Retroperitoneum is often the site of occurrence of schwannoma, but reports on schwanoma of the adrenal gland is exceptional and only 4 cases have been documented in the literature. This report is to add one such case occurred in a 53 year-old male who had anorexia, nausea and indigestion for one month. Whole body bone scan and abdominal CT scan revealed a 10 cm sized solid mass at upper pole of the left kidney. Under the impression of renal cell carcinoma, an operation was performed. The tumor was well encapsulated and appeared not to involve the kidney. The cut surfaces were light yellow and seemed to be composed of several hard lobules with areas of mucoid, cystic and calcific changes. No adrenal gland was identified grossly. But microscopically, the tumor was found to be partly surrounded by a small portion of adrenal cortical tissue. Histologically the tumor was a typical schwannoma with Verocay bodies, although modified in some extents by mucoid degeneration, cystic change, hyaline change and focal calcification. It is worthwhile to remember that the retroperitoneal schwannoma commonly had a huge size, sometimes involving the adjacent structures.
Male ; Humans

Radiographic increase in the size of tibial and femoral tunnels has been observed following the reconstruction of the ACL with a bone-patellar tendon-bone autograft. The purpose of this study is to determine if any differences exist in the amount of enlargement of the bone tunnel with the clinical results and to know the factors which affected to the enlargement of the bone tunnels. Total 27 patients were retrospectively reviewed for tunnel enlargement radiographically at one year after operation. Anteroposterior and lateral x-ray were obtained and the tunnel were measured by two independent observers. The measurements were made at the widest part of the tunnel. The distance between tibial interference screw and knee joint line also measured. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed with Wilcoxon rank sum test. The radiographic tunnel enlargement was an average of 1.7+/-1.3mm for the femur and 1.9+/-0.8mm for the tibia. The proximal migration of the tibial interference screw was an average of 2.3++/-1.1 mm. There was no statistically significant correlation between the changes in tunnel diameter and either the modified Hughston knee score, Lysholm knee score, or the joint laxity measured by a KT-2000 arthrometer, Lachman test. There were no correlations between the mild proximal migration of the tibial interference screw and the clinical results. Conclusively, the tunnel enlargement and mild proximal migration of the interference screw did not appear to affect the functional outcome adversely. It needs longer follow up for the evaluation of etiology and natural history of this tunnel enlargement.
Anterior Cruciate Ligament Reconstruction ; Autografts ; Femur ; Follow-Up Studies ; Humans ; Joint Instability ; Knee ; Knee Joint ; Natural History ; Patellar Ligament* ; Retrospective Studies ; Tibia ; Transplants*

Kupffer cells are tissue macrophages (histiocytes) fixed in hepatie sinusoids. Since malignant hepatocytes are the only tumor parencymal cells of the hepatocellular carcinoma, theoretically there are no Kupffer cells within the hepatocellular carcinoma. To clarify whether it is true or not, 12 cases of hepatocellular carcinoma of the trabecular type with some extents of the non-neoplastic surrounding liver were subjected to immunoperoxidase staining for lysozyme and S-100 protein and the results are as follows. 1) Kupffer cells were stained positively by the immunoperoxidase staining for lysozyme but not for S-100 protein, indicating that they are monocyte derived macrophages. 2) Kupffer cells were also present within the hepatocellular carcinoma, but were 2-7 times fewer within the hepatocellular carcinoma than in the non-neoplastic areas (p<0.05). 3) The non-neoplastic hepatic tissue of patients with serum HBsAg shows a tendency to have more kupffer cells than those without HBsAg.
Carcinoma, Hepatocellular

PURPOSE: Neonatal surgical conditions affecting the gastrointestinal tract are varied, can affect any part of the intestinal tract, and frequently require urgent surgical intervention. Unfortunately, nonspecific and overlapping symptomatology exists among the conditions affecting the intra-aMominal intestinal tract and requires of the evaluating physician a thorough understanding of their pathophysiology. So we studied signs and symptoms, frequency and incidence, ages at diagnosis, and diagnostic method of the neonatal gastrointestinal obstructions. METHOD: We reviewed retrospectively the charts of patients, who had been diagnosed as gastrointestinal obstruction during the neonatal period, and had been admitted to Gyeongsang National University Hospital from Feb. 1988 to Feb. 1997. RESULT: Total 77 cases were enrolled in this study. There were 59 rnales (76.796) and female 18 cases (23.4%). The male to female ratio was 3.28: 1. Twenty-two cases of imperforate anus (28.6%), 18 cases of hypertrophic pyloric stenosis (23.4%), 15 cases of congenital megacolon (19.5%) were observed. Other diseases causing the neonatal gastrointastinal obstruction were annulus pancreas (7.8%), jejunal atresia (6.5%), duodenal atresia (1.3%), duodenal web (2.6%), ileal atresia (2.6%), midgut volvulus (2.6%), intussusception (1.3%), and trachoesophageal fistula (2.6%). The rnost common symptom was vomiting with 32 cases (41.6%), followed by abdominal distension with 31 cases (40.3%), absence of anus with 17 cases (22.1%), and delayed meconium passage with 9 cases (11.7%). Associated other anomalies were observed in 18 cases (23%). Imperforate anus was seen with the highest rate of associated anomalies. The most common associated anomaly was the cardiac anomaly. Colon study (26%), physical examination (24.7%), abdominal sonography (15.6%), upper GI series (11.7%), and simple abdomen (9.1%) were diagnostic in the neonatal gastrointestinal obstructions. Seventeen cases (22%) were died before or after the surgical intervention. CONCLUSION: Neonatal gastrointestinal obstructions were associated with the high mortality rate. Abdominal distension and vomiting were the specific symptoms of neonatal gastrointe- stinal obstructions. Extensive search for the associated anomalies are reqiured because of its high frequency in the patients of the neonatal gastrointestinal obstructions. Thorough physical examination, colon study, abdominal sonography, upper GI series, and simple abdomen were essential in the diagnosis of the neonatal intestinal obstructions.
Abdomen ; Anal Canal ; Anus, Imperforate ; Colon ; Diagnosis ; Female ; Fistula ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Atresia ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Male ; Meconium ; Mortality ; Pancreas ; Physical Examination ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies ; Vomiting

