Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. Males in bulimia account for 10-15% of all bulimic patients. There are many methods of treatment, including drug therapy, or psychotherapy. Among them cognitive behavior therapy is reported to be the most effective method of improving the binge eating behavior and the cognitive distortion about body weight and body image. In this case, a male bulimic patient, who was hospitalized in the closed ward involuntarily, was treated with modified Fairburn's cognitive behavior therapy model. After 6 weeks of treatment, binge eating and self-induced vomiting behaviors were controlled and weight gain was nearly successful.
Body Image ; Body Weight ; Bulimia Nervosa* ; Bulimia* ; Cognitive Therapy* ; Drug Therapy ; Female ; Humans ; Male* ; Psychotherapy ; Vomiting ; Weight Gain

The androgen insensitivity syndrome is a heterogeneous disorder with a wide spectrum of phenotypic abnormalities, ranging from complete female to ambiguous forms that more closely resembles males. Mutations of the androgen receptor gene are responsible for a variable degree of impaired androgen action. The complete androgen insensitivity syndrome is characterized by normal female external appearance in spite of the normal male karyotype 46XY with testes and normal testosterone production and metabolism. This is transmitted by X-linked recessive manner. Wolffian duct does not develop. However, m llerian development does not occur in presence of antim llerian hormone activity. Recently we experienced a case of complete androgen insenditirity syndrome. We reported a case with concerned literatures.
Androgen-Insensitivity Syndrome* ; Female ; Humans ; Karyotype ; Male ; Metabolism ; Receptors, Androgen ; Testis ; Testosterone ; Wolffian Ducts

OBJECTIVE: This study was to analyze the characteristics of work-related carpal tunnel syndrome, as listed by the Korea Labor Welfare Corporation (KLWC). METHOD: Using the database of the KLWC, 163 approved work-related carpal tunnel syndrome cases were collected, which occurred between 1st, 2000 and 31th, 2002. Investigations were conducted by mail survey and interviews. RESULTS: Women accounted for 57.1%. The mean age and disease-related working duration were 44.7 years and 6.7 years, respectively. The most common industrial type of enterprise was manufacturing (104 workers) and the most common job was craft and related trades (51 workers), respectively. The most common cause of disease was repetitive work (104 workers). The duration between job starting and occurrence of disease was shorter in excessive force (5.5 years), women (5.7 years), non-manufacturing industries (4.4 years), and elementary occupations (5.0 years) than those having bad posture (14.8 years), men (8.2 years), manufacturing (8.1 years) and craft and related trades (8.7 years), respectively. CONCLUSION: Through this study, we elucidated certain characteristics of workers such as age, sex, working duration and high risk groups (women, workers at small scale industries and at non-manufacturing industries and excessive- forced work) with approved occupational carpal tunnel syndrome.
Accidents, Occupational* ; Carpal Tunnel Syndrome* ; Compensation and Redress* ; Female ; Humans ; Insurance* ; Korea ; Male ; Occupational Diseases ; Occupations ; Postal Service ; Posture

The osteopoikilosis is commonly known as harmatoma in which metaphyseal and epiphyseal area of long bones and the bone of pelvis, hands, feet and et al, contain islands of dense cortical bone with normal Harversian system without any symptoms. The radiologic findings of the osteopoikilosis is multitude of oval or well-circumscribed areas of increased density, 2 to 10 mm in size, in symmetrical distribution and normal uptake in bone scan. Buschke-Ollendorff syndrome, which is transmitted by autosomal dominant, is characterized by the association of osteopoikilosis and connective tissue nevi which are popular and symmetrically distributed lesions on chest, back, buttock, thigh or arm. Authors report three Buschke-Ollendorff syndrome, studied by CT scan, MRI, bone scan and bone and skin biopsy, among five patients associated with osteopoikilosis found by simple radiologic study from ten members in one family with their pedigree.
Arm ; Biopsy ; Buttocks ; Connective Tissue ; Foot ; Hand ; Humans ; Islands ; Magnetic Resonance Imaging ; Nevus ; Osteopoikilosis ; Pedigree ; Pelvis ; Skin ; Thigh ; Thorax ; Tomography, X-Ray Computed

PURPOSE: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of Tc(99m) DISIDA scan and presence of acholic stool. METHODS: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent Tc(99m) DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. RESULTS: Patients who had negative intestinal activity on Tc(99m) DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on Tc(99m) DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on Tc(99m) DISIDA scan. The result of Tc(99m) DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on Tc(99m) DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on Tc(99m) DISIDA scan showed higher serum level of ALT. CONCLUSION: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.
Biliary Atresia ; Bilirubin ; Biopsy ; Cholestasis* ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Liver ; Radionuclide Imaging* ; Retrospective Studies

OBJECTIVES: The current Korean Mental Health Act (KMHA) indicates that a patient, who voluntarily gave their permission for admission into a mental health facility, has the right to be discharged upon personal request. However, there is no clause in the KMHA that allows a change in a patient's voluntary status under special circumstances. The purpose of this study was to investigate problems that may arise from the lack of such a clause ; problems that can result in misinterpretation and lead to the prohibition of voluntary admission status conversion. METHODS: Previous cases presented to the National Human Rights Commission of Korea were investigated in order to determine the current state in Korean psychiatric practice regarding the conversion from voluntary to involuntary admission status. In addition, examples of similar mental health legislation in use by the United Nations (UN), World Health Organization (WHO), and several advanced countries pertaining to such conversions were investigated. These examples were used as models for making recommendations for possible changes to the KMHA. RESULTS: From 2010 to 2014, more than 220 petitions were filed with the National Human Right Commission of Korea. The petitions involved voluntarily institutionalized patients who had their requests for discharge rejected. Based on mental health regulations of the UN, WHO, and such countries as the United States, England, Canada, Australia, and Japan, the KMHA should include a provision that, upon receiving a discharge request, allows for discharge refusal if the voluntarily admitted patient is considered not mentally fit. CONCLUSION: The results suggest that the absence of a regulation allowing admission status conversion in the current KMHA is inappropriate. Rectification of this absence is urgently needed.
Australia ; Canada ; England ; Human Rights ; Humans ; Japan ; Korea ; Mental Health ; Patient Admission ; Social Control, Formal ; United Nations ; United States ; World Health Organization

