Cellular Neurothekeoma on the Nose: A Case Report / 대한피부과학회지

Neurothekeoma is a rare, benign, cutaneous tumor of unknown origin that can be classified into myxoid, cellular, and mixed types. The tumor presents as a solitary nodule mainly on the head, neck, and upper extremities of children and young adults with female preponderance. Histopathologically, epithelioid to spindled-shaped cells form lobules or micronodules and cytologic atypia are occasionally observed with variable fibrous and myxoid stroma.Neurothekeoma can mimic several benign and malignant tumors and recur if incompletely excised. Therefore, it is important to be aware of this tumor for accurate diagnosis. Herein, we report a case of nasal cellular neurothekeoma with a review of related literature.

Comparison of Treatment Satisfaction and Perception in Psoriasis Patients with Biologics or Oral Agents: A Single Center Study / 대한피부과학회지

Background@#Many aspects are considered when selecting psoriasis treatments, such as psoriasis severity. In particular, patients’ subjective aspects, such as quality of life and treatment satisfaction, are important when planning treatment, and several studies on these aspects exist. However, studies on the direct thoughts of Korean patients with psoriasis, such as what patients value the most, are limited. @*Objective@#This study aimed to evaluate treatment satisfaction and perceptions regarding the importance or subjective achievement of goals in Korean patients with psoriasis treated with biologics or oral agents. @*Methods@#A total of 59 patients with psoriasis treated with biologics or oral agents for ＞16 weeks completed the questionnaire. The questionnaire consisted of four main parts: patient information, past history and treatment experience associated with psoriasis, treatment satisfaction, and subjective importance and degree of achievement of treatment goals in daily life. @*Results@#Treatment satisfaction in the biologics group was higher in terms of effectiveness, improvement in symptoms, speed of improvement, method of administration, frequency of administration, and comprehensive aspects than that in the oral agents group (p＜0.05). However, in both groups, the degree of improvement did not reach the patients’ subjective importance, and “concerned with other people’s eyes due to lesions in exposed area” had the biggest difference. @*Conclusion@#Although biologics had higher treatment satisfaction than oral agents, in some parts of daily life, the degree of improvement did not reach the patients’ subjective importance; therefore, some points still needs to be improved.

Creativity in medical education: concepts related to creative capacity / 영남의대학술지

In the 21st-century postmodernism era, which represents diversity and relativity, one of the most essential elements in the field of education is to strengthen individual human values. Accordingly, we must focus on developing capacity in order to adapt to change. It is clear that the medical field maximizes the need for new judgments to solve life-related problems constantly, and this problem-solving capacity is an essential skill for a physician. Problem-solving capacity can be achieved simultaneously with creativity to apply them in an appropriate manner based on standardized expertise and well-trained skills. Creativity is also a key element that medical education is currently pursuing. Many studies on creativity have resulted in confusion and misunderstandings on the concept of creativity due to similar terms and varied definitions, such as creation, innovation, etc. In this study, we attempt to identify the importance of creativity in medical education by comparing and organizing concepts related to creative capacity.

Primary Extragonadal Germ Cell Tumors in Klinefelter Syndrome: 10-Years of Experience from a Single Institute / 임상소아혈액종양

Background@#Approximately 8% of male patients presenting with primary mediastinal germ cell tumors (GCTs) have Klinefelter syndrome (KS), while patients diagnosed with retroperitoneal GCTs also exhibit a range of chromosomal abnormalities. The exact mechanism underlying the development of GCTs in Klinefelter syndrome is unknown, but KS frequently goes underdiagnosed as a result of its varied symptoms and a low general awareness of this condition. Thus, the Children’s Oncology Group recommends screening of Klinefelter syndrome in pediatric and adolescent male subjects who present with GCTs. @*Methods@#We retrospectively reviewed the medical records of extragonadal germ cell tumor patients treated at Severance hospital, department of pediatrics or division of pediatric hematology-oncology over the last ten years. @*Results@#A total of 95 patients with extragonadal germ cell tumors were included in this study. Karyotyping was done in eight patients out of 95 patients, three patients with KS and one patient with Down syndrome. Twelve of extragonadal GCT patients presented at mediastinum, with most common histology of mature teratoma, and three patients presented with chromosomal abnormalities, two with KS and one with Down syndrome. A total of nine patients were diagnosed with retroperitoneal GCTs and only one had KS. @*Conclusion@#We described the characteristics of 95 cases of extragonadal GCTs. Although the mechanism of extragonadal GCTs in KS is not clear, karyotyping in pediatric and adolescent extragonadal GCT patients could be helpful in figuring out chromosomal abnormalities including KS and their roles in GCT pathophysiology, which can contribute to improve one’s health.

