No abstract available.
Alzheimer Disease* ; Creutzfeldt-Jakob Syndrome*

PURPOSE: Recently, researchers at medical schools have shown increasing interest in developing a curriculum for medical humanities and improving 'humanity' in existing curriculums. This study introduces the process of developing the 'doctor & leadership' curriculum at K University from 2002. The results of the three-year implementation were analyzed. The effectivenessof the curriculum development is discussed. METHODS: The curriculum development followed the ADDIE model. A sixteen-week curriculum with three subjects was developed. The main methods of instruction were self-regulation learning and collaboration learning. The instruction method was a blended learning approach composed of both on-line and off-line instructions. Students were assessed through a portfolio assessment. 'Leadership self-assessment' and 'satisfaction index' of the overall curriculum were measured. RESULTS: The results on pre- and post- leadership self-assessment shows that leadership increased significantly after the learning process. Of the 4 sub-factors of the satisfaction index, the satisfaction indices on the blended learning, professor-student interaction, and instruction design had the greatest influence on the total satisfaction index (p<.001) CONCLUSION: Our outcome indicates that the 'doctor & leadership' curriculum is significantly effective. And generally, to increase the satisfaction index of courses, collaboration learning based on team projects and blended learning, as well as, professor-student interaction are helpful in encouraging the application of skills.
Cooperative Behavior ; Curriculum* ; Humanities ; Humans ; Leadership ; Learning ; Schools, Medical ; Self-Assessment

BACKGROUND: Neuromyelitis optica (NMO) is characterized by optic neuritis and longitudinally extensive transverse myelitis. Generally, the brain had been considered healthy in NMO patients, though recent studies have demonstrated that T2-weighted abnormalities may be observed in various brain regions. Logically, NMO brain lesions are localized at sites of high aquaporin-4 expression. CASE REPORT: A 68-year-old right-handed man with dysuria, weakness in the bilateral upper and lower limbs, and decreased sensation of the lower extremities, was diagnosed with neuromyelitis optica. The patient was gradually speaking less, was showing reduced interest in hobbies, and had undergone changes in character and behavior. An examination was performed using the Seoul Neuropsychological Screening Battery (SNSB), which revealed that the profile of frontal lobe dysfunctions was prominent as compared with other cognitive domains. The patient was treated with prednisolone and azathioprine for about 1 year without recurrence, and showed prognostic improvement according to further SNSB testing. CONCLUSIONS: Further studies are considered necessary in order to find the most effective medication regimen for improving cognitive functions in those accurately diagnosed with NMO, and to develop systematic treatment using even more diversified immune-related agents.
Aged ; Azathioprine ; Brain ; Dysuria ; Frontal Lobe* ; Hobbies ; Humans ; Logic ; Lower Extremity ; Mass Screening ; Myelitis, Transverse ; Neuromyelitis Optica* ; Optic Neuritis ; Prednisolone ; Recurrence ; Sensation ; Seoul

This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed.
Commerce ; Employment ; Health Policy ; Jurisprudence ; Korea ; Punishment ; Risk Assessment ; Social Control, Formal

This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed.
Commerce ; Employment ; Health Policy ; Jurisprudence ; Korea ; Punishment ; Risk Assessment ; Social Control, Formal

There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.
Adult ; Brain Neoplasms ; Dementia ; Female ; Humans ; Lewy Body Disease ; Meningioma ; Parkinson Disease, Secondary ; Parkinsonian Disorders

BACKGROUND: Posterior cortical atrophy (PCA) is characterized by slowly progressive early onset dementia with cortical visual dysfunction and disproportionate atrophy of the posterior cortex. CASE REPORT: A 55-year-old right-handed woman developed visuo-spatial impairments that progressed rapidly into cortical blindness over the following 3 months. Neuro-psychological evaluation revealed Gerstmann syndrome and severe constructional impairments with all components of Balint syndrome. However, her memory, insight, and judgment were preserved. Her brain MRI was normal. However, 18F fluorodeoxyglucose positron emission tomography revealed a marked hypometabolism in the bilateral parieto-occipital region. CONCLUSIONS: Although rapid progression of visuo-spatial dysfunction without memory impairment occurred, we considered PCA as well.
Atrophy* ; Blindness, Cortical ; Brain ; Dementia ; Female ; Fluorodeoxyglucose F18 ; Gerstmann Syndrome ; Humans ; Judgment ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Passive Cutaneous Anaphylaxis ; Positron-Emission Tomography

