Tubular apocrine adenoma is a well-circumscribed intradermal benign tumor with tubular structures showing apocrine differentiation. Most of those cases occur on the scalp in middle aged women. Histologically, tubular structure with apparent apocrine decapitation secretion, cystic dilatation of tubule, and connection with epidermis are the characteristic features of tubular apocrine adenoma. We presented a case of tubular apocrine adenoma that had recurred after incomplete excision. It showed apocrine decapitation secretion histologically and both eccrine and apocrine differentiation on immunohistochemical study.
Adenoma* ; Decapitation ; Dilatation ; Epidermis ; Female ; Humans ; Middle Aged ; Scalp

Ota nevus is a dermal melanocytic harmatoma derived from neural crest melanoblast and involves skin innervated by the trigeminal nerve. Although most cases are clinically apparent at birth or around puberty, acquired lesions in adults have been rarely reported. We reported a 73 year-old Korean man with Ota nevus of the face and scalp that onset in his eighth decade and accompanied multiple solar comedo of the face.
Adolescent ; Adult ; Humans ; Neural Crest ; Nevus of Ota* ; Parturition ; Puberty ; Scalp ; Skin ; Trigeminal Nerve

Mixed tumor of the skin (chondroid syringoma) is a rare benign tumor composed of epithelial elements intermingled with myxoid or cartilagenous stroma which is not separated by basement membrane. It had been believed to originate from the eccrine gland but recently, it was described to be of apocrine gland origin in case of showing apparent apocrine secretion. We report on a 63-year-old man with a tumor on the right upper eyelid showing typical microscopic features of mixed tumor of the skin. Many apocrine decapitation secretions were seen in tubular structures and follicular differentiations were also seen, which represents the common origin of folliculo-sebaceous-apocrine unit.
Adenoma, Pleomorphic ; Apocrine Glands ; Basement Membrane ; Decapitation ; Eccrine Glands ; Eyelids ; Humans ; Middle Aged ; Skin

BACKGROUND: The aim of this study was to determine the cytologic features of anaplastic lymphoma kinase (ALK) expressing pulmonary adenocarcinoma. METHODS: We analyzed the cytopathological findings of 15 cases of endobronchial ultrasound guided aspiration and a case of bronchial washing. These cases were selected based on the histomorphology of ALK-rearranged lung adenocarcinoma. RESULTS: Cytology showed mucinous (81.3%) and hemorrhagic (50%) backgrounds. The cells were arranged in tubulopapillary or tubulocribriform patterns (93.8%), and clusters (56.3%) admixed with signet ring cell features (87.5%). The tumor cells were monotonous and uniform with vesicular nuclei and a small nucleolus. CONCLUSIONS: The characteristic findings were sheets showing a tubulopapillary or tubulocribriform appearance, with vesicular nuclei and a bland chromatin pattern (p<0.001). Scattered signet ring cells were helpful in suggesting ALK-positive adenocarcinoma (p<0.001).
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Chromatin ; Lung ; Lymphoma ; Mucins ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns and clinical responses in inpatients and/or outpatients with obsessive compulsive disorder (OCD) at a university hospital. METHODS: A total of 71 OCD patients were included and followed during the first 4 months, first year and second year from 1998. The patterns of medication use and clinical responses according to the Yale-Brown obsessive-compulsive scale (Y-BOCS) were analyzed descriptively in this period. RESULTS: During the first 4 months, 26.7% of the patients underwent monotherapy in which most of the drugs were serotonin reuptake inhibitors (SRIs). Therapy with two or more drugs was administered in 66.6% of the patients and combination drugs with SRIs were atypical antipsychotics and clonazepam. The clinical response rate using Y-BOCS was 24.0% compared with baseline score. During the first year, the frequency of the monotherapy decreased to 6.5%, while that of therapy with two or more drugs increased to 80.6% (two and three drug frequencies were 35.3%, and 32.3%, respectively). The clinical response rate was 26.4% during this period. During the second year, the frequency of the monotherapy was 25% and that of multidrug therapy was 70.8% (two and three drug frequencies were 20.8%, and 45.8%, respectively). The clinical response rate was 39.3% compared with baseline score. CONCLUSIONS: In this study, the frequency of the combination therapy was relatively high compared with SRI monotherapy during the first 4 months and it increased further during the first year. The combination therapy was maintained without change of SRI dosage during the second year. Most of the drugs used in the combination therapy were atypical antipsychotics and clonazepam.
Antipsychotic Agents ; Clonazepam ; Drug Therapy* ; Humans ; Inpatients ; Obsessive-Compulsive Disorder* ; Outpatients ; Serotonin Uptake Inhibitors

