Large-cell acanthoma is a generally hyperkeratotic, sharply demarcated patch on sun-exposed skin with the outstanding pathologic feature being composed of large, relatively uniform keratinocytes. We describe a case of large-cell acanthoma that involved the skin of the nasal bridge. Patient was a 56-year-old women with a tannish brown patch, 2 cm in size and of 5 years' duration. Controversial issues about nosologic entity of large cell acanthoma are discussed.
Female ; Humans

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Verrucous carcinoma is a variant of well-differentiated squarmous cell carcinoma. Although this tumor is well-documented in the oral cavity, its occurrence on the glans penis is rare. It is a relatively nonaggressive tumor which seldom metastasizes to the resional lymph node or distantly. With proper treatment, the prognosis is excellent. We have experienced a case of verrucous carcinoma arising on the glans penis with the previous insertion of paraffin and penile prosthesis for the augumentation of penis, which was treated with total phallectomy. We report this case with a review of literature.
Carcinoma, Verrucous* ; Lymph Nodes ; Male ; Mouth ; Paraffin ; Penile Prosthesis* ; Penis* ; Prognosis

Relapsing polychondritis is a rare systemic disorder manifested by recurring episodes of inflammation in cartilagenous tissues including the eye, the audiovascular and cardiovascular systems. We describe a 53-year-old oriental woman with a one month history of painful swelling of both ears accompanied by intermittent hoarseness, dyspnea, impaired visual acuity, and swelling of hands. Both ear lobes were typically uninvolved. Auricle including cartilaginous tissues were histologically examined, which revealed loss of basophilic staining, degenerative changes, inflammatory cells infiltrations with eosinophils and neutrophils, and perichondrial inflammation of the cartilage. Oral prednisolone and colchicine were prescribed and the successful resolution of both ears swelling were observed. As the disease progressed optic neuritis and chewing difficulty by non-erosive motion limit of temporo-mandibular joints developed.
Basophils ; Cardiovascular System ; Cartilage ; Colchicine ; Dyspnea ; Ear ; Eosinophils ; Female ; Hand ; Hoarseness ; Humans ; Inflammation ; Joints ; Mastication ; Middle Aged ; Neutrophils ; Optic Neuritis* ; Polychondritis, Relapsing* ; Prednisolone ; Visual Acuity

Malignant proliferating trichilemmal tumor is a rare neoplasm derived from the outer root sheath of the hair follicle. We report a 64-year-old woman with nodular mass in her scalp of for 10 years. Despite surgical removal of the mass, the residual lesion grew with ulceration. In fine needle aspiration, malignant cells were detected. Histological examination of the skin lesion revealed a lobulated tumor exhibiting keratinization beneath the epidermis. In some area, cord of atypical cells infiltrating surrounding tissue, stromal desmoplasia, mitotic figures were seen. For treatment wide surgical excision and skin graft were done.
Biopsy, Fine-Needle ; Epidermis ; Female ; Hair Follicle ; Humans ; Middle Aged ; Scalp ; Skin ; Transplants ; Ulcer

OBJECTIVES: It has been reported that caregivers of patients with chronic mental illness including schizophrenia are in higher risk for psychological and physical health problem. This study was performed to evaluate the depressive symptoms and associated factors in caregivers of patients with chronic mental illness. METHODS: The subjects were 77 unaffected caregivers (30 parents, 30 siblings, 10 offspring, and 7 spouses) of patients with chronic mental illness (62 schizophrenia, 4 schizoaffective disorder, 11 bipolar disorder) and 100 healthy controls. Depressed mood was assessed by Beck Depression Inventory (BDI) in all subjects. For their sick family members, clinical factors including psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), duration of illness, number of admission were assessed. RESULTS: The mean BDI score of the caregivers was significantly higher than that of control subjects (11.2+/-11.6 and 8.0+/-7.5). Given that 23.4% of family group and 23.0% of control group are attributed to mild to moderate depressed state and 22.0% of family group and 8.0% of control group to above moderate depressed state, significant depressive symptom is more frequently observed in family group. The mean BDI score of parent group was higher than that of sibling group controlling for sex and age. In the parent group, BDI scores are positively correlated with age while the offspring and spouse group had negative correlation between BDI scores and age. Higher age, lower socioeconomic state, more severe positive symptom scores of patients were potential predictors for BDI scores of caregivers. CONCLUSION: This study showed that caregivers of patients with chronic mental illness have significant depressive symptoms. It may be suggested that depressive symptoms of caregivers are associated with aging, low socioeconomic state, and severe positive symptom rather than chronicity of their sick family members.
Aging ; Caregivers ; Depression ; Humans ; Parents ; Psychotic Disorders ; Schizophrenia ; Siblings ; Spouses

