No abstract available.
Humans ; Urinary Retention*

Craniosynostosis has a varied clinical spectrum, ranging from isolated single suture involvement to multi-sutural fusions. Greater understanding of the pathogenesis of craniosynostosis has led to the development of practical treatment protocols. Three stages of growth have determined the approach to managing craniosynostosis : the early period, up to 12 months; the intermediate period, from 1 to 10 years; and the late period, beginning at 10 years. This review discusses current surgical management and future perspectives in craniosynostosis.
Clinical Protocols ; Craniosynostoses* ; Neurosurgery ; Sutures

Tularemia is a zoonosis caused by Francisella tularensis. It is primarily a disease of wild animals. Human infection is incidental and usually results from interaction with biting or blood-sucking insects, wild or domestic animals, or the environment. An increasing number of cases have been reported in several countries. However, in Korea it has not been reported until now. A 40-year old male patient visited our department on Jan 13, 1997, complaining of multiple swollen lymph-nodes on his axillae and reddish swollen left upper arm which contained an abscess at its central portion for about ten days. On Dec 25, 1996, he found a dead wild rabbit on a nearby mountainside, ate it after cooking it by himself with his hands injured. His abscess was drained and microbiologic examination was done. However no microorganism was isolated. His lymph nodes were surgically removed from both axillae, and we investigated them microbiologically and pathologically. On microbiologic examination, small aerobic gram negative coccobacilli were grown on a chocolate agar plate in an aerobic condition with 5% CO2 at 37 degrees centigrade. On H & E staining, the lymph node showed chronic granulomatous inflammation. We sent the microorganism and lymph nodes to the Centers for Disease Control and Prevention in the United States of America for the definitive diagnosis. Finally the microorganism was identified as F. tularensis by culture morphology, biological tests and immunohistochemical staining. We report the first case of F. tularensis in Korea.
Abscess ; Adult ; Agar ; Americas ; Animals ; Animals, Domestic ; Animals, Wild ; Arm ; Axilla ; Cacao ; Centers for Disease Control and Prevention (U.S.) ; Cooking ; Diagnosis ; Francisella tularensis ; Hand ; Humans ; Inflammation ; Insects ; Korea ; Lymph Nodes ; Male ; Tularemia* ; United States

PURPOSE: Hepatocellular carcinomas (HCC) are one of the most common cancers in Korea. The mechanism of HCC development is still unclear, and the aberration of the tumor suppressor genes in HCC remains to be clarified. MATERIALS AND METHODS: To study the expressions of p53 and Rb protein, and their correlation with the clinicopathological parameters in HCC, 68 patients, with surgically resected hepatocellular carcinomas, were analyzed by an immunohistochemical method. The expressions of p53 and Rb protein were classified into three categorizes, depending on the percentage of stained cells. RESULTS: The expression of the p53 protein was 51.5% (35/68), and was significantly correlated with differentiation (p<0.05). The altered Rb protein expression was 72.2% (49/68). The expressions of p53 and altered Rb protein had no significant correlation with the tumor size, gender, WHO histological pattern, cirrhosis or vascular invasion (p>0.05). There was a positive correlation between p53 and Rb protein overexpression (p<0.05). The expressions of p53 and Rb protein had correlation with the Ki-67 labeling index (p<0.05). CONCLUSION: These findings suggest the aberrant expressions of p53 and Rb protein may play a role in the progression and carcinogenesis of HCC.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Fibrosis ; Genes, Tumor Suppressor ; Humans ; Korea ; Retinoblastoma Protein*

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

Carcinoma Showing Thymus-Like Differentiation (CASTLE) is a rare tumor, which occurs in the thyroid gland and surrounding soft tissue, or soft tissue of the neck. It is thought to originate from ectopic thymus or branchial pouch remnants. We report a case of CASTLE of the thyroid gland in a 42-year-old woman. Grossly, a nodular, partly well demarcated, grayish yellow, 3.0 2.0 cm sized, solid mass was found in the right thyroid gland. Microscopically, the tumor was divided into lobules of variable size and shape, nests and cords with thin and thick fibrous septa which were infiltrated by lymphocytes and plasma cells. The tumor cells were large, polygonal and had vesicular nuclei with prominent nucleoli and eosinophilic cytoplasm. Some cells, especially in the central portion of the nests had abundant eosinophilic cytoplasm and showed squamoid feature.
Adult ; Cytoplasm ; Eosinophils ; Female ; Humans ; Lymphocytes ; Neck ; Plasma Cells ; Thymus Gland ; Thyroid Gland*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

We report two cases of biliary papillomatosis, a rare disease which is characterized by multiple, papillary adenomas of the intrahepatic and/or extrahepatic bile ducts. Cases 1 and 2 were a 45-year-old woman and a 61-year-old woman, respectively, with upper abdominal pain. Abdominal computed tomography scan of case 1 revealed a 4-cm sized cystic and solid mass within the dilatated intrahepatic bile duct. Hepatobiliary ultrasonography of case 2 showed dilatation of the main intrahepatic and common bile duct with nonshadowing echogenic material. Soft, friable papillary masses were noted grossly in the dilated intrahepatic bile duct. Microscopically, the tumor was composed of papillary structures, most of which were lined by a layer of tall columnar cells. Complex papillary fronds with pseudostratification, cellular atypia, structural atypia and foci of invasion were noted in case 2. The p53 expression increased in the dysplastic and carcinomatous area and was correlated with the Ki-67 labeling index.
Abdominal Pain ; Adenocarcinoma ; Adenoma ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Common Bile Duct ; Dilatation ; Female ; Humans ; Liver ; Middle Aged ; Papilloma* ; Rare Diseases ; Ultrasonography

BACKGROUND: The development and progression of a tumor can be determined by a complex multistep process involving the activation of oncogenes and the inactivation of tumor suppressor genes. The purpose of this study is to investigate the expression of p53, Rb, bcl-2 protein and Ki-67 labeling index in the intrahepatic cholangiocarcinoma. METHODS: We analyzed 36 cases of intrahepatic cholangiocarcinoma obtained by surgical resection. Expression of p53, Rb, bcl-2 proteins and Ki-67 labeling index were evaluated by immunohistochemical study. RESULTS: Expression of p53 protein was detected in 61.1% (22/36) of cholangiocarcinoma. Rb protein loss and overexpression were observed 27.8% (7/36) and 72.2% (29/36) of cholangiocarcinoma. But bcl-2 protein was not expressed. No significant correlation was found between p53, Rb and bcl-2 protein expression and age, sex, gross type, histologic grade, vascular invasion and lymph node metastases. The Ki-67 labeling index was significantly higher in p53 positive group and Rb overexpression group than in p53 negative group (p<0.01) and Rb loss group (p<0.05). There was a positive correlation between p53 protein and Rb protein expressions, but a negative correlation between Rb protein and bcl-2 protein expressions. CONCLUSIONS: The overexpression of p53 protein and Rb protein may be closely associated with cholangiocarcinogenesis, while bcl-2 has a less crucial role in cholangiocarcinogenesis.
Cholangiocarcinoma* ; Genes, Tumor Suppressor ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Retinoblastoma Protein