The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without Calcium sulfate membrane in beagle dogs. Contralateral fenestration defects (6 x 4 mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered Calcium sulfate membrane (experimental group). Calcium sulfate membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows. 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes like cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control gruop, at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecule was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with Calcium sulfate membrane.
Animals ; Bicuspid ; Bone Regeneration ; Calcium Sulfate* ; Calcium* ; Dogs* ; Furcation Defects* ; Guided Tissue Regeneration ; Heterografts ; Membranes* ; Osteocytes ; Osteogenesis ; Powders ; Regeneration* ; Tooth

A malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in adults. About 70% of tumors arise from the soft tissue of the extremities with only 12~14% of the tumors occur in the retroperitoneum. The clinical characteristics of this tumor consist of an abdominal mass, tendency for local recurrence, paraneoplastic syndrome and a poor prognosis. A 51-year-old woman was admitted to St. Vincent's Hospital with complaining of fever and an abdominal mass. Ultrasound and computed tomography revealed a huge, heterogenous mass in the lesser sac area. The patient underwent an extensive mass resection with a histologic examination revealing a MFH which was positive for alpha1- antitrypsin. We report a case of MFH presenting in the lesser sac with a review of the literatures.
Adult ; Extremities ; Female ; Fever ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Paraneoplastic Syndromes ; Peritoneal Cavity* ; Prognosis ; Recurrence ; Sarcoma ; Ultrasonography

A biloma is an extrahepatic or intrahepatic bile collection caused by traumatic, iatrogenic, or spontaneous rupture of the biliary tree. Prior reports have documented an association of a biloma with abdominal trauma and surgery, but spontaneous bile leakage associated with other primary causes has rarely been reported. A 72-year-old man was admitted to our hospital with the complaint of epigastric pain and yellowish discoloration of the sclera. Ultrasonography and computed tomography revealed a large fluid collection in the abdominal cavity. Endoscopic retrograde cholangiography demonstrated leakage of contrast medium from a distended segmental biliary branch in the left lobe of the liver. A perihepatic biloma was confirmed by sonographically guided percutaneous aspiration, and the patient underwent a left lateral segmentectomy of the liver, a cholecystectomy and T-tube choledochostomy. Histological examination showed left lateral bile duct hyperplasia, with abscess formation and chronic cholecystitis. Herein, a case of a biloma associated with choledocholithiasis is reported, with a review of the literatures.
Abdominal Cavity ; Abscess ; Aged ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic* ; Biliary Tract ; Cholangiography ; Cholecystectomy ; Cholecystitis ; Choledocholithiasis* ; Choledochostomy ; Humans ; Hyperplasia ; Liver ; Mastectomy, Segmental ; Rupture* ; Rupture, Spontaneous ; Sclera ; Ultrasonography

Medullary thyroid cancer (MTC) accounts for 5% to 10% of all thyroid cancers, and originates from the parafollicular or C-cells of the thyroid gland. More than 50% of patients present with a thyroid mass and up to 75% of these patients have locoregional lymph node metastasis at the time of diagnosis. The neuroendocrine C-cells of the thyroid gland secrete calcitonin, a relatively accurate tumor marker for MTC. Plasma basal and stimulated calcitonin measurements have been used to screen patients who are at risk of developing MTC and indispensable for the detection of residual MTC after initial surgical treatment. The overall survival rate of patients with MTC is intermediate to that of patients with differentiated thyroid cancer and anaplastic thyroid cancer. Postoperative radioiodine ablation therapy, chemotherapy and radiation therapy are generally ineffective. Surgical resection, therefore, remains the only definite treatment for patients with MTC. Unfortunately, residual MTC as indicated by elevated plasma basal or stimulated calcitonin levels is common even after apparent complete initial surgical resection. We present a case of metastatic MTC in the anterior mediastinum with review of the literatures.
Calcitonin ; Diagnosis ; Drug Therapy ; Humans ; Lymph Nodes ; Mediastinum* ; Neoplasm Metastasis ; Plasma ; Survival Rate ; Thyroid Carcinoma, Anaplastic ; Thyroid Gland* ; Thyroid Neoplasms*

