BACKGROUND: The diagnostic accuracy of fine needle aspiration cytology (FNAC) of salivary lesions is relatively high, but cytologic interpretation might be confusing if the sample is lacking typical cytologic features. METHODS: There were 77 cases of benign salivary lesions, consisting of pleomorphic adenoma (PA) in 61 cases, Warthin's tumor (WT) in 12 cases, and other benign lesions in 4 cases. The causes of the discrepancies between the FNAC and the histologic diagnoses were evaluated. RESULTS: Major discrepancies were noted in 4 of the 61 PA cases, and in 1 of 12 WT cases. The causes of the major discrepancies were a mislabeled site in 1 PA and 1 WT case, and an interpretation error in 3 PA cases. Minor discrepancies were more common in the WT cases (7 of 12 cases) than in the PA cases (11 of 61 cases). The causes of the minor discrepancies were a mislabeled site in 1 PA and 1 WT case, an inadequate sample in 7 PA and 2 WT cases, a lack of typical cytomorphology in 2 PA and 2 WT cases, and an interpretation error in 1 PA and 2 WT cases. CONCLUSIONS: To increase the diagnostic accuracy in the benign salivary lesions, recognition of both characteristic and less typical cytomorphology is needed.
Adenoma, Pleomorphic ; Biopsy, Fine-Needle ; Salivary Glands

Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear. We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwide claim database. Methods: Data from the Health Insurance Review and Assessment Service database in South Korea for 2007–2016 were used. Linear regression analysis and Cox proportional hazard models were used to evaluate the associations between the duration of the first antipsychotic treatment, time to re-initiation of treatment, and occurrence of treatment re-initiation. Results: Of 30,143 patients with FES, 80.4% (n=24,231) received <2 years of the first antipsychotic treatment. In patients who discontinued treatment (n=23,030), the rate of treatment re-initiation was 74.2% (n=17,086). As the duration of the first antipsychotic treatment increased, the time to re-initiation of treatment decreased (β=-0.146, p<0.001); however, the rate of treatment re-initiation was relatively constant (hazard ratio=1.001, p<0.001). Conclusion Long-term antipsychotic treatment was not significantly associated with the rate of treatment re-initiation but showed a negative association with the time to re-initiation of treatment. Further research is needed to better understand the optimal treatment duration for FES.

Objectives: Early pharmacologic intervention is considered necessary for improving the prognosis in patients with first-episode schizophrenia (FES). However, few nationwide population-based studies have focused on early medication adherence. We investigated the status of early adherence to antipsychotics and the effect of early adherence on later clinical outcomes in FES. Methods: We used data from the South Korean Health Insurance Review Agency database (2009-2021). We selected 28,931 patients with FES who had a prescription record of at least one antipsychotic medication within 180 days after their diagnosis. We measured early medication adherence using the medication possession ratio (MPR) and compared demographic characteristics and results of psychiatric hospitalization between the adherence group (0.6≤MPR<1.1) and the non-adherence group (MPR<0.6). Results: The average early medication adherence was 0.82 by MPR, and the non-adherence group accounted for 15.6% of all subjects. From 1 to 2 years after diagnosis, the adherence group showed a higher number of psychiatric hospitalizations per hospitalized patient but a shorter duration than the non-adherence group. Additionally, the proportion of patients who experienced psychiatric hospitalizations was smaller in the adherence group. Conclusion In patients with FES, early medication adherence is associated with lower rates of psychiatric hospitalization and shorter hospitalization durations.