No abstract available.
Lymphatic Diseases*

This study was carried out to investigate the immunohistochemical expression of bcl-2 and p53 protein in the intestinal type and the diffuse type of gastric adenocarcinoma by Lauren's classification. A total of 100 cases, including 50 cases of the intestinal type and 50 cases of the diffuse type from paraffin embedded gastrectomy specimens, were immunohistochemically stained for bcl-2 and p53 protein. Bcl-2 protein was expressed in 38% (19/50) of intestinal type and 30% (15/50) of diffuse type. The incidence of bcl-2 protein expression was higher in the intestinal type than in the diffuse type, but no significant correlation was present (p>0.05). p53 protein was expressed in 68% (34/50) of the intestinal type and 60% (30/50) of the diffuse type. The incidence of p53 protein expression was higher in the intestinal type than in the diffuse type, but no significant correlation was present (p>0.05). And an expression of bcl-2 and p53 protein did not correlate with depth of invasion, lymph node meatastasis and TNM stage, respectively (p>0.05). These results suggest that bcl-2 and p53 gene alteration appear to play a more important role in the carcinogenesis of the intestinal type than the diffuse type. However, there is no significant difference between the intestinaPU: The Korean Society of Pathologistsl type and the diffuse type in bcl-2 and p53 protein expression.
Adenocarcinoma* ; Apoptosis ; Carcinogenesis ; Classification ; Gastrectomy ; Genes, p53 ; Incidence ; Lymph Nodes ; Paraffin

A forty-nine-year-old woman with polycystic disease had a right nephrectomy for what was preoperatively thought to be a polycystic disease, but at surgery turned out to be a tumor based on frozen section. Microscopic examination revealed papillary type, renal cell carcinoma with classical features of adult polycystic kidneys. Radiologic findings revealed multiple cysts in the liver. The clinical recognition of a carcinoma developing in polycystic kidneys is often difficult because of the presence of preexisting large renal masses and occasional hematuria. Renal cell carcinoma should be thought of when confronted with abdominal pain or back pain, severe hematuria, sudden dysuria or a new renal mass occurring in a patient with polycystic kidneys.
Adult ; Male ; Female ; Humans ; Cysts

Soft tissue perineurioma is a very rare tumor composed of entirely of neoplastic perineurial cells. A 54-year-old woman presented with a palpable mass in the right lower leg. The mass was excised. Grossly, the tumor measured 2.0x2.0x1.5 cm. The cut surface was well circumscribed, pale pinkish gray, and rubbery soft. Histological examination showed that the tumor was composed of spindle cells within collagenous and myxoid stroma. The tumor cells had elongated, tapering nuclei with long and thin cytoplasmic processes, and were arranged in fascicular, whorled, and storiform pattern. The tumor cells were positive for epithelial membrane antigen and collagen type IV and negative for S-100 protein. Ultrastructurally, tumor cells showed long and thin cytoplasmic processes, pinocytic vesicles, and incomplete external lamina. The diagnosis of soft tissue perineurioma was confirmed by immunohistochemical stain and ultrastructural study.
Collagen ; Collagen Type IV ; Cytoplasm ; Female ; Humans ; Immunohistochemistry ; Leg ; Middle Aged ; Mucin-1 ; Nerve Sheath Neoplasms ; S100 Proteins

Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.
Aged ; Arm ; Arthroplasty* ; Humans ; Musculocutaneous Nerve* ; Paralysis* ; Radial Nerve ; Rotator Cuff ; Shoulder* ; Tears ; Traction

The treatment of extensive soft tissue injury of lower extremities is known to be one difficulty in the field of orthopedic surgery. At present, reconstructive surgery with free flap is being employed under the microscopy actively. But the size of defect is found larger than the maximum size of one free flap frequently. The authors present 6 cases of a combined scapular flap and latissimus dorsi flap for extensive soft tissue injury of the lower extremities at the department of orthopedic surgery of Severance hospital, during years period from 1983 to 1985. The results of the study are as follow: l. A one stage reconstruction of extensive soft tissue injury was done with a combined scapular flap and latissimus dorsi flap. 2. In spite ofa few complications of donor and recipient sites, the advantage of combined scapular flap and latissimus dorsi flap exceed the any methods that have been employed in functional and plastic aspects. 3. There was no limitation of motion of the shoulder in spite of the excision of the large combined scapular flap and latissimus dorsi flap around the axillary area. 4. The primary closure of the donor sites was feasible. 5. The reconstructive surgery of the extensive soft tissue injury using the above combined scapular flap and latissimus dorsi flap can be used without restriction as to the age of the patient.
Free Tissue Flaps ; Humans ; Lower Extremity ; Microscopy ; Orthopedics ; Plastics ; Shoulder ; Soft Tissue Injuries ; Superficial Back Muscles ; Tissue Donors

