Angioleiomyoma(ALM) of the cavernous type is a rare subtype of leiomyomas arising from the smooth muscle of veins. ALM of this type invariably shows clinically and histopathologically distinctive features, compared with the classical solid or venous type. However, no case of ALM of this type has been yet reported in Korea although there have been several reported cases of other types. We herein present the case of a 39-year-old man with a 7-year history of a painless ALM of the cavernous type on his buttock with the histological features of markedly ectatic vascular channels and thin intervascular bundles of smooth muscles.
Adult ; Angiomyoma ; Buttocks* ; Humans ; Korea ; Leiomyoma ; Muscle, Smooth ; Veins

BACKGROUND: Inflammatory bowel disease(IBD) such as ulcerative colitis or Croln's disease is often related with varied diseases including pyoderma gangrenosum, erythema nodosum, ankylosing arthritis and psoriasis. To date, however, a cIinical observation of IBD accompanied by psoriasis has been sparcely accomplished although an immunogenetic mechanism explaining a coexistence of IBD and psoriasis has been proposed. OBJECTIVE: We estimated the prevalence of IBD in patients with psoriasis in Korea and investigated the clinical characteristics of IBD accompanied by psoriasis. METHODS: 92 psoriatic patients and 389 non-psoriatic control subjects were enrolled in this study. Colonoscopic biopsy and barium series were performed in 47 psoriatic patients and 110 control subjects showing irritative intestinal symptoms. RESULTS: 1. The prevalence of IBD in psoriatic patients(14.1%) was significantly greater than in the control group(1.0%). 2. In the temporal relationship, psoriasis developed several years prior to the onset of IBD in 84.6% of psoriatic patients. 3. The frequency of arthropathies in the psoriatic patients possessing IBD(84.6%) was significantly higher than that of non-psariatic counterparts with IBD(25.0%) or that of psoriatics without lBD(2.5%), 4. The psoriatir. patients with IBD demonstrated much more frequently diffuse colonal extension than in non-psoriatic subjects with IBD. CONCLUSION: Our findings of an increased prevalence of IBD in the psoriatic population present further evidence of an association between IBD and psoriasis. In the psoriatic patients showing acute or chronic gastrointestinal symptoms, colonoseopic evaluation might be mandatory for the evaluation of IBD.
Arthritis ; Barium ; Biopsy ; Colitis, Ulcerative ; Colon ; Erythema Nodosum ; Humans ; Immunogenetics ; Inflammatory Bowel Diseases* ; Korea ; Prevalence ; Psoriasis* ; Pyoderma Gangrenosum

The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For ceserean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals between hospital groups by size. The most frequent indication of C/S was repeated operation, followed by cephalopelvic disproportion(CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons for admission were 'failure to initial treatment', 'suspected bacterial pnermonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activities would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studies with plentiful subjects and more representative diseases or procedures should be tried.
Cesarean Section* ; Child ; Cholecystectomy* ; Female ; Humans ; Physicians, Family ; Pneumonia* ; Pregnancy ; Specialization ; Trial of Labor ; Utilization Review

BACKGROUND: A pathogenesis of skin-homing lymphoid cells in primary cutaneous T-eell lymphoma(CTCL) has not been elucidated, CLA(cutaneous lymphocyte-associated antigen) defined by HECA-452 monoclonal anfibody has been proposed as the novel skin-homing receptors of infiltrative lymphocytes in atopic dermatitis and graft-versus-host disease. Accordingly, CLA may be a determinant explaining about the skin-homing properties of lymphoid tumor cells in CTCL. OBJECTIVE: This study was conducted to investigate the immunohistochemical expression of CLA in the lesional tissue specimens of cutaneous lymphomas. METHODS: Immunohistochemicslly, we examined the expression of CLA, E-selectin, ICAM-1 and LFA-1 antigens in the tissue specimens taken from the skin lesions and lymph nodes of the 22 patients with cutaneous lymphomas and the 20 control subjects with non-cutaneous lymphomas. Results : 1. The expression rate of CLA was 40.9% in the skin specimens of cutaneous lymphomas. We could not fad any expression of CLA in non-cutaneous lymphomas. 2. CTCL showed a more frequent expression of CLA(80%) than cutaneous B-cell lymphomas (CBCL)(8.3%). We found more frequently CLA+ high endothelial venules in non-cutaneous lymphomas(40%) than in cutaneous lymphomas(9.1%). 3. CLA and E-selectin were more frequently expressed in primary CTCL(100%, 83.3%) than in secondary CTCL(50%, 0%). 4. The positivity to ICAM-1 and LFA-1 antigens was higher in primary cutaneous lymphomas (72.7%, 81.8%) than in secondary forms(9.1%, 9.1%). Conclusion : CLA and E-selectin may represent the pivotal skin-homing receptor of infiltrative tumor cells and vascular counter-receptor in primary CTCL, respectively. Also, ICAM-1 and LFA-1 may have a role in the primary cutaneous infiltration of lymphoma cells as the additional cofactors.
Dermatitis, Atopic ; E-Selectin ; Flavin-Adenine Dinucleotide ; Graft vs Host Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Lymphocyte Function-Associated Antigen-1 ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Skin ; Venules

