Melanosis duodeni is an uncommon pathologic condition characterized by diffuse small black spots on the first and second portions of the duodenum. It occurs predominantly in elderly patients and is linked to chronic renal failure, use of antihypertensive drug and oral iron supplementation, and/or presence of gastric hemorrhage. We report a case of melanosis duodeni in a 60-year-old woman diagnosed with hypertension 20 years ago and chronic renal failure 6 years ago. She has taken antihypertensive drugs for many years. On endoscopy, speckled black pigmentation of duodenal mucosa was detected. Microscopically, this duodenal lesions showed numerous coarse pigments in macrophages confined within the lamina propria. By ultrastructural study, macrophages contained electron-dense granules admixed with lipofuscin-like material in residual bodies.
Aged ; Antihypertensive Agents ; Duodenum ; Endoscopy ; Female ; Hemorrhage ; Humans ; Hypertension ; Iron ; Kidney Failure, Chronic ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Pigmentation

OBJECTIVES: The purpose of this research is to help solve adolescent issues involving substance uses, which may become begin to undergo many changes(i. e. practising various roles, thereby leading to independent life styles). More often than not, adolescent drug problems develop into social problems, chiefly behavioral imitations and heavy dependence on medicine. The authors conducted a survey of adolescent substance uses to develop preventive measures against the drug habit prevalent among young people, thereby formulating a policy to deal with problematic community. Funded by a Youth Counselling Center in the city of H. the research was conducted on the following assumptions that there will be:Firstly, a comparison of drug uses by sex and age:Secondly, variance of substance users by family background and peer group:Thirdly, a combination of heavy drinking, smoking and delinquency resulting in the drug habit. METHODS: The survey included a total of 1613 students during 3 days, 12 through 14, July, 1999. The subjects were 833 pupils(51.6%) from 4 middle schools and 780 students(48.4%) from 3 high schools in the city of H with a ratio of 49.5 %(males) and 50.5%(females). RESULTS: 1) Experience of substance use is most referable to drinking(59.4%) and smoking(34.4%) while given to analgesics(33.1%) among medicines, glue(0.7%) among inhalants and philophone(0.4%) among narcotics. 2) High school students found more than double the amount of smoking and drinking as well as uses of hypnotics, stimulants and sedatives by junior high school students. 3) Our resalt showed was significantly noted that non-users had a better relationship with their parents than most users. 4) Smoking and drinking problean could be more easily developing into adolescent substance uses. 5) Alcohol, cigarette, and drug users showed more misconducts than other adolescents. 6) Most adolescents believe that drinking is necessary for making friends(55.0%), while smoking is just for killing time(50.9%). 7) Drinking, smoking, and other substance users were found to develop into more problematic habits. CONCLUSION: The present survey and several others show that adolescent substance uses in Korea are on the rise. Therefore, extensive counter-measures will be necessary followed by nationwide epidemiological survey of the pending issue, with the psychiatrists participating in the campaign.
Adolescent* ; Drinking ; Drug Users ; Financial Management ; Homicide ; Humans ; Hypnotics and Sedatives ; Korea ; Narcotics ; Parents ; Psychiatry ; Smoke ; Smoking ; Social Problems ; Tobacco Products

Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.
Actins ; Adipose Tissue ; Aged ; Angiomyolipoma* ; Blood Vessels ; Cytoplasm ; Desmin ; Eosinophils ; Epithelioid Cells ; Estrogens ; Female ; Giant Cells ; Glycogen ; Hamartoma ; Humans ; Keratins ; Kidney* ; Melanosomes ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Receptors, Progesterone ; Tuberous Sclerosis ; Vimentin

Exercise is one of the most ubiquitous triggers of acute bouts of asthma. Late asthmatic responses(LARs) have been described following strenuous exercise, as in allergen-induced asthma. However, most studies have reported that airway responsiveness is not increased after exercise, even in subjects with LAR to exercise. This suggests that LAR after exercise may not be associated with inflammatory changes in the airways. We have frequently seen asthmatic children whose complaint is that symptoms are exacerbated at night after strenuous daytime exercise. Furthermore, airway responsiveness to allergen was reported to increase after LAR to exercise. Therefore, it is crucial to know whether exercise can induce airway inflammation, as in allergen-induced asthma. As an indirect measure to investigate it, we measured the activation status of eosinophil granulocyte in the peripheral blood during the early and late phase of exercise- or allergen-induced asthma. Eight subjects who showed early asthmatic response(EAR) and LAR(group 1), or EAR only (group 2) to allergen (Dermatophagoides pteronyssinus) challenge were selected. Similarly eight subjects who showed EAR and LAR(group 3), or EAR only (group 4) to exercise were selected. Blood samples were drawn at baseline, the early phase, the late phase, and 24 hours after each stimuli. Eosinofphil cationic protein (ECP) was measured in the serum. Eosinophil granulocytes were separated and the production of leukotriene C4 (LTC4) from purified eosinophfis was measured after stimulation with the calciumionophore. Serum levels of ECP were unchanged at EAR after allergen or exercise challenge. In the dual responder to allergen (group 1), serum ECP level was elevated at LAR and 24 hours after allergen challenge, as compared with the baseline level. On the other hand, in the dual responder to exercise (group 3), it remained unaltered up to 24 hours after exercise challenge. Eosinophils at EAR after allergen or exercise challenge in each group generated the similar amounts of LTC4 as baseline values. In group 1, the production of LTC4 was slightly increased though not significantly at LAR, and significantly increased 24 hours after allergen challenge. In group 3, it was increased significantly at LAR, but restored to the baseline values at 24 hours after exercise challenge. These results indicate that not only allergen but also exercise can activate eosinophils in accordance with LAR. The present findings suggest that LAR to exercise may also have the potential to induce airway eosinophilic inflammation although its duration may be shorter than that of LAR to allergen. Therefore exercise should be understood not only as a triggering factor of bronchoconstriction but also as one that incites or deteriorates airway inflammation.
Asthma* ; Bronchoconstriction ; Child ; Ear ; Eosinophils* ; Granulocytes ; Hand ; Humans ; Inflammation ; Leukotriene C4