Spondyliolisthesis is the major structural changes in the spine and is more directly related to the low back pain syndrome. The many operative techniques have been used but each of them had several disadvantage as well as advantage. Since the anterior lumbar fusion in spondylolisthesis was introduced by Carpener in 1932, many authors have reported the favorable results regard to anterior arthrodesis in spine. Ideally the system of spine fixation is mechanically efficient and anatomical restoration of deformed structure. The anterior interbody fusion is more satisfactory to this deal fixation of spine than any other surgical method. We reviewed the cases of fifty seven patients who underwent anterior interbody fusion with autoiliac bone grafts for spondylolisthesis and were followed for one to twelve years. 1. The most common type was isthmic type in 61% and the degenerative type was observed in 25%. 2. The fifty lumbar vertebra slipping was observed most commonly and in two patinets, L4 and L5 vertebra slipped simultaenously. 3. In radiological results, we obtained complete fusion of grafts to vertebra in 73%, incomplete fusion in 15% and absorption of graft noticed in seven patients(12%). 4. We obtained the favorable results in 84% patients clinically. 5. The clinical results was not correlated with roentgenografic evidence of union. 6. Anterior discectomy and arthrodesis with autoiliac bone graft was a safe procedure in grade I and II spondylolisthesis but in grade III, the procedure was not recommended. 7. The simple Knight-Kim back brace was satisfactory to immobilization after anterior interbody fusion without graft union failure.
Absorption ; Arthrodesis ; Braces ; Diskectomy ; Humans ; Immobilization ; Low Back Pain ; Methods ; Spine ; Spondylolisthesis ; Transplants

The purposes of this study were to detect the indices of evaluating for degree of compression and to detect the indices of recovery after decompression in different time intervals in the animal model of 50 percent compression of the cauda equina, through the examination of neurologic status and electrodiagnosis. Twenty-one male dogs, weighing between nine and eleven kilogram, were used. Three experimental groups were studied. One group (5 dogs) served as controls. In the other groups, the cauda equina was constricted by 50 percent to produce chronic compression, and decompression was done after 2 weeks compression in one group and 4 weeks compression in another group. The dogs in which the cauda equina had been decompressed at 2 weeks, showed the recovery of sensory evoked potentials at 2 weeks after decompression and bulbocavernosus reflexes at 4 weeks. The dogs in which the cauda equina had been decompressed at 4 weeks, showed the recovery of sensory evoked potentials and bulbocavernosus reflexes at 4 weeks after decompression. In both groups of the cauda equina compression, motor evoked potentials were partially recovered by 6 weeks after decompression. The initial neurological deficits in both groups were improved by 6 weeks. The cauda equina revealed that the epidural scar tissue in compressed site was more severe in 4 weeks compression group. But the substance of the cauda equina did not have any pathological changes in gross examination. Microscopically, neural tissue was showed the normal appearance without pathological changes in all groups. In conclusions, the early decompression of cauda equina revealed that the onset of recovery was more faster and the amplitude of recovery was larger comparing with delayed decompression in electrodiagnostic test. Also, the surgical decompression itself was helpful to improve the electrodiagnostic changes around 4 weeks after decompression. Sensory evoked potential was improved at the first and motor evoked potentials was recovered after disappearance of the claudication.
Animals ; Cauda Equina* ; Cicatrix ; Decompression* ; Decompression, Surgical ; Dogs* ; Electrodiagnosis ; Evoked Potentials ; Evoked Potentials, Motor ; Humans ; Male ; Models, Animal ; Polyradiculopathy ; Reflex

