Leiomyosarcoma of small intestine is an uncommon tumor, comprising less than 20 percent of all primary malignant tumors of small intestine. Duodenal leiomyosarcoma is rare disease which amount to about 20 percent of all small bowel malignancy but potentially curable tumors often diagnosed at an advanced age, so its five-year survival following resection approximates 50% in reported series. Recently, several cases of leiomyosarcomas of duodenum were diagnosed by hypotonic duodenograhy in Korea. We experienced a woman with duodenal leiomyosarcoma that was diagnosed by endoscopic duodenal biopsy and received currative resection of the tumor(Whipple's operation). We report the case with review of the literatures.
Biopsy ; Duodenum ; Endoscopy ; Female ; Humans ; Intestine, Small ; Korea ; Leiomyosarcoma* ; Rare Diseases

No abstract available.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

The authors regret that two co-authors were missing in the article.

PURPOSE: In Korea, the number of migrant workers is increasing. However, migrant workers have low job satisfaction due to poor working environment, and insufficient social support. This study aimed to investigate the role of social support for job satisfaction of migrant workers. METHOD: We have analyzed the survey data of 397 migrant workers collected from free clinic for migrant workers located in Seoul, Gyeonggi-do and Chungcheong-do. RESULT: When the migrant workers received monetary and emotional supports from supervisors and colleagues, their job satisfaction turned out to be significantly high. The factors that influence job satisfaction of migrant workers are as follows: involvement in manufacturing industry, over 9 hours of daily sleep, monetary and emotional support from supervisors. Their job satisfaction strongly influenced by these factors. CONCLUSION: Social support will increase job satisfaction of migrant workers and it will subsequently decrease job turnover rate and increase productivity as well as quality of life.
Efficiency ; Humans ; Job Satisfaction ; Korea ; Transients and Migrants

PURPOSE: The purpose of this study was to determine factors affecting the burden on employment of occupational health care providers as well as to develop strategies to reduce burden on employment of them in the middle size manufacturing enterprises. METHODS: The target population of this study was 123 managers working in the middle size manufacturing enterprises. The study questionnaires were selected, as theories and literature suggested, for explaining employment burden, general characteristics of participants and occupational health providers, general characteristics of companies, evaluation of occupational health provider's role and burden score. RESULTS: The mean of employment burden score of manager was 2.2. There was a significant difference in the employment burden scores, manager's age and education, and occupational health provider's age, type of work, certification, and employment status. Also there was a negative relationship between employment burden scores and occupational health provider's role scores (need, role, satisfaction, and benefit). In the results of the standard multiple regression analysis, manager's need scores on occupational health providers were significant predictors of the employment burden scores. CONCLUSION: It is necessary to change the manager's perception to promote employment of occupational health providers.
Certification ; Delivery of Health Care ; Employment ; Health Personnel ; Health Services Needs and Demand ; Humans ; Occupational Health ; Surveys and Questionnaires

Understanding of brain morphology and magnetic resonance image(MRI) is essential for accurate diagnosis and treatment of the brain diseases. As education tools, the cadaver dissection, plastic models, and neuroanatomy books have been used for understanding brain morphology; and the MRI films and radiology books have been used for understanding brain MRI. Recently, due to the popularization of powerful personal computers, computer programs compensating the conventional education tools have been used. But these computer programs have a disadvantage that it is not possible to visualize the details of brain morphology or to compare the corresponding sectioned specimens and MRI. Therefore, we attempted to make a computer program which could visualize not only the details of brain morphology but also the corresponding sectioned specimens and MRI by using the brains removed from Korean cadavers. Three brains were removed from Korean cadavers. With a brain, 122 MRI and 122 serially-sectioned specimens with an 1.4mm interval were acquired and inputted into the computer. Ten brain structures were segmented, and 83 fine structures were designated on the images. With two brains, 27 dissected specimens were acquired and inputted into the computer. One-hundred two fine structures were designated on the images. Based on these images, a computer program for understanding brain morphology and MRI was made. The computer program, which was made in this study, visualized the corresponding sectioned specimens, MRI, and segmented images after sectioning a brain horizontally or at any angles. In addition, the computer program visualized the images of dissected brain. This computer program is helpful to understand brain morphology and MRI. This computer program is expected to be used through CD-title or Internet as an educational tool for medical students and doctors.
Brain Diseases ; Brain* ; Cadaver ; Diagnosis ; Education ; Humans ; Internet ; Magnetic Resonance Imaging ; Microcomputers ; Neuroanatomy ; Plastics ; Students, Medical

OBJECTIVES: This study aimed to report the incidence of chronic posttraumatic stress disorder (PTSD), to identify psychosocial risk factors posttraumatically affecting the severity of PTSD symptoms, to compare the pattern of symptom changes over time, and to find early self-rated measures for the prediction of chronic PTSD in the patients physically injured by motor vehicle accident. METHOD: One-hundred-and-four motor vehicle victims, who were systematically recruited for the study of Kim et al(1998), were reevaluated through interview and questionnaire after twenty-four months. Clinician Administered PTSD Scale(CAPS), Beck Depression Inventory(BDI), Spiel-berger State Trait Anxiety Inventory(STAI), Impact of Event Scale(IES), questions about socioen-vironmental experiences after accident, and The Ways of Coping Checklist(WCC) were included in follow-up assessment. Of these subjects, 68 victims participated in CAPS interview and only 54 victims finished CAPS Interview, and questionnaire. The subjects with PTSD at initial and follow-up assessment were classified as the chronic PTSD group, subjects who recovered from PTSD at follow-up assessment were classified as the recovered group, and subjects who did not meet criteria for PTSD at initial and follow-up assessment were classified as the non-PTSD group. RESULTS: The prevalence of PTSD in motor vehicle victims was 39.8% in follow-up assessment. Compensation of disabilities, return to previous job and financial difficulty were associated with chronicity and poor psychological adjustment of PTSD. In total group of victims, PTSD symptoms that appeared at initial assessment were improved or disappeared at follow-up assessment. However, avoidance and numbing symptoms significantly increased in chronic PTSD group and "acting or feeling as if event were recurring" and "exaggerated startle response" were not recovered over time in recovered group. Only IES at initial assessment showed significant differences among Non-PTSD, PTSD and recovered group. BDI, STAI-II, active coping and passive coping at follow-up assessment showed significant differences among three groups. IES at initial assessment contributed 18.6% to CAPS variance at follow-up. CONCLUSION: This study showed a high risk of developing PTSD among physically injured victims after motor vehicle accident. Risk factors such as event severity, compensation of disabilities, return to previous job and financial difficulty were identified. High IES score at initial assessment was regarded as major factor affecting chronic PTSD.
Emotional Adjustment ; Anxiety ; Compensation and Redress ; Depression ; Follow-Up Studies ; Humans ; Incidence* ; Motor Vehicles* ; Prevalence ; Prospective Studies* ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

Pilomattiaoma, aften called calcifying epithelioma of Malherbe, is a benign tumor originating from the outer root sheath cell of the hair follicle and extending into the hair matrix, Pilomatricoma usually occurs as a single, asymptomatic dermal or subcutaneous nodule. Multiple lesions are quite unueuel, comprising only 2-3.5% of cases. We report two patients with multiple pilomatricoma.
Hair ; Hair Follicle ; Humans ; Pilomatrixoma*