Diabetic muscle infarction (DMI), also known as diabetic myonecrosis, is a rare complication of diabetes mellitus (DM); hence, it is often underdiagnosed. Thus, timely diagnosis and treatment are essential for a better prognosis. We describe a 24-year-old woman with Prader-Willi syndrome and an 8-year history of uncontrolled type 2 DM, who presented with a sudden onset of fever and subacute painful swelling of her left thigh. She was finally diagnosed with DMI based on magnetic resonance imaging and muscle biopsy after excluding other infectious and inflammatory diseases of proximal muscles. The patient was treated with bed rest, strict glycemic control, and analgesics, and her symptoms gradually resolved. DMI should be considered in the differential diagnosis of patients with poorly controlled DM, who present with subacute pain and swelling of lower extremity muscles, without a history of trauma.

Diabetic muscle infarction (DMI), also known as diabetic myonecrosis, is a rare complication of diabetes mellitus (DM); hence, it is often underdiagnosed. Thus, timely diagnosis and treatment are essential for a better prognosis. We describe a 24-year-old woman with Prader-Willi syndrome and an 8-year history of uncontrolled type 2 DM, who presented with a sudden onset of fever and subacute painful swelling of her left thigh. She was finally diagnosed with DMI based on magnetic resonance imaging and muscle biopsy after excluding other infectious and inflammatory diseases of proximal muscles. The patient was treated with bed rest, strict glycemic control, and analgesics, and her symptoms gradually resolved. DMI should be considered in the differential diagnosis of patients with poorly controlled DM, who present with subacute pain and swelling of lower extremity muscles, without a history of trauma.

To introduce an OEM course of problem-based learning(PBL) on tutorial basis, we developed the case-studies on both clinical and community contexts. The 2nd grade medical students were divided into eight small groups. The case-study course was for 3 weeks from September 30 to October 14 in 1998. There were 3 steps for design of case-study course : course planning, implementation, and evaluation which were conducted by 3 tutors and 91 students. We developed 32 cases, and a student solved 3 clinical cases during 3 weeks. There were 3 cases which were the case I(metals), the case II(solvent) and the case III(systemic toxicity). The case-study program was evaluated with questionnaire survey method at the start and end of the course by students. We obtained satisfactory responses from students. Multiple-choice tests revealed that students in case-study group had significantly(P<0.05) higher score than those attended the standard lecture. We concluded that problem-based learning with specific occupational contents is well accepted by students and improves their occupational medicine knowledge.
Surveys and Questionnaires ; Humans ; Occupational Medicine ; Problem-Based Learning* ; Students, Medical

OBJECTIVE: To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. METHODS: The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. RESULTS: Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. CONCLUSION: Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.
Arm ; Electrodes ; Electroencephalography ; Humans ; Neuropsychological Tests ; Pilot Projects* ; Prefrontal Cortex* ; Rehabilitation* ; Seoul ; Stroke*

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

PURPOSE: To evaluate the significance of high signal intensity of the septum pellucidum in hydrocephalus on proton density-weighted brain MR images. MATERIALS AND METHODS: Authors reviewed the MR images of 418 cases of patients with normal(175 cases), hydrocephalic(35 cases), atrophic(58 cases), and other groups(150 cases) retrospectively. We analyzed the signal intensity of the septum pellucidum in the normal group and the incidences of high signal intensities of periventricular area of frontal horn of lateral ventricle(area 1), periventricular area except area 1(area 2), callososeptal area(area 3), and septum pellucidum(area 4) in the normal and abnormal groups. RESULTS: In the normal group, the septurn pellucidum was isointense to the head of caudate nucleus on proton density-weighted image. High signal intensity of the septurn pellucidurn was seen in 31 cases (22 cases of hydrocephalus, 5 cases of brain atrophy, and 4 cases of others), and showed high specificity(91.4%) for hydrocephalus in spite of low sensitivity(62.9%), as compared with periventricular hyperintensities of other areas. CONCLUSION: High signal intensity of the septum pellucidum on proton density-weighted image may be caused by transependymal CSF migration in the patients with hydrocephalus, and considered as an additional finding of hydrocephalus in the cases of ventriculomegaly.
Animals ; Atrophy ; Brain ; Caudate Nucleus ; Head ; Horns ; Humans ; Hydrocephalus* ; Incidence ; Protons ; Retrospective Studies ; Septum Pellucidum*