A survey of intestinal parasites infection among Korean people has been carried out during July 1969 to December 1970. A total of 2,250 stool specimens (male 1,101, female 1,146) was collected from all the provinces and Seoul city in Korea. The specimens were examined routinely by direct fecal smear, zinc sulfate flotation and formalin-ether sedimentation techniques. The results are summarized as follows: Of 2,250 specimens examined, l,803(80.l per cent) were positive for intestinal parasites. The positive rates of intestinal helminths were 1,644(73.1 per cent) among 2,250; Ascaris lumbricoides 46.0 per cent, Trichocephalus trichiurus 46.8 percent, hookworm 6.8 per cent, Trichostrongylus orientalis 7.0 percent, Clonorchis sinensis 12.1 percent, Enterobius vermicularis 1.6 per cent, Hymenolepis nana 0.7 percent, Taenia species 0.3 per cent, Metagonimus yokogawai 0.04 percent, Fasciolidae 0.04 per cent and one case of lung fluke Paragonimu westermani. The positive rstes of intestinal protozoa were 786(34.9 per cent); Entamoeba histolytica 6.4 per cent, Entamoeba coli 20.5 percent, Endolimax nana 10.0 per cent, Giardia lamblia 5.1 per cent, Trichomonas hominis 1.1 percent, Chilomastix mesnili 0.5 percent, Iodamoeba butschlii 0.6 percent, Enteromonas hominis 0.7 percent, Dientamoeba fragilis 0.1 per cent and one case of Isospora hominis. Sexual distribution of helminths and protozoan infections showed higher rate in female than that of male, except C. sinensis, H. nana, Taenia species or G. lamblia Infections of T. trichiurus, hookworm, T. orientalis, C. sinensis, Taenia species, E. histolytica, E. coli and E. nana increased with age. Conversely, H. nana and G. lamblia infections were more predominent in younger ages.
parasitology-helminth-protozoa-trematoda-nematoda-cestoda ; Ascaris lumbricoides ; Trichocephalus trichiurus-Trichuris trichiura ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Enterobius vermicularis ; Hymenolepis nana ; Taenia species ; lamblia ; Trichomonas hominis ; Chilomastix mesnili ; Iodamoeba butschlii ; Enteromonas hominis ; Dientamoeba fragilis ; Isospora hominis ; epidemiology ; stool examination

We reviewed 36 patients with carcinoid tumors, which had been diagnosed at the St. Mary's hospital, Kangnam St. Mary's hospital and St. Vincent's hospital affiliated with Catholic Medical Center during 18 years from July 1978 to June 1996. The peak age group was the third decade (25%), and the sex ratio of males to females was 1.57 : 1 with an age range of 13 to 73 years. The most common location of the tumors was the bronchus, 11 cases; next were the rectum, 9 cases, and the appendix, 5 cases. These were followed by the stomach, the duodenum, the ovaries, the gallbladder, the thymus, the sigmoid colon, and the ascending colon. One of cases had such widespread metastases that its primary site of origin could not be determined. According to the embryological classification, the foregut was the most common site, 15 cases; next were the hindgut, 10 cases, and the midgut, 7 cases. The malignant potential is determined by the size, the histological feature of the tumor, and the status of the regional lymph nodes. Among these, the size of the tumor was the most important; the extent of the resection was usually determined by the size of the tumors.There were no cases of classic carcinoid syndrome, but two cases of rectal and duodenal carcinoid tumors had symptoms similar to those of the carcinoid syndrome. We experienced three synchronous carcinomas and one metachronous carcinoma of different sites on the carcinoid tumors.
Appendix ; Bronchi ; Carcinoid Tumor* ; Classification ; Colon, Ascending ; Colon, Sigmoid ; Duodenum ; Female ; Gallbladder ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Ovary ; Rectum ; Sex Ratio ; Stomach ; Thymus Gland

PURPOSE: E-cadherin (ECD) plays a pivotal role in integrating the normal tissue architecture and the suppression of cancer invasion, including stomach cancer. The epidemiology of stomach cancers is noticeably different according to the site of the index tumor, even though the stomach cancers all have similar gross shapes. In this study, the relation between the expression of ECD, along with the clinicopathologic parameters and recurrence or survival, were investigated for patients with gastric adenocarcinoma according to the tumor location. METHODS: We examined formalin-fixed, paraffin-embedded archival tissues from 50 surgically resectable gastric adenocarcinomas, which were grouped by the index tumor site as follows: distal (antrum) versus proximal (mid and upper body). To elucidate the correlation between the ECD expression and the site of the stomach cancer with the other clinicopathologic factors, we examined the ECD tissue status via performing immunohistochemistry. To compare the rates of recurrence and survival among subgroups, the patients were followed up for an average of 42 months. RESULTS: Among the 50 tumors examined, 28 (56%) tumors showed various degrees of a ECD expression. The gender, age, size, depth of invasion, lymph node metastasis, stage, lymphatic invasion and vascular invasion were not related with the ECD expression. The Lauren classification was cor-related with the ECD expression in the mid and upper body stomach cancer, but not in the antral stomach cancer (P=0.042). The expression of ECD was not related with the survival rate (P=0.223). There was no significant difference in the recurrence rate between the subgroups with and without an abnormal expression of ECD (P=0.588). CONCLUSION: For the mid and upper body stomach cancer, the expression of E-cadherin correlated with the diffuse type of cancer, according to the Lauren classification, but not with the survival rate.
Adenocarcinoma ; Cadherins* ; Classification* ; Epidemiology ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms* ; Stomach* ; Survival Rate