A 42-year-old man with left posterior inferior cerebellar artery (PICA) infarction presented with akinetic mutism and cognitive impairment. Initially he suffered from akinetic mutism and MRI-documented infarction in the distribution of the left PICA. Twelve days later he developed cognitive impairment. Neuropsychological tests were performed, with the results corrected for age and education being compared with published Korean norms. Impaired performances were evident on executive function testing, with difficulties in planning, abstract reasoning, set-shifting, and perseveration. Akinetic mutism and cognitive-affective syndrome may be a manifestation of unilateral PICA infarction.
Adult ; Akinetic Mutism* ; Arteries ; Education ; Executive Function ; Humans ; Infarction* ; Neuropsychological Tests ; Pica*

BACKGROUND: Clinical diagnosis of multiple system atrophy (MSA) relays on signs and symptoms that are often difficult to identify particularly at early stage. Indeed neuropathological studies have demonstrated that Parkinson variant of MSA (MSA-P) is the first cause of misdiagnosis in a cohort of patients presenting with parkinsonian features. But accurate diagnosis of these disorders is important for deciding on treatment, appropriate advice and prognosis since atypical parkinsonian disorders are characterized by poor response to dopaminergic treatment and more rapid disease progression. Therefore, we conducted this study to investigate difference of perfusion Single Photon Emission Computed Tomography (SPECT) in patients with the early phase of MSA-P using SPM program. METHODS: We recruited consecutively 21 patients with MSA-P and 48 age-matched healthy controls. All subjects underwent Tc-99m HMPAO perfusion SPECT and this perfusion images were analyzed. RESULTS: For MSA-P, only hypoperfusion was seen in the middle frontal gyrus of left frontal lobe, superior frontal gyrus of right frontal lobe, precentral gyrus of left frontal lobe, middle frontal gyrus of right frontal lobe and precentral gyrus of right frontal lobe with respect to healthy subjects. CONCLUSIONS: We cautiously assume that perfusion SPECT may offer significant advantages compared to other imaging techniques in the assessment of neuronal degeneration in MSA-P and may help the clinician in the diagnostic characterization of patients presenting with atypical parkinsonism.
Cohort Studies ; Diagnosis ; Diagnostic Errors ; Disease Progression ; Frontal Lobe ; Humans ; Multiple System Atrophy* ; Neurons ; Parkinsonian Disorders ; Perfusion* ; Prognosis ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND AND PURPOSE: Acetyl-L-carnitine (ALC) is a widely used drug for various neurodegenerative diseases including dementia. The aim of the present study was to elucidate the efficacy of ALC in dementia patients with cerebrovascular disease (vascular cognitive impairment; VCI). METHODS: Fifty-six patients were randomized to treatment with 500 mg ter in die ALC, or placebo in this 28-week, double-blind, placebo-controlled trial. The primary outcome measure was the Korean version of Montreal Cognitive Assessment (MoCA-K). RESULTS: Following treatment with ALC, the cognitive function measured by the MoCA-K was significantly improved in the ALC-treated groups. However, other secondary outcomes were not statistically significant between ALC- and placebo-treated groups. In MoCA-K analysis, attention and language sub-items significantly favored the ALC-treated group. CONCLUSIONS: Compared with placebo, treatment with ALC 1,500 mg/day produced significant changes in MoCA-K in dementia patients with VCI. ALC was well tolerated in this population. Despite the study limitations, the findings suggested the potential benefits associated with the use of ALC in dementia patients with VCI.
Acetylcarnitine* ; Cerebrovascular Disorders* ; Cognition ; Cognition Disorders ; Dementia* ; Humans ; Neurodegenerative Diseases ; Outcome Assessment (Health Care)