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

The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.

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 role of the Orthodontist in cleft lip and cleft palate therapy is primarily ill correction of malocclusion which is required by practically every child who has these defects. He can contribute to the assessment of dento-facial growth and development. We may gain the possible limited correction of delayed malocclusion due to cleft lip and palate. The authors have attempted delayed orthodontic treatment of a cleft lip and palate of 12.9 years old girl, who had a cleft lip and palate of surgical closure at 2,3 and 4 years old.
Child ; Child, Preschool ; Cleft Lip* ; Cleft Palate ; Female ; Growth and Development ; Humans ; Malocclusion ; Palate*

A retrospective analysis was conducted on ski injury collected in past 12 years, from 1982 to 1995, exception of 1986 and 1987 at the Young Pyeong Ski Resort in Korea. A total of 3,093,667 skiers during the 12 years period are cohort of this investigation. Of 3,093,667 skiers, 7,172 injuries were indexed by anatomic region and severity according to diagnosis on initial evaluation. The frequency of injury changes from 3.4 to 1.5 per 1,000 skier-days during the 12 years. The rate of upper extremity to lower extremity injury increased from 1:1.33 to 1:0.89 during the study period(P<0.005). The most common upper extremity injury pattern was simple injury including laceration and contusion(74.2%). The ulnar collateral ligament injury of thumb make up of 6.5% of all injuries. In conclusion, upper extremity skiing injury was related to 1) Skiers activity level, 2) Skiers skill, 3) Degree of fatigue, 4) Slope condition, 5) Improvement of ski equipment, and 6) Increased skiing population density.
Cohort Studies ; Collateral Ligaments ; Diagnosis ; Fatigue ; Health Resorts ; Korea* ; Lacerations ; Lower Extremity ; Population Density ; Retrospective Studies ; Skiing ; Snow* ; Thumb ; Upper Extremity*

The case of a 56-year-old woman with a keratoacarithoma(KA) of the labial mucosa is herein reported, The tumor was excised and the pathological features were characteristic of a KA, This case is reported because the oral mucosa is such an unexpected location for solitary KA and the labial mucosa of this patient received chronic actinic damage, which suggested an etiological relationship. Follow-up examination of the patient after four months showed no recurrence.
Actins ; Female ; Follow-Up Studies ; Humans ; Keratoacanthoma* ; Middle Aged ; Mouth Mucosa ; Mucous Membrane* ; Recurrence ; Solar System*

The study was undertaken to determine the most adequate tidal volume when used volume preset ventilator during anesthesia. The thirty patients were received controlled mechanical ventilation with constant inspiratory pressure of 10 cmH2O and respiratory frequency of 12/minute. The results were as follows: 1) The PH was 7.39±0.01 and it is within normal limit. 2) The PaCO2 was 34.0±0.6 mmHg and it is a slightly hyperventilatory state. 3) The PaO2 was 228.0±8.2 mmHg. 4) The Buffer base was 20.7±0.3 mEq/L and it is a slightly buffer base deficient state. From the above results. We concluded that if patients were fully relaxed during general anesthesia, it is desirable to maintain the inspiratory pressure of anesthetic mechanical ventilator to 10 cmH2O for adequate alveolar ventilation.
Anesthesia ; Anesthesia, General ; Humans ; Hydrogen-Ion Concentration ; Respiration, Artificial ; Tidal Volume ; Ventilation ; Ventilators, Mechanical*

No abstract available.
Endocrinology

To examine the association of hypertension with cluster of obesity, abnormal glucose and dyslipidemia in Korean urban population, we conducted this cross-sectional study among 3027 men and 2127 women age 20-85 years who visited a prevention center between May 1991 and June 1995 for a multiphasic health check at St. Mary's Hospital, Seoul. By the self-administered questionnaire, the informations of educational attainments, monthly income, alcohol consumption, cigarette smoking, and physical excercise level were obtained. Height, weight, and blood pressure were measured by a trained nurse. The fasting blood sugar(FBS), total cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride were tested by enzyme method. Low density lipoprotein (LDL) cholesterol was calculated by 'total cholesterol - HDL cholesterol - triglyceride/5'. For testing the differences of cardiovascular risk factors between hypertension and normotension group, t-test and x2 test were performed and for the age adjusted odds ratios of hypertension in persons with obesity, abnormal glucose, and dyslipidemia compared with normal, logistic regression was performed by using SAS pakage programme. The results obtained were as follows: 1. Age, weight, body mass index, blood glucose, total cholesterol, low density lipoprotein, triglyceride of hypertension group in men and women were significantly higher than normotension group, but height and high density lipoprotein of hypertension group only in women significantly lower than normotension group. The frequency of obesity (body mass index > or =25 kg/m2), abnormal glucose (> or = 120 mg/dl), hypercholesterolemia (> or =240 mg/dl), lower HDL cholesterol (<45 mg/dl in women only), higher LDL cholesterol (> or =160mg/dl), and hypertriglyceridemia (> or =250 mg/dl) in hypertension group of men and women were significantly higher than normotension group. 2. Systolic and diastolic blood pressure were negatively correlated with hight, but positively with age, weight, BMI, total cholesterol, LDL cholesterol, and triglyceride in men and women. And BMI was positively correlated with fasting blood sugar, total cholesterol, LDL cholesterol and triglyceride but negatively with HDL cholesterol. 3. The odds ratios of hypertension were as follows in men and women : among persons who were obese compared with those nonobese, 2.53 (95% Confedence Intervals [C.I.] 2.08-3.07) and 2.22 (95%C.I. 1.71-2.87); among persons who were abnormal glucose compared with those normoglycemic, 1.43 (95%C.I 1.13-1.82) and 2.01 (95%C.I 1.36-2.94); and among persons who were dyslipidemia (hypercholesterolemia or lower HDL cholesterol or higher LDL cholesterol or hypertriglyceridemia) compared with those normal lipid, 1.59 (95%C.I 1.30-1.95) and 1.51 (95%C.I 1.16-1.96). After combined more than one risk factor, the odds ratios were increased. Among persons with cluster of obesity, abnormal glucose, and dyslipidemia, the odds ratio of hypertension was 2.25 (95%C.I 1.47-3.37) in men and 3.02 (95%C.I 1.71-5.30) in women. In conclusion, it was suggested that hypertension was associated with cluster of obesity, abnormal glucose, dyslipidemia in this Korean urban population.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cross-Sectional Studies ; Dyslipidemias* ; Fasting ; Female ; Glucose* ; Humans ; Hypercholesterolemia ; Hypertension* ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Male ; Obesity* ; Odds Ratio ; Surveys and Questionnaires ; Risk Factors ; Seoul ; Smoking ; Triglycerides ; Urban Population*