PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies

BACKGROUND: The phenotypic heterogeneity of psoriasis could be explained by the alternate activation of either T-helper (Th)-1- or Th-17-related cytokines. However, evidence directly supporting this hypothesis is scarce. OBJECTIVE: To characterize the expression of Th-1- and Th-17-related cytokines according to the morphological psoriasis phenotype: guttate vs. plaque. METHODS: In this study, we enrolled 68 patients exhibiting either guttate or plaque psoriasis, and 10 healthy controls. To avoid age-related bias, age matching was performed for each group. Circulating levels of interferon (IFN)-gamma, interleukin (IL)-1RA, IL-2, IL-12p40, IL-17A, IL-22, and IL-23 were measured with an enzyme-linked immunosorbent assay (ELISA). Psoriasis-affected tissue was obtained through biopsy sampling from the eight patients who exhibited the most typical morphology. Levels of IL-1RA, IL-12p40, IL-17, IL-22, and IL-23 in the psoriasis tissue samples were measured with western blot analysis. RESULTS: ELISAs of the serum samples showed higher levels of inflammatory cytokines such as IL-1RA, IL-2, IL-23, and IFN-gamma in patients with psoriasis than in healthy controls. However, the inflammatory cytokine levels did not differ significantly between guttate and plaque psoriasis patients. Western blot analysis of psoriatic tissue revealed higher protein levels of Th-1- and Th-17-related cytokines in patients than in healthy controls. The levels of IL-12p40 and IL-23 were unexpectedly higher in plaque tissue than in guttate tissue. CONCLUSION: The morphological phenotype of psoriasis does not appear to be determined by a specific activation of either the Th-1 or Th-17 pathway. Rather, the cytokine profile influences disease activity and is altered according to the status of the lesion (early or chronic).
Bias (Epidemiology) ; Biopsy ; Blotting, Western ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interferons ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-12 Subunit p40 ; Interleukin-17 ; Interleukin-2 ; Interleukin-23 ; Interleukins ; Phenotype ; Population Characteristics ; Psoriasis*

OBJECTIVE: We assessed the characteristics of Capgras syndrome in patients diagnosed as probable Alzheimer disease, and compared the clinical and imaging findings with other previous reports. METHODS: We obtained medical records of patients with Capgras syndrome diagnosed as probable Alzheimer disease in three hospitals from March 2009 to March 2010. The basic characteristics, neuropsychologic tests, brain imaging data were investigated. RESULTS: The mean age of the patients was 74.7 years old and all of the patients experienced this syndrome in relation to a spouse. Brain magnetic resonance imaging showed mild-to-moderate global atrophy, variable hippocampal atrophy in this study. The Mini-Mental State Examination mean scores were 18.78 and clinical dementia rating scores were from 1 to 2. All of the patients took medicine of acetycholine esterase inhibitors and two patients recovered with antipsychotic medication. Five patients had showed continuous Capgras syndrome, at the last follow-up day, for a year. CONCLUSION: Capgras syndrome patients in this study who were diagnosed as probable Alzheimer disease showed similar results to the individuals from other reports. More study is needed to estimate the numbers and characteristics of patients with this syndrome.
Alzheimer Disease ; Atrophy ; Brain ; Capgras Syndrome ; Dementia ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neuroimaging ; Neuropsychological Tests ; Spouses

