The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series ana]ysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis, so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.
Delivery of Health Care* ; Elasticity ; Family Characteristics ; Fees and Charges ; Hand Strength ; Health Expenditures* ; Humans ; Insurance ; Korea ; National Health Programs ; Quality of Health Care

To investigate the factors influencing workers' perception and attitude toward special periodic health screening test for workers, a survey with self-administered questionnaires was performed on 279 workers who had special periodic health screening test from september 1 to October 15, 1994. A study model was developed by modifying the health belief model. The end and intermediate response variables of the model were the voluntary participation and necessity perception on the special screening for workers, and The result of analysis was consistent with the study model. Rates for the necessity perception and voluntary participation on the special1 screening for workers were 77.2%, 79.2%, respectively. Factors influencing on the voluntary participation were necessity perception, benefit of special screening for workers, and cue to action. And on the necessity perception were susceptibility and severity to occupational disease, knowledge to special screening for workers, and support of company. General and occupational characteristics influencing on the susceptibility and severity to occupational disease were sex, age, educational level, work duration, and health education. On the knowledge to special screening for workers were age, educational level, work duration, and locus-of-control. On the benefit of special screening for workers were age, locus-of-control, pride on health, and health education. Therefore, to increase the voluntary participation and necessity perception on the special periodic health screening for workers, l) if a worker is judged as occupational disease, the judgment should be widely known in his workplace, 2) the screening result forms should be directly sent to the workers themselves, 3) for the positivity of employers, the campaign and education program subjected to them should be planned, 4) health education should give the first consideration to the younger, lower educational level, and newly employed women, and its frequency should be increased and it should be more frequently dealt with occupation-related subjects, and 5) the employers should have a careful concern in not being disadvantageous to workers due to result of screening.
Cues ; Education ; Female ; Health Education ; Humans ; Judgment ; Mass Screening* ; Occupational Diseases ; Surveys and Questionnaires

Desmoplastic trichoepithelioma, a tumor of hair follicle, is usually seen as solitary lesions. Its clinical configuration is hard and annular, asympromatic, white or yellowish and varied in size from 3 to 8 mm, but the appearance of these lesion is not so distinctive to hair follicle tumors that the diagnosis is estabilished by the histopathologic findings. Microscopical findings of desmoplastic trichoepithelioma consist of narrow strands of tumor cells, horn cyst, desmoplastic stroma. We present here a case of desmoplastic trichoepitheliorna, which develops as 6 mm sised papule on the left cheek in a 57-year-old woman.
Animals ; Cheek ; Diagnosis ; Female ; Hair Follicle ; Horns ; Humans ; Middle Aged

Many investigators are trying to elucidate the pathogenesis of psychiatric disorders on the basis of neuroendocrine responses to stimulation or perturbation. Dexamethasone(DEX) suppression has been the most widely utilized as the prototypical challenge test. Dexamethasone suppression test(DST) has proven to be valuable in diagnosing the depressive spectrum disorder. Reported specificity of diagnosis of depression is relatively high, but sensitivity is limited. Some researchers used the combination of dexamethasone and corticotropin releasing hormone(CRH) in order to improve the sensitivity. They reported that combined DEX/CRH test, i.e., we administered the insulin instead of CRH. Total subjects were 28(7 normal controls, 10 manic patients, 11 schizophrenic, patients). Subject were token DEX(1.5mg p.o.) at 11 p.m., insulin 16 hours later(0.1 unit/kg i.v.). Five blood samples for the determination of cortisol and ACTH were serially drawn at 15 minute interval. The results are as following : 1) The cortisol an ACTH levels of manic subjects increased following insulin administration. Manic subjects showed higher levels of cortisol and ACTH than schizophrenic and normal control subjects. The cortisol and ACTH levels of schizophrenic and normal control subjects did not show gross changes. 2) The sensitivity of the test was lower than that of reported DEX/CRH test.
Adrenocorticotropic Hormone ; Depression ; Dexamethasone ; Diagnosis ; Humans ; Hydrocortisone ; Insulin ; Research Personnel ; Sensitivity and Specificity