OBJECTIVE: In order to compare and find the HRQOL and it's determinants among occupationally injured workers, TA patients and general workers, we performed a crosssectional study in Masan and Changwon city, Korea. METHODS: Cases were 169 occupationally injured workers who admitted in the hospital, and controls were 78 TA patients who admitted in the hospital and 166 general workers who worked at Ulsan industrial area. HRQOL were measured by SBQOL. We investigated confounding variables which were age, sex, marital status, employment status, family numbers, monthly income, diagnosis, treatment duration, expectation for health recovery, and expectation for return to work. We compared the HRQOL among occupationally injured workers, TA patients and general workers. We made four factors from twenty three items by factor analysis and used multiple logistic regression to find determinants on HRQOL in each group. RESULTS: There were significant differences in HRQOL between case and control. The main determinants on HRQOL from multiple logistic regression varied in each group. In occupationally injured workers, age(OR 2.73), treatment duration(> 6 months) (OR 3.09) and expectation for return to work(OR 2.62) were main determinants for HRQOL. And age(OR 1.07), marital status(OR 7.41), family members(OR 5.73), expectation for health recovery(OR 4.23) in TA patients. However, monthly income (<1,300,000 won)(OR 1.76) were main determinants for HRQOL in general workers. CONCLUSION: Return to work is major determinants of HRQOL for occupationally injured workers.
Confounding Factors (Epidemiology) ; Diagnosis ; Employment ; Gyeongsangnam-do ; Humans ; Korea ; Logistic Models ; Marital Status ; Occupational Injuries ; Occupations* ; Quality of Life* ; Return to Work ; Ulsan

Leiomyosarcoma(LMS) is a malignant tumor from smooth muscle origin that arises most commonly in the gastrointestinal tract and uterus, but rarely in the oral and maxillofacial area which lacks smooth muscles. 63 cases of oral LMS have been reported, especially LMS that occurred in the mandibular gingiva is only 2 cases. Major symptom of oral LMS is painful or painless swelling. Besides it, oral LMS has no specific characteristics. So it is difficult to diagnose the case as LMS of the oral cavity. Certain cases report that LMS of the oral cavity was misdiagnosed as periodontitis and the patients were treated with unnecessary procedures. Conventional treatment of LMS is the radical surgical excision. LMS that is infiltrative and very malignant has poor prognosis despite of well-circumscribed boundary. LMS of the oral cavity is often recurred, has high rate of distant metastasis and 5-year-survival rate is as low as 23%. This article reports LMS of the mandibular gingiva that treated with surgical intervention, had local recurrence and metastasis to the lymph node after 16-month's follow-up examination.
Follow-Up Studies ; Gastrointestinal Tract ; Gingiva* ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Mouth ; Muscle, Smooth ; Neoplasm Metastasis ; Periodontitis ; Prognosis ; Recurrence ; Unnecessary Procedures ; Uterus

PURPOSE: The purpose of this study was to establish the guidelines for normal splenic length by sonographic measurement. MATERIALS AND METHODS: In 481 children (age range : 2-16years, M:F=1.5:1), abdominal sonography for the purpose of health screening was carried out, and the greatest length of spleen between the dome and tip was measured. Correlation and regression analysis was used to determine whether the relationship between splenic length and a patient's age, height, weight and body surface was statistically significant. RESULTS: The length of the spleen gradually increased according to age. Correlation and regression analysis showed significant positive correlation (p<0.0001) between splenic length and age (r=0.610) height (r=0.630), weight (r=0.598), and body surface (r=0.628). CONCLUSION: From the mean values of spleen length in children, an index useful for clinical application might be derived.
Child* ; Humans ; Mass Screening ; Spleen* ; Ultrasonography*

OBJECTIVE: This study is designed to investigate whether early surgery can result in a better outcome for seizure control and brain development in pediatric patients with intractable epilepsy. METHODS: Preoperative evaluation methods for surgery included history taking, neurological examination, chronic video-EEG monitoring with surface and subdural grid electrodes, magnetic resonance image(MRI), 3-dimensional surface rendering with MRI, PET and SPECT. The Denver Developmental Screening Test II, and the Full Scale Intelligence Quotient(FSIQ) were evaluated for developmental status before and after surgery. Seizure outcome was classified according to Engel's classification. Surgical procedures included temporal lobectomy in four subjects, extratemporal resection in 14, callosotomy in one and tumor removal in one. RESULTS: Seizure outcomes were class I in 11 patients(55%), class II in three(15%), class III in 4(20%) and class IV in two(10%). Under the age of 6 years, the preoperative average developmental delay was 12.4 months. Postoperatively, two of them caught up to their normal developmental status. Over the age of 6 years, the preoperative average FSIQ was 87.5 and the postoperative average FSIQ was 103.3. CONCLUSION: In pediatric patients with intractable epilepsy, the early surgical treatment is very helpful in the normalization of their brain function.
Brain ; Classification ; Electrodes ; Epilepsy* ; Humans ; Intelligence ; Magnetic Resonance Imaging ; Mass Screening ; Neurologic Examination ; Seizures ; Tomography, Emission-Computed, Single-Photon