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

We report the case of a 20-year-old female with lymphoma of the breast. Mammography showed an asymmetric pattern of confluent densities without any discrete mass. Sonography revealed diffuse heterogenous echoic mass intermingled with low-and medium level echoes. We present the clinical, radiographic and histologic features of primary breast lymphoma with a brief review of the literatures.
Adult ; Breast Neoplasms/*pathology/therapy/ultrasonography ; Female ; Humans ; Lymphoma/*pathology/therapy/ultrasonography ; Mammography ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology/therapy/ultrasonography

Antiandrogens are generally used for the treatment of prostate cancer, with gynecomastia the most common adverse event seen during therapy. However, a breast mass in a man with a carcinoma of the prostate may represent a metastatic disease or, less often, a primary carcinoma of the breast. Clinically diagnosed metastatic prostate cancer to the breast is a rare event. Breast metastasis represents an end-stage manifestation of the cancer, with an extremely poor prognosis. Herein, the case of a 62-year-old man, who presented with bilateral breast masses 7 months after antiandrogen therapy for the treatment of prostate cancer, is reported. An excisional biopsy of the breast mass revealed a metastatic prostatic adenocarcinoma.
Adenocarcinoma ; Androgen Antagonists ; Biopsy ; Breast* ; Gynecomastia ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Prostate* ; Prostatic Neoplasms

PURPOSE: To evaluate the low attenuation of mosaic pattern in pulmonary embolism, as observed on HRCT, and to correlate the findings with the pathologic features of resected lung. MATERIALS AND METHODS: Using permanent embolic materials, pulmonary embolism was induced in eight Yorkshire pigs. Pre-and post-embolic pulmonary angiography was performed and after 6 weeks, the incidence and pattern of parenchymal change in low attenuation (mosaic pattern), as seen on HRCT, was evaluated. The animals were then sacrified and contact radiography of the lung was performed. Thirty-eight segments of pathology were taken from the area in which the presence of embolism had been suggested. Pathologic and HRCT findings were then correlated. RESULTS: On HRCT, low attenuation was seen in 23 of 36 segments (64%) and showed variable patterns : crescent peripheral hyperlucency (61%, n=14), heterogeneous mottled hyperlucency (17%, n=4), lobular hyperlucency (13%, n=3), and homogeneous segmental hyperlucency (9%, n=2). Parenchymal low attenuation was seen on HRCT in 10 of 11 segments (91%) in which large segmental arterial occlusion occurred, and in 3 of 16 segments (19%) in which there was small segmental arterial occlusion. Abnormal pathologic findings were pulmonary congestion, dilatation of pulmonary arteries, interlobular septal thickening, and thrombus formation. Among the 38 pathologic segmental specimens, 29 were from the area in which HRCT findings were positive, and in which pulmonary embolism subsequently occurred. In only four of nine segments (44%) in the area in which HRCT fingings were negative was pulmonary embolism subsequently. CONCLUSION: HRCT findings of pulmonary embolism at six weeks after embolization showed variable patterns of low attenuation, diminished diameter of pulmonary arteries, and normal diameter of bronchi. In cases with large segmental arterial occlusion, the finding of low attenuation was more common ; this may be due to reduced blood flow to the embolic area, in combination with bronchiolar spasm. For the early diagnosis of pulmonary embolism, these findings may be useful.
Angiography ; Animals ; Bronchi ; Dilatation ; Early Diagnosis ; Embolism ; Estrogens, Conjugated (USP) ; Incidence ; Lung ; Pathology ; Pulmonary Artery ; Pulmonary Embolism* ; Radiography ; Spasm ; Swine ; Thrombosis