCLUSION: Communication skills in medical students undergoing dermatologic clerkship can be effectively trained, and improved by use of role play.
Ambulatory Care Facilities ; Clinical Competence ; Education, Medical ; Humans ; Students, Medical ; Surveys and Questionnaires

OBJECTIVE: To evaluate the force, endurance and influencing factors for wheelchair propulsion in paraplegics using BTE work simulator, and to find out a better method improving fitness levels for the paraplegics. METHOD: Seventeen paraplegic men were enrolled for the study. Isometirc and isotonic strength and dynamic endurance levels for wheelchair propulsion were measured using BTE work simulator. Neurological and demographical characteristics of patients were collected by personal interviews and direct examinations. RESULT: The spinal cord injured level showed a significant correlation with dynamic endurance (r=0.503, p<0.05) but not with the isometric and isotonic strength. The total duration of wheelchair use showed a significant correlation with the isotonic strength (r=0.497, p<0.05), but not with the isometric strength and dynamic endurance. The age and outdoor activities or exercise time during one week showed no significant correlation. CONCLUSION: Spinal cord injured level positively correlated with dynamic endurance. Both cardiorespiratory effect and trunk balance may influence this correlation. The total duration of wheelchair use wasn't correlate with dynamic endurnace. It seems to be more advisable trunk balance training goes with dynamic endurance training in rehabilitation program.
Humans ; Male ; Rehabilitation ; Spinal Cord ; Wheelchairs*

Painful legs and moving toes syndrome (PLMT) is a rare syndrome characterized by pain in the lower extremities and involuntary movements of single or multiple toes. A 29-year-old woman with lumbosacral intervertebral disc herniation complained of bilateral foot pain and involuntary toe movements for three months. This is the first case of PLMT in a young adult patient with a lumbosacral intervertebral disc herniation in Korea.

No abstract available.
Chickenpox ; Herpesvirus 3, Human*