The aim of this study was to clarify the role of Kupffer cells in the mechanism of endotoxin-induced liver injury. The study on fine structure of Kupffer cells was performed after the injection of endotoxin. The endotoxin(Escherichia soli lipopolysaccharide 026: B6, 1.5mg/100 g of body weight) was intraperitoneally injected in Sprague-Dewley rats. Animals were sacrificed at 1/4, 1/2, 1, 2, 4, 8, 16, 24, 72 and 120 hours after the injection of endotoxin. Livers were extirpated and processed to be examined by light and electron microscopy. The results obtained were summerized as follows: Early changes observed in liver after endotoxin injection included the increased number and hypertrophy of Kupffer cells, infiltration of neutrophils and presence of fibrin thrombi within the sinusoids. The coritinuous increase of the Kupffer cells in number with hypertrophy, congestion and infiltration of inflammatory cells within the sinusoids were observed. Hepatocytes showed* fatty change and occasional necrosis. At 72 hours the congestion decreased. At 120 hours the number of Kupffer cells was increased, but the morphology of Kupffer cells became similar to that of the control group. The numbers and sizes of primary and secondary lysosomes and amount of euchromatin of Kupffer cells increased. Swellings and increase in number of mitochondria, Golgi complex, smooth endoplasmic reticulum, rough endoplasmic reticulum were evident. Microthrombi were present within the sinusoids. The swelling of rough endoplasmic reticulum and mitochondria, decrease of glycogen particles, fatty change, hypoxic vacuoles, pyknotic nuclei and occasional necrosis were observed in hepatocytes. At 72 hours the number of secondary lysosomes in Kupffer cells decreased. At 120 hours the morphology of Kupffer cells became similar to that of the control group. According to these results, it was postulated that the endotoxin was initially taken up by pinocytosis into Kupffer cells and degraded in secondary lysosomes of activated Kupffer cells. Kupffer cells may play an important role in the defense mechanism of liver during endotoxemia. The dysfunction of Kupffer cells and ischemia by sinusoidal microthrombi may cause liver injury.
Animals ; Endoplasmic Reticulum, Rough ; Endoplasmic Reticulum, Smooth ; Endotoxemia ; Estrogens, Conjugated (USP) ; Euchromatin ; Fibrin ; Glycogen ; Golgi Apparatus ; Hepatocytes ; Hypertrophy ; Ischemia ; Kinetics* ; Kupffer Cells* ; Liver ; Lysosomes ; Microscopy, Electron ; Mitochondria ; Necrosis ; Neutrophils ; Pinocytosis ; Rats* ; Vacuoles

To investigate the immunohistochemical expression of mutated p53 protein and bcl-2 protein in the cutaneous melanocytic lesion, 15 cases of compound nevus, 10 cases of congenital melanocytic nevus, 15 cases of primary malignant melanoma(4 cases less than 1.5 mm thick and 11 cases more than 1.5 mm thick), and 10 cases of metastatic malignant melanoma(7 cases in lymph node and 3 cases in soft tissue) were examined. All cases of compound nevi and of congenital melanocytic nevi showed no immunoreactivity for p53 protein. p53 protein overexpression was observed in 75%(3/4) wth primary malignant melanoma less than 1.5 mm thick, 81%(9/11) with primary malignant melanoma more than 1.5 mm thick, and 100%(10/10) with metastatic malignant melanoma. The difference in p53 protein overexpression was statistically significant between benign nevi and malignant melanoma(p<0.01). Bcl-2 protein expression was observed in 73%(11/15) with compound nevus, 70%(7/10) with congenital melanocytic nevus, 75% (3/4) in primary malignant melanoma less than 1.5 mm thick, 54%(6/11) with primary malignant melanoma more than 1.5 mm thick, and 40%(4/10) with metastatic malignant melanoma. These findings suggested that mutation of p53 gene may be an important mechanism in the development of malignant melanoma. Although bcl-2 protein was expressed in cutaneous melanocytic lesion, no correlation was found between p53 protein and bcl-2 protein expression in malignant melanoma.
Genes, p53 ; Lymph Nodes ; Melanoma ; Nevus ; Nevus, Pigmented ; Skin*