Stress Fracture of the Capitate

Most capitate fractures occur in association with additional carpal injuries, particularly scaphoid fractures. Isolated fractures of the capitate account for only 0.3% of carpal injuries, and stress fractures are one form of this fracture. We report the case of a 20-year-old male who had a stress fracture of the capitate after serving as an honor guard in the military. Conventional radiographs and computed tomography of the right wrist revealed a minimally displaced fracture line located at the midcarpal aspect of the right capitate. A magnetic resonance imaging scan demonstrates a subarticular capitate fracture with diffuse bone marrow edema, small osteophytes, and irregularity of the midcarpal articular cartilage. We also review the carpal kinematics which possibly caused the stress fracture. Although stress fractures of the capitate are rare, they should also be accounted for with patients who perform repetitive motions of the wrist to a considerable extent.

An Unusual Cause of Knee Pain: Periosteal Glomus Tumor of the Distal Femur

Glomus tumors are rare neoplasms that characteristically occur in subungual regions, but may also be found in other regions of the body. The clinical diagnosis of this tumor may be difficult if the tumor is located in an extradigital site. Most extradigital glomus tumors form in superficial locations. Herein, we present the case of a 34-year-old woman who experienced chronic knee pain with pinpoint tenderness resulting from a deep-seated periosteal glomus tumor of the distal femur. Extradigital glomus tumors should be considered in the differential diagnosis when characteristic clinical features and imaging findings indicative of glomus tumors are present, even if the tumor is located within deep tissues.

Changes of Sociodemographic and Clinical Characteristics of Patients Registered in a Community Mental Health Center: Comparing 2008 with 2012 / 대한정신약물학회지

OBJECTIVE: This study was designed to investigate the changes of sociodemographic and clinical characteristics of patients who were registered in a community mental health center. METHODS: The patients enrolled in this study were those registered in Suwon City Community Mental Health Center in 2008 and 2012, and there were 440 and 460 patients, respectively. The authors analyzed demographic data, medical insurance status, registration status of mental disability and clinical characteristics, such as diagnosis, type of medical institution the patients received medical care from, medication, duration of illness, Brief Psychiatric Rating Scale and global assessment function scores. RESULTS: There were more married patients in 2012 than in 2008 (23.1% vs. 34.3%, p<0.001) and the proportion of patients who were employed was larger in 2012 (8.2% vs. 10.2%, p=0.302). Also, in 2012, more patients received Level 1 medical care rather than health insurance (27.9% vs. 35.3%, p=0.007) and the number of patients with registered mental disability increased (27.7% vs. 52.6%, p<0.001). From 2008 to 2012, the number of patients diagnosed with other disorders besides psychotic disorders increased (15.5% vs. 22.9%, p=0.007). Also, more patients tended to receive medical treatment from private mental clinics (38.6% vs. 58.1%, p<0.001), and to be administered with atypical antipsychotics rather than conventional antipsychotics (58.6% vs. 80.4%, p=0.022). CONCLUSION: This study suggests that many characteristics of the patients registered in a community mental health center have been gradually changed. The patients registered in 2012 were likely to be diagnosed with other disorders besides psychotic disorders and to get more atypical antipsychotics compared to patients registered in 2008. This study would contribute to finding out the proper roles and functions of mental health centers, and, as a result, the mental health centers could be able to provide better quality of service to their registered patients.

Xanthoma Simulating Plantar Fibromatosis on Sonography

Xanthomas are local collections of lipid-laden macrophages and collagen, which are usually associated with impaired lipoprotein metabolism. Xanthomas occur frequently in the skin, subcutis, or tendon, and occasionally in the plantar fascia. Small numbers of xanthomas have been surgically confirmed in the plantar fascia and their sonographic appearance has not been described in the literature. We present sonographic findings of a pathologically proven plantar fascia xanthoma, which was initially mistaken as plantar fibromatosis.