A case of enteric cyst in the anterior two-thirds of the tongue is reported. The patient, a 42 day-old female infant, presented with a protruding tongue mass since birth. Under the impression of ectopic thyroid gland or leiomyoma, complete resection was performed. The mass proved to be an enteric cyst, lined by small intestinal mucosa with an underlying coat of smooth muscle. Enteric cysts arising in the tongue is rare and only 8 such cases have been reported in the literature.
Female ; Humans ; Infant ; Intestinal Mucosa ; Leiomyoma ; Muscle, Smooth ; Parturition ; Thyroid Dysgenesis ; Tongue*

Chronic ulcerative colitis is a systemic inflammatory disease with uncertain etiology primarily involving the colonic mucosa. The mucosal biopsy interpretation is important for an evaluation of the disease state and further medical or surgical treatment. However, few clinical and pathological studies of the endoscopic diagnosis of this disease are available in Korea. Therefore, we evaluated the clinical and pathological characteristics of it diagnosed by endoscopic biopsy and analysed the reasons for the discrepancy between clinical and pathologic diagnosis for a more accurate endoscopic mucosal biopsy diagnosis in the future. A total of 702 cases of colonic mucosal biopsy specimens during Feb. 1994 and Jan. 1995 at Severance hospital, Yonsei University College of Medicine were reevaluated for the study. A clinical diagnosis of ulcerative colitis, after endoscopic examination, was made in 61(8.7%) cases. A pathological diagnosis was made when there is an increased inflammatory cell infiltration in the mucosa with evidences of a chronic crypt injury in the biopsy specimens. Using this criteria, a diagnosis was made in 32(52.3%) cases. In 29 cases the diagnosis was made in the first biopsy specimen and in the remaining 3 cases the diagnosis was made in the second or third biopsy specimens. No pathologic diagnosis of ulcerative colitis was made in the cases that clinical diagnosis was not. In the 32 cases diagnosed as ulcerative colitis, 14 cases were involved the rectum and sigmoid colon, 9 cases were involved up to the descending colon, 1 case was involved up to the transverse colon and 8 cases showed pancolonic involvement. In 29 cases, which ulcerative colitis was suspected clinically but was not consistent with it pathologically, 8 cases were proved to be ischemic colitis, 5 cases were acute infectious colitis and one case was Crohn's disease by repeat examination and follow up. Ten cases were histologically within normal range and lesions subsided spontaneously with no recurrence. A conclusive diagnosis could not be made in 5 cases during this study period. From these results, we conclude that ulcerative colitis can be diagnosed accurately by endoscopic biopsy, and clinical follow up and repeat examination are valuable in the differential diagnosis of this disease.
Diagnosis, Differential ; Biopsy

Angiogenesis depends on the net balance between positive and negative angiogenic factors. Tumor cells are angiogenic resulting from increased production of positive factors and decreased production of negative factors. Among these, vascular endothelial growth factor and glioma- derived angiogenesis inhibiting factor are related to glioblastoma multiforme. The p53 gene is more frequently mutated than any other known oncogene or tumor suppressor gene in human tumors including glioblastoma multiforme. Angiogenesis is reported to be controlled by p53 regulation in recent studies. To examine the effect of p53 overexpression on angiogenesis in glioblastoma multiforme, we performed immunohistochemical staining in 51 cases of glioblastoma multiforme, using monoclonal antibodies to p53 protein and factor VIII. 20 cases of low grade astrocytoma were used as control. p53 overexpression was present in 15(75%) of 20 cases of low grade astrocytoma and the mean vessel count was 37.7+/-9.9 at x200 field and 17.5+/-5.8 at x400 field. p53 overexpression was present in 35(68%) of 51 cases of glioblastoma multiforme and the mean vessel count was 91.9 45.8 at x200 field and 40.7 19.1 at x400 field. Mean vessel count in low grade astrocytoma with p53 overexpression was 39.4 10.2 at x200 field and 18.9 5.7 at x400 field, while in cases without p53 overexpression it was 32.4+/-7.6 at x200 field and 13.2 3.5 at x400 field. Mean vessel count in glioblastoma multiforme with p53 overexpression was 94.5+/-51.8 at x200 field and 42.1+/-16.8 at x400 field, while in cases without p53 overexpression it was 86.1+/-29.5 at x200 field and 37.1+/-16.8 at x400 field. The mean survival time was 12.4 months in the 39 cases of glioblastoma multiforme in which follow-up studies were possible. Significant prognostic factors were age, p53 overexpression and adjuvant therapy. These results show that p53 gene mutation is one of the many contributing factors to angiogenesis in glioblastoma multiforme. In addition, other oncogenes and tumor suppressor genes, as well as growth factors may be involved. Age, p53 overexpression and adjuvant therapy proved to be significant prognostic factors, while microvessel density was not.
Angiogenesis Inducing Agents ; Antibodies, Monoclonal ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Factor VIII ; Follow-Up Studies ; Genes, p53* ; Genes, Tumor Suppressor ; Glioblastoma ; Humans ; Intercellular Signaling Peptides and Proteins ; Microvessels ; Oncogenes ; Survival Rate ; Vascular Endothelial Growth Factor A