PURPOSE: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. MATERIALS AND METHODS: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. RESULTS: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from 14.2degrees, 96.7degrees, 50.8degrees and 53.3degrees to 5.4degrees, 122.1degrees, 63.3degrees and 67.5degrees, respectively (p<0.05).RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. CONCLUSION: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.
Arthroplasty* ; Diagnosis ; Dislocations* ; Elbow* ; Humans ; Humeral Fractures ; Pronation ; Range of Motion, Articular ; Supination ; Tea

OBJECTIVES: The purpose of this study was to investigate the changes of cognitive dysfunctions in patients with obsessive compulsive disorder (OCD) over the two-year of pharmacological treatment. METHODS: The thirty-three OCD patients and thirteen normal subjects were administered the neuropsychological tests and clinical evaluations twice (at the baseline and two-year). RESULTS: In spite of the two-year treatment, the accuracy of delayed recall on the Rey-Osterrieth Complex Figure Tests (RCFT), the numbers of responses on the category and letter test of Controlled Oral Word Association Test (COWA), the response time on the Trail Making Test part A (TMT-A) remained significantly impaired in the OCD patients compared with the normal controls. CONCLUSION: These findings suggest that the cognitive dysfunctions such as visuospatial memory and verbal fluency might be the underlying persisting neuropathophysiology of OCD.
Follow-Up Studies* ; Humans ; Memory ; Neuropsychological Tests ; Obsessive-Compulsive Disorder* ; Reaction Time ; Trail Making Test ; Word Association Tests

OBJECTIVES: The purpose of this study was to investigate the changes of cognitive dysfunctions in patients with obsessive compulsive disorder (OCD) over the two-year of pharmacological treatment. METHODS: The thirty-three OCD patients and thirteen normal subjects were administered the neuropsychological tests and clinical evaluations twice (at the baseline and two-year). RESULTS: In spite of the two-year treatment, the accuracy of delayed recall on the Rey-Osterrieth Complex Figure Tests (RCFT), the numbers of responses on the category and letter test of Controlled Oral Word Association Test (COWA), the response time on the Trail Making Test part A (TMT-A) remained significantly impaired in the OCD patients compared with the normal controls. CONCLUSION: These findings suggest that the cognitive dysfunctions such as visuospatial memory and verbal fluency might be the underlying persisting neuropathophysiology of OCD.
Follow-Up Studies* ; Humans ; Memory ; Neuropsychological Tests ; Obsessive-Compulsive Disorder* ; Reaction Time ; Trail Making Test ; Word Association Tests

Fracture and fracture-dislocation of the ankle may be caused by a variety of mechanisms. In addition to the fracture, injury of soft tissue such as ligaments, tendons, nerves, and muscles may occur. Among these, tibialis posterior tendon injury is difficult to identify due to swelling and pain at the fracture site. There is no clear finding in radiological examination, therefore, it is found during surgery. In this case, irreducible fracture-dislocation of the ankle due to tibialis posterior tendon interposition was observed after the primary operation. The authors obtained satisfactory results in performance of a secondary operation assisted with arthroscopy.
Ankle Fractures ; Ankle* ; Arthroscopy ; Ligaments ; Muscles ; Tendon Injuries ; Tendons*

PURPOSE: To learn the long-term prognosis of patients with deep vein thrombosis (DVT), we evaluated the location and extent of thrombotic changes, hemodynamic status and clinical symptoms of patients of more than 12 months after development of acute thrombosis. METHODS: 31 patients (man; 24, female; 7, mean age; 44.7 13.2 years) with phlebograpically documented DVT were followed-up for 13~90 months (mean: 32.6 20.4 months) with Duplex scanning, and photo-plethysmography (PPG), and clinical symptoms. To evaluate the effects of treatment modality, the patients were devided into 3 groups; Group 1 (heparine warfarin, n=17), Group 2 (heparine warfarin catheter directed urokinase, n=10), Group 3 (heparine warfarin systemic urokinase, n=4). But, the size of Group 3 was inappropriate to compare with other groups, we performed analysis of the results of Group 1 and 2. RESULTS: Remained thrombi were detected in 22 patients (70.2%) of 31 patients by Duplex scanning, even 1 year later. Of the 29 patients studied with PPG, 24 patients (83%) revealed valvular incompetence in deep (11 cases, 38%) and superficial venous systems (13 cases, 45%). Thrombolytic rate in Group 2 was much higher than Group 1; complete resolution (40% vs 23%), complete obstruction (0% vs 41%). The statistically significant correlation between resolution degree and symptomatic improvement was shown (p=0.008). CONCLUSION: Residual thrombi and valvular damages after DVT were common. But, thrombolysis by catheter-directed urokinase may be associated with a higher rate of thrombolysis and clinical improvement. Anticoagulation alone may not be a sufficient method for treatment of DVT.
Catheters ; Female ; Follow-Up Studies* ; Hemodynamics ; Humans ; Lower Extremity* ; Prognosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin