PURPOSE: To identify trends in patient satisfaction adjusted for sociodemographic factors and health status from 1989-2003. METHODS: Five repeated cross-sectional surveys were used. The study sample included 290,534 household members 20 years of age and over from the five survey periods of 1989, 1992, 1995, 1999, and 2003. Satisfaction was measured using a five-point scale, ranging from "very satisfied" to "very dissatisfied." Crude satisfaction rates, representing the proportion of patients satisfied (very satisfied or satisfied), were calculated for each survey period. Satisfaction rates adjusted for age, sex, marital status, education, and selfrated health status were calculated for each of the five years. RESULTS: Crude satisfaction rates increased from 15.4% in 1989 to 40.5% in 2003. The proportions of satisfaction and dissatisfaction were reversed after 15 years had passed. However, the satisfaction trend was not linear throughout the different years, with 1992 being the year with the lowest satisfaction rate (9.7%). These trends in crude rates did not change even after adjusting for patient characteristics. The odds of satisfaction in 1992 were 38% lower (odds ratio 0.62, 95% CI 0.60 to 0.64) than the odds in 1989. In 2003, the odds of satisfaction were 4.01 times (95% CI 3.89 to 4.13) the odds for 1989. Older, female, married, and less-educated people were more likely to be satisfied. Patients who rated their health as "very good" had the highest satisfaction rate, and those with "neutral" health ratings had the lowest. General hospitals achieved substantial improvement whereas pharmacies became the lowest-rated of all institutions. CONCLUSIONS: The Korean health system has achieved better patient satisfaction rates over the past 15 years. Increased health expenditure, resources, and quality improvement efforts may have contributed to this progress.
Adult ; Aged ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Korea ; Male ; Middle Aged ; *Patient Satisfaction ; Quality of Health Care/*trends ; Socioeconomic Factors

Takayasu's arteritis is a chronic vasculitic disease of the aorta, its major branches and the pulmonary arteries, resulting in stenosing, occlusive or aneurysmal lesion. While the precise etiology of Takayasu's disease is unknown, an autoimmune mechanism or active tuberculous inflammation have been suggested. It is more common in young oriental women but has a rare incidence in children. We experienced a case of Takayasu arteritis type IV in an 8years old girl. The diagnosis was made by physial examination and digital substraction aortography(DSA) which showed narrowing of left common carotid artery, right subclavin artery and left renal artery. The perfusion defect at posterior segment of right upper lobe was noted in lung perfusion scan. Medical treatment and percutaneous transluminal angioplasty(PTA) were performed. In addition to case report, a brief review of literature was added.
Aneurysm ; Angioplasty* ; Aorta ; Arteries ; Carotid Artery, Common ; Child ; Diagnosis ; Female ; Humans ; Incidence ; Inflammation ; Lung ; Perfusion ; Pulmonary Artery ; Renal Artery ; Takayasu Arteritis*

Cancer is a very heterogeneous disease, displaying heterogeneity between patients (inter-tumoral heterogeneity) and heterogeneity within a patient (intra-tumoral heterogeneity). Precision oncology is a diagnostic and therapeutic approach for cancers based on the stratification of patients using genomic and molecular profiling of tumors. To develop diagnostic and therapeutic tools for the application of precision oncology, appropriate preclinical mouse models that reflect tumor heterogeneity are required. Patient-derived xenograft (PDX) models are generated by the engraftment of patient tumors into immunodeficient mice that retain several aspects of the patient’s tumor characteristics, including inter-tumoral heterogeneity and intra-tumoral heterogeneity. Therefore, PDX models can be applied in various developmental steps of cancer diagnostics and therapeutics, such as biomarker development, companion diagnostics, drug efficacy testing, overcoming drug resistance, and co-clinical trials. This review summarizes the diverse aspects of PDX models, addressing the factors considered for PDX generation, application of PDX models for cancer research, and future directions of PDX models.

