Serous cystadenoma of the pancreas, also known as microcystic adenoma or glycogen-rich cystadenoma, is an unusually benign tumor. It is usually large and composed microscopically of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. It has been suggested that serous cystadenoma probably arise from the ductular cells or centroacinar cells. Herein, we report on a case of serous cystadenoma of the pancreas in a 55-year-old female. The tumor, measuring 13.5x11.5x10.0 cm, was located in the head of the pancreas and the cut surface revealed a sponge-like appearance due to innumerable tiny cysts containing clear serous fluid. Microscopic analysis showed cystic spaces lined by cuboidal cells with intracytoplasmic glycogen.
Female ; Humans ; Cysts ; Adenoma

An antrochoanal polyp is a solitary polypoid mass that arises from the maxillary sinus, and protrudes through the natural ostium into the middle meatus, and reaches the choana, The polyp does not differ histologically from an ordinary nasal polyp, which is composed of edematous, hyperplastic submucosal connective tissue stroma, and is relatively hypocellular, In this sequence of events. Its computed tomographic(CT)findings are characteristic. We retrospectively analyzed CT studies of nine cases, all of which showed similar CT findings; a solitary, homogeneous, hypodense mass without bony destruction that extends from the maxillary sinus through the widened ostium into the choana.
Connective Tissue ; Maxillary Sinus ; Nasal Polyps ; Polyps* ; Retrospective Studies

BACKGROUND: Recent studies have suggested that house dust mite allergy is an important cause of the atopic dermatitis(A.D). However, it is not clear that. what factors may be related to the development of the mite illergy in patients with AD. OBJECTIVE: This study was done to see whether the presence of a familial background of RA implies a relationship to the mite allergy in AD. METHODS: Skin prick test and fluoroallergosorbent, test (FAST) with house dust mit,e were performed in 47 patients wih AD. RESULTS: 1. In comparison the esult of prick test with that of FAST to house dust mite antigen, it showed a concordance ra!e of 82%. And the prick test was more sensitive than the FAST. 2. The prevalence of positive FAST reactions was significantly increased in the patients with AD who had a family hitory of RA than those in patients with AD who had neither family or personal history of RA. 3. The level of specific IgE against house dust mite did not relate to the presence of family cr personal history of RA. 4. The prevalence of positive prick test results did not relate to the presence of family or personal history of RA. 5. The prevalence of positive FAST reactions, the level of specific IgE, and the rate of positive prick test results did not relate to the severity of skin involvement. 6. The most common allergens which caused positive skin reactions were house dust, cat fur, Dermatophagoides farinac, Dermatophagoides pteronyssinus, et al. Antigen score of prick test to 55 common antigens wa. significant increased in the patients with AD who had a family history of RA, but did not relat to the severity of skin involvement or the presence of personal history of RA. CONCLUSION: We may conclude that type I allergy to the house dust mit,e is not directly related to AD perse. This type of allergy to the mite seems to occur predominantly in those patient s with AD who have a farilial background of RA.
Allergens ; Animals ; Cats ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Prevalence ; Pyroglyphidae* ; Skin

In Asia, the roots of Paeonia lactiflora and Astragalus membranaceus have been used as therapeutic agents for thousands of years. Once the medicinal plants are harvested, they are dried and their ingredients are extracted by heat-mediated reflux extraction. However, the condensed structure of organic products (especially roots) limits the extraction of bioactive components. In this study, we assessed the effect of the puffing method (using high temperature and pressure) before the extraction process in relation to the profile and antioxidant capacity of active ingredients. We demonstrated that the additional puffing process before extraction methods improves the yield of polyphenol concentrations and antioxidant activities from the roots of P. lactiflora and A.membranaceus.

BACKGROUND: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. METHODS: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0oC were predefined as test criteria of successful block. RESULTS: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) CONCLUSIONS: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult.
Adult ; Humans ; Oximetry* ; Sensitivity and Specificity ; Skin Temperature* ; Skin* ; Toes