OBJECTIVES: Schizophrenic patients having a disturbance of cognition and emotion are least likely to identify emotional (especially negative) stimuli and cue in tense background stimuli. Also, schizophreinic patients tend to experience relapse if they are exposued to a situation which is emotionally laden. Although emotion itself is important, emotional processing has not been a therapeutic target and skill trainig which improves social competence has provided patients with emotional load. Therefore, we introduced Emotional Management Trainig (EMT) which deal with indirect and direct emotional processing, applied it to schizophrenic patients, and investigated the therapeutic effects. METHODS: We applied the Emotional Management Training (EMT) to 30 schizophrenic patients for 12 weeks, 2 times every week and psychoeducation to 23 schizophrenic patients as control group attention-placebo for 12 weeks, during the same period. Before and after treatment, we used the Trait Meta Mood Scale-short form (TMMS-S) as emotional proper, Social Perception Scale, Verbal Fluency Test, Verbal Paired Associates, and Similarities for cognitive functions. We also used Positive And Negative Syndrome Scale (PANSS) as psychopathology measurement and Social Problem Solving Scale (SPSI) as various kinds of social problem solving function measurement before and after treatment. RESULTS: The results showed that EMT group appeared to be more effective in improving the visual perception of social perception scale, verbal fluencies, positive symptoms, general psychopathology, and total score in PANSS than the control group. Also EMT group seemed to be more effective in total score and Problem Orientation score in SPSI than the control. But there were no differences in abstract function and verbal memory, negative symptoms, and Problem-Solving Skill score between the two groups. CONCLUSION: This study suggests that despite the limitations of the generalizability and the questions for the persistence of effectiveness, EMT might help schizophrenics get the motivational aspects, the familiarity with emotional-loaded situation, and initial processes, for social problem-solving.
Cognition ; Cues ; Humans ; Memory ; Mental Competency ; Psychopathology ; Recognition (Psychology) ; Recurrence ; Schizophrenia ; Social Perception ; Social Problems ; Transcutaneous Electric Nerve Stimulation ; Visual Perception

Lymphangiomas are benign tumors of lymphatic vessels, which can occur anywhere the lymphatics exist. The lymphangioma of the esophagus is exceedingly rare. Seven cases had reported in the world and there is no case report about the lymphangioma of the esophagus in our country. So we present one case of lymphangiomas that coexist in esophagus and sigmoid colon. This kind of case don't have been reported yet.
Colon, Sigmoid* ; Esophagus* ; Lymphangioma* ; Lymphatic Vessels

Behcet's disease is a chronie inflammatory symptom complex consisting of recurrent oral ulcer, genital ulcer, ocular lesion or skin lesion. Intestinal involvement in Behcet's disease most commonly affects the ileocecal region in the patient with gestrointestinal symptoms, But esophageal involvement in Behcet's disease is very uncommon, most commonly affects the midesophagus with localized ulcerative lesion. A 38-Year-old woman with refractory and recurrent oral and genital ulcer was admitted because of aggravation of pharyngodynia and dysphagia. Gastrofiberscopic examination showed multiple, small sized ulcers on oral cavity and mid-to-distal esophagus. She was treated with steroid.
Adult ; Deglutition Disorders ; Esophagus ; Female ; Humans ; Mouth ; Oral Ulcer ; Skin ; Ulcer

Sclerosing epithelioid fibrosarcoma (SEF) is a rare and poorly recognized variant of fibrosarcoma of deep soft tissue. We report the case of a 34-year-old woman who presented with a painful and palpable mass in the left buttock that was diagnosed as SEF.
Adult ; Buttocks ; Female ; Fibrosarcoma ; Humans

BACKGROUND: The verbal fluency test consists of two separate tests of semantic fluency and phonemic fluency. The performance patterns of these tests differ with the type of dementia. We studied the patterns of verbal fluency between Alzheimer's disease (AD) and subcortical vascular dementia (SVaD), and assessed the clinical utility of these tests. METHODS: The 1,475 selected participants comprised 73 normal control subjects, 673 patients with amnestic mild cognitive impairment (aMCI), 535 AD patients, 42 patients with subcortical vascular mild cognitive impairment (svMCI), and 152 SVaD patients. We analyzed the z-score for the total number of animal items as a semantic fluency index and the z-score of the phonemic total score as a phonemic fluency index. RESULTS: The performance of semantic fluency was lower than that of phonemic fluency in all groups. The SVaD group showed the worst scores and abnormal performances on both tests, while the AD group presented abnormal performance only for semantic fluency. Dividing the patients with dementia according to severity revealed a different pattern between AD and SVaD for the clinical dementia rating (CDR) stage of 0.5. The performance of the AD group declined gradually with CDR. However, the SVaD group performed very poorly in both tests even for very mild dementia (CDR stage of 0.5). The aMCI and svMCI groups exhibited similar performance patterns. CONCLUSIONS: The pattern of semantic and phonemic fluency was not clinically useful at the MCI stage, but it could be helpful in differentiating AD and SVaD in the early stage of dementia.
Alzheimer Disease* ; Animals ; Dementia* ; Dementia, Vascular* ; Humans ; Mild Cognitive Impairment ; Semantics ; Task Performance and Analysis*

Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. This uncommon but serious disease requires special attention because of its nonspecific presentation such as dysuria, frequency, urgency, fever, acute urinary retension and/or perineal pain. We report here on a case of emphysematous prostatitis that was combined with a liver abscess caused by Klebsiella pneumoniae. A 55-year-old man was admitted due to a 3-day history of urinary retention with a febrile sensation. He had histories of liver cirrhosis and uncontrolled diabetes mellitus. After blood and urine cultures, levofloxacin 500 mg was started intravenously. On the third hospital day, he displayed septic shock. The kidneys-ureters bladder (KUB) X-ray showed pockets of air-accumulation in the lower pelvic cavity, and abdominopelvic computed tomography (CT) with contrast enhancement taken on the third day showed a 5-cm liver abscess with an emphysematous prostate. Intravenous antibiotics was changed to metronidazole 500 mg q.i.d. and cefotaxime 2 g t.i.d. On the sixth day, transurethral resection and drainage were performed under spinal anesthesia. However, the postoperative bleeding continued and hypovolemic shock persisted, which then provoked multiorgan failure. The patient died on the 11th hospital day. K. pneumoniae was cultured from the liver abscess aspirate, blood and prostatic tissue, and the bacteria were sensitive to both levofloxacin and cefotaxime. Emphysematous prostatitis is a difficult to diagnose because of its rarity and nonspecific symptoms. A delayed diagnosis can cause high mortality and morbidity, so making a prompt clinical diagnosis of this condition is essential. Appropriate antibiotics with early adequate incision and drainage are also needed.
Abscess ; Anesthesia, Spinal ; Anti-Bacterial Agents ; Bacteria ; Cefotaxime ; Delayed Diagnosis ; Diabetes Mellitus ; Drainage ; Dysuria ; Fever ; Hemorrhage ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Liver Cirrhosis ; Metronidazole ; Middle Aged ; Ofloxacin ; Pneumonia ; Prostate ; Prostatitis ; Sensation ; Shock ; Shock, Septic ; Urinary Bladder ; Urinary Retention

Background: Chronic kidney disease (CKD) has a negative impact on growth and development in children and is a risk factor for neurocognitive impairment; however, there is limited research on the cognitive function of children and adolescents with CKD. This study therefore aimed to investigate the mean intelligence and risk factors for low intelligence in children and adolescents with CKD. Methods: Eighty-one patients with CKD under 18 years old were included in the KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD). Participants completed either the Wechsler Intelligence Scale for Children (6–16 years), or Wechsler Adult Intelligence Scale (> 16 years). Results: The mean full-scale intelligence quotient (IQ) was 91 ± 19; 24.7% of participants scored a full-scale IQ below 80. Participants with a short stature (height Z scores < −1.88), failure to thrive (weight Z scores < −1.65), more severe CKD stage (≥ IIIb), longer duration of CKD (≥ 5 years), and those who were Medicare or Medicaid beneficiaries, had significantly lower mean full-scale IQs. Conclusion On linear regression analysis, the association between the full-scale IQ, and longer duration of CKD and growth failure, remained significant after controlling for demographic and clinical variables. It is therefore necessary to investigate cognitive impairment in pediatric patients with CKD who exhibit growth failure or for a longer postmorbid period. It is believed that early interventions, such as kidney transplantation, will have a positive effect on IQ in children with CKD, as the disease negatively affects IQ due to poor glomerular filtration rate over time.