Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.
Actins* ; Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnostic Errors ; Female ; Humans ; Keratosis, Actinic* ; Melanins ; Melanocytes ; Melanoma ; Physical Examination ; Skin ; Thorax

To evaluate the normal development of the paranasal sinuses in children with CT, authors prospectively studied with brain CT scans of 260 children without known sinus diseases, ranging in age from 7 days to 16 years. Maximal anteroposterior and transverse diameters(mm) and maximal cross-sectional area(mm2) of both sides of the maxillary sinus were measured with the aid of computer device. As to the ethmoidal and sphenoidal sinuses, we simply documented the presence of the aplastic ethmoidal sinus and calculated the age-incidence of the sphenoidal sinus pneumatization, respectively. There noted three phases in the development of the maxillary sinus. The anteroposterior and transverse diameters of the maxillay sinus increased nearly in parallel. The former was always greater than the latter. In no cases was the ethmoidal sinus aplastic and almost all sinuses were pneumatized even in infants as early as 7 days old. CT identified the conchal pattern of sphenoidal sinus pneumatization in infants as early as 11 days old. Sphenoidal sinus pueumatization was seen in 38% of the children under the age of 1 year, 82% of the children between the age of 1 and 2 years, and almost all children older than 2 years. The anteroposterior and transverse diameters of the maxillary sinus seem to reach the adult size by 8 years of age, and the conchal pattern of sphenoidal sinus pneumatization can be recognized earlier with CT than on the plain radiographs.
Adult ; Brain ; Child* ; Humans ; Infant ; Maxillary Sinus ; Paranasal Sinuses* ; Prospective Studies ; Tomography, X-Ray Computed

OBJECTIVES: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. METHODS: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. RESULTS: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. CONCLUSIONS: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.
Brain ; Comorbidity ; Disabled Persons ; Employment ; Female ; Hospitals, General ; Housing ; Humans ; Insurance, Health ; Logistic Models ; Marital Status ; Medicine, East Asian Traditional ; Public Health ; Rehabilitation Centers ; Surveys and Questionnaires

BACKGROUND: Primary angiitis of the central nervous system (PACNS) is a rare disorder and is often difficult to diagnose due to the lack of a confirmatory test. PACNS can generally be diagnosed based on typical angiographic findings. We describe herein a patient diagnosed with PACNS despite the presence of normal findings on conventional angiography. CASE REPORT: A 44-year-old man with a recent history of ischemic stroke in the right posterior cerebral artery territory developed acute-onset vertigo. Diffusion-weighted imaging revealed an acute infarction within the left posterior inferior cerebellar artery. His medical history was unremarkable except for hyperlipidemia; the initial examination revealed mild gait imbalance. During the 10 days of hospital admission, the patient experienced four recurrent ischemic strokes within the posterior circulation territory (occipital lobe, pons, and cerebellum). He was diagnosed with recurrent cerebral infarctions due to PACNS. The basilar artery exhibited no demonstrable luminal stenosis, but there were direct imaging signs of central nervous system angiitis including wall thickening and contrast enhancement. High-dose intravenous steroid therapy followed by oral prednisolone was administered. There was no further stroke recurrence and follow-up imaging of the arterial walls showed normalization of their characteristics. CONCLUSIONS: The present case emphasizes the importance of wall imaging in the diagnosis and treatment of PACNS.
Adult ; Angiography ; Arteries ; Basilar Artery ; Central Nervous System* ; Cerebral Infarction ; Constriction, Pathologic ; Diagnosis* ; Follow-Up Studies ; Gait ; Humans ; Hyperlipidemias ; Infarction ; Inflammation ; Magnetic Resonance Imaging* ; Phenobarbital ; Pons ; Posterior Cerebral Artery ; Prednisolone ; Recurrence ; Stroke ; Vasculitis* ; Vasculitis, Central Nervous System ; Vertigo

Two cases of pulmonary atypical carcinoid tumor were diagnosed by fine needle aspiration cytology. Although the cytologic features of atypical carcinoid tumor have been relatively well described, it is easy to confuse atypical carcinoid tumor with typical carcinoid tumor, small cell carcinoma and adenocarcinoma of the lung. Atypical carcinoid tumor has been recognized as a distinct variant of pulmonary neuroendocrine carcinoma, with characteristic histopathologic and clinical features that separate it from both carcinoid and small cell carcinoma. The distinction of atypical carcinoid tumor from small cell carcinoma has important prognostic and therapeutic implications. The cytologic characteristics of atypical carcinoid tumor included polygonal to fusiform cells with a variable amount of lacy cytoplasm, oval nuclei with coarsely dispersed chromatin and frequent nucleoli, and mild pleomorphism. The malignant cells were arranged either in acinus-like clusters or in epithelial sheets.
Adenocarcinoma ; Biopsy, Fine-Needle* ; Carcinoid Tumor* ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Chromatin ; Cytoplasm ; Lung*

OBJECTIVES: To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. METHODS: The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. RESULTS: Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. CONCLUSIONS: We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.
Adult ; Aged ; Female ; Health Expenditures ; Health Services/economics/*utilization ; Humans ; Insurance, Health/*statistics & numerical data ; Korea/epidemiology ; Male ; Middle Aged ; Neoplasms/economics/*therapy ; *Private Sector ; Socioeconomic Factors

