Extraskeletal Neoplasm Resembling Ewings Sarcoma was firstly reported with comprehensive review of 39 cases by L. Angervall and F.M. Enzinger in 1975. The tumors chiefly affected young adults and most commonly involved the soft tissue of lower extremity. Microscopically, they were consisted of solidly packed small, round or ovoid cells arranged in sheets or lobules, which were indistinguishable from those of the Ewings sarcoma of bone. The authors recently experienced a soft tissue sarcoma occurring in deltoid area of young male patient, which was diagnosed extraskeletal neoplasm resembling Ewings sarcoma. The case review is presented.
Humans ; Lower Extremity ; Male ; Sarcoma ; Sarcoma, Ewing ; Young Adult

PURPOSE: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. METHODS: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. RESULTS: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). CONCLUSION: Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.
Cost Sharing ; Delivery of Health Care ; Early Detection of Cancer ; Health Behavior ; Health Care Costs ; Health Expenditures ; Humans ; Korea ; Medicaid ; Medication Adherence ; National Health Programs ; Outpatients ; Quality of Life ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. METHOD: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. RESULTS: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. CONCLUSIONS: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.
Case Management ; Compliance ; Delivery of Health Care ; Health Behavior ; Hospital Costs ; Humans ; Medicaid ; Medication Adherence ; Outpatients ; Surveys and Questionnaires ; Telephone

No abstract available.
Delivery of Health Care* ; Family Practice* ; Humans ; Inpatients* ; Insurance* ; Korea*

No abstract available.
Humans*

The role of GABA or glycine as an inhibitory neurotransmitter is well established, and GABAergic or glycinergic neurons appear to play an important role in the mammalian retinas. It has been reported that certain amacrine, bipolar, displaced amacrine and ganglion cells are consistently labeled with anti-GABA or anti-glycine antisera in the mammalian retinae so far, and it has been suggested that colocalization of GABA and glycine within the retinal neurons could be common in the mammalian retina by recent immunecytochemical and electrophysiological studies. This study was conducted to localize GABAergic and glycinergic neurons and to define whether GABA and glycine are colocalized within same retinal neurons of the rat retina by immunocytochemical method using anti-GABA and anti-glycine antisera. The results were as follows : 1. GABAergic neurons of the rat retina were amacrine, interplexiform, bipolar, displaced amacrine and ganglion cells, and processes of GABAergic neurons formed dense networks with distinct two bands in the inner plexiform layer. 2. Glycinergic neurons were amacrine, bipolar, displaced amacrine and ganglion cells,and their processes were evenly distributed as dense networks through whole inner plexiform layer. 3. 28.5% of GABA immunoreactive amacrine cells and 9.8% of GABA immunoreactive bipolar cells located in the inner nuclear layer,and 11.9% of labeled neurons located in the ganglion cell layer showed glycine immunoreactivity in the rat retina. These results demonstrate that GABA and glycine, major inhibitory neurotransmitters, are colocalized within certain amacrine and displaced amacrine cells, and a few bipolar cells, and that neurons synthesizing and utilizing both GABA and glycine as their neurotransmitters may play an unique role in the visual processing in the rat retina.
Amacrine Cells ; Animals ; GABAergic Neurons ; gamma-Aminobutyric Acid* ; Ganglion Cysts ; Glycine* ; Immune Sera ; Neurons* ; Neurotransmitter Agents ; Rats* ; Retina* ; Retinal Neurons

We carried out the Schirmer test to measure objectively the amount of lacrimation among 51 clinically diagnosed parkinsonian patients (33 men and 18 women aged 50 to 79 years, mean 64) and 75 age-matched controls (42 men and 33 women aged 50 to 76, mean 62). Whatman No. 2 paper, prepared in precut strips 5mm by 35mm, was placed in the cul-de-sac for five minutes, after which the wetted length of the strip was studied. It was noted that the lacrimation amount decreased in patients with Parkinson's disease compared with controls: the average amount of lacrimation was 3.4 +/- 2.3mm in the former group and 8.1 +/- 6.5mm in the latter group (p < 0.01). We believe that the decrease in the amount of lacrimation is associated with emotional disturbance and autonomic dysfunction, and presume that the lacrimation may be under the control of the basal ganglia which has a connection with the superior salivatory nucleus downward and the limbic system upward.
Aged ; Autonomic Nervous System/physiopathology ; Female ; Human ; Limbic System/physiopathology ; Male ; Middle Age ; Parkinson Disease/*physiopathology ; Tears/*secretion

BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

BACKGROUND: Chronic idiopathic thrombocytopenic purpura is an autoimmune disorder caused by sequestration of antibody-sensitized platelets in the reticuloendothelial system. However, uncertainty as to the specificity, frequency and clinical significance of such antibodies still remains. So, we tried to further clarify the above uncertainty in childhood chronic idiopathic thrombocytopenic purpura. METHODS: We analyzed sera from 29 patients. Twenty six patients were chronic ITP who were admitted or followed up to the Department of Pediatrics, Severance Hospital, Yonsei University Medical College from August 1996 to March 1997 by employing a modified antigen-capture ELISA(MACE), flow cytometry and electrophoresis(SDS-PAGE) and immuno-blotting(IB) assays. Three patients with ITP less than 6 months after onset of ITP were included to know the possibility to differrentiate between acute ITP and chronic ITP in this study. RESULTS: 1) Glycoprotein(GP)-specific antibodies were found in 28% (8/29) of patients, with 2 patients having antibodies directed solely to Gp II b/III a, no patients holding antibodies specific only for GPI b/I X and 6 possessing antibodies against both anti-GP I b/I X and Gp II b/III a antigen. 2) The detection rate of GP-specific antibodies of flow cytometry was about 10%. The positivity of anti-GPI b/I X antibodies by MACE and immunoblotting was 14% (4/29), respectively, the positivity of anti-Gp II b/III a antibodies by MACE and immunoblotting was, 21 % (6/29) respectively. The concordance rate between two assays(MACE and IB) was 79% (23/29). None of the three methods was good enough to stand alone. 3) Serum antibodies were not more frequently detected in active(p=1.0) or non-splenectomized(p=.54) chronic ITP patients. 4) No association was found between antibody specificity(anti-GPI b/I X, anti-Gp II b/ III a) and platelet counts(p : .87). CONCLUSION: We conclude that in korean childhood chronic ITP, antibodies against both anti-GPI b/I X and Gp II b/III a antigen were predominant antibody. But, the longterm follow-up in more cases is needed to further clarify the clinical significance of antral-platelet antibody in chronic ITP should be assessed.
Antibodies* ; Blood Platelets* ; Flow Cytometry ; Follow-Up Studies ; Humans ; Immunoblotting ; Mononuclear Phagocyte System ; Pediatrics ; Purpura, Thrombocytopenic, Idiopathic* ; Sensitivity and Specificity ; Uncertainty

A preliminary study was performed to investigate the staining characteristics of trabecula. endothelial cells with low density lipoprotein (LDL) and acetylated low density lipoprotein (Ac-LDL) labeled with a fluorescent probe, 1, 1`- dioctadecyl-3,3,3`, 3`- tetramethyl-indocarbocyanine perchlorate (Dil). Trabecular endothelial cells revealed a strong fluorescence with Dil-LDL, which was contradictory to the previous results obtained from other types of endothelial cells. These cells also showed a moderate fluorescence with Dil-Ac-LDL. Scleral fibroblasts and keratocytes showed a moderate to strong fluorescence with Dil-LDL and a weak fluorescence with Dil-Ac-LDL. Corneal endothelial cells revealed a very weak background fluorescence with Dil-LDL and a moderate fluorescence with Dil-Ar-LDL. Therefore, these four kinds of cells could not be definitely differentiated depending only on the staining characteristics with Dil-LDL and Dil-Ac-LDt.
Animals ; Cattle ; Endothelium/cytology ; Fluorescent Dyes/*diagnostic use ; Lipoproteins, LDL/*metabolism ; Trabecular Meshwork/*metabolism