Korean National Health Insurance (NHI) was established during only 12 yr from its inception (1977-1989), providing universal medical coverage to the entire nation and making a huge contribution to medical security. However, the program now faces many challenges in terms of sustainability. The low birth rates, aging population, low economic growth, and escalating demands for welfare, as well as unification issues, all add pressure to the sustainability of NHI. The old paradigm of low contribution - low benefits coverage - low NHI's fee schedule needs to be replaced by a new paradigm of proper contribution - adequate benefit coverage - fair NHI's fee schedule. This new paradigm will require reform of NHI's operating system, funding, and spending.
Health Care Reform ; Humans ; National Health Programs/*economics ; Program Evaluation ; Republic of Korea ; Risk Factors ; Universal Coverage/economics

No abstract available.
Small Cell Lung Carcinoma*

PURPOSE: Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program. MATERIALS AND METHODS: The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence. RESULTS: Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group. CONCLUSION: The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.
Aged ; Breast ; Breast Neoplasms ; Early Detection of Cancer ; Humans ; Insurance ; Korea ; Mammography ; Mass Screening ; National Health Programs ; Patient Participation

PURPOSE: Even though the importance of micrometastases (MMS) and isolated tumor cells (ITC) has been brought up by many physicians, its impact on the prognosis in stage II colorectal cancer is uncertain. In this research, we tried to investigate the clinical features of MMS and ITC and to prove any correlation with prognosis. METHODS: The research pool was 124 colorectal cancer patients who underwent a curative resection from April 2005 to November 2009. A total of 2,379 lymph nodes (LNs) were examined, and all retrieved LNs were evaluated by immunohistochemical staining with anti-cytokeratin antibody panel. Clinicopathologic parameters and survival rates were compared based on the presence of MMS or ITC and on the micrometastatic lymph node ratio (mmLNR), which is defined as the number of micrometastatic LNs divided by the number of retrieved LNs. RESULTS: Out of 124 patients (26.6%) 33 were found to have MMS or ITC. There were no significant differences in clinicopathologic features, such as gender, tumor location and size, depth of invasion, histologic grade, except for age (P = 0.04). The three-year disease-free survival rate for the MMS or ITC positive group was 85.7%, and that for MMS and ITC negative group was 92.8% (P = 0.209). The three-year disease-free survival rate for the mmLNR > 0.25 group was 73.3%, and that for the mmLNR < or = 0.25 group was 92.9% (P = 0.03). CONCLUSION: The presence of MMS or ITC was not closely correlated to the prognosis. However, mmLNR is thought to be a valuable marker of prognosis in cases of stage II colorectal cancer.
Colorectal Neoplasms ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Micrometastasis ; Prognosis ; Survival Rate

PURPOSE: This study estimated the economic burden of cancer in Korea during 2000-2010 by cancer site, gender, age group, and cost component. MATERIALS AND METHODS: Data came from national health insurance claims data and information from Statistics Korea. Based on the cost of illness method, this study calculated direct, morbidity and mortality cost of cancer in the nation during 2000-2010 by cancer site, gender, and age group. RESULTS: With an average annual growth rate of 8.9%, the economic burden of cancer in Korea increased from 11,424 to 20,858 million US$ (current US dollars) during 2000-2010. Colorectal, thyroid, and breast cancers became more significant during the period, i.e., the 5th/837, the 11th/257, and the 7th/529 in 2000 to the 3rd/2,210, the 5th/1,724, and the 6th/1,659 in 2010, respectively (rank/amount in million US$ for the total population). In addition, liver and stomach cancers were prominent during the period in terms of the same measures, i.e., the 1st/2,065 and the 2nd/2,036 in 2000 to the 1st/3,114 and the 2nd/3,046 in 2010, respectively. Finally, the share of mortality cost in the total burden dropped from 71% to 51% in Korea during 2000-2010, led by colorectal, thyroid, breast, and prostate cancers during the period. These results show that the economic burden of cancer in Korea is characterized by an increasing importance of chronic components. CONCLUSION: Incorporation of distinctive epidemiological, sociocultural contexts into Korea's cancer control program, with greater emphasis on primary prevention such as sodium-controlled diet and hepatitis B vaccination, may be needed.
Aging ; Breast ; Cost of Illness ; Diet ; Hepatitis B ; Humans ; Incidence ; Korea ; Liver ; Mortality ; National Health Programs ; Primary Prevention ; Prostatic Neoplasms ; Stomach Neoplasms ; Thyroid Gland ; Vaccination

No abstract available.
Birth Weight* ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Parturition* ; Pregnancy