PURPOSE: The purpose of this study is to find what medical students think the reward for their future work should be and whether they would keep their ideals or abandon them for prestige and wealth by analyzing the book reports of Cronin's The Citadel. METHODS: Participants were 50 medical students of junior class. A month before the classroom lecture, the book and digital video disk were provided. Students had discussions in groups of seven and wrote book reports which include answers of three questions. RESULTS: Regarding what should be the reward for the medical doctor, two-thirds of students (66.7%) answered with spiritual compensation, while one-third (33.3%) chose material reward. In the situation presented to Manson, three-fifths (60.0%) answered they would keep their ideals (idealist), while the remaining two-fifths (40.0%) decided they would abandon them. Less than one-third of students (30.0%) answered they would reveal the corruptions of the doctor's society, while two-thirds (64.0%) would not. CONCLUSION: The larger number of idealists who prefer spiritual reward rather than a material reward represents the innocence of youth as in portrayed in The Citadel.
Adolescent ; Compensation and Redress ; Humans ; Medicine in Literature ; Reward ; Students, Medical

Various sequences have been developed for MRI to aid in the radiologic diagnosis. Among the various MR sequences, susceptibility-weighted imaging (SWI) is a high-spatial-resolution, threedimensional gradient-echo MR sequence, which is very sensitive in detecting deoxyhemoglobin, ferritin, hemosiderin, and bone minerals through local magnetic field distortion. In this regard, SWI has been used for the diagnosis and treatment of various neurologic disorders, and the improved image quality has enabled to acquire more useful information for radiologists.Here, we explain the principle of various signals on SWI arising in neurological disorders and provide a retrospective review of many cases of clinically or pathologically proven disease or components with distinctive imaging features of various neurological diseases. Additionally, we outline a short and condensed overview of principles of SWI in relation to neurological disorders and describe various cases with characteristic imaging features on SWI. There are many different types diseases involving the brain parenchyma, and they have distinct SWI features.SWI is an effective imaging tool that provides complementary information for the diagnosis of various diseases.

BACKGROUND: The effect of arterial carbon dioxide tension (PaCO2) during ischemia and reperfusion has been a controversial issue. In this study, the effect of PaCO2 during ischemia and reperfusion was evaluated by 31P magnetic resonance spectroscopy (MRS). METHODS: Incomplete global cerebral ischemia was induced by ligation of carotid artery under lowered mean blood pressure (mean blood pressure= 40 mmHg) for 30 minutes followed by 2 hours of reperfusion. Eighteen cats were divided into 3 groups: For group 1 (n=6) (control group), animals were subjected to normocarbia (PaCO2=28~33 mmHg) during ischemia and reperfusion, for group 2 (n=6), animals were subjected to hypocarbia (PaCO2=18~23 mmHg) during ischemia and reperfusion, and for group 3 (n=6), animals were subjected to normocarbia during ischemia and hypocarbia during reperfusion. RESULTS: For group 1, the energy metabolism measured by [PCr/Pi] was recovered about 74.7 6.4%. For group 2, the energy metabolism failed to be completely recovered by 120 minutes of reperfusion (69.3 7.3%), whereas for group 3, the energy matabolism was completely recovered by 120 minutes of reperfusion (97.6 2.4%). There were statistically significant differences between group 1 and group 3 (p<0.05). The changes in pH were not significantly different among the groups. CONCLUSION: In this study, a condition of hypocarbia during reperfusion seems better for the energy metabolism after incomplete global ischemia of cats.
Animals ; Blood Pressure ; Brain Ischemia ; Brain* ; Carbon Dioxide ; Carotid Arteries ; Cats* ; Energy Metabolism* ; Hydrogen-Ion Concentration ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Reperfusion

BACKGROUND: The immune thrombocytopenia (ITP) criteria were newly standardized by the International Working Group. Thus, we analyzed the natural course of childhood chronic ITP to predict the prognosis based on the revised criteria. METHODS: The medical records of children with chronic ITP from May 2000 to February 2013 in our institute were reviewed. RESULTS: Forty-seven children with chronic ITP who were not undergoing corticosteroid therapy were included. Their initial platelet count was 23+/-25x10(9)/L, and age at diagnosis was 6.3+/-4.1 years. The follow-up period was 5.4+/-3.7 years. Among them, 44.7% (21/47) showed spontaneous remission and maintained a platelet count > or =100x10(9)/L. And 66.0% (31/47) maintained a platelet count > or =50x10(9)/L until the last follow-up date. The time periods required for the platelet count to be maintained > or =50x10(9)/L and > or =100 x10(9)/L were 3.1+/-2.7 and 3.6+/-2.7 years. Age at diagnosis in the > or =50x10(9)/L group (5.7+/-4.4 years) was significantly lower than the age at diagnosis in the <50x10(9)/L group (7.4+/-3.3 years) (P=0.040). And follow-up period was the factor influencing prognosis between the > or =100x10(9)/L group and <50x10(9)/L group (P=0.022). CONCLUSION: Approximately 45% of children with chronic ITP recovered spontaneously about 3-4 years after the diagnosis and 2/3 of patients maintained a platelet count > or =50x10(9)/L, relatively safe state. Age at diagnosis of ITP and follow-up period were the factors influencing prognosis in this study.
Child ; Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Platelet Count ; Prognosis ; Remission, Spontaneous ; Thrombocytopenia*

