Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.
Arthropathy, Neurogenic ; Diagnosis ; Edema ; Joints ; Radiography ; Range of Motion, Articular ; Rare Diseases ; Shoulder* ; Syringomyelia*

PURPOSE: This study investigated the attitudes of medical students toward physicians and the roles which the doctors and patients should play in the health care process. METHODS: Attitudes toward the patient-doctor relationship of 436 medical students of the K university in Seoul were measured using the Patient-Practitioner Orientation Scale(PPOS), a validated instruments designed to measure individual preferences toward various aspects of the patient-doctor relationship. The PPOS was composed of Sharing(sharing information, take part in decision making) and Caring(respect one's feelings, interpersonal relationship) subscale. Total PPOS scores can range from patient-centered(egalitarian, whole person oriented) to disease- or doctor-centered(paternalistic, less attuned to psychosocial issues). Socio-demographic data including gender, age, school year, marital status, undergraduate major, student's and her/his family medical background and specialty choice were collected and it was investigated the possible impact of socio-demographic factors on students' attitudes. RESULTS: The PPOS score was 3.82. The Sharing and Caring scores were 3.74 and 3.90, respectively. Female gender and students of graduate entry program were significantly associated with patient-centered attitudes. Age, school year, marital status, academic background, student's and her/his family medical background, and specialty choice did not show significant associations with PPOS scores. CONCLUSION: Female and graduate students showed more patient-centered attitudes than male and undergraduate students, respectively. Given the emphasis placed on patient-centered care in the current medical environment, our results suggest further research to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centered care.
Delivery of Health Care ; Education, Medical ; Female ; Humans ; Male ; Marital Status ; Patient-Centered Care ; Seoul ; Students, Medical

OBJECTIVES: Dance therapy can be applied as one of various psychiatric rehabilitation programs in clinical situations. This study was aimed to investigate applicability of dance therapy to schizophrenic outpatients, in regard to improving social adjustment and quality of life for these patients. METHODS: Twenty one psychiatric outpatients enlist who met DSM-IV criteria for schizophrenia were studied. We conducted dance therapy session once a week, totally 8 sessions. The assessments were done before and after dance therapy. Patients reported Self & Others Representation Inventory-Adjective Checklist (SORI), Self-esteem Scale, and Relationship Change Scale (RCS) and Doctors assessed Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), and Quality of Life Scale (QoLS) in interview. RESULTS: After 8 sessions of dance therapy, patients showed significant improvements in sociability in SORI, satisfaction, intimacy, sensitiveness, openness, comprehensiveness in RCS, and significant decrease of symptoms in BPRS, SANS. QoLS also was improved significantly. There was no significant change in Self-esteem Scale. CONCLUSION: These results suggested that dance therapy could be applied to schizophrenic outpatients in clinical situations, and it helped to improve self-representation, interpersonal relationship, and quality of life.
Brief Psychiatric Rating Scale ; Checklist ; Dance Therapy ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Outpatients ; Quality of Life ; Schizophrenia ; Social Adjustment

Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.
Arthropathy, Neurogenic ; Diagnosis ; Edema ; Joints ; Radiography ; Range of Motion, Articular ; Rare Diseases ; Shoulder ; Syringomyelia

OBJECTIVES: The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. METHODS: The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. RESULTS: The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence (CMA > or =80%) rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. CONCLUSIONS: The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
Adult ; Aged ; Antihypertensive Agents/*administration & dosage ; Comorbidity ; Disabled Persons/*statistics & numerical data ; Drug Utilization ; Female ; Health Services Accessibility ; Humans ; Insurance Claim Review ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; National Health Programs ; Patient Compliance/*statistics & numerical data ; Residence Characteristics ; Socioeconomic Factors

Objectives: This study examined the influence of adult attention-deficit/hyperactivity disorder (ADHD) and insomnia on the risk of unintentional minor musculoskeletal injuries (UMMI). Methods: A prospective observational study was carried out in a single unit of the army in South Korea. One hundred and seventy-seven subjects participated in the study. The Adult ADHD SelfReport Scale (ASRS-v1.1) and Insomnia Severity Index (ISI) was used to screen. The risk of UMMI during one-week winter ranger training was investigated. Results: All subjects were male and aged 21.75 (standard deviation 1.5). Approximately 9.6% of subjects had clinically relevant adult ADHD symptoms. Subjects with ADHD had a higher stress index and higher rates of insomnia than those without symptoms. After adjusting for age, rank, service months, obesity, history of UMMI, sleep time, and risk of the task, the ADHD group was 4.90 times more likely to have UMMI than the control group. Insomnia increased the risk of UMMI 8.14 fold. Conclusion These results suggest that an evaluation and intervention for adult ADHD and insomnia should be made in people engaged in other tasks that may result in UMMI.

Objective: Maumgyeol Basic service is a mental health evaluation and grade scoring software using the 2 channels EEG and photoplethysmogram (PPG). This service is supposed to assess potential at-risk groups with mental illness more easily, rapidly, and reliably. This study aimed to evaluate the clinical implication of the Maumgyeol Basic service. Methods: One hundred one healthy controls and 103 patients with a psychiatric disorder were recruited. Psychological evaluation (Mental Health Screening for Depressive Disorders [MHS-D], Mental Health Screening for Anxiety Disorders [MHS-A], cognitive stress response scale [CSRS], 12-item General Health Questionnaire [GHQ-12], Clinical Global Impression [CGI]) and digit symbol substitution test (DSST) were applied to all participants. Maumgyeol brain health score and Maumgyeol mind health score were calculated from 2 channel frontal EEG and PPG, respectively. Results: Participants were divided into three groups: Maumgyeol Risky, Maumgyeol Good, and Maumgyeol Usual. The Maumgyeol mind health scores, but not brain health scores, were significantly lower in the patients group compared to healthy controls. Maumgyeol Risky group showed significantly lower psychological and cognitive ability evaluation scores than Maumgyeol Usual and Good groups. Maumgyel brain health score showed significant correlations with CSRS and DSST. Maumgyeol mind health score showed significant correlations with CGI and DSST. About 20.6% of individuals were classified as the No Insight group, who had mental health problems but were unaware of their illnesses. Conclusion This study suggests that the Maumgyeol Basic service can provide important clinical information about mental health and be used as a meaningful digital mental healthcare monitoring solution to prevent symptom aggravation.

