Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Mandibular Fractures ; Wounds and Injuries

Hemangiopericytoma is uncommon vascular neoplasm that arises from pericytes arround the capillary walls. It was first described as a distinct vascular neoplasm by Stout and Murray in 1942 The anatomic distribution is widespread throughout the body, with approximately one third occur in the head and neck. No sex predilection has been found. Although middle age appears to be the most prevalent time of onset, this neoplasm has been found in all age groups. The differentiation between benign and malignant hemangiopericytoma can be difficult. Although the majority of these tumors are benign, there are malignant variants that can metastasize. Metastasis of seemingly benign tumors may appear year of decade later, so long term close follow-up is needed The treatment of choice is complete surgical excision of the tumor. Despite their vascular origin, these tumors are relatively radioresistant. Radiation therapy is reserved for inoperable metastases or treatment of postoperative surgical fields. Here we present a case of hemangiopericytoma occuring on the Lt. buccal mucosa.
Capillaries ; Follow-Up Studies ; Head ; Hemangiopericytoma* ; Humans ; Middle Aged ; Mouth Mucosa* ; Neck ; Neoplasm Metastasis ; Pericytes ; Vascular Neoplasms

A new diagnosis-related group (DRG) based payment system has been implemented in most public hospitals in Korea. We investigated the effects of the new DRG system and its incentive policy on the utilization rate of diagnostic laboratory tests. Three groups were categorized; 36 hospitals under the new DRG system (participant group), 72 hospitals (control-1) matching with 36 participants according to the number of beds, and 42 tertiary hospitals (control-2). The patients of acute myocardial infarction, cerebral infarction, type 2 diabetes mellitus, and gonarthrosis receiving total arthroplasty were included. We analyzed the mean length of stay and the number of diagnostic laboratory tests conducted during hospitalization of the three groups according to the new DRG system and the incentive policy rates under the new DRG system. Before participating in the new DRG system, the number of diagnostic laboratory tests in the participant group was less than that in the two control groups for all four diseases. However, although the participant group’s length of stay decreased under the new DRG system, the number of diagnostic laboratory tests increased as the maximum incentive policy rate increased. The increment of the number of diagnostic laboratory tests was prominent in the period of a maximum of 35% incentive policy rates. Finally, the number of diagnostic laboratory tests of the participant group was similar to or exceeded that of the control-2 group. The new DRG system’s incentive policy rates played a driving force on the increased utilization rate of the diagnostic laboratory test. For preparing in advance for the change in incentive policy rates, monitoring and guidelines for the utilization of diagnostic laboratory tests are necessary.

The Osteoma is a benign tumor characterized by proliferation of compact or cancellous bone, that may form peripherally in a periosteal location or in a central position. The most common site of peripheral osteoma in craniofacial area is the frontal sinus, but rare in the maxillary sinus. Clinically, this lesion that shows slow growing without symptoms can produce swelling and cause asymmetry. This tumor may arise at any age, but slightly more frequently in men than in women, and more common in young age. Radiographically, this lesion appears as a well-circumscribed radiopacity and histopathologically shows proliferation of either compact or cancellous bone. The etiology of ostemas in the paranasal sinus is unknown, but it has been suggested that they are frequently associated with infection and trauma, and in a certain cases are believed to develop in sinus polyps, which are an inflammatory reaction. The treatment of osteoma is surgical excision, but need not be excised unless it causes obstruction to a sinus cavity or disturbing cosmetically, and this tumor usually does not recur after surgical removal. We report a case of peripheral osteoma on the maxillary sinus in 46 male-patient who came our hospital for discomfort of the left cheek and TMJ area.
Cheek ; Female ; Frontal Sinus ; Humans ; Male ; Maxillary Sinus* ; Osteoma* ; Polyps ; Temporomandibular Joint

Aggressive fibromatosis is best difined as a group of non-encapsulated, non-metastasizing fibrous tumors that have tendency for local recurrence. This tumor is chariaterized histologically by fibroblastic proliferation and clinically by the potential to infiltrate and to recur after surgical excision, but not metastasize. The most common anatomic location have been the abdominal muscle and the extrimities. The incidence of the head and neck is mentioned as from 9.5% to 50% of all desmoid tumors. Within this area, 40%-to 80% of the tumors are located in the neck, but rare in oral cavity. Histologically the tumor is composed of proliferative fibroblasts with a collagenous component. The degree of cellularity varies from area to area and from tumor to tumor. The cells are usually spindle-shaped and the nuclei present only slightly polymorphism, but mitosis are rare and never atypical. Oral fibromatosis has been described as fibrosarcoma, pseusarcoma, pseudosarcomatous fibrosarcoma, metastasizing fibromatosis, juvenile aggressive fibromatosis, and aggressive fibromatosis, but Wilkin and Waldron suggested that the aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the tumor. The treatment of aggressive fibromatosis is traditionally surgical resection with an area of tumor free tissue. But when the complete surgical excision is not possible, radiation and chemotherapy also can be used. Clinically the tumor reported to be not painful in most cases, but capable of rapid growth. Careful clinical and histological examinations are essential for correct diagnosis. We report a case of aggressive fibromatosis. Occurring of the maxilla in 10 year female patient.
Abdominal Muscles ; Collagen ; Diagnosis ; Drug Therapy ; Female ; Fibroblasts ; Fibroma ; Fibromatosis, Aggressive* ; Fibrosarcoma ; Head ; Humans ; Incidence ; Maxilla* ; Mitosis ; Mouth ; Neck ; Recurrence

