PURPOSE: To report a case of Merkel cell carcinoma on the left upper eyelid without metastasis and its immunohistochemical features. The carcinoma was successfully treated with excisional surgery and prophylactic radiation therapy. CASE SUMMARY: A 76-year-old woman presented to the hospital complaining of a 0.6 x 0.9-cm-sized painless and purplish-red colored mass that had grown rapidly on her left upper eyelid margin over the previous two months. An excisional biopsy was performed. On immunohistochemical examination of the lesion, the tumor cells expressed immunoreactivity for synaptophysin and were negative for LAC and cytokeratin, confirming the diagnosis of Merkel cell carcinoma. Additional surgery was performed because the surgical margins were positive. No other primary or metastatic lesions were found. The patient was treated with local prophylactic irradiation and remained disease-free at her 10-month follow-up visit.
Aged ; Biopsy ; Carcinoma, Merkel Cell ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Keratins ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Synaptophysin

OBJECTIVES: This study was performed to investigate the effectiveness of the questionnaire. METHODS: Workers'health examination records, work environment record, and questionnaires of selected industries as samples were analysed using logistic regression analysis and discrimination analysis Results'Cases of bearing impairment (Dl+C) as dependent variables, and age, work duration and level of environmental noise as independent variables were selected for multiple unconditional logistic regression analysis. Odds ratio was 4.04 in hearing difficulty, 2.78 in tlnnitus and 1.08 in age. In the second analysis Noise induced hearing loss is selected as dependent variable. The OR in hearing difficulty was 3.67(95 % C.1. : 1.61 8.61), and was 1.09(95 % C.1. : 1.05-1.14) in age. Conditionnal multlple logistic regression analysis was performed. In hearing impairment as dependent variable, the OR of age was 1.02(95 % C.1. : 1.00-1.04) and other variables were not significant. However, NIHL as dependent, the OR of hearing difficulty was 4.57(95 % C.1. : 1.43-14.67). According to multiple logistic regression adopting each items of questionnaire as dependent variable, the only item of hearing difficulty showed significant difference with hearing ability. The discrimination analysis was performed with the class variable of hearing impairment, and discrimination variables of age, work duration, and environment noise level. The sensitivity of 59 %, and specificity of 88 %, and average error count of 23 % were obtained. When the numbers of items answered in questionnaire were assumed as the parameter of judgement for noise induced hearing loss (NIHL), the highest sensitivity and specificity were 33.5% and 49.0% in cases of more than two items answered. CONCLUSIONS: The development of items that is simple and discriminative mainly consisted of chronic and specific diseases related items is needed. Computerization for newly developed items might be needed to establish effective surveillance system for NIHL in the future.
Discrimination (Psychology) ; Hearing Loss* ; Hearing* ; Logistic Models ; Mass Screening* ; Noise* ; Odds Ratio ; Questionnaires* ; Sensitivity and Specificity

Endoscopic variceal ligation(EVL) is newly developed method to manage esophageal variceal bleeding. This study asse initial control rate of active variceal bleeding, incidence of rebleeding and complications in EVL. From June in l992 to December in 1994, this study was performed on 70 patients who had visited to our medical center for melena or hematemesis by acute esophageal variceal bleeding. In all of 70 cases, eradication of esophageal varix was performed and variceal bleeding was controlled well. And first session was performed successfully with EVL. But rebleeding was occured in 12 cases(11 cases caused by esoyhageal varix and 1 case caused by esophageal ulcer) during follow-up period, so EVL therapy was performed repeatedly and 8 cases were eradicated and 4 cases were uncontrolled and died, and then 94% hemostatic effect was achieved during follow-up period. Complications of EVL therapy were mild(substernal discomfort in 12 cases, substernal pain in 4 cases, fever in 3 cases, mild dysphagia in 2 cases) and well controlled. Superficial esaphageal ulcer was shown in 18 cases by follow-up endoscopy after 1 week. These results show that EVL is a good therapeutic method to control active variceal bleeding and eradication of varix with repeat treatment. In conclusion, EVL is an effective and safe method of treatment and prevention for esophageal variceal bleeding.
Deglutition Disorders ; Endoscopy ; Equidae ; Esophageal and Gastric Varices* ; Fever ; Follow-Up Studies ; Hematemesis ; Humans ; Incidence ; Ligation* ; Melena ; Ulcer ; Varicose Veins