BACKGROUND: It has been known that p16, p21, and TGF-β are related to cellular proliferation and malignant transformation but the results of the previous studies are controversial. OBJECTIVE: This study was performed in order to investigate the possible role of p16, p21, and TGF-β in relation to the cellular proliferation and malignant transformation in various skin tumors. METHODS: For immunohistochemical staining we examined sections (4um thick) of formalin-fixed, paraffin-embedded tissue from 11 cases of squamous cell carcinoma (SCC), 13 cases of basal cell carcinoma (BCC), 7 cases of actinic keratosis, 5 cases of keratoacanthoma, and 4 cases of normal skin for control. Following conventional deparaffinization, the three step immunoperoxidase method was performed using the streptavidine-biotin complex and monoclonal antibodies. All sections were counterstained with hematoxylin. The expression of p16, p21, and TGF-β was evaluated and graded in relation to the intensity of cytoplasmic immunostaining of positive epidermal cells. RESULTS: p16, p21, and TGF-β were detected mainly in the cytoplasm. The p21 positive cells were localized exclusively in the upper squamous layer and were not visualized in the basal layer. The expression of p21 was higher in SCC than BCC (P value=0.03). The expression of p21 in normal control was higher than skin tumors, but there was no significant difference among these tumors. There was a significant loss in the expression of p16 and TGF-β in various skin tumors compared with normal control, but no difference in the expression of p16 and TGF-β among these skin tumors. CONCLUSION: 1. p21 is possibly related to the differentiation of epidermal cells, because p21 was observed not in basal cells but in squamous and granular cells of the normal epidermis and the higher expression of p21 was demonstrated in SCC compared to BCC. 2. It may imply that loss of expression of p16 may play a critical role in malignant trans-formation but not in tumor progression of human malignant skin tumors, because the significant loss of the expression of p 16 was found in SCC and BCC when normal skin and there was no difference in the expression of p16 among various skin tumors but the expression of p16 of SCC is higher than that of actinic keratosis (P value=0.04). 3. It may imply that the loss of the expression of TGF-β may play a critical role in malignant transformation, because the significant loss of expression of TGF-β was found in various skin tumors when compared to normal skin, but there was no difference in the expression of TGF-β among various skin tumors.
Antibodies, Monoclonal ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cytoplasm ; Epidermis ; Hematoxylin ; Humans ; Keratoacanthoma ; Keratosis, Actinic ; Skin

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

A 61-year-old woman, who had been treated by acupuncture on the glabellar region due to frontal headache ten days ago, had a rapidly growing tumor on that region. Histopathologically, the tumor was shown to be a central crater filled with eosinophilic keratin & a marginal but-tress formed by invagination of the epidermis. According to clinical & histopatholpgical findings, we can easily diagnose our case as solitary keratoacanthoma. As shown in our case, we think that acupuncture should be counted as one of the causative factors in the development of solitary keratoacanthoma.
Acupuncture* ; Eosinophils ; Epidermis ; Female ; Headache ; Humans ; Keratoacanthoma* ; Middle Aged

A 61-year-old woman, who had been treated by acupuncture on the glabellar region due to frontal headache ten days ago, had a rapidly growing tumor on that region. Histopathologically, the tumor was shown to be a central crater filled with eosinophilic keratin & a marginal but-tress formed by invagination of the epidermis. According to clinical & histopatholpgical findings, we can easily diagnose our case as solitary keratoacanthoma. As shown in our case, we think that acupuncture should be counted as one of the causative factors in the development of solitary keratoacanthoma.
Acupuncture* ; Eosinophils ; Epidermis ; Female ; Headache ; Humans ; Keratoacanthoma* ; Middle Aged

Erythromelalgia(Erythermalgia) is a syndrome of red, warm, congested, and burning painful extremities. Presently, there are three distinct clinicopathological entities: erythromelalgia, primary erythermalgia, and secondary erythermalgia. Secondary erythermalgia usually arises at an adult age either in association with a detectable underlying disorder or with the use of vasoactive drugs. Typically, it responds to proper treatment of the underlying disorder or discontinuation of the causative drugs. A seven-year-old boy presented with persisting burning pain, erythema, and warmth on both of his feet and lower legs, along with hypertension. He had had this condition for 20 months. Laboratory studies of the patient revealed increased urinary catecholamines and plasma renin activity. Various treatment modalities including aspirin, captopril, sodium nitroprusside, labetalol, epidural block, and stellate ganglion block yielded unfavorable results. Herein, we report an intractable case of secondary erythermalgia associated with hypertension in a child.
Adult ; Aspirin ; Burns ; Captopril ; Catecholamines ; Child ; Erythema ; Erythromelalgia* ; Estrogens, Conjugated (USP) ; Extremities ; Foot ; Humans ; Hypertension* ; Labetalol ; Leg ; Male ; Nitroprusside ; Plasma ; Renin ; Stellate Ganglion

We report two cases of extramammary Paget's disease associated with ad enocarcinoma with metascases. Histologically, Iaget cells in the epidermis and the hair follicles and adenocarcinoma in the der mis was observed in both cases. Of special interest was the demonstration of Eaget cells extending from the involved epidermis to the underlying dermis in case 2, There were metastatic lesioris of 3rd lumbar vertebra in case 1 and of the liver and lymph nodes in rase 2.
Adenocarcinoma* ; Dermis ; Epidermis ; Hair Follicle ; Liver ; Lymph Nodes ; Neoplasm Metastasis* ; Paget Disease, Extramammary* ; Spine