PURPOSE: Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. We studied the long term follow up results of our surgical procedures and sought to find a best surgical treatment methods. METHODS: From January 1991 to December 2006, a total of 1864 patients(587 men, 1277 women) had been treated with this procedure for axillary osmidrosis and hyperhidrosis. Follow up periods varied from 10 to 15 years. We used the subdermal excision technique, using two small incisions over the axilary folds and using a Kawata dissector(instrumental shaving) and additional manual subdermal excision(manual shaving). RESULTS: Among the total patients, 782 patients were followed up. Except a pure hyperhidrosis patients, 759 osmidrosis patients was included. 588 patients(77.4%) had a good results, 148 patients(19.5%) had a moderate results and 23 patients(3.1%) had a recurrence. Complication developed in 189 patients(10.1%): hematoma or seroma in 25 patients, wound dehiscence in 86 patients, partial skin necrosis in 45 patients, and infection in 28 patients. CONCLUSION: We conclude that our method has several advantages such as 1) short operation time, 2) minimal scaring, 3) lower complication rates, 4) high satisfactory rates.
Apocrine Glands ; Follow-Up Studies ; Hematoma ; Humans ; Hyperhidrosis ; Male ; Necrosis ; Odors ; Recurrence ; Seroma ; Skin

No abstract available.
Lung Neoplasms* ; Lung* ; Pneumothorax*

The goal of osmidrosis operation is not only to be free from odor, but also to leave a minimal operation scar. In practice, however, many patients suffer from unfavorable axillary operation scars. Therefore, we herein report various postoperative axillary scars which we experienced. From January 1991 to December 2006, a total of 270 patients(74 men and 196 women) whose axillary osmidrosis had been treated by various methods more than once were included. We observed pre-existing operation scars of recurred patients who wanted revisional operation. Among the total patients, 118 patients had been treated once, 138 patients less than 5 times, and 14 patients more than 5 times. Previous treatment methods included excision in 216 cases, laser in 188 cases, subdermal excision in 63 cases, ultrasonic liposuction in 25 cases, Kobayashi insulated needles in 29 cases, and botulinum toxin injection in 1 case. We observed irregular scar, wide spread scar, hypertrophic scar, postburn scar, depressed scar, and pigmented scar. Pre-existing operation scars were not improved enough by revisional operation. We propose that it is important to select a proper method to effectively get rid of an axillary odor, leaving a minimal operation scar, because axillary area is not optimal for scar revision.
Botulinum Toxins ; Cicatrix ; Cicatrix, Hypertrophic ; Drug Combinations ; Humans ; Lipectomy ; Male ; Needles ; Odors ; Piperonyl Butoxide ; Pyrethrins ; Ultrasonics

Osteogenesis imperfecta is a rare congenital disease. It is a heterogeneous group of inherited disorders characterized by multiple bone fracture, blue sclera, hearing loss, abnormalities of dentition and widespread connective tissue ahnormality. We experienced a case of osteogenesis imperfecta diagnosed in utero by ultrasonogram and confirmed hy postnatal radiograph after delivery. We present the case with a hrief review of the literature.
Connective Tissue ; Dentition ; Fractures, Bone ; Hearing Loss ; Osteogenesis Imperfecta ; Sclera ; Ultrasonography