PURPOSE: The purpose of the study was to examine the recording accuracy of faculty observers and standardized patients (SPs) on a clinical performance examination (CPX). METHODS: This was a cross-sectional study of a fourth-year medical students' CPX that was held at a medical school in Seoul, Korea. The CPX consisted of 4 cases and was administered to 118 examinees, with the participation of 52 SP and 45 faculty observers. For the study we chose 15 examinees per case, and analyzed 60 student-SP encounters in total. To determine the recording accuracy level, 2 SP trainers developed an answer key for each encounter. First, we computed agreement rates (P) and kappa coefficient (K) values between the answer key-SPs and the answer key-faculty observers. Secondly, we analyzed variance (ANOVA) with repeated measures to determine whether the mean percentage of the correct checklist score differed as a function of the rater, the case, or the interaction between both factors. RESULTS: Mean P rates ranged from 0.72 to 0.86, while mean K values varied from 0.39 to 0.59. The SP checklist accuracy was higher than that of faculty observersat the level of item comparison. Results from ANOVA showed that there was no significant difference between the percentage of correct scores by the answer key, faculty observers and SPs. There was no significant interaction between rater and case factors. CONCLUSION: Acceptable levels of recording accuracy were obtained in both rater groups. SP raters can replace faculty raters in a large-scale CPX with thorough preparation.
Checklist ; Clinical Competence ; Cross-Sectional Studies ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Korea ; Observer Variation ; Schools, Medical

PURPOSE: This study aims to explore which coping strategies medical students use more often, and how coping styles account for medical students' subjective well-being. METHODS: Subjects included 249 medical students from undergraduate and Graduate Entry Programme of a medical school in Seoul, Korea. Coping style was measured using the Ways of Coping Checklist. Subjective well-being was measured with Positive/Negative Affect Scale and Satisfaction with Life Scale. Analysis of Variance(ANOVA) was used to compare four coping strategies, and stepwise multiple regression was used to analyze the accountability of each of the coping strategy for subjective well-being. RESULTS: Medical students used avoidance and problem-focused coping strategy more often than they used emotion-focused coping strategy and seeking social support. Graduate Entry Programme students used avoidance less often and seeking social support more often than undergraduate students. Among subscales of subjective well-being, positive affect can be accounted for by problem-focused coping and seeking social support, and negative affect can be accounted for by problem-focused coping and avoidance. Life satisfaction can be accounted for by problem-focused coping as well. CONCLUSION: The results of this study showed that medical students had high adaptability as well as strong anxiety toward stressful situations in medical school. Moreover, three among the four coping strategies accounted for medical students' subjective well-being. These findings should be considered as a baseline for future research looking into additional variables affecting medical students' well-being.
Anxiety ; Checklist ; Education, Medical ; Humans ; Korea ; Schools, Medical ; Seoul ; Social Responsibility ; Students, Medical*

OBJECTIVE: The mGluR1 (metabotropic glutamate receptor 1) gene, a G protein–coupled receptor, is known to mediate perceptions of umami tastes. Genetic variation in taste receptors may influence dietary intake, and in turn have an impact on nutritional status and risk of chronic disease. We investigated the association of mGluR1 rs2814863 polymorphism with lipid profiles and cardiovascular disease (CVD) risk, together with their modulation by macronutrient intake in Korean adults. METHODS: The subjects consisted of 8,380 Koreans aged 40-69 years participating in the Anseong and Ansan Cohort Study, which was a part of the Korean Genome Epidemiology Study (KoGES). Data was collected using self-administered questionnaires, anthropometric measurements, and blood chemical analysis. RESULTS: Carriers of C allele at mGluR1 rs2814863 was associated with decreased high density lipoprotein cholesterol (HDL-C) and increased triglyceride as compared to carriers of TT. Also, carriers of the C allele showed higher fat intake and lower carbohydrate intake than those with carriers of TT. After adjustment for multiple testing using false-discovery rate method, the significant difference of HDL-C, triglyceride, dietary fat, and carbohydrate across genotypes disappeared. Gene-diet interaction effects between rs2814863 and macronutrients intake were not significantly associated with HDL-C and triglyceride levels. However, carriers of C allele demonstrated significantly higher odds of CVD {odds ratio=1.13, 95% CI=1.02-1.25} compared with carriers of TT. CONCLUSIONS: Our findings support significant associations between the mGluR1 rs2814863 genotype and CVD-related variables in Korean adults. However, these associations are not modified by macronutrient intake.
Adult* ; Alleles ; Blood Chemical Analysis ; Cardiovascular Diseases* ; Cholesterol, HDL ; Chronic Disease ; Cohort Studies ; Dietary Fats ; Epidemiology ; Genes, vif ; Genetic Variation ; Genome ; Genotype ; Gyeonggi-do ; Humans ; Methods ; Nutritional Status ; Polymorphism, Single Nucleotide ; Receptors, Glutamate ; Receptors, Metabotropic Glutamate* ; Triglycerides