We herein present two cases of generalized pustular psoriasis(GPP) followed by acquired bullous diseases during antipsoriatic management. Although there were several reports de-scribing the coexistence of psoriasis vulgaris and autoimmune bullous diseases such as bullous pemphigoid or pemphigus vulgaris(PV), a coexistence of GPP and bullous disease was sparcely reported. In one patient, we could define atypical autoantigen which was distinct from the other known antigens in documented cases of bullous diseases. The other case was compatible with PV. The psoriatic lesions and bullous eruptions of the two patients cleared in several weeks after administration of cyclosporine.
Cyclosporine ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Psoriasis*

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

We evaluated Immunochromatographic assay kit to screen HBsAg in human serum. When the reference HBsAg was applyed to ICA, HA and EIA kits, the limit of detection for HBsAg were found out to be 4, 2 and 0.25 ng/ml respectively. But ICA kit required 5 minutes to read the result whereas HA and EIA kit more than one hour. The sensitivity was 97% (29 of 30 samples) and the specificity 100% (45 samples) compared with conventional EIA. The ICA kit needs no instrument or machine to perform the test contrary to the conventional methods. Therefore, this rapid and sensitive ICA kit can be used for HBsAg-screening, especially in the emergency room and in the scene of the accident.
Emergency Service, Hospital ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunochromatography* ; Limit of Detection ; Sensitivity and Specificity

BACKGROUND: The opportunistic imperfect fungus Candida albicans causing life-threatening infections in immunocompromised patients is recognized to be one of important nosocomial pathogens. Recently, an outbreak of septicemia caused by C. albicans was occured in neonatal intensive care unit (NICU) of Chungbuk university hospital. To investigate the molecular epidemiology of these infections, we analyzed genotypes of C. albicans isolates from NICU and non-NICU. METHODS: Fourteen isolates of C. albicans were used for intraspecies genotyping, which were composed of 9 isolates from NICU and 5 isolates from non-NICU from January to April 1998. Each three isolates of C. albicans, C. parapsilosis and C. tropicalis were used for interspecies genotyping. The genotyping were analyzed by RAPD with four random primers. RESULTS: The genotypes of C. albicans isolates from immature neonates in NICU were identical with those from medical persons in NICU but different with those from patients in non-NICU. Interspecies RAPD profiles were more distinctive than intraspecies RAPD profiles. The reproducibility of RAPD showed good result. CONCLUSION: These results show that C. albicans isolated from NICU disclose the same RAPD genotype, which suggests the clonal origin, and RAPD can be the useful method for the epidemiological study of nosocomial infection caused by C.albicans.
Candida albicans* ; Candida* ; Chungcheongbuk-do ; Cross Infection ; DNA* ; Epidemiologic Studies* ; Fungi ; Genotype ; Humans ; Immunocompromised Host ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Molecular Epidemiology ; Sepsis*

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay

Wegener's granulomatosis is a small vessel vasculitis characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and kidney. Early diagnosis and immediate treatment are very important for a better prognosis, but the nonspecific, variable clinical manifestations and radiologic findings make the diagnosis difficult. A positive proteinase 3-antineutrophil cytoplasmic antibody test is helpful for the diagnosis of Wegener's granulomatosis. Here, we report a case of Wegener's granulomatosis in 54-year-old man who initially presented with fever and multiple cavitary consolidations on the chest radiograph suggestive of a lung abscess. The final diagnosis of Wegener's granulomatosis was based on the medical history of otitis media, gradually developed microscopic hematuria, necrotizing granulomatous inflammation on lung histopathology, and a positive proteinase 3-antineutrophil cytoplasmic antibody test.
Antibodies, Antineutrophil Cytoplasmic ; Cytoplasm ; Early Diagnosis ; Fever ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Lung ; Lung Abscess ; Lung Diseases, Interstitial ; Middle Aged ; Otitis Media ; Prognosis ; Respiratory System ; Thorax ; Vasculitis ; Wegener Granulomatosis