No abstract available.
Bowen's Disease*

No abstract available.
Carcinoma, Basal Cell* ; Nevus*

A 65-year-old female patient experienced melena for 10 days. Gastroduodenoscopy revealed a tumor in the duodenum, a portion of which was taken for biopsy, which showed a malignant tumor. She underwent pancreatoduodenectomy, and the final tumor pathology revealed invasive ductal carcinoma from the breast, which was confirmed using immunostaining of milk fat globule antigens. Nineteen years before, she had received a radical mastectomy due to invasive ductal carcinoma of the right breast. Hematogenous metastasis occurs in 33% of patients with breast cancer, mainly to the liver and lung, in invasive ductal carcinoma (IDC), and to the gastrointestinal tract, peritoneum, and retroperitoneum in invasive lobular carcinoma (ILC). Solitary metastatic duodenal tumors from breast cancer, especially IDC, is rare, particularly after a long time. This rare case is presented with a literature review.
Aged ; Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Lobular ; Duodenal Neoplasms ; Duodenum ; Female ; Gastrointestinal Tract ; Glycolipids ; Glycoproteins ; Humans ; Liver ; Lung ; Mastectomy, Radical ; Melena ; Milk ; Neoplasm Metastasis ; Pancreaticoduodenectomy ; Peritoneum

PURPOSE: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. METHODS: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. RESULTS: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. CONCLUSION: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.
Administrative Personnel ; Causality ; Chronic Disease ; Delivery of Health Care ; Education ; Health Policy ; Health Promotion ; Health Services* ; Humans ; Korea* ; Medicaid* ; National Health Programs

A sensitive and simple liquid chromatography-tandem mass spectrometry method was developed and validated for the simultaneous quantification of ticagrelor and its active metabolite, AR-C124910XX from 50 µL human plasma using tolbutamide as an internal standard as per regulatory guidelines. Analytes in plasma were extracted by simple protein precipitation using acetonitrile, followed by chromatographic separation with an Acclaim™ RSLC 120 C₁₈ column (2.2 µm, 2.1 × 100 mm) and a gradient acetonitrile-water mobile phase containing 0.1% formic acid within 8 min. Mass spectrometric detection and quantitation were conducted by selected reaction-monitoring on a negative electrospray ionization mode with the following transitions: m/z 521.11 → 361.10, 477.03 → 361.10, and 269.00 → 169.60 for ticagrelor, AR-C124910XX, and tolbutamide, respectively. The lower limit of quantifications was 0.2 ng/mL with linear ranges of 0.2–2,500 ng/mL (r² ≥ 0.9949) for both analytes. All validation data, including selectivity, cross-talk, precision, accuracy, matrix effect, recovery, dilution integrity, stability, and incurred sample reanalysis, were well within acceptable limits. This assay method was validated using K₂-EDTA as the specific anticoagulant. Also, the anticoagulant effect was tested by lithium heparin, sodium heparin, and K₃-EDTA. No relevant anticoagulant effect was observed. This validated method was effectively used in the determination of ticagrelor and its active metabolite, AR-C124910XX, in plasma samples from patients with myocardial infarction.
Heparin ; Humans ; Lithium ; Mass Spectrometry ; Methods ; Myocardial Infarction ; Pharmacokinetics ; Plasma ; Tolbutamide

Cantú syndrome (CS, OMIM 239850) is a very rare autosomal dominantly inherited genetic disease characterized by congenital hypertrichosis, neonatal macrosomia, a distinct facial features such as macrocephaly, and cardiac defects. Since the first description by Cantú et al. in 1982, about 50 cases have been reported to date. Recently, two causative genes for CS has been found by using exome sequencing analyses: ABCC9 and KCNJ8 . Most cases of clinically diagnosed CS have resulted from de novo mutations in ABCC9. In this study, we report three independent Korean children with CS resulting from de novo ABCC9 mutations. Our patients had common clinical findings such as congenital hypertrichosis, distinctive facial features. One of them showed severe pulmonary hypertension and hypertrophic cardiomyopathy, which require medical treatment. And, two patients had a history of patent ductus arteriosus. Although two of our patients had shown early motor developmental delay, it was gradually improved during follow-up periods. Although CS is quite rare, there are the concerns about development of various cardiac problems in the lifetime. Therefore, an accurate diagnosis followed by appropriate management and genetic counseling should be provided to CS patients.
Cardiomyopathy, Hypertrophic ; Child ; Databases, Genetic ; Diagnosis ; Ductus Arteriosus, Patent ; Exome ; Follow-Up Studies ; Genetic Counseling ; Humans ; Hypertension, Pulmonary ; Hypertrichosis ; Megalencephaly

