The osteochondroma is a common benign tumor with osteocartilaginous exostosis. It may arise from any bone, but is observed most often on long tubular bones, particularly on their metaphyseal region. Osteochondroma may also arise from the rib but seldom grow to giant size. We experienced a rare case of giant osteochondroma arising from the left 5th rib. The patient, 41 years old man, had an adult fist sized mass on the left lower chest with mild aching pain on respiration. The large mass was examined by biopsy. It showed characteristic microscopic findings of osteochondroma. No evidence of malignant change was seen in this large tumor.
Adult ; Biopsy ; Humans ; Osteochondroma ; Respiration ; Ribs ; Thorax

No abstract available.
Diagnosis* ; Echocardiography*

This is a clinical analysis of 48 patients who had tuberculous peritonitis laparoscopically confirmed at the Gastroenterologic Department of the Korea University Hae Wha Hospital from March 1980 to February 1988, and the results are as fallows: 1) The ratio of male to female was 1:1.7, and the age of the peak incidence was the third decade. 2) The freqeent symptoms were abdominal distension (77.1%), abdominal pain (60.4%), and fever (60.4%); others were indigestion (27.1%), diarrhea (18.8%), weight loss (6.3%), abdominal mass (6.3%), vomiting (6.3%), and dysmenorrhea (2.1%). The freguent physical signs were ascites (93.8%) and abdominal tenderness (45.8%); others were palpable mass (8.3%), hepatomegaly (8.3%), and mild jaundice (4,2%). 3) Hematologic findings in mean value revealed 11.8 g/m% in hemoglobin, 6088/mm in WBC, and 36 mm/hour in ESR, 4) Ascitic analysis revealed 1,031 in specific gravity, 5.2% in protein, and 1700/mm in WBC count with lymphocytic predominance (83%). AFB stain and culture were all negative in the specimens less than 20 ml. 5) On chest X-ray, pulmonary Tuberculosis or associated lesions were noted in 19 patients (39.6%). 6) Studded whitish miliary tubercle, omental change, ad adhesions were noted in a mixed nature. 7) Classifications according to laparoscopic finding revealed wet type in 28 patients (58.3%), mixed type in 13 patients (27.1%), and dry type in 7 patients (14.6%); and laparoscopic type was not related with the duration of symptom up to admission. 8) Microscopic finding of biopsy specimens revealed caseous necrosis or granuloma in 43 patient (89.6%) and nonspecific inflammation in 5 patients. In these 5 patients, characteristic gross findings of tuberculous peritionitis were noted. 9) Intestinal perforation was developed in 2 patients.
Abdominal Pain ; Ascites ; Biopsy ; Classification ; Diarrhea ; Dysmenorrhea ; Dyspepsia ; Female ; Fever ; Granuloma ; Hepatomegaly ; Humans ; Incidence ; Inflammation ; Intestinal Perforation ; Jaundice ; Korea ; Male ; Necrosis ; Peritonitis, Tuberculous* ; Specific Gravity ; Thorax ; Tuberculosis, Pulmonary ; Vomiting ; Weight Loss

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

No abstract available.
Congenital Abnormalities*

Klippel-Trenaunay-Weber syndrome(KTWS) is a rare, and sporadically occurring disorder characterized by hemihypertrophy(unilateral limb hypertrophy), varicose veins, hemangiomas and occasionally arteriovenous malformations. In 1900, noted French physicians Klippel and Trenaunay first described the syndrome in 2 patients presenting with port-wine stains and varicosities of extremities associated with hypertrophy of the affected limb's bones and soft tissues. There are other, and less frequent abnormalities. These may include limbs that are atrophic, fingers and toes that are disproportionately large or small, digits that are webbed(syndactyly), and too many digits(polydactyly), or too few digits(oligodactyly). The hemangiomas can occur in internal organs including the intestinal and the urinary tract systems. The exact cause of KTWS remains to be elucidated, although several theories exist. Most cases are sporadic, although a few cases in the literature report a multifactorial patterns of inheritance. We report a case of Klippel-Trenaunay-Weber syndrome in a 3-year-old boy who had hypertrophy of the left facial bones and tissues, large hemangiomas on the right trunk and back, and hypertrophy of the right upper and lower limb's soft tissues.
Arteriovenous Malformations ; Child, Preschool ; Extremities ; Facial Bones ; Fingers ; Hemangioma ; Humans ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome* ; Male ; Malformations of Cortical Development* ; Port-Wine Stain ; Toes ; Urinary Tract ; Varicose Veins ; Wills