BACKGROUND: Immune thrombocytopenic purpura (ITP) is a frequently observed bleeding disorder in children. High dose intravenous immunoglobulin G (IVIG) has been used for the treatment of ITP since 1981, and now several methods of IVIG infusion are used. Since 1983, we have treated ITP patients with short-term and low-dose IVIG according to the individual patient's daily response. This study aimed to evaluate individual patient's response after IVIG for the prediction of chronic ITP.METHODS: We evaluated 259 childhood ITP patients retrospectively who were newly diagnosed at the Department of Pediatrics, Kyungpook National University Hospital from 1983 to 2012. We analyzed the individual response to treatment and current state of disease. We evaluated the time to reach desired platelet counts after treatment of IVIG, relapse rate and diagnosis of chronic ITP. The patients were classified into 2 groups according to the time to reach desired platelet counts (50,000/microL) after daily treatment of IVIG, rapid (1 or 2 doses) and slow responder (more than 3 doses).RESULTS: Among 182 patients followed up over 6 months, 41 patients (22.5%) were eventually diagnosed with chronic ITP. Hundred and two patients (56.7%) belonged to rapid response group, and 17 of them (16.7%) were diagnosed with chronic ITP. Eighty patients (44.4%) belonged to the slow response group, and 24 of them (30%) were diagnosed with chronic ITP, which were higher than the early response group (P=0.033).CONCLUSION: Individual response rate of IVIG treatment could be a useful predictor of chronic ITP, but this finding needs support from further studies.
Child ; Diagnosis ; Hemorrhage ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunoglobulins, Intravenous ; Methods ; Pediatrics ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies

Systemic lupus erythematosus (SLE) which is thought to be autoimmune in nature affects multiple organs and produces a diversity of signs and symptoms. However, cardiovascular manifestations of SLE are manifested more frequently by autopsy. Recently, with the prolonged survival and improvement of diagnostic methods in SLE including echocardiography, the morbidity and mortality associated with cardiovascular manifestations of SLE became more apparent and increased. Simultaneous involvement of the pulmonary artery and the myopericardium in SLE is known to be rare. Pulmonary hypertension is known to be associated with poor prognosis. We report a 27 year-old female patient of SLE with pulmonary hypertension, pericarditis and left ventricular systolic dysfunction.
Adult ; Autopsy ; Echocardiography ; Female ; Humans ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Mortality ; Pericarditis* ; Prognosis ; Pulmonary Artery

PURPOSE: 45,XY,t(13;14)(q10;q10) karyotype can suggest infertility associated with more or less severe oligospermia in male adults. In addition, 45,XX,t(13;14)(q10;q10) karyotype carries reproductive risks such as miscarriage or infertility in female adults. However, reports on the phenotype of this karyotype in children are very rare. This study was done to observe various phenotypes of this karyotype in children. METHODS: Between January 2007 and December 2012, children diagnosed with 45,XY,t(13;14)(q10;q10) or 45,XX,t(13;14)(q10;q10) karyotype by chromosome analysis were analyzed retrospectively. RESULTS: Eight children (5 boys and 3 girls) were diagnosed with 45,XY,t(13;14)(q10;q10) or 45,XX,t(13;14)(q10;q10) karyotype. They ranged in age from 5 years and 6 months to 12 years and 4 months. The phenotypes of the study patients consisted of 1 hypogonadotrophic hypogonadism, 1 precocious puberty, 3 early puberty, 2 growth hormone deficiency (GHD) (partial) and 1 idiopathic short stature. As shown here t(13;14)(q10;q10) Robertsonian translocation shows a wide range of phenotypes. CONCLUSION: It can be said that t(13;14)(q10;q10) Robertsonian translocation shows various phenotypes from GHD to precocious puberty in children. Further large-scale studies are necessary.
Child* ; Endocrine System Diseases* ; Female ; Growth Hormone ; Humans ; Hypogonadism ; Karyotype ; Male ; Phenotype ; Puberty ; Puberty, Precocious ; Translocation, Genetic*

