Academic Medical Centers ; Faculty, Medical ; Humans ; Mentoring ; Mentors ; Teaching

PURPOSE: Graves' disease presenting concurrently with thyroid cancer is a rare condition. The clinical behaviors and the extent of surgery in this condition is still controversial. This study examined the prognostic factors influencing the long-term outcomes as well as the appropriate treatment modalities in patients with Graves' disease presenting concurrently with thyroid cancer. METHODS: Forty nine patients who underwent surgery for thyroid cancer with Graves' disease were enrolled in this study. The outcomes of various types of surgical treatments as well as the factors associated with the long-term outcome were retrospectively analyzed. RESULTS: There were 42 women and 7 men with a median age 39 years (15~70 years). The surgical procedures included a bilateral subtotal thyroidectomy (n=17), a bilateral total thyroidectomy (n=16), and a total and contralateral subtotal thyroidectomy (n=16). The mean follow-up period was 83 months (4~218 months) after surgery. Disease-free survival at 5 and 10 years were 97.6% and 88.9%, respectively. Univariate log-rank survival analyses revealed that the age at diagnosis, the size of the thyroid cancer, capsular invasion, multiplicity, lymph node involvement, and clinical cancer to be poor prognostic factors. However, the extent of the surgical treatment was not significant for survival. CONCLUSION: The prognosis is expected to be poor when thyroid cancer presenting concurrently with Graves' disease is clinically apparent or has invaded the thyroid capsule. Patients with Graves' disease should be screened with ultrasonography to detect thyroid cancer. A total thyroidectomy or completion total thyroidectomy is not necessary in patients who do not have any of the poor prognostic factors, such as incidentally detected microcarcinoma postoperatively.
Diagnosis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Lymph Nodes ; Male ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

PURPOSE: The aims of this study were to introduce an alternative surgical technique using a ballooning catheter and assess the outcomes of its use in patients with an upper mediastinal mass originated from the thyroid gland. METHODS: Between May 2001 and April 2004, 8 patients undewent an operation via a cervical approach using a ballooning catheter were enrolled in this study. The study group was reviewed by their clinical characteristics, diagnostic methods, postoperative results, histopathological findings and prognosis. Instead of a sternotomy, a ballooning catheter technique was used to assist in the transcervical delivery and extraction of these huge or deep mediastinal masses. The ballooning catheter was placed at the base of the mediastinal mass via a narrow plane which could not be reached by the surgeon's fingers. When the mediastinal mass was freed up by careful dissection with traction using an inflated ballooning catheter, could the mass was able to be delivered without injury to the surrounding tissues. RESULTS: There were 3, 2 and 3 cases of substernal goiters, substernal goiters combined with a papillary microcarcinoma and metastatic papillary carcinoma from thyroid cancer, respectively. The mean operation time and period of hospitalization were 121 minutes, (ranging from 70 to 195 minutes), and 6 days, (ranging from 3 to 10 days), respectively. In the 5 cases with a substernal goiter, the average size of the resected specimen was 9.9 cm, (ranging from 5.5 to 17.6 cm), with an average weight of 100.2 g, (ranging from 45 to 172.2 g). In the 3 cases of metastatic mediastinal lymph nodes, the postoperative 131I scan and serum thyroglobulin level showed no evidence of remnant metastatic tissue or cancer spillage. The median follow up duration was 24.8 months (ranging from 13 to 42 months). No major complications were documented, and no evidence of recurrence was encountered. CONCLUSION: The use of the ballooning catheter was found to be helpful in the transcervical removal of an upper mediastinal mass, and useful for substernal goiters. Furthermore, for mediastinal lymph node metastasis, this technique can be adopted as an alternative method in carefully selected cases.
Carcinoma, Papillary ; Catheters* ; Fingers ; Follow-Up Studies ; Goiter, Substernal ; Hospitalization ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sternotomy ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms ; Traction

Two Years Reports of "Journal of Korean Neuropychiatric Association" during 2001 to 2003 were evaluated by 17 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropychiatric Association" will develope a good journal.
Evaluation Studies as Topic*

