Benign lichenoid keratosis is an asyrnptomatic, isolated, plaque-like lesion frequently mistaken for basal cell carcinoma, Bowens disease, and actinic or seborrheic keratosis because of its variable clinical appearance. We present two cases of benign lichenoid keratosis. The first case was a 44-year-old female who had mild pruritic, ll x15rnrn sized, single, slightly elevated brownish plaque with fine scaling on the right zygornatic area of 5 years' duration. The second case was a 35-year-old female who had mild prutitic, single, pea- sized erythernatous patch on the left ala nasi of one month's duration. On histologic examination, these two cases showed same histologic findings, such as focal parakeratosis, moderate hyperkeratosis, irregular acanthosis and liquefaction degeneration of basal cells in the epidermis and band-like mononuclear infiltration and colloid bodies in the dermis.
Actins ; Adult ; Bowen's Disease ; Carcinoma, Basal Cell ; Colloids ; Dermis ; Epidermis ; Female ; Humans ; Keratosis* ; Keratosis, Seborrheic ; Parakeratosis

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 "The Medical Insurance program for self-Employeds Statical Yearbook", and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows: We have divided benefits into these four components such as the utilization rate for out-patients. expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings: in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are: first, the determinant factor for administrative expenses was the number of households. The more the number of household, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second. in urban areas. the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas. a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Since the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.
Family Characteristics ; Financial Management ; Health Expenditures* ; Humans ; Insurance Carriers ; Insurance* ; Jurisprudence ; Outpatients ; Public Health ; Rehabilitation ; Societies, Medical

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
Biliary Tract ; Colonic Neoplasms ; Communicable Diseases ; Diabetes Mellitus ; Endophthalmitis ; Escherichia coli ; Hepatic Artery ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Neoplasm Metastasis ; Pneumonia ; Portal Vein ; Pulmonary Embolism ; Risk Factors ; Stomach Neoplasms*

BACKGROUND AND OBJECTIVES: Fulminant invasive fungal sinusitis (IFS) is an aggressive, destructive disease most commonly affecting the immunocompromised hosts. This study aimed to investigate the clinical features of invasive fungal sinusitis and to determine its prognostic factors. MATERIALS AND METHOD: Fifteen cases of invasive fungal sinusitis were retrospectively reviewed. Prognosis was analyzed according to predisposing factors including the underlying disease, the extent of disease, the mycotic species, and treatment modalities. RESULTS: Overall 5-year survival rate of the patients with IFS was 60%. There was significant survival gain in the group for which underlying disease was well controlled (p=0.04). There was no difference in survival in terms of mycotic species and extent of disease at presentation. No statistically significant difference in survival was observed between the conservative surgery and the radical surgery group. CONCLUSION: Survival is usually determined at the very early period of treatment. The most important prognostic factor is not the surgical modalities including wide surgical resection or conservative debridement, but the optimal control of underlying disease.
Causality ; Debridement ; Fibrinogen ; Humans ; Immunocompromised Host ; Prognosis ; Retrospective Studies ; Sinusitis* ; Survival Rate

BACKGROUND AND OBJECTIVES: We report our initial experience with percutaneous transvenous closure of atrial septal defects (ASD). MATERIALS AND METHOD: Between September 1997 and May 2000, we attempted transcatheter closure of ASD in 18 patients using CardioSEALTM (8), STARFlexTM (4) and Amplatzer septal occluder (6). The ages of patients ranged from 4.5-64.8 (mean 32.8) years, body weight ranging from 16-76 (mean 51) kg, Qp/Qs ratio from 1.3-3.4 (mean 2.2). RESULTS: Embolization of device occurred in two patients; right pulmonary artery in one and left atrium in the other. In one patient, the device slipped into the right atrium before detachment. After retrieval of the device, the defect seemed too large for transcatheter closure. There were no other complications apart from a transient aggravation of pre-existing atrial premature beats in two patients. There was no significant size difference between the data measured by transthoracic and transesophageal echocardiography. The stretched ASD diameter was larger (5.1 3.2 mm) than the size measured by transesophageal echocardiography. In the remaining 15 patients, complete closure of defects was confirmed by transthoracic echocardiography on the 1 day or 1 month follow-up. During the same period, transcatheter closure of patent foramen ovale(PFO) was also attempted in 7 patients with stroke. The guidewire could not be passed in 2 of the patients. In the other 5 patients, transcatheter closure was successfully performed without any problems. Though the follow-up period may have been short, no patients were found with further stroke attack. CONCLUSION: Transcatheter closure of ASD can be performed with high efficiency and safety if patient selection is adequate. The indication for ASD closure can be extended to patients with larger defects. Transcatheter closure of PFO is an easy and safe procedure, but the indications of PFO closure in patients with stroke is still unclear. Further evaluation is necessary for long-term results.
Body Weight ; Cardiac Complexes, Premature ; Echocardiography ; Echocardiography, Transesophageal ; Follow-Up Studies ; Heart Atria ; Heart Septal Defects, Atrial* ; Humans ; Patient Selection ; Pulmonary Artery ; Septal Occluder Device ; Stroke