Dexamethasone converts pluripotent pancreatic AR42J cells into exocrine cells expressing digestive enzymes. In order to address molecular mechanism of this differentiation, we have investigated the role of mitogen-activated protein (MAP) kinase pathway and gene expressions of p21(waf1/cip1)and nuclear oncogenes (c-fos and c-myc) during AR42J cell differentiation. Dexamethasone markedly increased the intracellular and secreted amylase contents as well as its mRNA level. However, cell growth and DNA content were significantly decreased. With these phenotypic changes, AR42J cells induced transient mRNA expression of p21(waf1/cip1)gene, which reached maximal level by 6 h and then declined gradually toward basal state. In contrast to p21(waf1/cip1), c-fos gene expression was transiently inhibited by 6 h and then recovered to basal level by 24 h. Increased c-myc expression detected after 3 h, peaked by 12 h, and remained elevated during the rest of observation. Dexamethasone inhibited epidermal growth factor-induced phosphorylation of extracellular signal regulated kinase. Inhibition of MAP kinase pathway by PD98059 resulted in further elevation of the dexamethasone-induced amylase mRNA and p21(waf1/cip1)gene expression. These results suggest that p21(waf1/cip1)and nuclear oncogenes are involved in dexamethasone-induced differentiation and inhibition of MAP kinase pathway accelerates the conversion of undifferentiated AR42J cells into amylase-secreting exocrine cells.
Amylases/genetics ; Animals ; Cell Differentiation/*drug effects ; Cell Division/drug effects ; Cell Line, Tumor ; Cyclins/genetics/*metabolism ; Dexamethasone/*pharmacology ; Gene Expression Regulation/drug effects ; Genes, fos/genetics ; Genes, myc/genetics ; MAP Kinase Signaling System/*drug effects ; Mitogen-Activated Protein Kinases/*metabolism ; Pancreas/cytology/*drug effects/enzymology/metabolism ; RNA, Messenger/genetics/metabolism ; Rats ; Support, Non-U.S. Gov't

This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. PATIENTS AND Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. CONCLUSION: Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.
Follow-Up Studies ; Head ; Humans ; Mandible* ; Mandibular Condyle ; Mouth

Anaplasia ; Biopsy ; Chondrocytes ; Diagnosis ; Fibroblasts ; Head ; Humans ; Jaw ; Mandible ; Mitosis ; Neck ; Osteoblasts ; Osteosarcoma ; Sarcoma ; Survival Rate

BACKGROUND: There have been several studies showing that angiotensin II and the angiotensin convertingenzyme (ACE) contribute to the activation of fibroblast including the pulmonary fibrosis, and apoptosis of the al veolar epithelium in idiopathic intersititial pneumonia. This study was performed to identify the relationship between the serum angiotensin II. ACE and the pulmonary function test (PFT), the dyspnea score, and the cell fraction of the bronchoalveolar lavage fluid (BALF). METHODS: Twenty three patients with idiopathic interstitial pneumonia from March, 1999 to October, 2001 at Gachon medical school were enrolled in this study. They were divided into IPF(UIP) (16) and NSIP (7) group. Twelve of the idiopathic interstitial pneumonia patients (UIP : 5, NSIP: 7) were diagnosed by an open lung biopsy, 11 of IPF patients were diagnosed by the American Thoracic Society (ATS) diagnostic criteria. The PFT values, dyspnea score, serum ACE and angiotensin II were measured, and a bronchoscopy was performed to obtain the BALF. RESULTS: Of all the patients, 7 were in the normal range and 14 showed an increase in the serum level of angiotensin II. In terms of the serum ACE level, 14 patients had an increased level. The DLCO% of the angiotensin II. increased group was significantly lower than the not-increased group (p=0.021). Other factors did not correlate with the serum ACE or the angiotensin II increased group and not-increased group. CONCLUSION: These results suggest that an increased angiotensinII serum level may be associated with in crease in the of alveolar capillary block in the progression of pulmonary fibrosis in idiopathic interstitial pneumonia.
Angiotensin II* ; Angiotensins* ; Apoptosis ; Biomarkers* ; Biopsy ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Capillaries ; Dyspnea ; Epithelium ; Fibroblasts ; Fibrosis ; Humans ; Idiopathic Interstitial Pneumonias* ; Lung ; Peptidyl-Dipeptidase A* ; Pneumonia ; Pulmonary Fibrosis ; Reference Values ; Respiratory Function Tests ; Schools, Medical