The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder of neuromuscular transmission that is frequently associated with malignancy, particulary small cell carcinoma of the lung. To our knowledge, there was no report of LEMS in Korean listeratures and this might be the first case in this country. The patient is a 55 year old man with muscle weakness and fatigability of proximal lower limbs for 2 months. Bronchogenic carcinoma is confirmed radiologically and pathologically. The electrophysiological studies suppert the clinical diagnosis of LEMS with (1) low amplitude of evoked compound muscle potential to a single supramaximal stimulus on nerve, (2) significant decremental response at low rates of stimulation and (3) marked incremental response at high rates of stimulation.
Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Diagnosis ; Humans ; Lambert-Eaton Myasthenic Syndrome* ; Lower Extremity ; Lung ; Middle Aged ; Muscle Weakness

Blindness or serious visual impairment is a common and well known sequela of methanol intoxication in man, while other manifestations such as focal neurological deficits and abnormal brain CT scan are reported rarely. We experienced a case of acute methanol intoxication, which showed not only visual impairment but also bulbar symptoms and characteristic bilateral symmetrical hypodensity area in basal ganglia, especially putamen on brain CT scan. We tried 'pulse therapy'-continuouis dripping of methyl prednisolone (Solumedrol 1gm/day) for 5 days-with transient improvement of visual impairment, but bulbar symptoms were stationary. One month later, visual impairment was recurred, and the 'pulse therapy' was tried again but without benefit. On follow-up brain CT scan, the size of previous hypodensity area in basal ganglia was decreased.
Basal Ganglia ; Blindness ; Brain* ; Bulbar Palsy, Progressive* ; Follow-Up Studies ; Methanol* ; Prednisolone ; Putamen ; Tomography, X-Ray Computed* ; Vision Disorders

Paroxymal nocturnal hemoglobinuria is a kind of intravascular hemolytic anemia due to acquired corpscular defects, and is not rare in this country. The corpscular defect is originated from hematopoietic stem cells, and white blood cells and platelets are also involved. Consequently, the major complications which might affect mortality and morbidity include thrombotic phenomena, especially hepatic and cerebral venous thrombosis. This is a case report of cerebral venous thrombosis with hemiparesis, seizure and change of consciousness in paroxysmal nocturnal hemoglobinuria accompanied by intravascular hemolysis. The diagnosis is confirmed by CT brain scan and cerebral angiography and the patient is effectively treated with antiplatelets, anticonvulsants and steroids.
Anemia, Hemolytic ; Anticonvulsants ; Brain ; Cerebral Angiography ; Consciousness ; Diagnosis ; Hematopoietic Stem Cells ; Hemoglobinuria ; Hemoglobinuria, Paroxysmal* ; Hemolysis ; Humans ; Leukocytes ; Mortality ; Paresis ; Seizures ; Steroids ; Venous Thrombosis*

No abstract available.
Anemia, Aplastic*

We experienced an autopsy case of esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies in a 4 days old male infant. Esophageal atresia with tracheoesophageal fistula was type C by Gross Classification. Combined anomalies were malrotation of left kidney, one left accessory renal artery form right renal artery and one left accessory renal vein from right renal vein, duodenal atresia and annular pancreas. Until now, the esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies (7 congenital anomalies) are not reported in the korean literature, except our case. Our autopsy case, it suggests that esophageal atresia with tracheoesophageal fistula has often close relation-ship with other multiple congenital anomalies.
Infant ; Male ; Female ; Humans

The purpose of educational effort for career planning in medical school is to help students develop identity as a competent physician and to assist them in selecting their future career properly. To achieve the above, the specific education programs for career plan together with an individual counselling and problem solving approach are required. We proposed an education model for career planning in Gachon Medical School which would be directed by cooperative system consisted of medical school, faculty mentor and student counselling office. Career education should not be limited to several lectures or short-term counselling, but it requires a continuous and consistent program implemented throughout 6 years of medical school life. At the same time, an opportunity to explore future career and to consult their problems in accord with needs and characteristics of individual students must be provided. Further study should be directed to examine the usefulness and problems of this education model. In addition, a persistent attention to the problems in career planning of medical students and efforts to solve them is needed.
Education* ; Humans ; Lectures ; Mentors ; Problem Solving ; Schools, Medical* ; Students, Medical