To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviewed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per 100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Birth Intervals ; Birth Rate ; Child ; Condoms ; Contraception ; Family Planning Services ; Female ; Fertility* ; Follow-Up Studies* ; Humans ; Korea ; Live Birth ; Menstruation ; Middle Aged ; Parturition ; Pregnancy Rate ; Pregnancy* ; Pregnant Women ; Primary Health Care ; Spouses

PURPOSE: To find the risk factors associated with coronory artery lesions, non-responsiveness to intravenous immunoglobulin(IVIG) treatment, and recurrences in Kawasaki disease patients. METHODS: We retrospectively analyzed 1,000 Kawasaki disease patients who were admitted to Yonsei University Medical Center from September 1990 to December 2003. We compared between responder and non-responder groups to IVIG treatment as well as between relapsed and non-relapsed groups, and as to the relapsed group, we also compared variables between patients in their first and second attack states. Finally, factors associated with longer-fever duration from disease onset were evaluated. RESULTS: Longer fever durations before and after IVIG treatment, male sex, lower Hgb and Hct level, higher WBC count and segmented WBC proportion, and higher CRP and Harada's score were related with coronary artery lesions. Non-responsiveness was related to higher WBC count, segmented WBC proportion, CRP, SGPT, Harada's score, and pyuria. Moderate-to-severe coronary artery dilatations and recurrences were more commonly seen among the non-responder group. No significant predictive factors for recurrence were found. In the relapsed group, lower WBC count, CRP, and shorter fever duration from disease onset were observed in their second attack state. Fever duration from disease onset showed positive correlation with WBC count, CRP, and Harada's score and negative correlation with Hgb levels. CONCLUSION: Higher WBC count, CRP, and higher Harada's score were related to both higher incidences of coronary artery lesions and non-responsiveness to IVIG treatment, and these factors were also related with longer fever duration. Non-responders to IVIG treatment showed higher recurrence rate and more moderate-to-severe coronary artery dilatations than responders.
Academic Medical Centers ; Alanine Transaminase ; Arteries ; Coronary Vessels ; Dilatation ; Fever ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Male ; Mucocutaneous Lymph Node Syndrome* ; Pyuria ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Treatment Outcome

This study was conducted to estimate the prevalence rate of cervical cancer and to investigate its risk factors. 5,417 asymptomatic married women were screened from March, 1984 to December, 1990 in Taegu city. Of 5,417 examinees, 3,817 (70.46%) were normal, 1,542 (28.7%) showed inflammatory change, 51 (0.94%) were dysplasia and 7 (0.13%) were carcinoma in situ or invasive carcinomas. The prevalence of abnormal finding (dysplasia, carcinoma in situ or invasive carcinoma) was 1,070 per 100,000 population. The prevalence of dysplasia was 940 per 100,000 and that of carcinoma in situ or invasive carcinoma was 130 per 100,000. Age-adjusted prevalence rate for abnormal finding adjusted with standard population of Taegu city was estimated to be 850 per 100,000. The prevalence of cervical cancer was significantly increased with age (P<0.05). The prevalence of cervical cancer was significantly decreased with age at marriage and educaitonal level (P<0.05). The history of induced abortion and the number of pregnancies were significantly associated with the prevalence of cervical cancer (P<0.05), whereas, the number of parity was not. Age at marriage was significantly associated with the prevalence of cervical cancer after stratification by age (P<0.05). However, the level of education, parity, induced abortion, number of pregnancies were not significant. Inflammation and human papiloma virus infection were associated with cervical cancer with odds ratio of 13.48(95% confidence interval 7.80~23.40) and 474.29 (95% confidence interval 196.80~1143.10), respectively. In conclusion, for early detection of cervical cancer it should be recommended to perform mass cytological screening. In particular, regular and periodic cytologic screening, starting at age 25, for cervical cancer should be recommended for those women who have frequent cervical inflammation and for those women married before age of 20.
Abortion, Induced ; Carcinoma in Situ ; Daegu ; Education ; Female ; Humans ; Inflammation ; Marriage ; Mass Screening* ; Odds Ratio ; Parity ; Pregnancy ; Prevalence ; Risk Factors ; Uterine Cervical Neoplasms*

Microbiomes are known to have a beneficial effect on human health by promoting the effective removal of improperly functioning immune cells and protecting the host from pathogen infection. On the other hand, these microbiomes are also known as the causative agent of numerous malignant tumors. Until now, the bladder has been regarded as aseptic, but the concept of the “sterile bladder” has been changed with the discovery of living bacteria embedded in the bladder with the recent development of polymerase chain reaction and culture techniques. This paper referred to the relationship between microbiome and bladder cancer. Microbiome will be able to be seen as a non-invasive biomarker to predict the success rate of intravesical bacillus Calmette-Guerin instillation treatment in patients of bladder cancer.

Microbiomes are known to have a beneficial effect on human health by promoting the effective removal of improperly functioning immune cells and protecting the host from pathogen infection. On the other hand, these microbiomes are also known as the causative agent of numerous malignant tumors. Until now, the bladder has been regarded as aseptic, but the concept of the “sterile bladder” has been changed with the discovery of living bacteria embedded in the bladder with the recent development of polymerase chain reaction and culture techniques. This paper referred to the relationship between microbiome and bladder cancer. Microbiome will be able to be seen as a non-invasive biomarker to predict the success rate of intravesical bacillus Calmette-Guerin instillation treatment in patients of bladder cancer.