BACKGROUND: Squamous cell carcinoma(SCC) may occur anywhere on the skin and on mucous membranes with squamous epithelium. OBJECTIVE: The purpose of this study was to investigate the clinico-pathological characteristics of SCC. METHODS: A total of 62 patients with SCC were enrolled in this study. Six cases with metastatic SCC were included. The hospital charts and histopathological slides of the patients with SCC diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. RESULTS: 1. The male and female ratio was 1.8:1. The mean age at diagnosis was 61.5 years in male patients and 71.8 years in female patients. 2. Most commonly involved sites were the face(41.8%). Upper extremities, trunk, lower extremities, genitalia and scalp were followed in decreasing order. The proximal nail fold was involved in 3 case of primary cutaneous SCC and 1 cases of metastatic SCC. 3. Six cases(9.7%) of metastatic SCC were included. Lung cancer(83.3%) was the most common cause of metastatic SCC in this study. Interestingly, one case presented with SCC of the proximal nail fold revealed metastatic SCC from the lung. 4. The possible causative diseases of primary cutaneous SCC were actinic keratosis(12.5%), burn scar(8.9%), immune suppression(8.9%) owing to kidney transplantation and chemotherapy, arsenical keratosis(7.1%), Bowen's disease(5.4%), trauma(5.4%), osteomyelitis(3.6%), and porokeratosis(1.8%). The causes of 25 cases(44.6%) were undetermined. 5. Histopathological differentiation of the primary cutaneous SCC was performed as follows: 29 cases(51.8%) of well-differentiated, 11 cases(19.6%) of moderately-differentiated, 8 cases(14.3%) of poorly-differentiated, 6 cases(10.7%) of acantholytic, and 2 cases(3.6%) of verrucous SCC. 6. Metastatic rate of primary cutaneous SCC was 16.1%. Metastasis of SCC from osteomyelitis (100%) and burn scar(40%) or trauma(33.3%) and that of poorly differentiated SCC(37.5%) were more common. Regional lymph nodes(55.6%), skin(44.4%), and lung(33.3%) were common metastatic organs.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Epithelium ; Female ; Genitalia ; Humans ; Kidney Transplantation ; Lower Extremity ; Lung ; Male ; Mucous Membrane ; Neoplasm Metastasis ; Osteomyelitis ; Scalp ; Skin ; Upper Extremity

Biliary adenofibroma is a rare tumor with a bile duct origin characterized by a complex tubulocystic non-mucin secreting biliary epithelium with abundant fibrous stroma. The MRI features of biliary adenofibroma are not well established. The authors encountered two patients with biliary adenofibroma and reviewed the literature focusing on the MRI findings. A well-circumscribed multicystic tumor with septal enhancement and no intrahepatic bile duct communication may be the characteristic MRI findings of biliary adenofibroma.
Adenofibroma ; Bile Ducts ; Bile Ducts, Intrahepatic ; Epithelium ; Humans ; Magnetic Resonance Imaging

OBJECTIVE: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. METHODS: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED. The control group contained patients admitted to the IM department between September and December 2014, during which IM residents were present in the ED. Changes in medical care between the presence and absence of IM residents in the ED were studied by comparing admission rates from the ED, length of ED stay, duration of hospitalization, and concordance of diagnoses between admission and discharge by the IM department. RESULTS: The study group contained 2,341 patients; the control group contained 2,215 patients. Admission rates from the ED increased by 53.4% (95% confidence interval [CI], P < 0.001); lengths of stay decreased by 15.1% (95% CI, P < 0.001); and durations of hospitalization in the pulmonology department decreased by 38.4% (95% CI, P=0.001). Concordance of diagnoses between admission and discharge decreased by 14.2% in the cardiology department (95% CI, P=0.021). CONCLUSION: Lengths of stay were reduced without critical declines in diagnostic concordance rates when emergency medicine physicians, instead of IM residents in the ED, decided upon admissions of IM patients.
Academic Medical Centers ; Cardiology ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Internal Medicine* ; Length of Stay ; Pulmonary Medicine

Intramuscular hemangioma (IMH) primarily develops in the skeletal muscles of the limbs or trunk. The occurrence of IMH in the neck muscle is very rare. In the present report, we describe a case of IMH in the posterior neck muscle. A 58-year-old woman presented with a mass on the right posterior neck area, which had developed 2 years previously. The tumor was round in shape, had a size of 3.5x3.0 cm, and was fixed to the surrounding soft tissue. The patient complained of mild dull pain and tenderness at the mass without reddish discoloration. The mass showed a diurnal variation in size - the mass grew in size in the morning and became smaller in the afternoon. Preoperative study confirmed the vascular nature of the tumor. During peritumoral dissection, the mass shrank rapidly following profuse bleeding and arterial cauterization, and hence, it was difficult to distinguish the mass from the surrounding tissues. A total resection was possible with careful dissection of its fibrotic boundary. Based on the histological findings, a definitive diagnosis of cavernous type IMH was made. An initial suspicion of IMH, according to the clinical findings, would be helpful for decision making of further evaluations and surgical plan.
Cautery ; Decision Making ; Diagnosis ; Extremities ; Female ; Hemangioma* ; Hemorrhage ; Humans ; Middle Aged ; Muscle, Skeletal ; Neck ; Neck Muscles

A total of 672 surgically resected gastric carcinomas were reviewed, and fourteen cases(2.1%) of "gastric carcinoma with lymphoid stroma" were identified. The tumor was located mostly in cardia and body portion(86%). Thirteen patients one was lost to follow up were alive without recurrence of tumor. Grossly, this carcinoma was characterized by an expanding growth pattern or a multinodular pattern. Histologically, this carcinoma showed an irregular trabecular and alveolar arrangement and densely infiltrated lymphoid cells with lymph follicles. The tumor cell nests were widely separated by non-desmoplastic lymphoid stroma. On immunohistochemical study, T cells were evenly distributed throughout the tumor lesion with intimate contact with individual carcinoma cells, but B cells were mainly present within the germinal centers of lymph follicles. Thus, the organized immune response combined with cell mediated and humoral immunities against the carcinoma cells may be a defense mechanism of the host in this type of gastric carcinoma.