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

OBJECTIVES: This 6-week, open label randomized, multicenter study was conducted to evaluate the antidepressant effect and safety of milnacipran and fluoxetine in patients with major depression. METHODS: The study was done in patients with major depression diagnosed by DSM-IV who score > or =17 in 17 items Hamilton Rating Scale for Depression (17-item HAM-D) and score > or =25 in Montgomery and Asberg Depression Rating Scale (MADRS). A total of 87 patients were randomized to milnacipran group and fluoxetine group. In cases of the patients taking other antidepressants, 6 weeks of each medication was administered after 7 days of drug excretion period. The evaluation was done using 17 item HAM-D, MADRS, Clinical Global Impression Scale (CGI), and COVI scale after baseline, 1 week, 2 weeks, 4 weeks, and 6 weeks. The side effects that had occurred during the period of our study were put in records by developed/disappeared time, severities, incidences, managements and results. RESULTS: A total of 87 patients were enrolled. 70 (milnacipran group 39;fluoxetine group 31) of them were included for the 6 weeks of research and 17 of them dropped out within the first week, not due to adverse reactions or deficiency of effects. Total 17 item HAM-D scores, total points of MADRS, and CGI showed significant decrease after 1 week in each treatment group and continued decrease after 2 weeks and 4, 6 weeks. But there was no difference between milnacipran group and fluoxetine group in the antidepressant effect. There were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The commonly reported side effects of minlacipran were nausea (25.0%), headache (10.7%), vomiting (7.1%), constipation (7.1%), dizziness (7.1%) and those of fluoxetine were GI trouble (11.1%), diarrhea (11.1%), insomnia (11.1%), agitation (5.6%), and dizziness (5.6%). CONCLUSION: Milnacipran was effective for the improvement of depressive symptoms and was well tolerated and safe in patients with depression.
Antidepressive Agents ; Chemistry ; Constipation ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Diarrhea ; Dihydroergotamine ; Dizziness ; Electrocardiography ; Fluoxetine* ; Headache ; Humans ; Incidence ; Nausea ; Sleep Initiation and Maintenance Disorders ; Vital Signs ; Vomiting

BACKGROUND: Various eccrine tumors are rather common diseases in clinicians. However, data on the clinicopathologic features of eccrine tumors in Korea are limited. OBJECTIVE: The purpose of this study was to investigate the clinicopathologic characteristics of eccrine tumors in Korea. METHODS: Two hundred and sixty five cases of eccrine tumors, seen from 2002 to 2004 in Korea, were retrospectively analyzed clinically and histopathologically. RESULTS: The most common eccrine tumors identified within Koreans were syringoma (61%), followed by eccrine poroma (13%), eccrine hidrocystoma (9%), and nodular hidradenoma (6%). Moreover, eccrine tumors were usually found to occur in middle-aged woman as multiple asymptomatic skin-colored papules. The most common site of occurrence was the face (45%), followed by the neck (9%), scalp (5%), foot (5%), abdomen (4%), and vulvar (3%). CONCLUSION: The results of this study will be useful and fundamental data on eccrine tumors for clinicians and pathologists.
Abdomen ; Acrospiroma ; Female ; Foot ; Hidrocystoma ; Humans ; Korea ; Neck ; Poroma ; Retrospective Studies ; Scalp ; Syringoma

BACKGROUND: Data on the clinicopathologic features of hair follicle tumors in Korea are limited. OBJECTIVE: The purpose was to investigate the clinical and histopathologic characteristics of hair follicle tumors in Korea. METHODS: Two hundred sixty four cases of hair follicle tumors seen from 1999 to 2001 in Korea were analyzed clinically and histopathologically. RESULTS AND CONCLUSION: The most common hair follicle tumor in Korea was pilomatricoma(81.0%), followed by trichoepithelioma(6.4%), dilated pore of Winer(3.8%), and proliferating trichilemmal tumor(2.2%). Hair follicle tumors usually occurred as a solitary skin-colored nodule. The most commonly involved site was the face, and the peak age of presentation was 10 to 19. Pilomatricoma usually occurred as a solitary skin-colored nodule. The most commonly involved site was the arm, and more than 50% of tumors occurred before the age of 20. Histopathologically, the tumor was often surrounded by fibrous capsule and was composed of basophilic and shadow cells. It was usually located in the dermis and extended into the subcutis. Retraction spaces between tumor nests and stroma were frequently observed. Trichoepithelioma usually occurred as multiple skin-colored papules on the face. Histopathologically, the tumor was usually located in the dermis with sometimes connected to the epidermis. It frequently showed peripheral palisading. Dilated pore of Winer usually occurred as a solitary brownish to pigmented papule on the face in middle-aged persons. Proliferating trichilemmal tumor occurred as a solitary or multiple tumors. Histopathologically, the tumor was usually surrounded by incomplete fibrous capsule. Tumor cells frequently showed clear cell formation, nuclear atypia, mitosis, peripheral palisading, trichilemmal keratinization, and individual keratinization.
Arm ; Basophils ; Dermis ; Epidermis ; Hair Follicle* ; Hair* ; Humans ; Korea ; Mitosis ; Pilomatrixoma

BACKGROUND: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. OBJECTIVE: The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. METHODS: The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. The relative frequency of the major diagnostic group according to WHO classification was as follows: mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone lymphoma, 1%; angioimmunoblastic lymphadenopathy, 1%. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma.
Academies and Institutes ; Classification ; Continental Population Groups ; Geography ; Humans ; Immunoblastic Lymphadenopathy ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Pathology ; Retrospective Studies