Cancrum oris is a kind of gangrenous disease happening on the maxillofacial region. It is characterized by developing rapidly, high lethality and deforming rate. This article reported a case of maxillofacial deformity caused by cancrum oris, and discussed based on relevant literatures.
Humans ; Maxilla ; pathology ; Noma

PURPOSE: Sulphomucin is secreted by immature foveolar cells of the stomach and is expressed in gastric adenocarcinomas. Carcinoembryonic antigen (CEA) is well known to be expressed in gastric adenocarci nomas and is correlated with the cellular differentiation of gastric adenocarcinomas. However, at the moment, there are no conclusions about the relationships between the expression of sulphomucin and pathological classifications. METHODS: This study was designed to determine the significance of expression of sulphomucin and CEA in advanced gastric adenocarcinomas. Also, these two factors were compared with established clinicopathological prognostic factors. Thirty-two paraffin-embedded surgical specimens of gastric adenocarcinomas were obtained from January 1993 to December 1995 and were selected for study. The expressions of sulphomucin and CEA were studied by using the Spicer method and immunohistochemical staining with CEA 2-7 monoclonal antibody. RESULTS: The expressions of sulphomucin and CEA were positive in 9 (28%) cases and 25 (78%) cases, respectively. There was a significant correlation between sulphomucin expression and histologic differentiation (p<0.05). However, the expression of CEA was correlated with neither clinopathological factors nor sulphomucin expression. CONCLUSION: These results suggest that expressions of sulphomucin are well correlated with cellular differentiations of advanced gastric adenocarcinomas.
Adenocarcinoma* ; Carcinoembryonic Antigen ; Classification ; Noma ; Stomach

PURPOSE: Sulphomucin is secreted by immature foveolar cells of the stomach and is expressed in gastric adenocarcinomas. Carcinoembryonic antigen (CEA) is well known to be expressed in gastric adenocarci nomas and is correlated with the cellular differentiation of gastric adenocarcinomas. However, at the moment, there are no conclusions about the relationships between the expression of sulphomucin and pathological classifications. METHODS: This study was designed to determine the significance of expression of sulphomucin and CEA in advanced gastric adenocarcinomas. Also, these two factors were compared with established clinicopathological prognostic factors. Thirty-two paraffin-embedded surgical specimens of gastric adenocarcinomas were obtained from January 1993 to December 1995 and were selected for study. The expressions of sulphomucin and CEA were studied by using the Spicer method and immunohistochemical staining with CEA 2-7 monoclonal antibody. RESULTS: The expressions of sulphomucin and CEA were positive in 9 (28%) cases and 25 (78%) cases, respectively. There was a significant correlation between sulphomucin expression and histologic differentiation (p<0.05). However, the expression of CEA was correlated with neither clinopathological factors nor sulphomucin expression. CONCLUSION: These results suggest that expressions of sulphomucin are well correlated with cellular differentiations of advanced gastric adenocarcinomas.
Adenocarcinoma* ; Carcinoembryonic Antigen ; Classification ; Noma ; Stomach

Congenital macrostomia is a result of defective union between the mandibular and maxillary processes and it is a rare deformity seen in every 100 to 300 facial clefts. Ohnizuka1`classified macrostomia into two groups as congenital and posttraumatic. We experienced two cases of acquired macrostomia due to NOMA sequelae(58/F:Lt & 51/F:Rt) and one case of congenital macrostomia (3 months/M:Rt). Many plastic surgeons have developed surgical procedures for repair of this congenital macrostomia. Among them, McCarthy6,11 described the classic commissuroplasty. We could repaired 1 case of congenital macrostomia and two cases of acquired macrostomia due to NOMA sequelae using modified technique of McCarthy,s classic commissuroplasty. McCarthy described new oral commissure 2-3mm laterally for prevention of postoperative contraction, orbicularis oris muscle transposition to restore labial function and a z- plasty cutaneous closure. But some author raise an objection to new oral commissure 2-3mm laterally, and they made new oral commissure at same distance of opposite side normal commissure. And so, we designed the new oral commissure moved 1mm laterally comparing to original commissuroplasty in a congenital case for the prevention of displacement. In cases of acquired macrostomia due to NOMA sequelae, we reconstructed new oral commissure like congenital case, moved 1mm laterally. Orbicularis oris muscle transposition could not be possible because of destruction of muscle, adhesion and atrophy. And so we dissected muscle and just sutured side by side. Acquired macrostomia following NOMA sequelae manifsted facial deformity variably, and reconstruction of the facial deformity is difficult by using simple approach. Other variable reconstructive procedures were needed with commissuroplasty as like Washio flap, rotation advancement flap, bone graft and free radial forarm flap, etc. Postoperative results were relatively good. We propose that macrostomia due to NOMA sequelae must add to Ohnizuka classification of acquired macrostomia.
Atrophy ; Classification ; Congenital Abnormalities ; Macrostomia* ; Noma ; Transplants