We aimed to study the clinicopathologic features of inflammatory fibroid polyp by histological and immunohistochemical methods. The materials used in this study consisted of 9 cases of inflammatory fibroid polyp: 4 in the stomach, 4 in the small intestine and 1 in the cecum. The results were as follows: Females were affected more frequently than males and the average age was 45 years(range:27-61). In cases of gastric lesion, the size tended to be smaller, the mass was mainly located along the greater curvature side of antrum, and confined to the submucosa. However inflammatory fibroid polyp of the small intestine was over 2.5 cm in size, located along the antemesenteric border, and involved the proper muscle layer. In addition, intussusception was accompanied by polyp in 2 cases of small intestinal lesions. Histologically inflammatory fibroid polyps of the stomach were characterized by prominent lymphocytic infiltration and occasional onion-skinning of stromal cells, whereas plasmocytic infiltration was prominent in those of the small intestine. Main component cells comprising this lesion were confirmed to be fibroblasts by immunohistochemistry which revealed strong reactivity to vimentin in the cytoplasm of slindle cells.
Female ; Male ; Humans

In an attempt to discover the factors contributing to the increased proliferative activity in hepatocytes and subsequent development of HCC, the proliferative activity of hepatocytes was compared with the size of regenerative nodules and HBcAg expression status in the surrounding nontumorous liver of 45 surgically resected hepatocellular carcinomas, including 34 HBV related ones. In the tumor, the difference in proliferative activity and the histological grade was analyzed in terms of p53 gene alteration. The proliferative activity was assessed by immunohistochemical methods using Ki-67 monoclonal antibody. HBcAg expression in the surrounding nontumorous liver correlated with both the inflammatory and proliferative activity of hepatocytes (p<0.05). p53 overexpression was associated with high proliferative activity and aggressive phenotype of tumor. No correlation was observed between the proliferative activity of hepatocytes and the size of regenerative nodules in cirrhosis (p>0.05). p53 overexpression was not evident in surrounding nontumorous liver including cirrhosis. In conclusion, the above results are in line with the view that hepatic carcinogenesis is a mutistep, progressive process. In the initial stage, chronic cellular injury incurred by immumologic reaction against HBcAg seems to play a pivotal role in increased cellular regeneration. However, once transformation of hepatocytes occur the major contributor to tumor growth seems to be alteration in p53 tumor suppresor gene.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Fibrosis ; Genes, p53 ; Hepatitis B Core Antigens* ; Hepatitis B virus ; Hepatocytes ; Liver* ; Phenotype ; Regeneration

To understand better the complex natural course of HBV infection, the expression patterns of HBcAg and HBsAg in the liver of 51 inactive serum HBsAg carriers (24 CPH and 27 NPD) were studied by immunohistochemical methods. The inactive serum HBsAg carriers were devided into 3 groups by the following expression patterns of serum HBeAg/anti-HBe status and tissue HBcAg and HBsAg. Pattern A (18 cases) : HBeAg+, cHBcAg+ (94.4%), mHBsAg+ (61.1%), pATTERN B (14 cases) : anti-HBe+, nHBcAg+, cHBsAg+, Pattern C (19 cases) : anti-HBe+, HBcAg-, cHBsAg+ (89.5%). There were no significant differences between CPH and NPD, lthough the core free pattern was more common in the latter. The cHBcAg was expressed in 17 of 18 (94.4%) HBeAg seropositive cases but only one of 33 cases with serum anti-HBe, suggesting that the cHBcAg is intimately related to HBeAg. Since the inactive HBsAg carriers also expressed cHBcAg and/or mHBsAg, the necro-inflammatory activity of HBV infected liver is assumed to depend on the host immune response rather than their presence alone

Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over the period of weeks to months, being replaced by bone of normal architecture. When the antibiotics incorporated into plaster of Paris, the antibiotics are capable of prolonged local release in bactericidal concentrations. Therefore it is proposed that antibiotics loaded plaster of Paris might be a simple adjuvant technique after good surgical debridement for the treatment of bone infection. The authors carried out an experiment to study the effect of plaster of Paris containing antibiotics for a prevention of experimental osteomyelitis, using 45 rats, which were divided into 3 groups. In the Group 1, a defect was made at the proximal metaphysis of the tibia, inoculated by Staphylococcus aureus sensitive to Cephradine and Tobramycin and then filled with plaster of Paris pellet. In the Group 2, a defect was filled with Cephradine loaded plaster of Paris pellet. In the Group 3, a defect was filled with Tobramycin loaded plaster of Paris pellet. Then we observed the healing process of the bone defect in the point of view of the gross findings, radiologic findings and histologic findings at 4th, 8th and 12th week after operation. The results of this study were as follows:l. In the control Group;all 30 cases were infected. 2. In the Group 2;only 4 of 30 cases were infected. 3. In the Group 3;all 30 cases were not infected. 4. The plaster of Paris filled into the defect was absorbed continuously and stimulated the new bone formation.
Animals ; Anti-Bacterial Agents ; Calcium Sulfate ; Cephradine ; Debridement ; Osteogenesis ; Osteomyelitis ; Rats ; Staphylococcus aureus ; Tibia ; Tobramycin

In anterior dislocations of shoulder complicated by fracture of greater tuberosity, the prognosis of shoulder after reduction of dislocation depends upon associated injury of the rotator cuff. Early recognition and repair are thought to be essential if better functions is to be obtained. Among 40 patients with 41 dislocations, 28 cases with fracture of greater tuberosity were managed and treated at the Department of Orthopaedic Surgery, Hangang Sacredheart Hospital, Hallym University, from January, 1985 to December, 1988. The results obtained from this study were as follows: l. Among 40 patients with 41 cases of fracture-dislocation, 27 patients with 28 cases(68.3%) were complicated by fracture of greater tuberosity. Most of these were by traffic accident and occurred at the age of 40s and 50s. 2. According to the Depalma's classifcation, the most common type was type 2(15 cases, 53.5%). 3. Open reduction with repair of cuff was done in 2 cases of type 2 and 4 cases of type 3. 4. Rotator cuff injury was confirmed in eight operatively treated cases and in 3 cases by arthrography and ultrasonography. 5. Five operatively treated cases of fracture-dislocation with rotator cuff injury showed improved function especially in abduction. Therefore in anterior disloations with fracture of greater tuberosity, careful evaluation of anatomic reduction state of fragment after reduction and accompanying rotator cuff injury is necessary. If the fragment retracts under the acromion or still shows displacement more than 8-10mm after reduction, we may assume that a tear of rotator cuff is present and open reduction of fracture with repair of rotator cuff is essential for the better function of the shoulder.
Accidents, Traffic ; Acromion ; Arthrography ; Dislocations ; Humans ; Prognosis ; Rotator Cuff ; Shoulder ; Tears ; Ultrasonography

A case of fibrolipomatous hamartoma of the median nerve in the palm and digits of the hand in a 14 year old man developed in the right hand is reported. This is rare disease characterized by fatty and fibrous tissue infiltration in themedian nerve of the palm and digits. This case was treated by limited debulking of the redundant tumor tissue and excision of the transverse carpal ligament. This case was performed with relief of the symptom.
Hamartoma ; Hand ; Ligaments ; Median Nerve ; Rare Diseases

Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
Adenocarcinoma* ; Barrett Esophagus* ; Epithelium ; Esophagogastric Junction ; Esophagus* ; Gastroesophageal Reflux ; Humans ; Intestines* ; Middle Aged ; Mucous Membrane ; Stomach* ; Ulcer