There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants

No abstract available.
Humans ; Infant, Newborn*

Eccrine spiradenomas are clinically characterized by a solitary, tender mass and they are situated on the upper parts of the body, predominantly on the ventral aspect. We herein report two cases of eccrine spiradenoma in 35-year-old man and 53-year-old woman, which located on upper extremity and inguinal region. The masses are round, well circumscribed and measuring 0.7x0.5x0.5 cm, 5x4.5x3 cm in size, respectively. Histopathologically, the tumor consists of masses of two types of cells, intensely staining cells and pale staining cells, usually arranged in chains, cords and pseudoglands. Immunostainings for low molecular cytokeratin, high molecular cytokeratin, carcinoembryonic antigen, and S-100 protein show positivity in neoplastic cells. Electron microscopically, the tumor was composed of three types of cells, i. e. 1) round or ovoid tumor cells in shape with scanty cytoplasm and poorly developed intracytoplasmic orgenelles, 2) spindle shaped dark cells interconnected by desmosomes, 3) large epithelial cells with abundant cytoplasm and cytoplasmic intermediate filaments which formed glandular structures. The large epithelial cells joint each other by desmosomal attachments and luminal cells featured small numbers of microvilli, but either secretory granules nor ductal type granules were noticed.
Female ; Male ; Humans

PURPOSE: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells, and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogical parameters in breast cancer. METHODS: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. RESULTS: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histological grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. CONCLUSION: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.
Antibodies ; Biological Processes ; Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Coloring Agents ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Paraffin ; Phenotype ; Protein-Tyrosine Kinases ; Receptor, IGF Type 1

In the present study, immunohistochemical detection of p53 oncoprotein was performed to determine whether the grade of differentiation and the histologic type of gastric adenocarcinoma, and the degree of atypia accompanied with adenoma can be related to p53 mutation. Paraffin sections of 22 gastric adenomas and 56 gastric adenocarcinomas were examined for the overexpression of p53 oncoprotein with the avidin-biotin peroxidase complex staining procedure. The obtained results were as follows; 1. All the 22 cases of adenomas and 16 cases of well differentated adenocarcinomas showed uniformly negative staining. 2.Seven of 18 cases of moderately differentiated adenocarcinomas(39%), and five of 30 cases of poorly differentiated adenocarcinomas(17%) exhibited p53 protein expression. 3. Three of 29 cases of diffuse type (10%) and 9 of 19 cases of intestinal type(47%) exhibited p53 protein expression. These results suggest that p53 mutation is important in carcinogenesis of the intestinal type of gastric adenocarcinoma, and there is no correlation between the differentiation of gastric adenocarcinoma and the degree of p53 oncoprotein overexpression.
Adenocarcinoma ; Adenoma

A 64-year-old woman presented with severe chest pain and indigestion for ten days. She had been repeatedly admitted for the same symptoms, and had been treated with oral medication with no improvement. Coronary angiography revealed total occlusion of the left anterior descending and circumflex arteries. The patient was referred to our department because the other medical treatments had been unsuccessful and neither angioplasty nor coronary artery bypass surgery was safe. An epidural catheter was placed at the T2-3 level and a 5 mL bolus of 0.25% bupivacaine completely relieved the patient's angina. The arterial blood pressure and heart rate remained unchanged and the IV nitrates were discontinued. An infusion of 100 mL 0.0625% bupivacaine with 10 mg morphine was started at 4 mL/h. During the following 13 days, the patient remained pain free with 5 mL of 0.25% bupivacaine. Her symptoms continued to diminish and she remained free of pain even after discontinuing the high thoracic epidural anesthesia (HTEA), but she still took an occasional oral dose of nitrates.
Analgesia, Epidural* ; Anesthesia, Epidural ; Angina Pectoris* ; Angioplasty ; Arterial Pressure ; Arteries ; Bupivacaine ; Catheters ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass ; Dyspepsia ; Female ; Heart Rate ; Humans ; Middle Aged ; Morphine ; Nitrates

To investigate the effect of tumor removal and administration of OK432 on the splenic natural killer (NK) cell activity in the subcutaneous tumor bearing rats, NK cell activity assay using a 4-hour 51Cr release assay and flow cytometric analysis for NK cell population were performed. The results were as follows: 1. Splenic NK cell activity and population in the subcutaneous tumor bearing rats decreased along with the growth of the tumor. 2. The rats with subcutaneous tumor removal showed decrease of splenic NK cell activity, but splenic NK cell population was not decreased. 3. In the rats with subcutaneous tumor removal and OK432 administration, splenic NK cell activity was significantly increased 1 week after administration of OK432 and then gradually returned to normal, whereas increase of NK cell population was not significant. In the present study, splenic NK cell activity was significantly decreased despite removal of subcutaneous tumor. But with the administration of OK432, splenic NK cell activity returned to normal. Considering the role of NK cells on the first line of defense against the metastatic implantation of circulating tumor emboli, we suggest that perioperative administration of immunopotentiator such as OK432 may improve the patient's outcome after surgery of human neoplasm.
Animals ; Humans ; Killer Cells, Natural* ; Picibanil* ; Rats* ; Spleen

