It has been well known that liver cirrhosis, regardless of its etiology, is an important predisposing factor in hepatocarcinogenesis. However, the type of cirrhosis in hepatocellular carcinoma(HCC)-bearing liver varies not only by geographic areas but also with the cirteria applied for morphological classification of cirrhosis. To elucidate the relationship between the nodule size of HCC-bearing cirrhotic liver and clinicopathologic features, we measured cirrhotic nodule areas of 49 surgically resected HCC cases using image analyzer. The morphological type of cirrhosis was predominantly macronodular(49%), and followed by mixed(37%) and micronodular(14%). Seventy percent of the cases showed seropositivity for HBsAg. The average area of cirrhotic nodules was significantly larger in HBsAg-positive cases(mean: 6.14 mm2) than that of HBsAg-negative cases(mean: 2.5 mm2)(p<0.05), and their size was bigger in cases with grossly expansile pattern of HCC than those cases with infiltrative ones(p<0.05). Based on the above findings, we assume that seropositivity of HBsAg may influence on the regenerative activity of cirrhotic nodules and also subsequent increase of risk for further development of HCC. The presence of cirrhohsis and nodule size seem to be the important contributing factors to determine the growing patterns of HCC.
Carcinoma, Hepatocellular

Hepatoid adenocarcinoma of the stomach has been designated to a primary gastric adenocarcinoma with minimum criteria of elevated serum alpha-fetoprotein and its histological resemblance to neoplastic liver cells. Of the 1,500 consecutive cases of surgically resected gastric carcinomas during a period of 4 years, we retrieved 14 cases of adenocarcinoma which met the histologic features of hepatoid growth and compared them histologically with 400 consecutive cases of non-hepatoid gastric adenocarcinomas. The patient's age ragned from 32 to 80 years(non-hepatoid group: 25 to 81 years) and their male to female ratio was 3.7 : 1(non-hepatoid group: 1.8 : 1). Grossly, five case were Borrmann type II and another five cases type III. All three cases of early gastric carcinomas were the submucosal type IIc. The remaining one was an advanced gastric carcinoma mimicking early gastric carcinoma. Microscopically, the hepatoid portions varied in growing patterns and arranged in either compact, trabecular or pseudoglandular pattern and gave an immunoreactivity to alpha-fetoprotein and alpha-1-antichymotrypsin. Regardless of the tumor stage, the hepatoid areas were located in the deeper portion of the tumor mass and grew in an expanding/nodular pattern. The associated adenocarcinomatous areas were mostly papillotubular, moderately to well differentiated, and frequently revealed clear PAS-negative cytoplasm reminiscent of the differentiated embryonal carcinoma. Tumor emboli and nodal metastasis were the frequent associations. We assume that the hepatoid adenocarcinoma may develop from gastric'adenocarcinoma through embryonal carcinomatous growth.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

A 56-year-old man received subtotal gastrectomy for an early gastric carcinoma type IIa+IIc with submucosal invasion. The tumor was made up of mixed papillo-tubular adenocarcinoma and solid carcinomatous portion, the latter comprising approximately four-fifths of the total tumor mass. The solid portion was confined within the submucosa and revealed a mixture of trabecular, compact and pelioid patterns of large polyhedra cells, resembling hepatocellular carcinoma of the liver(Edmondson-Steiner grade 2). Sinusoid-like vascular stroma of classical trabecular hepatocellular carcinoma intervened the tumor cell nests but was not associated with endothelial-cell lining. Immunohistochemical stainings with alpha-fetoprotein and alpha1-antitrypsin gave a strong reactivity in those areas of hepatoid differentiation and in the adjacent minute portion of adenocarcinoma. The findings suggest that a portion of gastric carcinoma may transdifferentiate into cells with hepatoid features along the line of endodermal lineage.
Male ; Humans ; Adenocarcinoma ; Carcinoma, Hepatocellular

The use of antituberculous drug made it possible to develop the radical operative procedure in the treatment of the spine tuberculosis. The anterior fusion is the most frequently used surgical measure in the treatment of the spine tuberculosis but several problems were observed not infrequently. One hundred and twenty-nine cases of childhood spine tuberculosis were treated by the anterior spinal fusion for the period of ten years from 1968 to 1977 at Seoul National University Hospital, and following results were obtained. Problems of the anterior spinal fusion could be divided into two categories; one is the complications and the others are difficulties in the surgical procedure. Complications of the anterior spinal fusion were divided into early and late. Early complications include graft failure, pulmonary problems, cord compression and spinal fluid leakage. Late complications include increasing kyphosis, draining sinus and graft failure. Degrees of increasing kyphosis were the greatest in the age group between the and five years, and greater degrees of increasing kyphosis were observed in more joint involvement. Increasing kyphosis were observed more frequently in longer follow up. The causes of increasing kyphosis could be considered as the relative discrepancies between the growth of the anterior and posterior comparment, and graft failure.
Child ; Follow-Up Studies ; Humans ; Joints ; Kyphosis ; Seoul ; Spinal Fusion ; Spine ; Surgical Procedures, Operative ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

No abstract available in English.
Spondylolisthesis

Osteogenesis imperfecta is a heterogenous group of inherited disorder, which has abnormalities in the synthesis of collagen. Among variable clinical manifestations, orthopaedic clinical features are laxity of ligament and deformities arising from frequent fractures or angulation due to skeletal fragility. We had managed 4 cases of osteogensis imperfecta, which were belonged to type IV-B in two cases, type I-A in one, and type I-B in remained one by Sillence classification and they had suffered from recent fractures or deformities due to previous fractures in the long bones of the lower extremities. These patients had been treated with various types of intramedullary nails, such as Bailey-Dubow extensile rod. Rush rod and Kuntcher nail, and the result of intramedullary nailing lead to improvement of walking ability.
Classification ; Collagen ; Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Humans ; Ligaments ; Lower Extremity ; Osteogenesis Imperfecta ; Osteogenesis ; Walking

There have been numerous hypotheses about the pathogenesis of idiopathic scoliosis, but it is still unclear. There are some reports that abnormalities of contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The purpose of this report is to study the quantitative abnormalities of contractile proteins in muscles and nonactivated and activated platelets, and to determine whether or not the abnormalities in contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The materials were 21 idiopathic scoliosis patients aged from 13 years to 28 years(average 19.2 years) and 20 persons aged from 17 years to 25 years(average 20.1 years) as a control group. The electrophoretic analysis(SDS-PAGE method) was done on platelets both unstimulated and stimulated with thrombin and also on proteins of paraspinal muscles and gluteus maximus of idiopathic scoliosis patient and paraspinal muscles of control group. The results are as follows. 1. The myosin/actin ratios of triton-insoluble fractions to paraspinal muscles in convex sides of main curvatures of scoliosis patients(1.69±0.81) were significantly decreased compared to those of concave sides(2.55±1.28), gluteus maximus muscles(2.56±1.70) and control group(2.61±1.01). 2. There were no significant differences between scoliosis group and control group in the actin/myosin ratios of triton-insoluble fractions of the platelets both nonactivated and activated by thrombin. In conclusion, abnormalities of contractile protein in paraspinal muscles of convex side may play a role in the pathogenesis of idiopathic scoliosis, rather than abnormalities of systemic contractile protein.
Actins ; Blood Platelets ; Contractile Proteins ; Humans ; Muscles ; Myosins ; Paraspinal Muscles ; Scoliosis ; Thrombin

No abstract available.
Computer Simulation* ; Orthognathic Surgery*

No abstract available.
Computer Simulation* ; Orthognathic Surgery*

No abstract available.
Meningitis*