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

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

No abstract available.
Anemia, Aplastic*

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*

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

No abstract available.
Carcinoma, Renal Cell*

Dorsal extradural migration of extruded disc material is clinically uncommon. We report a rare case of posterior epidural migration of an extruded lumbar disc mimicking a facet cyst. A 32-year-old man was admitted to our institute with a 2-week history of severe low back pain and radiating pain in the left leg. The magnetic resonance (MR) images revealed a dorsally located, left-sided extradural cystic mass at the L2-3 level. The initial diagnosis was an epidural facet cyst because of the high signal intensity on MR images and its location adjacent to the facet joint. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was observed and excised. The pathological diagnosis was degenerated disc material. After surgery, the patient experienced complete relief from leg pain.
Adult ; Diagnosis ; Humans ; Leg ; Low Back Pain ; Zygapophyseal Joint

PURPOSE: To compare the effect of breast milk containing fortifier with preterm formula on bone mineral metabolism in premature infants, we evaluated the state of bone mineralization, biochemical alteration and the frequency of rickets during the first five months of life. METHODS: Fourteen fortified breast milk-fed infants and eleven preterm formula-fed infants who were born at Il-Sin Christian Hospital from August, 1996 through July, 1997, were studied. The breast milk-fed group received human milk fortifier. The intake of Ca, P, Mg, protein, and fat was calculated at one month of age. Birth weight and weight at one, two and five months of age were measured. Serum Ca, P, alkaline phosphatase and 25-hydroxyvitamine D were measured at one month of age, and the wrist received X-ray examinations monthly. Total body bone mineral content was measured by Dual energy X-ray absorptiometry (Lunar WI) at two and five months of age. RESULTS: The two groups were similar in birth weight, gestational age, and weight at one, two and five months of age. Enteral Ca, P, protein, Mg, and fat intake, and urinary excretion of Ca, P were similar among the two groups. Serum Ca, P, ALP and 25-hydroxyvitamin D were not different. Occurrence of rickets and bone mineral content were similar among the two groups. CONCLUSION: Fortified breast milk-fed infants and preterm formula-fed infants showed no difference in total body bone mineral content and occurrence of rickets. Ultimately, we could enhance the advantage of breast milk fed to premature infants by adding fortifier.
Absorptiometry, Photon ; Alkaline Phosphatase ; Birth Weight ; Bone Density ; Breast ; Calcification, Physiologic ; Gestational Age ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Metabolism* ; Milk, Human* ; Rickets* ; Wrist