BACKGROUND/AIMS: This study was aimed to examine if FB1 induced-hepatotoxicity involves apoptosis, and cholesteryl hemisuccinate (CS) pre-treatment would selectively interfere with FB1 induced-apoptosis of hepatocytes. METHODS: Sprague-Dawley rats were intravenousely injected with FB1 (1.25 mg/kg/day) for two days, and were sacrificed at 3, 6, 12, 24 and 48 hours after injection. Another experiment group was composed of rats with pretreatment of CS (100 mg/kg/day, i.p.) before FB1 injection. RESULTS: This study demonstrated that administration of hepatotoxic dose of FB1 to Sprague-Dawley rats resulted in liver injury leading to cell death by apoptosis. FB1-induced apoptosis was preceded by early elevation in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and appearance of injured pre-apoptotic cells at 12 hours was followed by massive fragmentation and margination of heterochromatin at 24 hours. CS pre-treatment prior to FB1 injection ameliorated serum biochemistry and hepatic injury with apoptosis, demonstrated by histological, ultrastructural and TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling) methods. In addition, there was remarkable decrease in number of PCNA (proliferative cell nuclear antigen)-positive proliferating hepatocytes compared to that of FB1 treated group. CONCLUSION: This study suggests that apoptosis significantly contributes to FB1-induced hepatotoxicity in vivo, and pre-exposure of rat to CS prevents FB1-induced hepatic apoptosis and proliferation.
Alanine Transaminase ; Animals ; Apoptosis* ; Aspartate Aminotransferases ; Biochemistry ; Cell Death ; Cholesterol ; Hepatocytes* ; Heterochromatin ; In Situ Nick-End Labeling ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley

For the estimation of the proliferative activity, related to the biologic behaviour, malignant potential, and prognosis, of human thyroid tumors, PCNA(proliferating cell nuclear antigen) immunohistochemical staining was performed on paraffin-embedded sections of 9 normal thyroid tissues, 9 adenomatous goiters, 9 follicular adenomas, 4 Hurthle cell tumors, 12 papillary carcinomas, 4 follicular carcinomas, and 3 anaplastic carcinomas. The results were as follows: 1) The PCNA labeling indices in adenomatous goiter, follicular adenoma, and Hurthle cell tumor were 1.1, 1.5, and 2.4, respectively. They were significantly higher than the labeling index in normal thyroid. 2) The PCNA labeling indices in papillary carcinoma and follicular carcinoma were 3.5 and 4.4, respectively. They were significantly higher than the labeling indices in adenomatous goiter and follicular adenoma, but there was no significant difference between papillary and follicular carcinoma. 3) The PCNA labeling index in anaplastic carcinoma, 14.1, was significantly higher than those in benign and other malignant tumors. According to the results, the PCNA labeling index was well correlated with the malignant potential of a tumor. So the PCNA immunohistochemical staining is thought to be a useful method for the evaluation of the malignant potential and prognosis of a tumor.
Humans

Histologic, immunohistochemical and ultrastructural studies were performed on 6 cases of undifferentiated thyroid carcinoma to study the histogenesis of the undifferentiated thyroid carcinoma, to determine the most useful markers for diagnosing these tumors and to investigate the nature of osteoclast-like giant cells rarely observed in these tumors. For the immuno-histochemical study, a panel of antibodies to epithelial (cocktailed keratin, low molecular weight keratin, CEA), mesenchymal(vimentin, desmin, actin, FVIIIRAg) endocrine(calcitonin, chromogranin), lymphocytic(LCA), histiocytic(alpha-l-ACT, alpha-1-AT, lysozyme, CD68), and Schwann cell(S-100 protein) markers were used. The following results were obtained; 1) Well differentiated carcinoma was associated with 2 cases of spindle cell type and 1 case of giant cell type of undifferentiated thyroid carcinoma and a transitional zone between the well differentiated and undifferentiated lesions was observed. 2) All of the examined cases expressed keratin, and 3 tumors expressed CEA. 3) All the mesenchymal markers, LCA, S-100 protein, calcitonin, and chromogranin were not expressed. Vimentin was coexpressed with keratin in 4 cases. 4) Osteoclast-like giant cells were observed in 1 case of spindle cell type. They expressed CD68 but not keratin. 5) Ultrastructural study revealed the desmosomes between the tumor cells and non-neoplastic, follicular, thyroid epithelial cells. The above results indicate that undifferentiated thyroid carcinoma originates from follicular epithelial cell, keratin is the most useful marker for diagnosis of this tumor, and the osteoclast-like giant cells are histiocytic in nature and reactive, rather than neoplastic.