We present the therapeutic effects of an aromatic retinoid (Ro 10-9359) in two cases of sex-linked ichthyosis. Case 1, Uncle of Case 2, was a 24-year-old male who had had dark brown scales on the trunk and upper extremities for 15 years. Case 2 was a 10-year-old boy who had had dirty brown scales on the trunk and lower extremities since 3 years of age. The diagnosis of sex-linked ichthyosis was made by characteristic scales and histopathologic findings. Initially, both patients received an oral aromatic retinoid (Ro 10-9359) with a daily dose of 1.5mg/kg body weight for the first two weeks. Thereafter the drug was tapered gradually to the dose of 0.5mg/kg body weight according to the therapeutic response. There was near complete clearing of the skin lesions in both patients after 10 weeks treatment. Side effects were of mild intensity and included dryness of mouth and nose, chelitis, paronychia and arthralgia of knee joint.
Arthralgia ; Body Weight ; Child ; Diagnosis ; Humans ; Ichthyosis* ; Knee Joint ; Lower Extremity ; Male ; Mouth ; Nose ; Paronychia ; Skin ; Upper Extremity ; Weights and Measures ; Young Adult

It is believed that the photopatch test is a valuable screening procedure for the determination of responsible antigenic substances in photoallergic contact dermatitis. But the technigues used for this procedure are cumbersome and require expensive equipment. In the present study, we adapted an easy and inexpensive photopatch test met- hod to our need. We report the results of this test method which was performed. in 21 patients with photodermatitis and 9 patients with polymorphic light eruption. 1. The UVB sensitivity determined by minimal erytherna dose (mean+-standard deviation) was I1618mW sec/cm in photodermatitis group, 108+ROmW sec/cm in polymorphic light eruption group and 126-+32mW-sec/cm in control group. But there was no significant difference among them (p>0. 05). 2. The reaction to UVA were negative in all groups. R. The photopatch test using IO potential photosensitizers revealed 12 positive responses in 9 patients; including 7 patients in photodermatitis group and 2 patients in polymorphic light eruption group. And the number of positive photopatch responses obtaied with each photosensitizer in RO patients with photodermatoses was 5 in chlorhexidine, 2 in paraaminobenzoic acid, musk ambrette and bithionol and 1 in chlorpromazine, respectively.
Bithionol ; Chlorhexidine ; Chlorpromazine ; Dermatitis, Photoallergic ; Humans ; Mass Screening ; Photosensitivity Disorders ; Photosensitizing Agents

Background: Korea National Health Insurance Service (NHIS) is operated as a social insurance system in which people pay a portion of their monthly income as insurance premiums and receive benefits when they experience illness or injury. Since 2005, the national health insurance remained surplus accumulating cumulative reserves each year. However, as of 2018, NHIS revenue recorded 62.11 trillion won and spending of 62.29 trillion won. The deterioration of NHIS finances is expected to accelerate with the aging population, income growth, new medical technology development, and enhanced security policies. Methods: To examine the financial health and sustainability of NHIS, we estimated the future revenue and spending until 2030 using the data from Korea Health Insurance Review and Assessment Service statistical yearbook. 2004–2018 average percentage change in NHIS revenue and spending was calculated. We estimated the future NHIS financial status using two methods. In the first method, we calculated the revenue and spending of the future NHIS by applying the 2004–2018 average percentage change to the subsequent years consecutively. In the second method, we estimated the future NHIS financial status after adjusting for the predicted demographic changes such as the aging population and declining birth rate in South Korea. Results: The estimates from this study suggest that the NHIS’s cumulative reserves will run out by 2024. Conclusion In terms of spending on current health insurance, there should be a search for ways of more efficient spending and funding options.