Polypoid prolapse of mucosal folds can occur at various sites and in various conditions predominantly associated with strain during defecation. There are two well known types of mucosal prolapse syndrome(MPS), the inflammatory cloacogenic polyp(ICP) and the mucosal redundant polyp associated with diverticular disease(N4RPD). ICP is a mucosal prolapse of the anorectal junction and MRPD is a proximal analogue involving the sigmoid colon. We experienced two cases of eroded polypoid hyperplasia(EPH) of the rectosigmoid colon which manifested as a huge gyriform mass simulating the gross features of gastrointestinal lymphomas or other malignant tumors. The EPH consisted of confluent polypoid mucosal folds with rolled-up submucosa to form stalk, The polypoid lesion represented hyperplastic epithelium, erosion of the mucosal surface and congestive vascular ectasia of lamina propria and submucosa. To explain the whole morphologic features, the initial phenomenon should be the mucosal prolapse. Vascular stretching with ischemic erosion of the mucosal surface and compensatory epithelial hyperplasia ensue as the result. The ominous endoscopic and gross features of EPH should be kept in mind to avoid erroneous radical surgery.

One hundred seven consecutive patients aged 3 years to 34 years with simple ventricular septal defect were prospectively investigated with 2-dimensional Doppler echocardiography to assess the echocardiographic criteriae in defining the anatomic site of the VSD. The anatomy was confirmed in all patients at operation. Two-dimensional Doppler echocardiography correctly categorized the site and extension of VSDs in 104 of 107(97%). All doubly committed subarterial VSDs were correctly diagnosed as an area of discontinuity beneath the pulmonary valve in the parasternal short-axis plane taken at the aortic root level. Forty eight of 49 perimembranous VSDs with infundibular extension showed an area of discontinuity beneath the right aortic cusp in the parasternal long axis plane of the left ventricle. Of 17 perimembranous VSDs with trabecular extension, 16 had an area of discontinuity around the medial papillary muscle in the short axis plane taken at the level of high left ventricular outflow tract(LVOT). All 5 perimembranous VSDs with inlet extension showed an area of discontinuity adjacent to the septal leaflet attachment in the short axis plane taken at the level of high LVOT. One muscular trabecular VSD was categorized correctly by the short axis view and the apical 4-chamber view. Thus, these 2-dimensional Doppler echocardiographic criteriae are a simple and reliable in identifying the anatomic site of VSDs.
Axis, Cervical Vertebra ; Bays ; Classification* ; Echocardiography ; Echocardiography, Doppler* ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Papillary Muscles ; Prospective Studies ; Pulmonary Valve

Nickel is widely known as a common source of contact dermatitis and nickel sensitivity amounts to nearly 10 percent of allergic contact dermatitis patients. Common sources of nickel dermatitis are well known as necklaces, watches, rings, hooks, earrings and spectacle frames. Recently, we have seen five cases of nickel dermatitis the suspected sources of which were metal spectacle frames. The interim patch test result in our occupational and environmental clinic suggests that the metal spectacle frame is one of the most common sources of nickel dermatitis. Out of 84 medical students 27 wore metal spectacle frames. We have done a dimethylglyoxime spot test to the metal spectacle frames and got a positive result in 12 out of 27(44.4%). We conclude that metal spectacle frame seems to be one of the dominant causes of nickel dermatitis and it will be an increasing problem in our society.
Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Ear ; Humans ; Nickel ; Patch Tests ; Students, Medical

Mullerian Mucinous papillary Cyatadenernas of Borderline tumor(MMBT) is lined by mucinous epithelium of endocervical type and is characterized by papillae architecturally similer to those of serous horderline tumors, It has been described rarely in the literature, Thia case was reported with a brief review of the concerened literatures. It has important clinical and pathological diBerences from mucinous birderline tumors with intestinal differentiation, but has many similatities to mixed epithelial borderline tumora of Mulierian type. Recently, a case of MMBT in a 22 years old woman was experienced at our department. We presented this case with a brief review of literature.
Cystadenoma, Papillary* ; Epithelium ; Female ; Humans ; Mucins* ; Young Adult

No abstract available.
Histiocytosis*

No abstract available.
Cadherins* ; Carcinogenesis* ; Urinary Bladder*