BACKGROUND: There is considerable experimental evidence to indicate that tumor growth is dependent on angiogenesis. To investigate how tumor angiogenesis correlates with clinical factors and prognosis in breast carcinoma, we counted microvessels (capillaries and venules) and graded the density of micro vessels within the invasive ductal carcinomas of 59 patients. METHODS: Using light microscopy, we highlighted the vessels by staining their endothelial cells immu nohistochemically for rabbit antihuman factor-VIII related antigen (Dako L1809, USA). The microvessels were carefully counted (per 200 field) in the most active areas of neovascularization without knowledge of either the outcome in the patient or the clinical variables. RESULTS: The mean age was 47.8 years. There was no statistical correlation between angiogenesis and either estrogen receptor status or age. However, there was a statistical correlation with tumor size (p< or =0.05). There was a statistical difference between lymph-node-metastasis positive group and negative group (p= 0.006). Angiogenesis correlated statistically with TMN stage (microvessels count:stage I= 31.27, stage II= 40.74, and stage III= 78.9)(p= 0.001). There was a statistical correction between angiogenesis and follow-up results (microvessels counts:disease free group= 42.11, living metastatic group= 63.64, and expired group= 73.60)(p= 0.031). CONCLUSIONS: In this study, the degree of angiogenesis (the number of microvessels per 200 field in the area of most intensive neovascularization) may have a predictive value in invasive breast carci nomas. Therefore, assessment of tumor angiogenesis may give us useful information for selecting thera peutic and follow-up plan for patients with breast carcinomas.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Endothelial Cells ; Estrogens ; Follow-Up Studies ; Humans ; Microscopy ; Microvessels ; Noma ; Prognosis

Acquired facial deformities following cancrum oris sequelae manifested variably according to the nature of tissue necrosis. In cases that tissue loss extends over a wide area of the face, or the tissue nature is different due to congenital facial cleft, it is difficult to reconstruct with a single operation. As cancrum oris has virtually disappeared from our country, clinical report of reconstruction is also rare. We report 5 cases of facial deformities following cancrum oris sequelae. Since 1988, five adult patients(4 female and 1 male) were treated by authors. These patients, with an age ranged from 47 to 58 years, all suffered from acquired facial cleft such as facial mutilation, asymmetry. The stages of operation were from 1 to maximum of 5 operations. All surgeries achieved satisfactory results after a long-term follow-up. But one surgery in the case of palatal mucosal flap for the coverage of reconstructed maxilla alveolar bone resulted tissue sloughness, followed by osteomyelitis. Those were debrided and discarded. In conclusion, all sites of deformities were positioned around one of the oral commissures. In their past medical history, they have been suffering from measles, typhoid fever and unknown febrile illness. We diagnosed the acquired facial deformity following cancrum oris sequelae. The reconstruction of acquired facial deformity following cancrum oris sequelae were difficult due to extensive multiple tissue defects. Therefore multiple staged operations were inevitable. The authors reconstructed 5 cases of simple and complex form of facial deformity with minimum staged\ operations. All patients were satisfied functionally and cosmetically.
Adult ; Congenital Abnormalities* ; Female ; Follow-Up Studies ; Humans ; Maxilla ; Measles ; Necrosis ; Noma* ; Osteomyelitis ; Typhoid Fever