No abstract available.
Adenocarcinoma, Clear Cell* ; Urinary Bladder*

OBJECTIVES: This study was conducted in order to analyze oral health content and its importance in primary, middle, and high school textbooks. METHODS: A total of 1,176 textbooks was reviewed, and the items under investigation included: textbook division (national/authorized), titles; grade levels, semesters taught, inclusion of educational content for general and oral health, and the number of pages and rows containing the oral health information. The data were analyzed via paired t-tests, frequency analyses, and one-way ANOVAs. RESULTS: Oral health content was found in 12.1 percent of the primary school textbooks, 6.5% of the middle school texts, and 2.1% of the high school textbooks. The total average was 5.4%. Among the textbooks containing health (general and oral) content, the average number of pages (P<0.001) containing general and oral health information were 22.1 and 0.5, respectively. The average number of lines (P<0.001) for both types of health information were 475.1 and 6.2, respectively, in the primary school textbooks. Middle school textbooks included average numbers of health information-related pages (P<0.001) of 45.7 and 0.4 and average numbers of lines (P<0.001) of 1,086.9 and 5.3, respectively. The average number of pages (P<0.001) in the high school books containing general and oral health content were 83.0 and 0.9, respectively, and the average number of lines (P<0.001) were 2,128.6 and 10.7. Our research showed that, regarding the degree of reflecting oral health education objectives, high school textbooks gained 1.00 point (1 objective), middle school books obtained 0.67 point (5 objectives), and primary school books received 0.18 point (39 objectives; P<0.05). CONCLUSIONS: Oral health content in textbooks decreased as school level increased. The objectives of oral health education for primary school were not properly reflected in the textbooks because the objectives were relatively diverse, and the textbook treatment of the material was rather static.
Education ; Humans ; Oral Health*

PURPOSE: The purpose of this study was to examine the relationship among the levels of total serum cholesterol level, blood pressure, body mass index, and lifestyle. METHOD: This study was designed as a descriptive correlation study. Subjects were 972 adults participated voluntarily living in GyeongNam. The height, weight, blood pressure and fasting serum cholesterol were measured. Body mass index was caculated. Information on general characteristics (age, gender, education, job, family history) and life style(cigarette, alchol, sleeping time, regular exercise, meal pattern, peppery, salty, sweetness, vegetable diet, meat diet) were collected using a questionnaire by interviewing method. RESULT: The mean value of total serum cholesterol was 197+/-36.4mg/dl(mean; 189.4+/-36.7, women; 202.1 +/-35.1). By simple analysis, the serum total cholesterol according to general characteristics features was statistically significant in age(F= 6.765, p=000) and gender (t=5.372, p=.000). Total serum cholesterol levels increased significantly with increasing BMI. The serum total cholesterol according to life style features was statistically significant in cigarette(chi2 =12.12, p=.016), exercise(chi2=6.335, p=.042), salty taste(chi2=18.801, p=016), vegetable diet(chi2=19.488, p=012). The most affecting factor which total serum cholesterol factor was BMI(beta=.151, p=.000). CONCLUSION: The significant risk factors relating to serum total cholesterol were age, gender, BMI, smoking, and exercise. Therefore, for the reduction of serum total cholesterol level, it is recommended that nursing intervention for the prevention of obesity, change of life style should be implemented.
Adult ; Blood Pressure* ; Body Mass Index* ; Cholesterol* ; Climacteric ; Diet ; Education ; Fasting ; Female ; Humans ; Life Style* ; Meals ; Meat ; Nursing ; Obesity ; Risk Factors ; Smoke ; Smoking ; Statistics as Topic ; Vegetables

BACKGROUND: Lesch types 2 (L2, anxiety model) and 3 (L3, depressive model) of alcoholism exhibit different responses to anti-craving agents, and most treatment guidelines provide differential treatment strategies for bipolar depression (DEP) and unipolar DEP. We compare the psychological characteristics of L2 and L3 alcoholism and between the unipolar and bipolar subgroups.METHODS: We reviewed medical records of patients who were diagnosed with alcohol use disorder using the DSM-5 diagnostic criteria and classified as L2 and L3 using Lesch Alcohol typology software. All patients completed self-report scales (Alcohol Use Disorders Identification Test [AUDIT], Beck Anxiety Inventory [BAI], Beck Depression Inventory-II [BDI-II], and Korean Symptom Checklist-95 [KSCL95]). The data were analyzed using descriptive statistics, the Wilcoxon Rank-Sum test, and ANOVA.RESULTS: Of the 43 patients, 23 were assigned L2, and 20 were assigned L3. The scores for the KSCL95 subscales fell generally in the increasing order of the L2-unipolar (L2U, n=10), L2-bipolar (L2B, n=13), L3-unipolar (L3U, n=11), and L3-bipolar (L3B, n=9) types. The L3B scores were greater than the L3U scores for most KSCL95 subscales, by contrast with the DEP and BAI scores.CONCLUSION: We found psychological differences between L2 and L3 and identified the unique psychological characteristics for each subgroup by polarity. The psychological characteristics of these subgroups of alcohol use disorder may help improve the treatment success rates through individualized treatment strategies.
Alcoholism ; Anxiety ; Bipolar Disorder ; Depression ; Depressive Disorder ; Humans ; Medical Records ; Weights and Measures