BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

No abstract available.
Kidney Transplantation* ; Pregnancy*

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.
Administration, Oral ; Cell Count ; Dihydrotestosterone* ; Epithelial Cells ; Humans ; Hyperplasia ; Immunoblotting ; Male ; Neuroendocrine Cells* ; Phosphopyruvate Hydratase ; Prostate ; Prostatic Hyperplasia*

Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.
Adult ; Early Diagnosis ; Humans ; Male ; Megacolon ; Multiple Endocrine Neoplasia* ; Neuroma* ; Pheochromocytoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragonimiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax(20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary paragonimiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.
Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Paragonimiasis* ; Pleural Effusion ; Radiography ; Radiography, Thoracic ; Rare Diseases ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Calcinosis cutis may occur when connective tissue is abnormal (dystrophic), or where calcium or phosphate levels in the blood are high(metastatic); alternatively, there may be no obvious underlying cause(idiopathic). The exact incidence of calcinosis cutis in dermatologic patients is not well-kniown and the pathomechanism of it remains to be elucidated. OBJECTIVE: This study was performed to analyze the incidence, clinical and histopathological features of calcinosis cutis. METHODS: We studied 72 patients with calcinosis cutis who visited our department between January 1985 and December 1996. The patients were classified into 3 types (dystrophic, metastatic, and idiopathic) and were analyzed clinically and histopathologically. Results : The results were summerized as follows; 1. There were 60 cases(83.3%) and 12 cases(16.7%) of the dystrophic and idiopathic types, respectively but the metastatic type was not observed. The frequency of dystrophic calcification in individual disorders was 88.2% in pseudoxanthoma elasticum, 66.7% in trichilemmal cyst and dermatomyositis, and 64.6% in pilomatrichoma. 2. In the idiopathic type, it was common in females aged over 50 years and the mean duration of lesions was 2.8+/-2.0 years. The predilection site was the flank(5 cases) and most of the lesions(7 cases) showed skin-colored nodules 3. Histopathologically, calcified material of the idiopathic type was located predominently in the dermis(10 cases) and was present as large masses surrounded by a foreign body reaction. 4. In the dystrophic type, calcified deposits were noted predominently within the shadow cells of pilomatricoma, in the degenerated elastic fibers of pseudoxanthoma elasticum, and in the keratinized area of basal cell carcinoma, squamous cell carcinoma, trichilemmal cyst, and epidermal cyst. Foreign body reactions with giant cells and mononuclear cell infiltrations were often found around large deposits of calcium. Conclusion : The incidence of calcinosis cutis in dermatologic patients is relatively low, but a variety of disorders can be associated with cutaneous calcification. Therefore, dermatologists should be familiar with the different forms of cutaneous calcification and the dermatoses that manifest them.
Calcinosis* ; Calcium ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Connective Tissue ; Dermatomyositis ; Elastic Tissue ; Epidermal Cyst ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Humans ; Incidence ; Pilomatrixoma ; Pseudoxanthoma Elasticum ; Skin Diseases

No abstract available.
Reference Values*

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

BACKGROUND: It seems that herpes zoster is caused by reactivation of the varicella-zoster virus and its incidence is increasing. The reactivation of the varicella zoster virus is thought to be associated with the disturbance of the state of immunity in patients with herpes zoster. OBJECTIVE: The purpose of this study was to elucidate the state of immunity in patients with herpes zoster in its acute phase(less than 7 days). METHODS: 1. Thirty patients with acute phase herpes zoster matched by age and sex against a control group, were checked for Helper/Inducer T cell(CD4), Suppressor/Cytotoxic T cell(CD8), NK cell, B cell and activated T cell by three color flow cytometric analysis. 2. Forty patients with herpes zoster measured delayed cutaneous hypersensitivity by means of Multitest' CMI. 3. Thirty patients with herpes zoster measured Ig G, M, A by means of N-antisera method.
Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Hypersensitivity ; Immunity, Cellular ; Immunity, Humoral* ; Incidence ; Killer Cells, Natural

BACKGROUND: Mycosis fungoides(MF) is a form of cutaneous T cell lymphoma with clonal differentiation of helpr' T cell. It has a patch, plaque, and tumor stage. But pathogenetic factors controlling the development and progression of MF are still unclear. Apoptosis plays a major role in developmental biology and homeostasis. The bcl-2 oncogene prolongs ce11 life by inhibiting apoptosis. The mutant pS3 gene induces apoptosis indirectly. Ki-67 antigen is the cell proliferation marker. Recently, it has been shown that the relationships among them are important in the tumorigenesis of the various tumors. OBJECTIVE: The aim of this study was to examine the expression of these genes and apoptotic rate and clarify the relationship among them in the development and progression of MF. METHODS: The eighteen specimens from 8 patients with MF and 10 specimens from benign lymphocytic infiltrating diseases including 5 lichen planus, 3 lupus erythematosus, and 2 contact dermatitis were included. We performed immunoperoxidase staining(LSAB technique) using monoclonal antibodies including bc1-2, p~53, and Ki-67(MIB1). We used ApoptaqTM(Oncor) in situ labelling kit for detecting apoptotic cell.
Antibodies, Monoclonal ; Apoptosis* ; Carcinogenesis ; Cell Proliferation ; Dermatitis, Contact ; Developmental Biology ; Homeostasis ; Humans ; Ki-67 Antigen ; Lichen Planus ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Oncogenes