PURPOSE: A pancreaticoduodenectomy is the procedure of choice for patients with resectable carci nomas of the pancreatic head, duodenum, or periampullary region. Although the morbity and the mortality are decreasing now, but there are still high. Leakage of the pancreatic duct remains the major source of death and complications after a pancreaticoduodenectomy. Thus, the authors used a stented pancrea ticojejunostomy and jejunojejunostomy after a pancreaticoduodenectomy to decrease leakage of the pancreatic duct. METHODS: The authors studied retrospectively 44 consecutive patients who had a pancrea ticoduodenectomy with a stented pancreaticojejunostomy and jejunojejunostomy at Kwangju Christian Hospital between 1993 and 1998. RESULTS: Leakage of the pancreaticojejunostomy was diagnosed in one of the 44 patients (2.5%). There were two deaths after the pancreaticoduodenectomy, one from compli cation of leakage of the pancreaticojejunostomy and the other from UGI bleeding. CONCLUSION: The stented pancreaticojejunostomy and jejunojejunostomy is an effective and safe method for use with a pancreaticoduodenectomy. However, the leakage that might occur despite the stented pancreaticojeju nostomy and jejunojejunostomy can be managed less invasively.
Duodenum ; Gwangju ; Head ; Hemorrhage ; Humans ; Mortality ; Noma ; Pancreatic Ducts ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy* ; Retrospective Studies ; Stents*

Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.
Breast* ; Carcinoma, Papillary ; Epithelial Cells ; Macrophages ; Metaplasia ; Needles ; Noma ; Papilloma ; Papilloma, Intraductal ; Retrospective Studies

The purpose of this study is to analyze the cariogenicity of vitamin supplements for children by the Caries Potentiality Index (CPI), pH drop capacity, proliferation rate of Streptococcus mutans.Four vitamin supplements were selected - Noma (NM), Cenovis Kids (CK), Animal Parade (AP), and Character Vitamin (CV).CPI value decreased in the order of AP, CV, CK, and NM. Initial values of all experimental groups showed acidity below pH 7.0. Analysis of the colony forming units of Streptococcus mutans showed that NM and CV resulted a higher proliferation rate (p < 0.05) than CK and AP (p < 0.05). Bacterial activity of the control group was lower than other groups when observed with a confocal laser scanning microscope.Considering the bacterial activity and acidity of vitamin supplements, it is necessary to pay close attention when children taken the vitamin supplements for their oral health.
Animals ; Biofilms ; Child ; Humans ; Hydrogen-Ion Concentration ; Noma ; Oral Health ; Stem Cells ; Streptococcus mutans ; Vitamins

BACKGROUND: Activation of the K-ras oncogene by specific point mutations at codon 12 occurs at a remarkably high frequency in pancreatic adenocarcinomas. Also, inactivation of the p53 suppressor gene function in pancreatic adenocarcinomas leads to the loss of cellular proliferation regulation and to the induction of cell death. Though K-ras mutation and inactivation of the p53 suppresser gene have been considered to be events in the oncogenesis of a pancreatic adenocarcinoma, whether their association with differences or survival in pancreatic adenocarcinoma is controversial. We investigated the presence of K-ras mutation and overexpression of p53 protein in the carcinogenesis of a pancreatic adenocarcinoma. Also, their correlations with tumor grade, stage, and survival were investigated. METHODS: We examined surgically resected, formalin-fixed, paraffin-embedded pancreatic adenocarci nomas from 48 patients. By using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), we detected a K-ras oncogene mutation at codon 12. An overexpression of p53 protein was detected by using an immunohistochemical staining (IHC) method with anti-p53 monoclonal antibody. RESULTS: K-ras oncogene mutation at codon 12 was detected in 64.6% of the cases and p53 protein was overexpressed in 47.9%. Both K-ras oncogene mutation and p53 protein overexpression were detected in 29.2% of the cases. There was no correlation between the rate of K-ras mutation and tumor grade, T category (tumor size or depth of invasion), N category (lymph-node metastasis) and clinical stage. Also, K-ras mutation was not correlated with the survival rate. A positive correlation between p53 protein overexpression and clinical stage was found (p<0.05). The patients with p53 protein overexpression had a shorter survival than the patients without p53 protein overexpression (p>0.05). CONCLUSION: The mutation of the K-ras oncogene and p53 suppresser gene might play an important role in pancreatic carcinogenesis. However, the mutation of the K-ras oncogene is not thought to be related to the progression of a pancreatic adenocarcinoma and the corresponding survival rate. It is suggested that overexpression of the p53 protein seems to be associated with the progression of pancreatic adenocarcinoma.
Adenocarcinoma* ; Carcinogenesis ; Cell Death ; Cell Proliferation ; Codon ; Genes, ras ; Genes, Suppressor ; Humans ; Noma ; Point Mutation ; Prognosis ; Survival Rate