BACKGROUND: The purpose of this study was to examine the prevalence and distribution of unexpected antibodies detected in the Korean population with race-specific RBC panel cells. In spite of a relatively high prevalence of Dia and Mia antigen phenotype in the Korean and Southeast Asian population, there has been little documented research on the prevalence and clinical significance of anti-Dia and anti-Mia in Korea. METHODS: We analyzed the results of 17, 664 antibody screening tests performed during the recent 30-month period from March 2001 to September 2003. Antibodies were screened and identified by using LISS/Coombs gel card with DiaMed-ID system (DiaMed AG, Cressier, Morat, Switzerland) including Dia and Mia panel cells. RESULTS: The prevalence of unexpected antibodies was 1.2% (214/17, 664); antibodies detected most frequently were anti-Rh (74 patients), followed by anti-Lewis (21 patients) and anti-Dia (15 patients). Out of 6, 345 patients, anti-Mia was detected in three patients (0.047%). Anti-Dia and anti-Mia had the specificity of IgG. Anti-Dia was thought as an immune-mediated antibody, whereas anti-Mia was considered as a mixed type with immune and natural antibodies. CONCLUSIONS: This study shows that anti-Dia and anti-Mia antibodies are detected frequently in the Korean population; hence, it seems that Dia and Mia panel cells should be incorporated into antibody screening panels in Korea for safe transfusion.
Antibodies ; Asian Continental Ancestry Group ; Humans ; Immunoglobulin G ; Korea ; Mass Screening* ; Phenotype ; Prevalence* ; Sensitivity and Specificity*

BACKGROUND: Serum cystatin C has been suggested to be a better marker for GFR than creatinine because believed to be produced at a constant rate by most nucleated cells, and eliminated exclusively by glomerular filtration We compared serum cystatin C with creatinine-based estimates, especially in patients with old age or extreme protein composition to investigate the utility of cystatin C and to identify factors that influence on cystatin C other than renal function. METHODS: A total of 446 patients, admitted to department of nephrology of Korea University Anam Hospital From September 2003 to March 2004, had their glomerular filtration rate (GFR) estimated by DTPA scintigraphy, clearance of creatinine, and calculated from Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) formula. A body composition, the serum creatinine and cystatin C levels were also measured. RESULTS: Serum cystatin C showed similar correlation with DTPA GFR to serum creatinine. The formula, GFR (mL/min/1.73m2) = 61.84 x cystatin C(-0.8135), was derived with better precision than either Cockcroft-Gault or MDRD. The diagnostic accuracy of cystatin C was not better than creatinine in older patients as well as those with overweight, or an extreme protein composition. The addition of age, body surface area, and gender increased the R2 for both serum creatinine and cystatin C. CONCLUSION: Serum cystatin C is a good marker for GFR, but not superior to serum creatinine even in patients with old age, overweight, or an extreme protein composition, and affected by age, body surface area, and gender independent on renal function.
Body Composition ; Body Surface Area ; Creatinine ; Cystatin C* ; Diet ; Filtration ; Glomerular Filtration Rate* ; Humans ; Korea ; Nephrology ; Overweight ; Pentetic Acid ; Radionuclide Imaging

Arterial restenosis frequently develops after open or endovascular surgery due to intimal hyperplasia. Since tissue transglutaminase (TG2) is known to involve in fibrosis, wound healing, and extracellular matrix remodeling, we examined the role of TG2 in the process of intimal hyperplasia using TG2-null mice. The neointimal formation was compared between TG2-null and wild-type (C57BL/6) mice by two different injury models; carotid ligation and carotid loop injury. In ligation model, there was no difference in intimal thickness between two groups. In loop injury model, intimal hyperplasia developed in both groups and the intimal/medial area ratio was significantly reduced in TG2-null mice (P = 0.007). TG2 was intensely stained in neointimal cells in 2 weeks. In situ activity of TG2 in the injured arteries steadily increased until 4 weeks compared to uninjured arteries. Taken together, intimal hyperplasia was significantly reduced in TG2-null mice, indicating that TG2 has an important role in the development of intimal hyperplasia. This suggests that TG2 may be a novel target to prevent the arterial restenosis after vascular surgery.
Animals ; Carotid Arteries/pathology/*surgery ; Disease Models, Animal ; GTP-Binding Proteins/deficiency/genetics/*metabolism ; Hyperplasia ; Mice ; Mice, Inbred C57BL ; Transglutaminases/deficiency/genetics/*metabolism ; Tunica Intima/*pathology