No abstract available.
Animals ; Rats* ; Skin*

We present a patient diagnosed with skin sarcoidosis, breast cancer, pulmonary tuberculosis, and peritoneal sarcoidosis with a past history of colorectal cancer. During stage work up for breast cancer, suspicious lesions on peritoneum were observed in imaging studies. Considering our patient's history and imaging findings, we initially suspected peritoneal carcinomatosis. However, the peritoneal lesion was diagnosed as sarcoidosis in laparoscopic biopsy. This case demonstrates that abdominal sarcoidosis might be considered as a differential diagnosis when there is a lesion suspected of being peritoneal carcinomatosis with nontypical clinical presentations.
Biopsy ; Breast Neoplasms ; Carcinoma* ; Colorectal Neoplasms ; Diagnosis, Differential ; Humans ; Peritoneum ; Sarcoidosis* ; Skin ; Tuberculosis, Pulmonary

Structural micro-fat graft is one of the surgical techniques for facial rejuvenation, and it is reliable for correction of sunken upper eyelids especially. However, several factors may influence surgical outcomes substancially. The author introduces the modified micro-fat graft to correct sunken eyelids and multiple eyelid folds to make better results. A series of 162 patients who underwent the refined structural micro-fat graft were included in this study. The purified fat was injected into the subcutaneous and sub-orbicularis oculi muscle layer of the upper eyelids through the 19-gauge cannula with 1 ml syringe. After the operation, all patients were followed up on 2 weeks, 1 month, 3 months, 6months, and 1 year. Clinical photographs were taken every visit and the author evaluated the volume and symmetry of the eyelids and checked the satisfaction of each patient and any complications. Among the 162 patients, 156 patients were satisfied with the upper eyelid volume after primary fat graft and other 6 patients were performed secondary fat graft. Even though the volume of the fat was sufficient, 4 patients showed palpable fat nodule during the follow-up period. Modified micro-fat graft is a simple, safe, and alternative method to correct sunken eyelids and multiple eyelid folds.
Blepharoplasty ; Catheters ; Eyelids ; Follow-Up Studies ; Humans ; Muscles ; Rejuvenation ; Syringes ; Transplants

OBJECTIVES: This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. METHODS: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997. And we analyzed determinants of health care utilization due to skin disease of workers. RESULTS: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181(13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers in manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. CONCLUSION: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.
Delivery of Health Care* ; Dermatitis ; Dermatitis, Contact ; Eczema ; Female ; Humans ; Incheon* ; Insurance ; Logistic Models ; Male ; Skin Diseases* ; Skin* ; Solvents

BACKGROUND: The purpose of this study was to investigate the prognostic significance of the Epstein-Barr virus (EBV) infected non-neoplastic lymphocytes in patients with Hodgkin lymphoma (HL). METHODS: Seventy-seven cases of HL were evaluated by immunohistochemical analysis and EBV-encoded RNA in situ hybridization. The cases were divided into three groups according to the EBV status. EBV was negative in 48 cases (group 1), EBV was located in the Hodgkin/Reed-Sternberg (HRS) cells, but not in the non-neoplastic lymphocytes in 20 cases (26%) (group 2) and EBV was located in both the HRS cells and the non-neoplastic lymphocytes in 9 cases (12%) (group 3). RESULTS: The groups differed with respect to the age distribution, the clinical presentation and the prognosis. The median ages were 30 (group 1), 47.5 (group 2) and 23 years (group 3) (p = 0.011). B symptoms (p = 0.007) and the histologic subtype of mixed cellularity classical HL (p = 0.001) were more common in the EBV-positive patients than in their EBV-negative counterparts. Two patients from group 3 had associated chronic EBV infection syndrome. The five-year survival rate was 97.56% in group 1, 75.76% in group 2 and 100% in group 3 (p = 0.0178). CONCLUSIONS: HL with EBV located in both the HRS cells and the non-neoplastic lymphocytes is a distinct prognostic subgroup that has better survival than the HL with EBV located in only the HRS cells.
Age Distribution ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; In Situ Hybridization ; Lymphocytes ; Prognosis ; RNA ; Survival Rate

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.
Accidents, Occupational/psychology/*statistics & numerical data ; Adult ; Age Factors ; Cross-Sectional Studies ; Female ; Health Status Disparities ; Humans ; Insurance Benefits ; Male ; Middle Aged ; Odds Ratio ; Regression Analysis ; Republic of Korea ; Sex Factors ; *Social Class ; Workers' Compensation