PURPOSE: To investigate the arterial rupture, we evaluated the 15 victims of high tension injury. METHOD: The review included clinical course of injured limbs (entrance vs exit), site of spontaneous ruptures (subeschar: G1 vs zone of ischemia: G2), causes (spontaneous vs iatrogenic: G3, inflammatory vs associated thrombi), time and consequences of rupture (site of ligature, vascular manipulation). RESULT: 1) There were 18 spontaneous (G1, G2) and 4 iatrogenic ruptures (G3). 2) The G1 were 8 in 5 patients on the 19.6 +/- 8.1 (6-29)th post burn day: princeps pollicis/dorsalis indicis, dorsalis pollicis/superficial radial, radial, ulnar/radial and posterior tibial artery. The G2 were 10 in 8 patients on the 18.4 +/- 7.2 (9-31)th post burn day: brachial, ulnar, radial, ulnar/radial and branch/trunk of popliteal artery. 3) The G3 were superficial femoral/superficial femoral (at clamping site/anastomosis), subclavian (at clamping site) and princeps pollicis (at ligature) artery by inflammation 2-8 days after surgery. 4) The initial wound of limbs or fasciotomy cannot predict the possible ruptures. 5) The entrance had more ruptures than exit. 6) Five patients had multiple ruptures 1-13 days after first episode (3 at different, 2 at the same limb). 7) There was no difference of rupture time between G1 and G2. The G2 occurred at 2-7 cm apart from burn eschar. 8) Nine among 18 spontaneous ruptures were caused by inflammation. The rest 9 thrombotic ruptures occurred at the arterial wall over (2), at the margin (6) and 2 cm near (1) the thrombi. There was no time difference between inflammatory and thrombotic rupture [19.2 +/- 7.2 (9-31) vs 19.0 +/- 8.0 (6-29) days]. 9) There was no rupture after proximal 2-4 cm ligature at superficial arteries. The thrombi were formed finally in superficial femoral artery at 9 cm proximal to the rupture site. CONCLUSION: We recommend that timely decision to amputate must be made to reduce spontaneous ruptures. Also careful attention should be paid to select the safe distance, at least 10 cm in deep arterial injures, in vascular procedures.
Arteries* ; Burns* ; Constriction ; Extremities ; Femoral Artery ; Humans ; Inflammation ; Ischemia ; Ligation ; Popliteal Artery ; Rupture* ; Rupture, Spontaneous ; Tibial Arteries ; Wounds and Injuries

No abstract available.
Ebstein Anomaly*

BACKGROUND: The bcl-2 is a newly known oncogene involved in tumorigenisis by blocking apoptosis or programmed cell death. Overexpression of bcl-2 protein has been detected in a variety of human malignancies. However, recent studies of the expression of bcl-2 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: The purpose of this study was to examine whether there are any differences in the expression of bcl-2 protein between melanocytic nevus and rnalignant melanoma. METHODS: Immunohistochemical analysis of bcl-2 protein expression was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevus and 29 malignant melanomas (20 primary and 9 metastatic) using anti bcl-2 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: The results were as follows. 1. The positive rate for bcl-2 protein was observed in 95.4% (21/22) of melanocytic nevus and 95.0% (19/20) of primary malignant melanomas. Therefore, there was no significant difference between the two groups in the positive rate for bcl-2 prtoein. 2. The percentage of stained cells and the staining intensity of bcl-2 protein were significantly increased in melanocytic nevus compared to malignant melanoma (p<0.05). 3. The positive rate for bcl-2 expression of metastatic malignant melanoma [44.4% (4/9)] was significantly decreased compared to that of primary malignant melanoma [95.0%(19/20) ] (p<0. 05). But, there was no significant difference betweeen tumor thickness and histological type of malignant, melanoma in the expression of bcl-2 protein. 4. In melanocytic nevus, immunoreactivity of bcl-2 protein gradually diminished or even disappeared towards the deep dermis. CONCLUSION: the bcl-2 expression was decreased in malignant melanoma compared to melanocytic nevus. It. suggests that the loss of bcl-2 expression may play a significant role in the progression and metastasis of malignant melanoma.
Apoptosis ; Cell Death ; Dermis ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Pigmented* ; Oncogenes ; Peroxidase

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.
Anticonvulsants ; Arthralgia ; Carbamazepine* ; Dermis ; Edema ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Liver Function Tests ; Lymphatic Diseases ; Lymphoma ; Middle Aged ; Prednisolone ; Pseudolymphoma* ; Skin