Small or oat cell carcinoma arising in a gall bladder (GB) is very rare. It occupies about 5% or less of total GB cancers. A woman suspicious of GB empyema was admitted in our department via emergency room to get an operation. Emergent cholecystectomy was done, which was followed by intraoperative frozen sectional microscopic examinations of locoregionally enlarged lymphnodes around GB and a spherical mass, 1 cm in diameter, which was located at the neck of GB on computerized tomograms taken just before the operation. On frozen section, the mass in GB showed malignant features but not penetrating serosa and metastatic tumor involvement in regional lymphnodes. Then she got an additional regional lymphnodes dissection around GB and common bile duct, which was followed by hepatic wedge resection around GB bed. After confirming permanent pathology proven as small cell carcinoma of GB, we started 5-fluorouracil-based chemotherapy and external irradiation, total of 5,000 cGy, on her. Five months after the operation, she developed metastatic cervical lymphnodes on her left side, proven by fine needle aspiration cytology. Then systemic chemotherapy with etoposide and cisplatinum was initiated, and it showed some regression of the size of the conglomerated metastatic lymphnodes. We experienced one case of small cell carcinoma of GB in a woman, which is a very rare pathologic type of gall bladder cancer that shows very poor prognosis needing extensive adjuvant treatments, but presents highly malignant and devastating features.
Biopsy, Fine-Needle ; Carcinoma, Small Cell* ; Cholecystectomy ; Common Bile Duct ; Drug Therapy ; Emergency Service, Hospital ; Empyema ; Etoposide ; Female ; Frozen Sections ; Gallbladder Neoplasms ; Humans ; Neck ; Pathology ; Prognosis ; Serous Membrane ; Urinary Bladder*

Small or oat cell carcinoma arising in a gall bladder (GB) is very rare. It occupies about 5% or less of total GB cancers. A woman suspicious of GB empyema was admitted in our department via emergency room to get an operation. Emergent cholecystectomy was done, which was followed by intraoperative frozen sectional microscopic examinations of locoregionally enlarged lymphnodes around GB and a spherical mass, 1 cm in diameter, which was located at the neck of GB on computerized tomograms taken just before the operation. On frozen section, the mass in GB showed malignant features but not penetrating serosa and metastatic tumor involvement in regional lymphnodes. Then she got an additional regional lymphnodes dissection around GB and common bile duct, which was followed by hepatic wedge resection around GB bed. After confirming permanent pathology proven as small cell carcinoma of GB, we started 5-fluorouracil-based chemotherapy and external irradiation, total of 5,000 cGy, on her. Five months after the operation, she developed metastatic cervical lymphnodes on her left side, proven by fine needle aspiration cytology. Then systemic chemotherapy with etoposide and cisplatinum was initiated, and it showed some regression of the size of the conglomerated metastatic lymphnodes. We experienced one case of small cell carcinoma of GB in a woman, which is a very rare pathologic type of gall bladder cancer that shows very poor prognosis needing extensive adjuvant treatments, but presents highly malignant and devastating features.
Biopsy, Fine-Needle ; Carcinoma, Small Cell* ; Cholecystectomy ; Common Bile Duct ; Drug Therapy ; Emergency Service, Hospital ; Empyema ; Etoposide ; Female ; Frozen Sections ; Gallbladder Neoplasms ; Humans ; Neck ; Pathology ; Prognosis ; Serous Membrane ; Urinary Bladder*

PURPOSE: Tumor downstaging from preoperative chemoradiation has been associated with an increased probability of a sphincter-saving procedure and with improved local control and survival rate. We observed the effect and the prognostic value of pathologic tumor downstaging, including complete pathologic response to preoperative concurrent chemoradiation, resectability, sphincter-saving rate, disease- free survival, and overall survival in locally advanced rectal cancer patients. METHODS: From January 2000 to December 2003, we recruited a total 78 patients with computed tomography stages II and III rectal cancer which was treated by using preoperative concurrent chemoradiation; all patients had a radical resection with total mesorectal excision. Surgical resection was performed 6 to 8 weeks after completing the radiation therapy. The average follow up was 25.40+/-13.64 months. RESULTS: The number of patients according to CT stage before preoperative chemoradiation was 39 (II) and 39 (III). Tumor downstaging occurred in 51 (65.4%) patients, including 11 (14.1%) patients who had a complete pathologic response. Tumor size, radiation dose, and clinical stage were associated with tumor downstaging in the univariate analysis. None of the clinical or pathologic variables was associated with a complete pathologic response. The overall resectibality was 100%. The number of sphincter-saving procedures were 61 (78.2%). Recurrence occurred in 17 (21.8%) patients: local recurrence in 4 (5.1%) and distant metastasis in 13 (16.7%). None of the patients with a complete pathologic response recurred. Recurrences were 3 (17.6%)/7 (22.6%)/7 (36.8%) for pathologic stages I/II/III. Recurrence was more common among younger patients (P <0.05). Patients in the complete pathologic response group had more favorable disease-free survival compared with other group (yp stage I, II, III) (P=0.026). CONCLUSION: Preoperative concurrent chemoradiation for locally advanced rectal cancer seems to afford some potential advantages: high tumor response, resectability, and feasible sphincter preservation, and even a complete pathologic response. A complete pathologic response to preoperative chemoradiation is associated with an improved disease-free survival.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Survival Rate