Granulocytic sarcoma is a rare localized tumor composed of granulocytic precusor cells. Granu-locytic sarcoma occurs in a variety of clinical conditions and it is often misdiagnosed histologically. Differential diagnosis frorh lymphoma or nonhematopoietic malignancies such as undifferentiated carcinoma or sarcoma is difficult in the routing histologic examination. An evaluation of clinical and histopathologic features was done on 4 cases of granulocytic sarcoma which were diagnosed at Pusan Paik Hospital from 1988 to 1992. During the period, 282 cases of myelogenous leukemia were diagnosed. Immunohistochemical reaction for lysozyme, myelopero-xidase, leukocyte common antigen, epthelial membrane antigen and cytokeratin was assessed comparing to lymphoma and undifferentiated carcinoma. The histologic features of the granulocytic sarcoma revealed thin nuclear membrane, fine chromatin pattern and one or two small nucleoli. It also often involved the vascular wall and infiltrated the native structures without destruction. Immunohistochemical stain revealed that all(4 cases) of granulocytic sarcoma showed diffuse and strong positivity for myeloperoxidase, and partial but strong positivity for lysozyme. One case of granulocytic sarcoma was negative and 3 cases revealed focal positive reaction for LCA, and all 4 cases was negative for cytokeratin and EMA. In summary, careful observation under light microscopy with immunohistochemical stain for myeloperoxidase, lysozyme, and LCA is helpful in the differential diagnosis of granulocytic sarcoma from malignant lymphoma and cytokeratin and EMA is useful for differential diagnosis from undifferentiated carcinoma.
Diagnosis, Differential

No abstract available.
Interleukin-6* ; Rabbits*

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

PURPOSE: It is well known that use of intranenous methylprednisolone(IVMP)for the patients with idiopathic thrombocytopenic purpura(ITP) is not only as effective as use of intravenous gammaglobulin to mincrease platelets quickly, but also the former is less expensive than the latter. As the adequate dosage of IVMP has not been fully elucidated, we have tried to determine it. METHODS: The subjects were 35 childhood patients below 15 years of age, who were diagnosed with ITP for the first time and whose platelet count was less than 20,000/mm(3) at diagnosis. We divided them into three groups : Group A included 8 cases with IVMP dosage of 5mg/kg/day, Group B included 9 patients with IVMP dosage of 10mg/kg/day, and group C included 18 patients with IVMP dosage of 20mg/kg/day. We checked the platelet count every day after IVMP administration daily for 5 days and also observed for side effects if any. RESULTS: After IVMP administration, we obseved increasing tendency of platelets in all three groups, of which group C was more rapid and higher in increasing platelets than the other groups(p<0.05). After IVMP therapy for 5 days, cases with platelets>20,000/mm(3) were 6(75%) in group A, 7(78%) in group B, and 18(100%) in group C. Cases with platelets >50,000/mm(3) were 5(63%), 6(67%), 17(94%) in groups A, B, C, respectively, and cases with platelets> 100,000/mm(3) were 3(38%), 5(56%), 14(78%), in group A, B, C, respectively. And there were no remarkable side effects except a case of transient hypertensive headache in group C. CONCLUSIONS: We concluded that the effectiveness of IVMP therapy for increasing platelets was more rapid and higher in group C than in group A or B, and side effect was minimal.
Child* ; Diagnosis ; Headache ; Humans ; Methylprednisolone* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

PURPOSE: The purpose of this study was to examine the effects of aroma-inhalation on depression, sleep, mood, and smell in stroke patients and their caregivers. METHOD: This study employed one group pretest-posttest repeated design. Data were collected at three time points: baseline(pre-test), 10 days and 20 days after the intervention(post-test1 and post-test2, respectively). The sample included a total of 23 subjects. Data were analyzed by SPSS 12.0 program using repeated measure ANOVA. RESULTS: Depression was not statistically significant difference among pre-test, post-test1 and post-test2. Sleep was improved after intervention: 37.61+/-7.41(pre-test), 41.22+/-8.26 (post-test1), 44.33+/-7.67(post-test2)(F=8.182, p=.001). Mood was significantly improved after intervention: 16.95+/-4.89(pre-test), 14.89+/-6.31 (post-test1), 12.11+/-5.04(post-test2). Smell including smell perception, discomfort due to smell and relation between age and smell was significantly improved after intervention: 2.63+/-1.20(pre-test). 2.00+/-1.16(post-test1), 1.63+/-.96(post-test2)(F=6.176, p=.006) in smell perception, 2.50+/-1.10 (pre-test). 1.81+/-.91(post-test1), 1.19+/-.40(post-test2) (F=12.26, p=.000) in discomfort due to smell and 3.53+/-1.18(pre-test). 2.59+/-1.46(post-test1), 2.53+/-1.33(post-test2)(F=4.148, p=.025) in relation between age and smell. CONCLUSION: The results suggest that aroma-inhalation may have an effect on sleep, mood and smell and can be effective nursing intervention to increase the relaxation in stroke patients and their caregivers.
Aromatherapy* ; Caregivers* ; Depression* ; Humans ; Nursing ; Relaxation ; Smell* ; Stroke*

