The Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) is an autosomal dominant disorder of blood vessels associated with mucocutaneous telangiectasis and arterivenous malformations in several organs. A pulmonary arteriovenous fistulae can cause hypoxemia, hemoptysis, polycythemia and clubbing. However the condition is often not recognized until the 3rd decade of life. The authors report a case of a 28-year-old male patient who had been suffering from telangiectasis of the upper lip and upper portion of the chin and unexpedly became undersaturated of hemoglobin through general anesthesia during an operation of the upper lip lesion.
Adult ; Anesthesia, General ; Anoxia ; Arteriovenous Fistula ; Blood Vessels ; Chin ; Hemoptysis ; Humans ; Lip ; Male ; Polycythemia ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

Expression of the nm23 and E-cadherin proteins has been studied in a number of tumors. Reduced expression of the nm23 and E-cadherin proteins seems to be associated with metastasis or disease progression in some tumors, including breast carcinoma. To assess the role of nm23 and E-cadherin in tumor differentiation and metastasis of breast carcinoma, immunohistochemical staining for the nm23 and E-cadherin proteins was performed in paraffin embedded tumor samples from 86 breast carcinomas. The results were as follows: 1) Expression of the nm23 protein in breast carcinoma was strong positive in 32 cases (37.2%), weak positive in 26 cases (30.2%), and negative in 28 cases (32.6%) of the cases. Expression of the nm23 protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 2) Expression of the E-cadherin protein in breast carcinoma was strong positive in 50 cases (58.1%), weak positive in 24 cases (27.9%), and negative in 12 cases (14%) of the cases. Expression of the E-cadherin protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 3) There was a statistically significant correlation between the expression of the nm23 protein and the E-cadherin protein in breast carcinoma (p<0.05). These results suggest that the expression of the nm23 and E-cadherin proteins is related to tumor differentiation, and may also be an useful prognostic factor in breast carcinoma.
Breast Neoplasms* ; Breast* ; Cadherins* ; Disease Progression ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

A case of invasive cribriform carcinoma of the breast is presented with fine need- le aspiration cytologic features. The aspiration was performed from a papable 2.0cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth. No discernible nucleoli were present (nuclear grade 1-2). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.
Female ; Humans ; Biopsy

Endodermal sinus tumor of the mediastinum is a very rare malignant tumor, usually affecting young adolescents, and its histologic findings are characteristic as that of gonadal germ cell origin. We describe the cytologic finding of fine needle aspiration of mediastinal endodermal sinus tumor in a 19-year-old male patient, comparing with tissue section. The tumor cells in smears were usually in tight clusters with large overlapping cells, which were arranged in a papillary or microacinar pattern, suggesting carcinoma. The tumor cells were large, round or oval with a small amount of cytoplasm which was occasionally vacuolated and had indistinct border. The nuclei were large, pleomorphic, and vesicular with large promi- nent nucleoli. The tissue sections showed typical findings of endodermal sinus tumor. Careful correlation of cytological findings and the serum alpha-fetoprotein level would be helpful to confirm the diagnosis.
Adolescent ; alpha-Fetoproteins ; Biopsy, Fine-Needle ; Biopsy, Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Clonorchiasis ; Cytoplasm ; Diagnosis ; Dietary Proteins* ; Endodermal Sinus Tumor ; Female ; Germ Cells ; Giant Cells ; Gonads ; Humans ; Kidney Failure, Chronic* ; Male ; Mediastinum ; Middle Aged ; Thyroid Gland ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux* ; Young Adult

So-called sclerosing hemangioma of the lung is a rare benign neoplasm which usually presents with a coin lesion detected through routine chest X-ray. We report two cases showing characteristic cytologic appearances which have been rarely reported. Both cases were young females with coin lesions in the lung. Fine needle aspiration of each case revealed unique but some different cytologic features. Case 1 showed bland-looking polygonal epithelial cells resembling bronchioloalveolar cells having pre- dominantly papillary configurations with loosely arranged solid sheets or isolated cells. Cytoplasms were plump, cyanophilic, and finely granular, with eccentric nuclei, The nuclei were usually monotonous, round-to-ovoid, and vesicular with a small but conspicuous nucleolus. In comparison to case 1, case 2 revealed largely loose pavement-like solid sheets or clusters rather than papillary patterns in the hemorrhagic background. The size of tumor cells were a little smaller than that of case 1. Bronchioloalveolar carcinoma and papillary adenocarcinoma of metastatic origin were considered to be one of the important differential diagnoses with these cytologic features. Histologically, both cases exhibited findings compatible with so-called sclerosing hemangioma of the lung.
Adenocarcinoma, Bronchiolo-Alveolar ; Adenocarcinoma, Papillary ; Biopsy, Fine-Needle ; Cytoplasm ; Diagnosis, Differential ; Epithelial Cells ; Female ; Humans ; Kidney* ; Lung ; Numismatics ; Pulmonary Sclerosing Hemangioma ; Renal Insufficiency* ; Thorax

