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

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

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

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

BACKGROUND: Oral isotretinoin is an effective treatment modality for acne, but this agent may cause dryness of the skin and mucous membrane. Gamma-linolenic acid (GLA) has been known to improve skin moisture and reduce transepidermal water loss (TEWL). It is also known to have anti-inflammatory effects and to inhibit 5-alpha reductase. OBJECTIVE: This study was performed to evaluate the clinical efficacy of GLA in the prevention of xerosis and improvement of acne lesions after concomitant administration of isotretinoin. METHODS: In this prospective study, 102 Korean acne patients were enrolled and randomized to receive isotretinoin either with or without GLA for 12 weeks. Comparing evaluations included skin hydration, TEWL, visual analogue scale (VAS) score for dryness of the lips and skin, number of acne lesions such as comedos, papules, and pustules, Korean acne grading system (KAGS) grade, and patient satisfaction regarding treatment. RESULTS: The decrease of skin hydration and increase of the TEWL of the lips and cheek were less definite in the experimental group than those of the control group. VAS score for dryness of the lips and skin was significantly lower in the experimental group compared with the control group. The number of acne lesions decreased in both groups; only the numbers of papules were different between the two groups. The decrease of the KAGS grade was more definite in the experimental group than that in the control group. CONCLUSION: This study suggests that GLA could be used effectively for the improvement of acne lesions as well as for the prevention of xerosis.
Acne Vulgaris* ; Cheek ; gamma-Linolenic Acid* ; Humans ; Isotretinoin* ; Lip ; Mucous Membrane ; Oxidoreductases ; Patient Satisfaction ; Prospective Studies ; Skin

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: 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

PURPOSE: The purpose of this study was to investigate the use of an AED by 119 rescuers in prehospital cardiac arrest. METHODS: 132 patients who experienced prehospital cardiac arrest and was defibrillated by 119 rescuers using AED from January 2003 to December 2004 were included in this study. They were reviewed retrospectively based on 119 rescue service records and ECG. We analyzed patients' general characteristics, types of ECG rhythm, time intervals from EMS activation to arrival and from EMS activation to the first defibrillation, numbers of defibrillation, and return of spontaneous circulation (ROSC). RESULTS: The mean age was 57.33+/-17.84 years with 92 males and 40 females. 68 patients showed shockable rhythms (coarse ventricular fibrillation 41, fine ventricular fibrillation 24, pulseless ventricular tachycardia 3) and 39 patients showed unshockable rhythms (pulseless electrical activity 19 , asystole 18, normal sinus rhythm 2) as an initial rhythm at EMS arrival. Unshockable rhythms were changed to shockable rhythms after cardiopulmonary resuscitation. 25 patients had no ECG rhythms on 119 rescue service records. In the patients with shockable rhythms initially (68 patients), 18 patients experienced ROSC, whereas only 1 patients experienced ROSC in the patients with unshockable rhythms initially (39 patients). The patients with shockable rhythms initially had higher ROSC rates than the patients with unshockable rhythms initially (26.1% vs 2.6%, p=0.001) and received less defibrillation than the patients with unshockable rhythms initially (1.37+/-0.60 vs 2.49+/-1.87, p=0.016). There were no significant differences in the time intervals from EMS activation to arrival (5.74+/-2.13 minutes vs 7.12+/-4.33 minutes, p=0.529) and from EMS activation to the first defibrillation (14.20+/-7.97 minutes vs 13.75+/-7.30 minutes, p=0.542) between ROSC group & non-ROSC group. There was no significant difference in ROSC between male and female (13% vs 17.5%, p=0.164). CONCLUSION: The patients with shockable rhythms initially had higher ROSC rates than the patients with unshockable rhythms initially (26.1% vs 2.6%, p=0.001) and received less defibrillation than the patients with unshockable rhythms initially (1.37+/-0.60 vs 2.49+/-1.87, p=0.016).
Cardiopulmonary Resuscitation ; Defibrillators ; Electric Countershock ; Electrocardiography ; Female ; Heart Arrest ; Humans ; Male ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

This is to analyze and compare the distribution of the liver function test and its abnormal rates of the preemployment screening for office workers in asymptomatic young age groups between female and male. Liver function test(SGPT and SGOT) of 8,184 young adults(2,633 in female and 5,551 in male) were examined during the period from Jan.1,1994 to Dec. 31, 1994. The results were as follows; 1. Mean level of SGPT was 9.l+/-7.6(IU/L) in female, 21.0+/-27.9(IU/L) in male, and that of SGOT was 15.1+/-6.0(IU/L) in female, 20.5+/-26.5(IU/L) in male. There were significant differences(p<0.01) between female and male in both SPT and SGOT. And also there was significant increasing trend(p<0.05) by age groups in male for SGPT, decreasing trend(p<0.01) in female for SGOT. 2. In the abnormal rates of liver function test by the level of cut-off value, there were significant differences up to twice between the lowest and the highest cut-off value in both female(0.4% vs 0.7%) and male(6.5% vs 12.4%) 3. Abnormal rate of SGPT was 0.4% in female and 6.3% in male, and that of SGOT was 0.2% in female and 1.2% in male with significant differences between female and male in both tests.
Alanine Transaminase ; Aspartate Aminotransferases ; Female ; Humans ; Liver Function Tests* ; Liver* ; Male ; Mass Screening*