No abstract available.
Pancytopenia*

A 6-year-old girl visited us with a 4-week history of inflammatory, pustular, tender patches and plaques on the scalp, and a 3-day history of multiple, erythematous, indurated, tender, subcutaneous nodules on both pretibial areas. A swab was taken from the scalp lesion and colonies of Tiichophyton mentagrophytes grew on culture. The histopathological findings of the leg nodule were consistent with erythema nodosum. The patient was treated with oral itraconazole and deflazacort, combined with topical potassium permanganate solution. Erythema nodosum regressed two weeks later and the kerion of the scalp regressed six weeks after starting the treatment, leaving residual scarring alopecia. The patient was diagnosed as erythema nodosum probably induced by kerion celsi, that has not been reported in the Korean literature.
Alopecia ; Child ; Cicatrix ; Erythema Nodosum* ; Erythema* ; Female ; Humans ; Itraconazole ; Leg ; Potassium Permanganate ; Scalp ; Tinea Capitis*

No abstract available.
Drug Therapy* ; Humans ; Lung Neoplasms* ; Lung*

No abstract available.

OBJECTIVES: The purpose of this study was to assess the clinical and polysomnographic characteristics of Korean patients with obstructive sleep apnea syndrome (OSAS), especially in relation to differences due to age and gender. METHODS: All subjects were consecutive patients who were proven to have OSAS with nocturnal polysomnography. They were interviewed with a structured interview format including sociodemographic information, past medical history, medication, and sleep-related history. Simultaneously, they were also given Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to answer in order to check subjective sleep quality and subjective sleepiness. RESULTS: Mean age of the 308 subjects was 49.5+/-13.3 years, with 77.6% of the subjects being males and 22.4% of the subjects being females. The aging effects on the sleep architecture in Korean OSAS corresponded with normal aging, but with the effect of OSAS itself superimposed, the extent of aging effects was more marked than that of normal aging. The severity of Korean patients of OSAS was not correlated with age. When divided into age subgroups, significant correlation was found between RDI and BMI in patients of each subgroup of those in the 4th to 7th decades. The oldest subgroup (>70 years) described their subjective sleep quality as poorer than any other age subgroups, despite of less subjective drowsiness. The severity of OSAS and the change of sleep architecture of male subjects turned out to be severer than those of female ones. The female/male ratio of the subjects tended to increase with aging. CONCLUSIONS: The aging effect on the sleep architecture in Korean OSAS seems to be a mixture of the changes by normal aging and sleep disorder per se. The severity of OSAS was not correlated with age, but highly correlated with BMI. The severity of OSAS and the change of sleep architecture of male patients were severer than those of female ones.
Aging ; Body Mass Index ; Female ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; Sleep Stages

Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.
Adenoma

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows ; (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and inpatient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity. (3) In case of physician's inpatient and adjusted-patient service, nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.
Censuses ; Efficiency* ; Health Planning ; Hospitals, General* ; Hospitals, Teaching ; Humans ; Inpatients ; Korea ; Nursing ; Outpatients ; Physician's Role

OBJECTIVES: This exploratory study was designed to estimate the socio-demographic characteristics, course of homelessness, adverse childhood experiences, and prevalence of mental disorders among the street homeless people in Seoul, Korea. In addition, we examined the associations between chronic homelessness and study variables. METHODS: The study subjects were 75 homeless people dwelling in the street around Seoul Station. Questionnaires related to socio-demographic data and the course of homelessness were provided to each subject. The subjects' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorder diagnoses were made by using Mini International Neuropsychiatric Interview-Plus interviews. RESULTS: Most subjects exhibited chronic homelessness and the prevalence of DSM-IV mental disorders among the homeless subjects was higher than that among the Korean general population. There was a statistically significant association between chronic homelessness and adverse childhood experiences. Compared to those with no history of childhood adversity, homeless people with a history of childhood adversity had a younger age of first homeless episode and a higher prevalence of DSM-IV major mental disorders. The association between DSM-IV diagnosis and chronic homelessness was not significant, but the group with mental disorders had more prevalent re-housing and homeless recurrent histories. CONCLUSION: Street homeless people were often involved in chronic homelessness. Results of this study suggest that homeless people who were never married and had adverse childhood experiences were more vulnerable to chronic homelessness. In addition, we detected a possible relationship between the recurrence of homelessness and the presence of mental disorders.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Homeless Persons* ; Humans ; Korea ; Mental Disorders ; Prevalence ; Recurrence ; Seoul ; Single Person

BACKGROUND: This study used MDS-HC 2.0 (Minimum Data Set-Home Care) to analyze the health and the state of function of the traveling health objects. This study was intended to make use of it with the basic materials for providing them with traveling health service suited for the requirement on the health of the traveling health objects. METHODS: The subjects of this study were 1160 people (over 65 years) living under management control of local Health Center from September 7th to October 3th, 2006. This study was analyzed with inter RAI program & SPSS/WIN 10.0, chi-square -test, t-test, and ANOVA. RESULTS: The result showed that 8.97 CAPs per an elderly person was identified and the subjects over 60% had an injury problem from a fall, health prevention service, vision, IADL, pain, and cognition. The number of CAPs in general was high in higher age and the less educated, and those without a job. But, in subjects that had a life partner and a spouse, the number of CAPs was low. In CAPs by the distinction of sex, CAPs which was much more in man than women in statistics were the improvement of health, the abuse of alcohol and drinking wine, bedsore, and the weak supply system. CAPs which women had much more were the function of the heart and the lungs, pain, the performance of the doctor's advice, health prevention service, and incontinence of urine and insertion of catheter. According to the results comparing CAPs by the level of the ADL, the number of CAPs was shown that the group of ADL 2 was higher than group ADL 1. The matter in which the traveling health service had to be applied in all both ADL1 and ADL2 was injury from a fall, health prevention service, and vision. Conculsion: MDS-HC is applicable to decide the care needs for health and social service supplies. The results can be further applicable for careplan, and referral criteria in continuum of care service over long-term care spectrums.
Activities of Daily Living ; Aged ; Catheters ; Cognition ; Continuity of Patient Care ; Drinking ; Equipment and Supplies ; Female ; Health Services ; Heart ; Humans ; Long-Term Care ; Lung ; Pressure Ulcer ; Referral and Consultation ; Social Work ; Spouses ; Vision, Ocular ; Wine

Depression is a common psychiatric disorder, but accurate recognition of depression is somewhat difficult because of different symptom presentation by age. The consequence of not recognizing to depression is that clinically significant and potentially treatable depression might be overlooked, misdiagnosed, and mistreated in depressive patients. The overlap of somatic symptoms of depression and physical illness and minimal expression of sadness is common in old age. Because of that reasons, alternative approach to identifying depression should be provided by proper screening instruments.
Depression ; Humans ; Mass Screening