Forty five cases of adult tibial shaft fractures were treated with flexible intramedullary nails under image intensifier at the department of orthopaedic surgery, Capital Armed Forces General Hospital during between April 1986 to July 1988. The results were summarized as follows: 1. 45 cases were all male, the average age was 24.3 years and the most common cause of fractures was sports injury(20 cases) and the second most common cause was traffic accident(18 cases). 2. 11 cases out of 45 cases were open fracture and 34 cases were closed fracture. Eight cases of open fraeture were grade I and three cases were grade II. Twenty eight cases were comminuted fracture. The most common level of the fracture was middle third of the tibial shaft. 3. Average interval from injury to Ender nailing was 13.5 days and the mean duration of permission to full weight bearing was 9.2 weeks. 4. Out of 2 cases of delayed union, the average time of clinical bone union was 9.7 weeks and that of roentgenological bone union was 14 weeks. 5. 11 cases of complication were noted among the 45 cases of tibial shaft fracture which were treated by PGP nailing such as angulation, rotation, ankle joint stiffness, delayed union, shortening, and soft tissue infection. 6. PGP nailing is considered to be a valuable method in treating tibial shaft fracture because of their relative ease of nailing, allowing early weight bearing and decreased complication.
Adult ; Ankle Joint ; Arm ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Soft Tissue Infections ; Sports ; Tibial Fractures ; Weight-Bearing

BACKGROUND: Many physiologic, pharmacologic and immunologic abnormalities were reported in atopic dermatitis but the cause and pathogenesis of the disease remain obscure. OBJECTIVE: This study was done to investigate the systemic immunologic abnormalities in atopic dermatitis. METHOD: To evaluate the cell mediated immunity, me quantified pei ipheral blood T lymphocytes and their subsets, using flow cytometery, and assessed plasma neopteiin levels by means of radioimmunoassay. To evaluate the abnormal humoral immunity, we assessed the serum IgE levels by means of enzyme-immunoassay. RESULTS: Mean proportions of peripheral blood T lymphocytes and, heir subsets in atopic Dermatitis patients were within normal limits. Hut the suppvessor/cytotoxic T lyrphocytes(T8) were significantly decreased in the group of se"ere atopic dermatitis compared with the group of mild atopic dermatitis(P<0.05). Plasma neopterin lervels in the group of atopic dermatitis were found to be significantly elevated as compared vith the control group(P<0.01), but no significant cifference was found between the mild and severe group of atcpic dermatitis(P>0.05). Mean serum IgE levels in the patients with atopic dermatitis were higher than reference value. But there was no significant difference between the mild and severe atopic dermatitis group. Serum IgE levels ivere negatiiely correlated with T8(r=-0.3774, P<0.05) and positively with T4/T8 ratio(r =0.5007, P<0.05). Conclusions : These data;uggest that the atopic der matitis has abr ormalities in cell mediated immunity as well as elevated IgE level.
Dermatitis, Atopic* ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin E ; Neopterin* ; Plasma* ; Radioimmunoassay ; Reference Values ; T-Lymphocyte Subsets* ; T-Lymphocytes

PURPOSE: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. MATERIALS AND METHODS: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were an lysed with non-parameteric statistics method. RESULTS: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced . In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. CONCLUSION: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
Blood Platelets* ; Bone Density ; Bone Resorption ; Bone Transplantation ; Dental Enamel ; Dental Implantation ; Dental Implants ; Humans ; Inlays ; Maxillary Sinus ; Osteogenesis ; Platelet-Rich Plasma ; Tooth ; Transplants

We experienced an autopsy case of esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies in a 4 days old male infant. Esophageal atresia with tracheoesophageal fistula was type C by Gross Classification. Combined anomalies were malrotation of left kidney, one left accessory renal artery form right renal artery and one left accessory renal vein from right renal vein, duodenal atresia and annular pancreas. Until now, the esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies (7 congenital anomalies) are not reported in the korean literature, except our case. Our autopsy case, it suggests that esophageal atresia with tracheoesophageal fistula has often close relation-ship with other multiple congenital anomalies.
Infant ; Male ; Female ; Humans

Intracranial teratomas which were first described by Maier in 1861 are uncommon. Those presenting at birth are very rare and in our knowledge no case has been reported in Korea. In November, 1988, we experience a case of congenital intracrainal teratoma which replaced almost all cerebral tissue, filled out the oral cavity, and was protruded from the mouth. A female fetus was artificially delivered by a 25-year-old primigravida at 22 weeks of gestation, because of marked hydramnios and fetal hydrocephalus which were detected by prenatal ultrasonography. Microscopically, tissues from all three germ layers, including a lot of neuroepithelim and primitive mesenchymal tissue, were shown. A brief review of the literature was done.
Female ; Humans