With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.
Arteries ; Brain Infarction ; Brain ; Depression ; Diagnosis ; Humans ; Infarction ; Ischemia ; Jeollabuk-do ; Middle Cerebral Artery ; Stroke, Lacunar ; Tomography, X-Ray Computed

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2020), the Community Health Survey (CHS, 2008–2020), the Korea Health Panel Survey (KHP, 2011–2018), and the Korean Welfare Panel Study (KOWEPS, 2006– 2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

No abstract available.
Cataract* ; Chlorpromazine* ; Skin Pigmentation* ; Skin*

Hepatoblastoma is the most common primary malignant liver tumor encountered during childhood. Complete surgical resection is the most important factor in predicting which children would achieve cure. Some chemotherapy regimens are effective in reducing tumor size, often rendering initially unresectable lesions amenable to complete surgical resection, and dramatically improving disease-free survival. Liver transplantation provides an additional treatment option for patients whose tumor remains unresectable even after preoperative chemotherapy. We report a case of unresectable hepatoblastoma in a child who underwent living related liver transplantation with pre and post-operative chemotherapy.
Child* ; Disease-Free Survival ; Drug Therapy ; Hepatoblastoma* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors*

A 70-year-old female was referred for brown-to-gray colored papules and nodules on her lower legs. She had been diagnosed with diffuse large B-cell lymphoma (DLBCL) in her stomach, and myelodysplastic syndrome (MDS) by bone marrow biopsy. Three years after complete remission of DLBCL, she experienced DLBCL recurrence in her small bowel and was hospitalized. MDS had been stationary, but during the treatment of DLBCL, her laboratory findings suggested signs of leukemia. Bone marrow biopsy was done, and acute monoblastic leukemia (AMoL) was diagnosed. After 1 cycle of chemotherapy for AMoL, skin lesions developed, and her skin biopsy showed cutaneous T-cell lymphoma (CTCL). Terminal deoxynucleotidyl transferase staining and CD123 staining were negative, and bone marrow re-biopsy conducted after the skin lesion developed still showed monoblastic proliferation. Whether the CTCL represented with an AMoL lineage switch could not be completely proved due to the absence of molecular or clonal marker evaluations, but the possibility of coexistence of three different malignancies was higher. During treatment, a neutropenic fever developed, and the patient died due to sepsis. We herein report a rare case of CTCL accompanied by AmoL and DLBCL.

If hypertensive emergencies are left untreated, multiple damages on heart, brain and kindney can develop. So rapid control of blood pressure within safty with effective antihypertensive agents is mandatory. For the comparison of antihypertensive effects among hydralazine (IV or IM), clonidine (IV), and nifedipine (sublingual) in hypertensive emergency, which were frequently used in our hospital, we performed propective study with hypertensive emergency patients(243 cases) who visited emergency room from Oct. 1986 until Aug. 1987. The results are as follows ; 1) For 58 patients who recieved hydralazine (IV or IM), initial mean arterial blood pressure(MAP) was 167.2+/-21.5mmHg and 15 minutes later 138.9+/-24.4mmHg, 45 minutes later 141.7+/-21.1mmHg, 90 minutes later, 133.9+/-26.6mmHg and, respectively. For 55patients who recived clonidine(IV), initial MAP was 164+/-21.9mmHg and 15minytes later 137.4+/-18.9mmHg, 45 minutes later 127.5+/-34.9mmHg, respectively. For 130 patients who recived nifedipine(sublingual), initial MAP was 159.8+/-21.4mmHg and 15 minutes later 143.0+/-22.8mmHg, 45 minutes later 127.5+/-21.1mmHg, 90 minutes later 119.3+/-20.0mmHg, respectibely. 2) Pulse rate showed 12.9% increase afer administration of hydralazine, 15.8% decrease in clonidine, 5.6% increase in nifedipine, respectively. 3)Severe reduction of blood pressure(systolic BP<130mmHG) after administration of following antihypertensive agents was found. i.e., hydralazine 5.2%, clonidine 1.8%, nifedipine 1.5%, respectively. 4) In 4 cases(6.9%) out of the 58 cases using hydralazine, 3 cases(5.5%) out of the 55 cases using clonidine, 9 cases(6.9%) out of the 130 cases using nifedipine, acute paradoxic hyertensive effects were observed.
Antihypertensive Agents ; Blood Pressure ; Brain ; Clonidine* ; Emergencies* ; Emergency Service, Hospital ; Heart ; Heart Rate ; Humans ; Hydralazine* ; Nifedipine*

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.
Brain ; Cysticercosis ; Hemianopsia ; Humans ; Optic Chiasm* ; Pituitary Apoplexy ; Prevalence ; Retrospective Studies ; Visual Fields