Neurological complications occur frequently in patients undergoing liver transplantation. We report a case of multi-ple neurologic complications including central pontine and extrapontine myelinolysis, seizure, and mutism after liver transplantation. Though the cause would be obscure and multifactorial, the hyponatremia with its rapid correction dur-ing operation and the side effects of the immunosuppressant would be the most probable causes in this case.
Humans ; Hyponatremia ; Liver Transplantation* ; Liver* ; Mutism ; Myelinolysis, Central Pontine ; Seizures

BACKGROUND AND OBJECTIVES: Coronary angioplasty of total occlusion is associated with low primary success rate. The most common reason for failure is the inability to cross the lesion with a guidewire. The new nitinol wire consists of an extraordinary flexible nitinol core, a platinum/iridium coil at the distal tip, and a polymer hydrophilic coating providing the wire with an extremely slippery surface after moistening. METHODS AND MATERIALS: We analyzed the angiographic results in 117 patients (86 M, 31 F, 58.5+/-11.7 year), who underwent angioplasty for total occlusion with Crosswire (TM) at Chonnam University Hospital between Oct '97 and Apr '99. Clinical diagnosis was acute myocardial infarction (MI) in 61, old MI in 16, unstable angina in 23, and stable angina in 17 patients. RESULTS: Target coronary arteries were 51 left anterior descending arteries (LAD), 13 left circumflex arteries (LCX) and 53 right coronary arteries (RCA). Lesion morphology was 40 abrupt and 77 tapered lesions, and collateral circulation was observed in 75 cases. The success rate was 80.3% (94/117). The reasons of procedural failure were failure to cross the lesion using wire in 8 and balloon in 6 cases. In the failed cases, clinical diagnosis was acute MI in 10, unstable angina in 8 and stable angina in 5, and target artery was 11 LAD, 2 LCX and 10 RCA, and collateral circulation was observed in 20. In 56 cases of chronic total occlusion, the success rate was 76.8% (43/56) and the reasons of procedural failure were failure to cross the lesion using wire in 6 and balloon in 2 cases. No major cardiac events were developed. There was no predictive factor for the procedural failure with Crosswire (TM) for total occlusion. CONCLUSIONS: A new nitinol wire, Crosswire (TM) was an effective tool for the recanalization of total occlusive coronary artery.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Arteries ; Collateral Circulation ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Humans ; Jeollanam-do ; Myocardial Infarction ; Polymers

BACKGROUND AND OBJECTIVES: Coronary angioplasty of total occlusion is associated with low primary success rate. The most common reason for failure is the inability to cross the lesion with a guidewire. The new nitinol wire consists of an extraordinary flexible nitinol core, a platinum/iridium coil at the distal tip, and a polymer hydrophilic coating providing the wire with an extremely slippery surface after moistening. METHODS AND MATERIALS: We analyzed the angiographic results in 117 patients (86 M, 31 F, 58.5+/-11.7 year), who underwent angioplasty for total occlusion with Crosswire (TM) at Chonnam University Hospital between Oct '97 and Apr '99. Clinical diagnosis was acute myocardial infarction (MI) in 61, old MI in 16, unstable angina in 23, and stable angina in 17 patients. RESULTS: Target coronary arteries were 51 left anterior descending arteries (LAD), 13 left circumflex arteries (LCX) and 53 right coronary arteries (RCA). Lesion morphology was 40 abrupt and 77 tapered lesions, and collateral circulation was observed in 75 cases. The success rate was 80.3% (94/117). The reasons of procedural failure were failure to cross the lesion using wire in 8 and balloon in 6 cases. In the failed cases, clinical diagnosis was acute MI in 10, unstable angina in 8 and stable angina in 5, and target artery was 11 LAD, 2 LCX and 10 RCA, and collateral circulation was observed in 20. In 56 cases of chronic total occlusion, the success rate was 76.8% (43/56) and the reasons of procedural failure were failure to cross the lesion using wire in 6 and balloon in 2 cases. No major cardiac events were developed. There was no predictive factor for the procedural failure with Crosswire (TM) for total occlusion. CONCLUSIONS: A new nitinol wire, Crosswire (TM) was an effective tool for the recanalization of total occlusive coronary artery.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Arteries ; Collateral Circulation ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Humans ; Jeollanam-do ; Myocardial Infarction ; Polymers