Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

We report a case of hereditary trichilemmal cyst with proliferating trichilemmal tumor in a 64-year-oid man, who has generalized 157, variable sized firm cutaneous nodules for 40 years. The cystic nodules are chiefly located on the scalp and trunk which showed characteristic histopathologieal findings of trichilemmal cyst and proliferating trichilemmal tumors. His son also has multiple trichilemmal cysts and his mother seems to have had clinically similar lesions. The patient and his son were treated with surgical excision and therapeutic trial of oral isotretinoin for 2 months. Isotretionoin was ineffective in the patient, but the lesions of his son were decreased in size.
Humans ; Isotretinoin ; Mothers ; Scalp

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

OBJECTIVES: The purpose of this study was to examine the effects of positive psychological characteristics on posttraumatic stress symptoms after traumatic experiences. METHODS: The subjects were 97 firefighters (83 males and 14 females), who completed the Life Events Scale, the Rosenberg Self-Esteem Scale, the Connor-Davidson Resilience Scale, and the Impact of Event Scale-Revised Korean version. Pearson product-moment correlation coefficients were computed to examine the relationships among the variables, and Structural Equation Modeling was used to investigate the mediation process in the relationships among traumatic experiences, positive psychological characteristics, and posttraumatic stress. RESULTS: The results showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences affected posttraumatic stress symptoms not only directly, but also through self-esteem to posttraumatic stress symptoms. Therefore the lower firefighters' self-esteem was, the more posttraumatic stress symptoms occurred. Resilience, however, apparently had no function as mediating variable in the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences and resilience each seemed to affect posttraumatic stress symptoms directly. Hence, the lower firefighters' resilience was, the more posttraumatic stress symptoms occurred. CONCLUSION: This study showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. We also found that resilience affects posttraumatic stress symptoms directly, regardless of the number of traumatic experiences. Likewise, these results showed that we should be concerned in positive psychological characteristics such as self-esteem and resilience in order to prevent posttraumatic stress symptoms.
Firefighters ; Humans ; Male ; Negotiating

Vulvar leiomyoma is a rare benign solid tumor of the vulva. Their incidence is not known as most reports are of a single case or small series, and their origin is not known exactly. Most cases are asymptomatic and local excision is recommended as initial therapy and also for recurrences. We have experienced vulvar leiomyoma (the labia majora and vestibule of the vagina) in a 51 years old woman and present it with a brief review of the literatures.
Female ; Humans ; Incidence ; Leiomyoma* ; Middle Aged ; Recurrence ; Vulva

Turner's syndrome (TS) is a chromosomal disorder where phenotypic females have either a missing chromosome (45 XO) or a structural aberration in one of the chromosomes. Previous studies have suggested that women with TS may be at increased risk of several autoimmune diseases, such as Hashimoto thyroiditis, celiac disease, Crohn's disease, ulcerative colitis, juvenile rheumatoid arthritis, and vitiligo. Although a high risk has been documented for autoimmune diseases in TS, there is only one case reporting the relationship between TS and ankylosing spondylitis (AS) in the literature. Herein, we present an unusual case of AS associated with TS.
Arthritis, Juvenile Rheumatoid ; Autoimmune Diseases ; Celiac Disease ; Chromosome Disorders ; Colitis, Ulcerative ; Crohn Disease ; Female ; Hashimoto Disease ; Humans ; Spondylitis, Ankylosing ; Turner Syndrome ; Vitiligo