Suicide has been a public health issue in many countries, and Korea has ranked highest suicide rate among Organization for Economic Cooperation and Development (OECD) countries over a decade. To address these issues, we updated the recent trends in suicidal ideation and suicide attempts among Korean adults followed by previous data observation. We used data from five sources: Korean National Health and Nutrition Examination (KNHANES, '07–12, '13, '15–16), Korean Community Health Survey (KCHS, '08–09, '13), Korean Wealth Panel Study (KOWEPS, '12–16), Korea Health Panel Survey (KHP, '10–13), and cause of death data from Statistics Korea ('07–16). We used weighted frequencies and trend tests. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '15), 8.95% (KCHS, '13), 2.08% (KOWEPS, '16), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.59% (KNHANES, '16), 0.41% (KCHS, '13), and 0.08% (KOWEPS, '16). Annual percentage change of suicidal ideation was −2.80% (KNHANES, '07–12), 5.78% (KNHANES, '13–15), 0.62% (KCHS, '08–13), −8.50% (KOWEPS, '12–16), and −10.94% (KHP, '10–13). Annual percentage change of suicide attempts was −3.84% (KNHANES, '07–12), 2.26% (KNHANES, '13–16), −2.53% (KCHS, '08–13), and −20.22% (KOWEPS, '12–16). Annual percentage change of death by intentional self-harm was −0.49% (Statistics Korea, '07–16). Individuals who had lower income level were more likely to experience suicidal ideation and suicide attempts. According to these results, the rate of suicidal ideation and suicide attempts showed the decreasing tendency. However, the suicide rate of Korea has remained higher than that of OECD countries. Thus, continuous data observation and effective policies on suicide are needed.
Adult ; Cause of Death ; Health Surveys ; Humans ; Korea ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011–2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality.
Adolescent* ; Cell Phones* ; Child* ; Humans ; Incidence* ; Korea ; Longitudinal Studies*

The aim of this study was to investigate the relationship between retirement preparation and depressive symptoms among Koreans 50 years of age or older. We used data from the 2009 to 2013 Korean Retirement and Income Panel Study (KReIS), which included data from the 365 baseline participants of 50 years of age or older. Our sample included only newly retired participants who worked in 2009, but had retired in the 2011 and 2013. To monitor the change in depressive symptoms according to retirement preparation, we used repeated measurement data. We measured depressive symptoms using the Center for Epidemiological Studies Depression (CES-D) 20-item scale. In addition, we measured retirement preparation using a single self-report question asking whether the participant was financially ready for retirement. We evaluated relationship between retirement preparation and depressive symptoms after multivariable adjustment. Compared to subjects who had prepared for retirement (reference group), participants who had not prepared for retirement had increased depression scores (β = 2.49, P < 0.001). In addition, individuals who had not prepared for retirement and who had low household income had the highest increase in depression scores (β = 4.43, P < 0.001). Individuals, who had not prepared for retirement and without a national pension showed a considerable increase in depression scores (β = 3.02, P < 0.001). It is suggested that guaranteed retirement preparation is especially important for mental health of retired elderly individuals with low economic strata.
Aged* ; Depression* ; Epidemiologic Studies ; Family Characteristics ; Humans ; Mental Health ; Pensions ; Retirement*

BACKGROUND/AIMS: Although there is growing interest in hospice-palliative care, little information is available on the effects of such care in South Korea. Addressing this research gap, i.e., determining the cost-effectiveness of hospice-palliative care in South Korea, will help guide policy. Thus, the aim of this study was to evaluate the cost-effectiveness analysis of hospice-palliative care in adults diagnosed with terminal cancer. METHODS: We used a Markov model to construct a decision tree, for an analysis comparing the general ward with the hospice-palliative ward in terms of patient quality of life and cost-effectiveness. Cost and quality of life were estimated based on published Korean studies. Cost-effectiveness was calculated as the incremental cost relative to the incremental effect. Additionally, a one-way sensitivity analysis was performed to test the robustness of the results. RESULTS: Hospice-palliative ward care was more cost-effective than general ward care. The incremental cost was 290,401 Korean won (KRW) and the incremental effect was −0.25. The incremental cost-effectiveness ratio was −1,174,045 KRW. A similar pattern of results was obtained in the sensitivity analysis. CONCLUSIONS: Our results suggest that hospice-palliative ward care is more cost-effective than general ward care.
Adult ; Cost-Benefit Analysis ; Decision Trees ; Hospice Care ; Humans ; Korea ; Patients' Rooms ; Quality of Life