No abstract available.
Asthma*

No abstract available.
Asthma* ; Child* ; Humans

A case of myofibroblastoma of the breast in a 55-year-old man is described. Myofibroblastoma is a relatively recently recognized benign stromal tumor, and predominantly occurs in middle aged men. The pateint presented with a nontender firm mass in his right breast. Fine needle aspiration biopsy revealed bland looking stromal cell clusters without epithelial cells. Simple excision was done and the patient discharged uneventfully. The mass was well demarcated, lobulated and sligtly myxoid. Microscopically bipolar elongated spindle cell fascicles with interspersing broad collagen bands are so characteristic. Ultrastructurally the tumor cell show features of fibroblast as well as smooth muscle cell.
Male ; Humans ; Biopsy

No abstract available.
Humans ; Infant* ; Streptococcal Infections*

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

PURPOSE: The purpose of this study was to describe the clinical characteristics of neonatal urinary tract infection (UTI) caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae UTI. METHODS: We compared clinical characteristics of 84 neonatal patients with UTI caused by Klebsiella pneumoniae who were hospitalized at the Department of Pediatricsat Han Dong University, Sunlin Hospital during the period between May, 1994 and August, 1998. The cases were divided into two groups depending upon causative organisms' Klebsiella pneumoniae UTI vs non-Klebsiella pneumoniae UTI, and the clinical characteristics of these groups were compared. RESULTS: Escherichia coli was the most common bacterial pathogen causing neonatal UTI, followed by Klebsiella pneumoniae. There was no significant difference in the sex distribution of Klebsiella pneumoniae UTI, but non-Klebsiella pneumoniae UTI showed male predominence. There were no significant differences in the incidences of hematologic, urologic, radiologic findings and perinatal complications in between these 2 groups. CONCLUSION: Klebsiella pneumoniae is the second most common pathogen causing neonatal UTI. There were no specific differences in the laboratory, symptomatologic, and radiologic findings in these two groups.
Escherichia coli ; Humans ; Incidence ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Pneumonia ; Sex Distribution ; Urinary Tract Infections* ; Urinary Tract*

Background: The purpose of this study is to describe the current status of the payment rate of the Korean Medical Association (KMA) membership fee and to suggest a way to overcome the decreased payment rate of membership fees by analyzing the causal factors of the decrease. Methods: Quantitative analysis of the KMA membership data, qualitative research of in-depth interviews with 2 staff members of the regional subsidiaries, and literature research were conducted. Results: From the results, 6 major factors for reducing the membership fee payment rate were derived, and plans to improve the payment rate of membership fees were suggested to improve the factors. First, the role of the KMA and the promotion of its members should be strengthened. Second, there should be a flexible adjustment of the membership fee. Third, there should be an enhancement of the transparency of budget execution and increased awareness through the promotion of the members. Fourth, differentiated incentives should be offered to the members who pay dues. Fifth, an improvement of a more efficient and easier payment method should be installed. Finally, legal enforcement measures to pay the membership fee should be considered. Conclusion In order to improve the payment rate of the KMA membership fee, the KMA should try to make the members understand the performance of the business affairs and health policies. Furthermore, incentives that members can feel should be given.

BACKGROUND: Congenital melanocytic nevi may have various shapes according to the anatomic location. Therefore, it is desirable to apply proper surgical designs to the diverse forms considering the characteristics of the sites as well as the shape and size. OBJECTIVE: The purpose of this article is to introduce a new scar-saving flap design for semicircular defects after removing congenital melanocytic nevi without excising additional normal skin. METHODS: In most cases to excise semicircular nevi, normal skin should be excised to prevent dog ear, resulting in the long length of the scar. So we use a new scar-saving flap design by borrowing a partial length from the opposite side. RESULTS: We used this new technique for 4 cases of large semicircular skin defects. In all cases, this method had some advantages from this perspective: (1) it does not require excision of normal adjacent skin to convert a semicircular defect into a crescent shape or to remove dog-ears (2) the final suture line is not much longer than the diameter of the original defect and (3) it makes the removal of a much larger volume possible in one procedure rather than using the classic serial excision technique, which consists of a central elliptical excision within the confines of the nevus. In this way the frequency of procedures and discomfort to the patient can be reduced. CONCLUSION: We think that a scar-saving flap design by borrowing a partial length from the opposite side can be a good strategy for a semicircular skin defect.
Animals ; Cicatrix ; Dogs ; Ear ; Humans ; Nevus ; Nevus, Pigmented ; Skin ; Sutures

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

PURPOSE: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. METHODS: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. RESULTS: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. CONCLUSION: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.
Catheterization ; Catheterization, Central Venous ; Catheterization, Peripheral ; Catheters* ; Delirium ; Hospice Care ; Humans ; Palliative Care ; Retrospective Studies ; Rivers ; Terminal Care ; Terminally Ill* ; Thrombosis