BACKGROUND: The aim of this study was to analyze the questions in the shoulder and elbow section of the Korean Orthopaedic In-Training Examination (KOITE) and compare them with those of the US Orthopaedic In-Training Examination (US OITE). METHODS: Twenty-nine questions in the shoulder and elbow section of the KOITE from 2010 to 2014 were analyzed and compared with those of the US OITE (80 questions) by literature review. A thorough analysis of the contents was performed after categorizing as topics, diagnostic tools, treatment modalities, taxonomic classification, and references. RESULTS: The shoulder and elbow section of the KOITE was 5.8% weight which was similar to the US OITE (5.9%). The most commonly appearing topic was anterior labral injury (17.2%) on the KOITE compared to instability and arthritis (21.3%, each) on the US OITE. Magnetic resonance imaging was most frequently appeared imaging modality on the KOITE (41.0%) compared to the radiograph on the US OITE (43.0%). The Latarjet procedure was the most commonly asked treatment modality (22.2%) on the KOITE, whereas arthroplasty (33.3%) on the US OITE. The KOITE showed an even taxonomic classification distribution compared to the US OITE. Campbell's operative orthopaedics covered 96.6% questions as a reference on the KOITE compared to the Journal of Bone and Joint Surgery, American Volume on the US OITE, which covered 45.0%. CONCLUSIONS: This specific analysis shows us current trends of the shoulder and elbow section of the KOITE and it might be developed for use in the educational curricula for the trainee.
Arthritis ; Arthroplasty ; Classification ; Curriculum ; Elbow* ; Joints ; Magnetic Resonance Imaging ; Orthopedics* ; Shoulder*

Moyamoya disease is characterized by a bilateral progressive narrowing of the distal internal carotid and proximal portions of the anterior and middle cerebral arteries. The cerebral vessels of the 11 to 14 mm embryonic period are extremely similar to these moyamoya vessels. The vertebral arteries unite with a contralateral homologue to form the basilar artery during embryonic development and rarely, the failure of complete fusion results in duplication of these arteries. It is well known that moyamoya disease sometimes is accompanied by persistent primitive arteries, cerebral aneurysm, or rarely arteriovenous malformation. However, no case of the moyamoya disease with complete duplication of basilar artery has been previously reported. These two types of vascular abnormality are probably associated in certain developmental period, and moyamoya disease causes hemodynamic load in the basilar artery system as a collateral pathway and these effects are also involved in duplication of basilar artery. The relationship between these two varieties of vascular abnormality and possible pathogenesis of the moyamoya disease are discussed.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery* ; Cerebral Arteries ; Embryonic Development ; Female ; Hemodynamics ; Middle Cerebral Artery ; Moyamoya Disease* ; Pregnancy ; Vertebral Artery

BACKGROUND: The circadian rhythm of circulating melatonin is regulated by the endogenous oscillators, the suprachi-asmatic nuclei, and entrained by the light-dark cycle of the environment, but it seems that the rhythm can be affected by variable lesions outside the retina-pineal pathway. We intended to know how acute cerebral infarction affects on the cir-cadian rhythm of plasma melatonin secretion. METHODS: Plasma melatonin level was measured from 64 patients with acute cerebral infarction. On admission, blood samples were collected by venipuncture at 2AM, 4AM, 10AM, and 2PM and melatonin level was measured by radioimmunoassay. The state of consciousness of each patient was assessed clini-cally and the infarction site and size were evaluated clinically and radiographically. RESULTS: Among 64 patients with acute cerebral infarction, dramatic blunting or obliteration of nocturnal melatonin surge in the blood was found in 29 patients. The circadian rhythm of melatonin secretion was absent in 12 of 35 alert patients, in 10 of 20 drowsy patients, and in 5 of 7 stuporous patients. Melatonin secretion into plasma was markedly decreased in all 2 comatose patients. Of 14 patients with brainstem lesions, 8 patients showed decreased melatonin levels with the absence of a nocturnal rise, although most of them were alert. CONCLUSIONS: This study suggests that brainstem and the initial mental state might contribute to the regulation of the circadian rhythm of plasma melatonin even though the lesion does not involve the retina-pineal pathway, but further extensive study is required to elucidate it. (J Korean Neurol Assoc 19(4):359~363, 2001)
Biological Clocks ; Brain Stem ; Cerebral Infarction* ; Circadian Rhythm* ; Coma ; Consciousness ; Humans ; Infarction ; Melatonin* ; Phlebotomy ; Photoperiod ; Pineal Gland ; Plasma ; Radioimmunoassay ; Stupor

Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.
Aorta ; Aortic Aneurysm, Thoracic* ; Aortic Diseases ; Arterial Occlusive Diseases ; Blood Coagulation Disorders ; Leriche Syndrome* ; Thrombosis

Background: Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management. Objective: This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients. Methods: We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria. Results: According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria. Conclusion We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea.

Poroid hidradenoma (PH) is a rare benign tumor that shows differentiation of the eccrine sweat gland. It occurs mainly in adults, presenting as a 0.5 to 2 cm-sized intradermal nodule, mostly on the head, extremities, trunk and neck. We report two rare cases of PH, one on the face and the other on the heel. The first patient was a 50-year-old male who had a solitary, skin-colored nodule on his right temple for 6 months.The second patient was a 67-year-old female who presented with a solitary, bean-sized, tender nodule on her left heel for 1 year. The common histological examination finding was a well-circumscribed tumor composed of solid portions and large cystic spaces in the center. The tumor cells consisted of small, monomorphic poroid cells and large cuticular cells in both cases. To our knowledge, only few cases of PH have been reported. Herein, we report two rare cases of PHs with literature review

Poroid hidradenoma (PH) is a rare benign tumor that shows differentiation of the eccrine sweat gland. It occurs mainly in adults, presenting as a 0.5 to 2 cm-sized intradermal nodule, mostly on the head, extremities, trunk and neck. We report two rare cases of PH, one on the face and the other on the heel. The first patient was a 50-year-old male who had a solitary, skin-colored nodule on his right temple for 6 months.The second patient was a 67-year-old female who presented with a solitary, bean-sized, tender nodule on her left heel for 1 year. The common histological examination finding was a well-circumscribed tumor composed of solid portions and large cystic spaces in the center. The tumor cells consisted of small, monomorphic poroid cells and large cuticular cells in both cases. To our knowledge, only few cases of PH have been reported. Herein, we report two rare cases of PHs with literature review

Background: Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management. Objective: This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients. Methods: We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria. Results: According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria. Conclusion We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea.

Clear cell hidradenoma (CCH) is a rare benign tumor that shows differentiation toward the structure of a sweat gland. Recently, hidradenoma has been re-classified into apocrine and eccrine variants and CCH has been classified as apocrine differentiation. A 34-year-old man without any underlying diseases presented with an erythematous, papilliform, 1-cm exophytic nodule on the left neck that had been present for 3 years. Skin biopsy specimens were obtained by excision biopsy of his left neck. Histopathologic findings showed a well-circumscribed tumor composed of solid portions with polyhedral cells and clear cells, a tubular space with columnar cells, and decapitation secretion. Additionally, round, basophilic, poroid cells, tubular structures containing hyalinized material, and intercellular bridges were observed in the epidermis. Herein, we present a rare case of CCH with apocrine and eccrine differentiation.

Kikuchi’s disease, also referred to as histiocytic necrotizing lymphadenopathy, is a benign self-limiting lymphadenitis accompanied by mild fever and night sweats. This disorder usually affects young women and presents with non-specific cutaneous findings. A 15-year-old female adolescent presented with erythematous papules and plaques on both cheeks accompanied by fever, night sweats, and right cervical lymphadenopathy. Histopathological evaluation of a skin biopsy specimen showed mild perivascular and periadnexal infiltration in the dermis.Fine-needle aspiration biopsy of lymph nodes revealed coagulative necrosis with lymphocytic, histiocytic, and karyorrhectic debris. We present a rare case of Kikuchi’s disease that was diagnosed based on histopathological evaluation of skin and lymph node specimens.