BACKGROUND: Pityriasis versicolor(PV) is a superficial mycosis, theoretically unusual in children. Epidemiologic and clinical data for children with PV under 14 years were collected. OBJECTIVE: The purpose of this study was to evaluate the clinical features of PV in the young. METHOD: We included all cases of PV in patients under 14 years of age observed in our department from 1981 to 1995. All cases were diagnosed on the basis of clinical criteria and were confirmed by microscopic examination. RESULTS: From 1981 to 1995 we encountered 32 cases of PV in children, compared with 637 cases in adults; thus children represented 4.7% of all cases. The ratio of male to female was l. 7:1. Among the age groups, the incidence was the highest in the 10-14 years(43%). The monthly prevalence was the highest in August. Distribution of the lesions were the face(40.9%), neck (25%), chest(13.6%), back(11.3%), extremities(6.8%) and abdomen(2.2%). The incidence of hypopigmented lesions was 70.4% and that of hyperpigmented lesions was 29.6%. CONCLUSION: This study confirms that the face is a predilectionl site for PV in children and all facial lesions are hypopigmented. Other clinical features are variable and similar to those of adults.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Neck ; Pityriasis* ; Prevalence ; Tinea Versicolor*

No abstract available.
Sarcoma*

We report two cases of vulvar syringorna in a 40-year-old women and a 28-year-old woman who had 2-3mm sized, brownish papules on both valvar areas an l-3rnm sized, yellow-brownish papules on both vulvar ares with yellowish milia-like lesion the surface, respectively. Microscopically the lesions revealed characteristic findings of syrinzoiza However the second case showed a small cystic duct in the papillary dermis, which is lineilly a stratified epithelium and filled with concenteric lamellae of keratin.
Adult ; Cystic Duct ; Dermis ; Epithelium ; Female ; Humans ; Syringoma* ; Vulva

BACKGROUND: Fine Needle Aspiration Cytology (FNAC) is widely accepted as the most accurate procedure to differentiate malignant from benign thyroid nodules. It is a simple, safe, and inexpensive procedure, and the accuracy of FNAC is relatively high; however, its success usually depends upon the skill in using the aspiration technique and the experience and skill of the cytologist. The authors confirmed the diagnostic value of preoperative FNAC in differential diagnosis of thyroid nodules treated by the surgical resection. METHODS: Three hundred fifty specimens were taken in the Department of Surgery, Inje University College of Medicine, from July 1990 to June 1996. Fifty-one males and 299 females with ages ranging from 11 to 73 years were enrolled. The cytology of FNAC was compared to the final histologic diagnosis. RESULTS: The number of inadequate smears (or sampling error) was 15.7%. Preoperative cytologic diagnoses was consisted of 198 cases of benign disease (92 cases of nodular goiters, 96 cases of follicular lesion types III, and 10 cases of thyroiditis), 12 cases of highly suspicious malignant lesions (follicular lesions type II), and 85 cases of malignant disease (71 cases of papillary carcinomas and 14 cases of follicular lesions type I). Histologic diagnoses consisted of nodular goiters in 116 cases, adenomas in 66 cases, thyroiditis in 9 cases, papillary carcinomas in 84 cases, and follicular carcinomas in 20 cases. These results has an 84.6% sensitivity, a 95.2% specificity, a 15.3% false negative rate, and a 4.7% false positive rate. In the fifty-five cases of inadequate sampling, 13 cases (23.6%) were malignant lesions histologically. In the 16 cases proven as false negative, nine cases were papillary carcinomas, and 7 cases were follicular carcinomas histologically. Thirteen cases (16.1% of 27 cases of cystic lesions) of cystic nodules revealed malignant neoplasms histologically. CONCLUSION: FNAC is a single, useful diagnostic procedure for the initial screening for malignancy in thyroid nodules. Performing repeated aspiration in cystic nodules and clinically suspicious cases could reduce inadeguate sampling and the false negative rate.
Adenoma ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential* ; Female ; Goiter, Nodular ; Humans ; Male ; Mass Screening ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis

Prior to 1988, endometrial cancer was clinically staged but there was the considerable discrepancy between clinical and aetual stage. FIGO surgical staging classification of endometrial cancer(I988) provides the advanatage of recognizing the true disease distribution and extension, and more rational treatraent can be accomplished. This retrospective study was based on a clinical review of 73 patients with endometrial carcinoma from l982 through 1991 who underwent primary surgical evaluation. A11 cases were restaged ueing the newly adopted FIGO surgical staging. The distribution of FIGO clinical staging was as follows:85 patients(89.1%) were with stage I, 5(6.9%) with stage II, 2(2.7%) with stage III and 1(l.3%) with stage IV. Surgical restaging according new FlG0 classification reveald 56(76.7%) patients with stage I, 1(1.4%) with stage II, 14(19.2%) with stage III and 2(2.7%) with stage IV. Surgery upstaged 12.3% of clinical stage I patients, In clinical stage II patients, 80.0% was doenstaged. There wes no stage changing in cliaical stage III and IV patients. The acturial survival rates for surgical stages I a, I b, I c, and III were 80.0%, 77.2%, 68.4A%, and 35.0% respectively. By using FIGO surgical staging, the initial extent of endometrial cancer can be more accurately evaluated and we may predict prognosis and survival relatively well.
Classification ; Endometrial Neoplasms* ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate

Bipolar disorder is the main approved indication of mood stabilizers. In clinical practice, however, they are commonly used for 1) patients showing aggressive behavior regardless of the diagnosis and 2) schizophrenia patients. A literature review was performed to find evidence supporting this clinical “common sense.” The authors found no sufficient evidence supporting the efficacy of mood stabilizers either for aggressive behavior or for schizophrenia. The authors suggest that off-label use of mood stabilizers should be based on judicious clinical judgment, based on the understanding “what particular treatment for this patient does the behavior warrant at this time?”

Bipolar disorder is the main approved indication of mood stabilizers. In clinical practice, however, they are commonly used for 1) patients showing aggressive behavior regardless of the diagnosis and 2) schizophrenia patients. A literature review was performed to find evidence supporting this clinical “common sense.” The authors found no sufficient evidence supporting the efficacy of mood stabilizers either for aggressive behavior or for schizophrenia. The authors suggest that off-label use of mood stabilizers should be based on judicious clinical judgment, based on the understanding “what particular treatment for this patient does the behavior warrant at this time?”

Bipolar disorder is the main approved indication of mood stabilizers. In clinical practice, however, they are commonly used for 1) patients showing aggressive behavior regardless of the diagnosis and 2) schizophrenia patients. A literature review was performed to find evidence supporting this clinical “common sense.” The authors found no sufficient evidence supporting the efficacy of mood stabilizers either for aggressive behavior or for schizophrenia. The authors suggest that off-label use of mood stabilizers should be based on judicious clinical judgment, based on the understanding “what particular treatment for this patient does the behavior warrant at this time?”

Bipolar disorder is the main approved indication of mood stabilizers. In clinical practice, however, they are commonly used for 1) patients showing aggressive behavior regardless of the diagnosis and 2) schizophrenia patients. A literature review was performed to find evidence supporting this clinical “common sense.” The authors found no sufficient evidence supporting the efficacy of mood stabilizers either for aggressive behavior or for schizophrenia. The authors suggest that off-label use of mood stabilizers should be based on judicious clinical judgment, based on the understanding “what particular treatment for this patient does the behavior warrant at this time?”

BACKGROUND: The prevalence of dementia is estimated to be as high as 11.3% among coummunity-dwelling persons over 65 years of age in Korea. The fear of dementia for both patients and families is growing because of the chronicity and progressiveness of the disease. Though the recognition, evaluation, and management of patients with dementia are important for the care of older pateint, unfortunately, MMSE takes 5 to 10 minutes to administer and is cumbersome to carry for all elderly patients in busy office. The Clock Drawing Test has been known as valid, easily administered and low cost screening procedure for the congnitive impaiment associated with dementia in general geriatric clinic population. In this study, we assessed the usefulness of this measure as a screening test for dementia, on the basis of the correlation between clock drawing and MMSE-K. METHODS: The subjects for this study consisted of 47 elderly who visited to two elderly clubs in Seoul from April 1996 through June 1996 or the outpatient department of Family medicine of the Ehwa Mok-dong hospital. They received the Mini-Mental Status Exam and the Clock Drawing test. Three observers evaluated them by ratings from 10(best) to 1(worst). Inter-rater reliability of scores from the Clock Drawing Test was assessed and Pearson correlation coefficients were used to examine the relationships between scores from the Clock Drawing Test and MMSE-K. RESULTS: Their mean age was 75.4 years with range of 65 to 91 years. There were 34 women and 13 men. Correlations between individual raters was highly significant(y=0.8939, 0.8552, and 0.8698, respectively ; P<0.01). Compared to scores on MMSE-K, rating from clock drawings by each of 3 raters revealed statistically significant correlations(y=0.7164, 0.7398, and 0.6884, respectively ; P<0.01). CONCLUSIONS: The clock drawings can be rated reliably by even untrained observers and performance on this task relates significantly to performance on MMSE-K of severity. We confirmed the usefulness of clock drawings as a simple, easily administered, low cost, and reliable general screening tool for dementia in a general geriatric clinic population.
Aged ; Dementia* ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Outpatients ; Prevalence ; Seoul