PURPOSE: To evaluate the cause of asymptomatic bacteriuria (AB) or aseptic pyuria (AP) on physiologic phimosis and to evaluate the effect of topical steroid therapy and preputial hygiene on the resolution of AB and AP. METHODS: Ninety uncircumcised boys (age 1-72 month, median 16 month) with AB or AP were examined for physiologic phimosis and allocated by the preputial retractibility into the non-retractile group (n=59) or the retractile group (n=31). Topical steroid therapy [topical application of hydrocortisone (0.1%) cream with physiotherapy] were prescribed (three times a day) and the method of preputial hygiene (gentle retraction of prepuce and water cleansing) was instructed to the non- retractile group . After 2-4 weeks, the preputial retractibility was reevaluated and urine examination was repeated. To the retractile group, only the method of preputial hygiene was instructed and urine examination was repeated two weeks later. RESULTS: Among 90 boys with AB and AP, 65.6% (59/90) had the nonretractile prepuces and nonperformed preputial hygiene. In the nonretractile group, the prepuces became retractile in 81.4 % (48/59) after topical steroid therapy. Among boys (n=48) whose prepuces became retractile after topical steroid therapy, AB or AP resolved in 77.1%, decreased in 18.7% and persisted in 4.2%, which were significantly different to 18.2%, 2.37%, 54.5% in boys (n=11) whose prepuces were persistently nonretractile (P=0.0114). In the retractile group (n=31), 65.2% was compliant to preputial hygiene. In boys (n=23) who were compliant to preputial hygiene, AB or AP resolved in 65.2%, decreased in 26.0% and persisted in 8.2%, which were significantly different to 12.5%, 50%, 37.5% in boys (n=8) who were not compliant (P=0.0457). CONCLUSION: Physiologic phimosis was an important cause of AB or AP. Simple topical steroid therapy on the nonretractile prepuces and good preputial hygiene could improve AB or AP.
Bacteriuria ; Female ; Hydrocortisone ; Hygiene ; Phimosis ; Pyuria ; Water

Ultrasound is over 20 khz, which represents the upper frequency limit of human hearing. Acoustic vibrations are generated when piezoelectric materials on the thin disc-shaped transducers expand and contract. Although low frequency ultrasound devices have been used widely in the dermatologic area for a long time, the mechanism and side effects have been overlooked. A low-frequency ultrasound device has many benefits on the cosmetic dermatology area by thermal effect, vibration effect, and increase of transdermal delivery of lipophilic drugs or cosmetics. However, there have been reports of dermatitis, dyspnea, dizziness, and burns after treatment with ultrasound. Therefore, the use of this device should be under a doctor's supervision.
Acoustics ; Burns ; Contracts ; Cosmetics ; Dermatitis ; Dermatology ; Dizziness ; Dyspnea ; Hearing ; Humans ; Organization and Administration ; Transducers ; Ultrasonics ; Vibration

PURPOSE: This paper aims at reporting and examining the experiences of medical ethics education with case-based learning and large-group discussion. METHODS: The subjects were a group of 100 students in the third year medical student. The medical ethics course was designed to minimize unidirectional lectures and to maximize interactive work with a large group at the classroom utilizing cases as teaching material. In the middle of the course, all students were divided into small group of 4~5 members. Each group was to find and, based upon group discussion, analyze each different case containing ethical dilemma, and present it as a midterm report. To examine the effectiveness of case based learning in medical ethics education in a large classroom, the authors analyze the students' feedback and evaluation delivered in survey questionnaires from 94 out of 96 students. RESULTS: Students' feedback showed that small-group discussion, interactive work in a classroom, and case-based studies were effective as well as practicable for medical ethics education for a large group.
Education* ; Ethics, Medical* ; Humans ; Learning* ; Lectures ; Students, Medical ; Teaching Materials ; Surveys and Questionnaires

OBJECTIVES: To explore the possibilities of finding a heritable phenotype(s) in patients with psychosis, we examined the similarities of clinical variables between psychotic sibling patients who share the half of genetic information. METHODS: We recruited a group of sibling patients, whose diagnoses were schizophrenia, schizoaffective disorder and bipolar disorder and confirmed the diagnosis using SCID-RV(Structured Clinical Interview for DSM-IV, Research Version). Using 30 sets of sibling patients, we examined concordances or similarities of diagnosis, diagnostic subtypes, clinical symptoms, and longitudinal outcomes. RESULTS: There were significant concordances in terms of age of onset, auditory hallucination persisted for more than 7 years, general level of functioning. No significant similarities or concordances were found in diagnosis, diagnostic subtypes, delusion, negative symptom, and thought disorder between sibling patients. CONCLUSION: Above mentioned similarities have the possibilities of genetically determined phenotypes that could be used in the future genetic studies. Concordance of hallucination persisted for more than 7 years, not the presence or absence of auditory hallucination between sibling patients suggests that it is more important to examine longitudinal patterns of symptoms than to merely examine the presence of symptoms at specific cross-sectional time points in terms of genetic studies.
Age of Onset ; Bipolar Disorder ; Delusions ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Hallucinations ; Humans ; Phenotype ; Psychotic Disorders* ; Schizophrenia ; Siblings*