OBJECTIVES: The purposes of the study were to assess the unmet needs of the chronic mental ill in low income class living in community and to provide basic data for developing services and programs in community mental health. METHODS: Face to face interviews were done for the subjects (n=320) who were diagnosed as schizophrenia, major depressive disorder, and bipolar I disorder. The Korean version of Camberwell Assessment of Need Short Appraisal Scale (CANSAS) was used as the assessment tool of the needs. Frequencies and rates of met needs and unmet needs of each 22 items of CANSAS were estimated. We classified 22 items into six need areas by operational definition, and then estimated mean percentages of unmet needs and met needs for each 6 need areas. We also classified subjects into 2 groups by the presence of psychiatric care needs, and then estimated mean percentage of unmet needs for other 5 need areas according to psychiatric care needs. RESULTS: Among the respondents, 77.7% of them had no spouses, and 66.4% had the education of six years and over. Of the respondents, 53.8% were males, 46.2% females. And 74.3% used medical aid in social security. Most respondents did not have present occupations and persons who were living with their parents were 48.3% and persons living alone reached 8%. The diagnosis of schizophrenia was 60.9%, major depressive disorder 15.2%, respectively. Most respondents (73.6%) had been admitted to the hospitals, but they hardly used rehabilitation services or programs during the daytimes. In estimating the unmet needs for each 22 items of CANAS, the need of company of others was the highest and that of welfare benefit and daytime activity were next. Information for treatment, intimate relationship, psychological distress, money, and psychotic symptoms follow the order. The mean percentages of unmet needs for each 6 needs area were 29.5% for income needs, 26.9% for social relation needs, 17.0% for physical care needs, 14.2% for psychiatric care needs, 11.6% for daily living skill needs, and 9.6% for residency needs. We classified subjects into 2 groups by the presence of psychiatric care needs: 49% of the subjects had no psychiatric care needs and 51% had psychiatric care needs. The group that had psychiatric care needs also had higher mean percentage of unmet need in 5 other needs areas than group that had no psychiatric care needs. And these results showed statistically significant except residency needs area. CONCLUSION: When preparing services or programs in community mental health, occupational rehabilitation and social support should be included as basic services. Other services such as physical treatment, psychiatric treatment, social skill training, and residency could be considered as optional.
Surveys and Questionnaires ; Depressive Disorder, Major ; Diagnosis ; Education ; Female ; Humans ; Internship and Residency ; Male ; Mental Health ; Mentally Ill Persons* ; Needs Assessment* ; Occupations ; Parents ; Rehabilitation ; Schizophrenia ; Social Security ; Spouses

Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications.
Aged ; Cocos ; Dental Porcelain ; Heart Atria ; Heart Valve Diseases ; Hematoma ; Humans ; Male ; Mitral Valve ; Recurrence ; Thrombectomy ; Thrombosis ; Warfarin

Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications.
Aged ; Cocos ; Dental Porcelain ; Heart Atria ; Heart Valve Diseases ; Hematoma ; Humans ; Male ; Mitral Valve ; Recurrence ; Thrombectomy ; Thrombosis ; Warfarin

PURPOSE: Our aim of research is to find novel genes that overexpressed in various samples such as cell lines and tissues that infinitely proliferate; so-called immortalized cells, cancer cells and tissues. In this study, we obtained a gene from immortalized cell line (WI-38 VA13) then identified it from various cell lines and human lung tissues. MATERIALS AND METHODS: Using suppressive subtractive hybridization (SSH) method, we obtained many genes and selected a novel gene of them. And then the novel gene fragment was amplified by PCR and ligated in T easy vector for sequencing. And finally we found a differentially expressed gene in cell lines and tissues when it was performed by reverse transcriptase-PCR (RT-PCR). RESULTS: As the result of transformation of genes that we gained using SSH, we obtained about 150 clones. And then we certificated several genes by DNA prep and confirmed it by sequencing. We examined whether the gene sequences are novel or known genes by genome homology search and we confirmed the gene expressions by RT-PCR. As a result, we identified a differentially overexpressed gene (named "clone 58") in immortalized cells, cancer cell lines and lung squamous cell carcinomas. CONCLUSION: The "clone 58" mRNA was significantly up-regulated in various human cell lines and also human lung cancer tissues compared to the normal. We suppose that this gene can carry out a specific role related to the induction of cancer and/or the mechanism of the changeover of a normal cell to an immortalized cell. In short, the discovery of our gene has an importance in the point that they are thought to have a connection with immortalization and carcinogenesis of human cells and tissues.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Line ; Clone Cells ; DNA ; Gene Expression ; Genes, vif ; Genome ; Humans* ; Lung ; Lung Neoplasms ; Polymerase Chain Reaction ; RNA, Messenger