Prostatic intraepithelial neoplasia (PIN), which is divided into low and high grade, has different clinicopathologic significance. We reviewed 158 prostatic tissues, which consisted of 144 cases of nodular hyperplasias and 14 cases of adenocarcinomas, to evaluate incidence of PIN, its histologic finding, and its clinical significance. Ten cases of PIN, 4 low grade and 6 high grade, were found. Four cases of low grade PIN (LPIN) and five cases of high grade PIN (HPIN) were associated with nodular hyperplasia. Only one case of HPIN occurred in carcinoma. The constant histologic findings of LPIN were nuclear stratification and nucleomegaly. The most prominent characteristics of HPIN were hyperchromasia and prominent nucleoli. Anisonucleosis was not so helpful for differential diagnosis between LPIN and HPIN. Basal layer disruption was present in one case of high grade PIN associated with adenocarcinoma, and important for the differentiatial diagnosis of cribriform HPIN from the cribriform adenocarcinoma. There was no significant difference in age incidence between the two groups with the mean age of 70.9 years in nodular hyperplasia and 69.4 years in adenocarcinoma. Serum PSA level was significantly different between the two group with the mean PSA value of 11.03 ng/ml in nodular hyperplasia and that of 73.76 ng/ml in carcinoma (p=0.000). However, PSA values between "nodular hyperplasia only" group and "PIN associated nodular hyperplasia" group were not significantly different. PIN association changed neither age distribution nor serum PSA level. During the follow up period, no adenocacinoma has occurred in the cases having PIN although serum PSA level has elevated in some cases. One case of adenocarcinoma associated with HPIN developed in the nodular hyperplasia patient. Although PIN did not increase the possibility of subsequent prostatic adenocarcinoma in transurethral resection specimens, it could not be excluded that PIN was a precursor of prostatic adenocarcinoma.
Adenocarcinoma ; Age Distribution ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Hyperplasia ; Incidence ; Prostate-Specific Antigen ; Prostatic Intraepithelial Neoplasia*

BACKGROUND: In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. METHODS: The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. RESULTS: Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. CONCLUSIONS: The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Lip ; Methods ; Microfilming* ; Skin* ; Surgical Flaps

This is a report revealing statical cause of death brought to the department of forensic medicine, Kyungpook National University School of Medicine based on the result of autopsy. The summary of result is as follows. 1. The number of autopsy made during 1998 were 356, of these 225 cases (63.2%) were male, and 131 (36.8%) were female. 2. 30's, 40's, 20's and 50's was the order according to the number of violent death, and in case of natural death, 30's, 50's, 40's was the oder. 3. August is the period during which autopsies are made most, with December placing second, and the other months are similar. 4. In distributing deaths by cases, violent deaths were 241 cases (67.7%), natural deaths were 105 (29.5%) and unknown cases were 10 (2.8%). 5. For the violent deaths, deaths due to injury were 128 cases (53.1%), asphyxia were 63 (26.1%), intoxications were 30 (12.4%) and abnormal temperature were 19 (7.9%). According to relationship with deaths, homicide is outstanding with 101 cases (41.9%), while suicide and accidental death was the same with 62 cases (25.7%). 6. For death due to injury, death due to blunt injury were 48 cases, sharp force injury which was used most in case of homicide were 43. 7. For the asphyxia, drowning is the most 20 cases, 13 cases of which is accidental death. 8. The deaths of intoxication is the largest part of suicide, and most of intoxication were involved in agrochemical. 9. Of 105 cases of natural death, deaths due to the disease of cardiovascular system were 51 cases (48.6%), of which deaths due to myocardial infraction were 35 cases. 10. Of all autopsy, alcohol intake were checked out in 90 cases and 21 cases of medical controversy took places. 11. Of all violent deaths, the cases involved in the discord between man and woman occupied percentage of 9.6. Of these, homicides were 18 cases, with all sacrificed being females, and of 16 cases of suicide, 13 cases were female.
Asphyxia ; Autopsy* ; Cardiovascular System ; Cause of Death ; Daegu* ; Drowning ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Homicide ; Humans ; Male ; Suicide ; Wounds, Nonpenetrating

Neurofibroma rarely occurs as a solitary lesion but mostly occurs as part of neurofibromatosis and reports of neurofibromas developed in the nasal cavity or paranasal sinus are very rare. We present here a case of neurofibroma in a 57 year-old female who complained of purulent rhinorrhea, nasal obstruction and epiphora, all of which persisted for a year. Anterior rhinoscopic examination showed huge polypoid mass in the right nasal cavity, and CT/MRI revealed an expansive, highly enhancing mass in the right nasal cavity remodeling the right lateral nasal wall, the middle turbinate and the inferior turbinate. The radiologic examinations also showed secretions in the right maxillary and ethmoid sinuses. We removed this tumor completely by transnasal endoscopic surgery. No evidence of recurrence was found by the twelfth month following the operation.
Ethmoid Sinus ; Female ; Humans ; Lacrimal Apparatus Diseases ; Middle Aged ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum* ; Neurofibroma* ; Neurofibromatoses ; Recurrence ; Turbinates