PURPOSE: The purpose of this study was to develop a comprehensive self-management program promoting self efficacy for Type 2 diabetic patients. METHODS: The study was a methodological research design in which previous related research was reviewed to develop the comprehensive self-management program promoting self efficacy using self efficacy theory. RESULTS: Comprehensive self-management programs promoting self efficacy included the whole range of eight self-management domains: diet, exercise, medication, self-testing of blood glucose, complication or foot, stress, time, and general health, and consisted of four sources of self efficacy: enactive mastery experience, vicarious experience, verbal persuasion, and physiological and affective states, as strategies to promote self efficacy. Developmental methods included, in addition to large and small group education, individual education or counseling, and telephone counseling. CONCLUSION: Further studies are needed in community health centers or hospitals to establish the effects on self-management compliance and glycemic control of the comprehensive self-management program promoting self efficacy.
Blood Glucose ; Community Health Centers ; Compliance ; Counseling ; Diabetes Mellitus, Type 2 ; Diet ; Foot ; Humans ; Persuasive Communication ; Research Design ; Self Care ; Self Efficacy ; Telephone

We report a rare case of delayed cement displacement after balloon kyphoplasty in patient with Kummell's desease. A 78-year-old woman with Kummell's desease at T12 level received percutaneous balloon kyphoplasty. Two months after surgery, the patient complained of progressive severe back pain. Computed tomographic scans revealed a breakdown of the anterior cortex and anterior displacement of bone cement. Although this complication is very rare, it is likely to occur in treatment of Kummell's desease accompanying anterior cortical defect.
Aged ; Back Pain ; Displacement (Psychology) ; Female ; Humans ; Kyphoplasty

PURPOSE: The aim of this study was to analyze the influence on voiding symptoms when performing sling operation on patients with stress urinary incontinence with detrusor underactivity. MATERIALS AND METHODS: We analyzed medical records of 100 patients who received the sling operation. Based on their preoperative urodynamic study, we defined "stress urinary incontinence with detrusor underactivity (SUI with DU)" group as these findings; peak flow less than 11 ml/s or void with abdominal pressure instead of detrusor contraction or residual urine volume more than 100 ml. And the others were defined as the "stress urinary incontinence only (SUI)"group. We compared two groups and analyzed the changes of pre- and postoperative uroflowmetry. RESULTS: The number of patients with the "SUI with DU" group was 30 and that with the "SUI" group was 70. In the "SUI with DU" group, there were no changes in peak flow rate and residual urine volume between postoperative uroflowmetry and preoperative urodynamic study (15.1 +/- 7.9 vs. 14.7 +/- 7.1 ml/s, 123.1 +/- 79.2 vs. 127.3 +/- 91.9 ml) (p>0.05). Twenty four patients underwent urinary drainage with nelatone catheter either on postoperative first or second day. However, 22 patients did not need to continue self catheterization. CONCLUSION: Sling operation could be performed on patients who are diagnosed as stress urinary incontinence with detrusor underactivity without aggravating their voiding symptoms.
Catheterization ; Catheters ; Drainage ; Humans ; Medical Records ; Urinary Incontinence* ; Urination Disorders ; Urodynamics

PURPOSE: We compared the recovery periods in zoster-associated voiding dysfunction according to the treatment modality to establish the best treatment policy. MATERIALS AND METHODS: From January 2004 to August 2006, medical records of 250 patients admitted for zoster infection were reviewed. Of 250 patients, patients complaining of lower urinary tract symptoms(LUTS) were selected. The clinical and urodynamic features, and treatment outcomes were analyzed. RESULTS: Thirty eight(15.2%) of 250 patients had zoster-associated LUTS. Urinary retention was the most common symptom. Urodynamically, detrusor underactivity was the most common finding(71.8%). Twenty were followed, of which 5 received oral medication, 10 received clean intermittent catheterization(CIC), 4 received indwelling catheterization(IC) and remained 1 was observed without treatment. All patients regained normal voiding function. Mean recovery period was 12 days. According to the treatment modality, mean recovery period was 21 days in medication group, 10 days in CIC group, and 6 days in IC group. The mean recovery period was significantly shorter in CIC or IC group than medication group(p=0.013, 0.005). CONCLUSION: Zoster-associated voiding dysfunction is a reversible condition. Thus, patients with mild symptoms can be observed. However, if symptoms are severe or retention develops, catheterization is recommended rather than medication alone.
Catheterization ; Catheters ; Herpes Zoster ; Humans ; Medical Records ; Urinary Retention ; Urinary Tract ; Urination ; Urodynamics