Economic Impact of Atopic Dermatitis in Korean Patients

BACKGROUND: Atopic dermatitis is a global public health concern owing to its increasing prevalence and socioeconomic burden. However, few studies have assessed the economic impact of atopic dermatitis in Korea. OBJECTIVE: We conducted a cost analysis of atopic dermatitis and evaluated its economic impacts on individual annual disease burden, quality of life, and changes in medical expenses with respect to changes in health related-quality of life. METHODS: The cost analysis of atopic dermatitis was performed by reviewing the home accounting records of 32 patients. The economic impact of the disease was evaluated by analyzing questionnaires. To handle uncertainties, we compared the results with the data released by the Health Insurance Review & Assessment Board on medical costs claimed by healthcare facilities. RESULTS: The direct cost of atopic dermatitis per patient during the 3-month study period was 541,280 Korean won (KRW), and expenditures on other atopic dermatitis-related products were 120,313 KRW. The extrapolated annual direct cost (including expenditures on other atopic dermatitis-related products) per patient was 2,646,372 KRW. The estimated annual indirect cost was 1,507,068 KRW. Thus, the annual cost of illness of atopic dermatitis (i.e., direct+indirect costs) was estimated to be 4,153,440 KRW. CONCLUSION: The annual total social cost of atopic dermatitis on a national level is estimated to be 5.8 trillion KRW.

Gastric Cancer Diagnosed in a Patient with Extramammary Paget's Disease

Extramammary Paget's disease (EMPD) is a rare intraepithel ial neoplasm arising in apocrine gland-bearing skin. EMPD may be regarded as a skin marker of associated malignancy because it tends to combine a variety of underlying malignancies in up to 50% of cases. Herein a case of gastric cancer diagnosed in a patient with extramammary Paget's disease of the scrotum is reported. The patient was a 65-year-old man whose chief complaint was exanthema of the right scrotum of 3 years duration. Biopsy samples taken from patient showed large, round cells with clear cytoplasm in the epidermis. The final diagnosis was EMPD of the scrotum. The extensive workups, including tumor marker, imaging studies and endoscopy to exclude associated malignancy were performed. Examination of the endoscopic gastric biopsy specimen revealed an adenocarcinoma of the stomach. On the basis of this result, a radical subtotal gastrectomy was successfully performed. This case suggests that, in cases of EMPD, the clinicians should consider the possibility of underlying malignancies and thoroughly examine not only the urogenital tract and lower gastrointestinal tract, but also the visceral organs, such as the stomach, even if there are no clinical symptoms of malignancy.

Recanalization of Acute Coronary Closure during Cardiopulmonary Resuscitation : Guiding Catheter Induced Embolization during PTCA Procedure

Acute coronary closure occurs 2-10% during the procedure of PTCA, 50-80% of those events are in the catheterization room. The causes of acute coronary closure are mainly due to dissection, thrombosis or spasm. We recently experienced a case of acute left main coronary artery closure due to guiding catheter induced embolization in the 56 year-old female, unstable angina patient complicated by diabetes mellitus and chronic renal failure. The patient received cardiopulmonary resuscitation shortly after acute closure because of cardiac arrest. During the resuscitation, we performed PTCA at the site of acute closure. The blood pressure maintained normaly after successful recanalization. And then we inserted IABP(intraaortic balloon pump) balloon and did PTCA of original stenosis sites. The patient removed IABP 24 hours later and discharged a month later without complication.

Atrioventricular plane displacement in the patients with congestive heart failure

No abstract available.