IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.
Deglutition Disorders ; Esophagus* ; Incidence ; Leiomyoma*

PURPOSE: Though web-based tests have many advantages, they do not become the main test form in medical education because of their many technical or operational limitations. We have developed a new web-based test system to overcome these limitations and, ultimately, to replace conventional paper and pencil tests. METHODS: We developed a web-based test system using a windows 2000 server, mySQL, visual basic 6.0 and ASP script as developing tools. We applied this system to formal examinations. The system was modified and optimized based on users' demands and problems identified during testing. RESULTS: Since web-based testing was first administered in 2003 to the third-year students during their clinical practice examinations, it has been used in 51 examinations at the College of Medicine in Chungbuk National University. In 2004, it was used in more than a half of the regular examinations at our medical college. At the beginning, lecturers were reluctant to adopt a new test system because of unfamiliarity and fear of additional workload. Shortly, however, they found that they were able to handle the multimedia contents more easily and obtain much information from results analysis without additional work. Examinees also favored web-based tests in presenting multimedia data but had some difficulties in focusing on the test. Overall, examinees' preference for web.based tests was comparable to conventional tests. According to user demand, we improved this test system by verifying question formats and making test analysis. CONCLUSION: Web-based tests can replace paper and pencil tests in medical education. Improvement of this testing system is expected with serious and continuous concerns from examiners.
Chungcheongbuk-do ; Education, Medical* ; Humans ; Multimedia ; Viperidae

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

Orbital complications of sinus disease continue to appear in clinical practice. Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. The classification which defines the degree of orbital extension is valuable, therapeutically and prognostically. The orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen and characterized by visual loss and ophthalmoplegia. But it has minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We experienced a case of temporary monocular visual loss and ophthalmoplegia caused by mucocele in the sphenoid sinus. Thus, we report, with a review of literature, a case of orbital apex syndrome caused by mucocele in the sphenoid sinus in a 53 year-old male patient.
Classification ; Edema ; Exophthalmos ; Humans ; Inflammation ; Male ; Middle Aged ; Mucocele* ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Orbital Diseases ; Sinusitis ; Sphenoid Sinus* ; Vision Disorders

PURPOSE: This study was aimed to evaluate whether the size of the changed area included in the registration area affects the validity of superimposition in three-dimensional (3D) images. MATERIALS AND METHODS: Ten mannequin heads which were sectioned to simulate maxillary and mandibular setback surgery were used. A total of 30 images, including 10 initial images, 10 images after moving both middle and lower faces, and 10 images after moving only lower face, were obtained. The 9 landmarks which consisted of the bilateral and midline landmarks of the upper, middle, and lower faces respectively were used. Each 3D image obtained after simulation was superimposed 3 times according to the different 3 registration areas. The one-way ANOVA and post-hoc analysis were performed.RESULT: In the case of moving middle and lower faces, there was no significant difference in all markers when superimposition was performed based on no changed area and forehead area. However, in the case of superimposition by the whole face, all measurements showed a significant difference (P<0.05) except for Pn (P>0.05). In the case of moving only lower face, all measurements did not show a significant difference regardless of the registration area. CONCLUSION The validity of 3D superimposition in 3D images could be affected by the size of changed areas included in the registration area. In the postoperative evaluation of mandibular surgery, the registration area does not affect the accuracy of the 3D superposition. However, after the maxilla-mandibular surgery, the registration area should be set except for the changed soft tissue.

Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.

Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.

Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.