Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

Liver cell dysplasia of Anthony(LCD) is a common association in hepatocellular carcinoma(HCC)-bearing liver and has been regarded as a premalignant condition with strong linkage to hepatitis B virus infection and cirrhosis. A total of 189 surgically resected livers [HCC(168 cases), cholangiocarcinoma(3 cases), metastatic carcinoma(3 cases), and non-neoplastic lesions(15 cases)] were reviewed to elucidate the nature of LCD by means of light microscopic examination, in situ hybridization method for HBV DNA and expression of proliferatin cell nuclear antigen(PCNA) using immunohistochemical technique. LCD was present in 141 cases(74.6%), and its prevalence rate was independently significant in HCCs with or without cirrhosis than other groups. There was no difference in mean age, although LCD-positive group was younger than its negative counterpart. Association rate of LCD in HCC-cirrhosis group was statistically significant than the non-cirrhotic group, and higher histological grading of LCD was correlated well with wider distribution pattern and clustering. Seropositivity of HBsAg was not correlated with presence of LCD or with histological grading. In situ hybridization techique using HBV DNA probe demonstrated fine granular stainable particles even in LCD cells. Immunohistochemical study for PCNA revealed that the proliferative activity of LCD was lower than that of the cirrhotic cell. With the above results it is concluded that LCD reflects neither a regenerating condition nor a premalignant lesion but suggest a reactive change.
Carcinoma, Hepatocellular ; Neoplasm Metastasis

A clinical observation in 8 cases of multiple laminectomies under the age of 16 years who had been followed for more than 3 years was carried out to analyze deformities and its results of treatment, and the following results were obtained. 1. Spinal deformities were developed in 5 cases-4 kyphosis and 1 lordosis. 2. The kyphosis was developed in 1 case at cervical spine, 1 at thoracic, 1 at thoracolumbar junction and 1 at lumbar, and the lordosis was developed in 1 case at lumbar spine. 3. Anterior interbody fusion was carried out on two cases of kyphosis who had severe pain and neurological symptoms and posterolateral spinal fusion was carried out on one case of lumbar lordosis, with satisfactory results in all cases. 4. Since the incidence of spinal deformities following multiple laminectomies in children is high, laminectomy should be performed only when it is definitely indicated, and when it is done, damage to the posterior complex should be minimized. 5. For the prevention and treatment of the spinal deformities, brace or close observation should be necessary postoperatively, and spinal fusion should be performed in increasing or severe deformities.
Animals ; Braces ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Laminectomy ; Lordosis ; Spinal Fusion ; Spine

Dedifferentiated chordoma is a rare pathologic entity presenting an additional sarcomatous component in otherwise classical chordoma. It has been also emphasized that this neoplasm is classified as a distinct entity because of its different clinical settings and aggressive behavior. Dedifferentiation is a peculiar phenomenon but its histogenesis has remained controversial. A 50-yera-old man developed a huge tumor mass in the retrorectal, presacral area, featured with two histological components. The one was a typical chordoma accounted for approximately 60% of the mass and the other was made up of highly cellular, plemorphic, undifferentiated tumor cells, reminiscent partly to the cells of plemorphic malignant fibrous histiocytoma. Ultrastructural features and immunoreactivity against cytokeratin, S-100 protein and alpha-1-antichymotrypsin in both portions support that histologically different components of this neoplasm derive from the same origin. To our knowledge, this is the first case of dedifferentiated chordoma in Korea.
Male ; Humans

Primary hemangioma of the lymph node is an extremely rare vascular neoplasm, and only four cases on the subject have been reported in the literature. We describe a case of cavernous hemangioma in an axillary lymph node that was incidentally found in 70-year-old woman who underwent a modified radical mastectomy for infiltrating duct carcinoma of the left breast. Brief review of the literature regarding vasoformative lesions occupying lymph node is made with special regard to differential diagnosis from reactive-proliferative processes and other true neoplasms.
Female ; Humans ; Diagnosis, Differential ; Hemangioma

The development of tophi in th absence of prior episodes of gauty arthritis is unusual. We report a case of extensive tophi in a 31 year-old man, whose initial skin lesion had started without arthritis.
Adult ; Arthritis ; Gout* ; Humans ; Skin

Elastofibroma is a rare benign tumorous growth presenting as a slowly growing ill-defined mass of fibroblastic tissue occurring in elderly persons and arising mainly form the connective tissue between the lower portion of the scapula and the chest wall. Its pathogenesis is not well established but it may be the result of nonneoplastic reactive hyperplasia taking place with constitutional predisposition in the background. A case of elastofibroma occurring in the subscapular area of a 65-year-old female cook is presented. The mass, 6x5x3 cm in maximum dimensions, was poorly circumscribed, solid, hard, pale fleshy and pray-white fibrous tumor. Microscopically, it was composed of numerous small globular and linear elastic fibers embedded in collagenous matrix. To our knowledge, it is the first case of elastofibroma in Korea.
Female ; Humans

No abstract available.
Fibroma*

With advance of diagnostic imaging technics, the detection rate of small hepatocellular carcinoma (HCC) has become much increased, but the questions whether the growth pattern and histologic nature of the HCC keep maintain the original gross and microscopic features with its advancement of tumor size remain still unclear. We reviewed 39 surgically resected hepatocellular carcinomas(HCCs) with a tumor size less than or equal to 3 cm in diameter(s-HCC), and their gross and microscopic features were compared with the HCCs bigger than 3 cm (i-HCC, 199 cases). Single nodular type(SN) was the most common gross type(60%) in s-HCCs, and was followed by single nodular type with perinodular extension(SNPE; 15.4%), multinodular-discrete type(10.3%) and multinodular-confluent type(5.1%). These figures contrasted to SNPE(42.2%) and SN(20.6%) in the i-HCCs. Of the 39 s-HCCs, 25 cases(64.1%) were encapsulated, and 14 cases(36%) demonstrated intratumoral fibrous septations, being contrasted to the i-HCCs in which fibrous septa formation was mord prominent but complete capsule formation was found only in 40.2% of the larger ones. Microscopically, the trabecular type was the most frequent one(53.9%), and increased with their size while the compact type transformed into trabecular one. Thirty three cases(84.6%) were associated with macronodular cirrhosis. Seropositivity for HBsAg was found in 26 cases(66.6%), and high serum alpha-fetoprotein level over 500 IU/L was found in 15 s-HCC cases(38.4%), while 53.3% in i-HCC. The above results suggest that HCCs change their pathologic features by increase of their size, and a comparison of the details with regard to the possible mechanisms involved is discussed.
Carcinoma, Hepatocellular

In order to elucidate the possibility of diagnosis in soft tissue cysticercosis in case no parasite in it, immunohistochemical staining with antihuman IgG, IgM, and IgA and anticysticercus antibody in tissue section were carried out. Not only the differential counts of infiltrated plasma cells but also the parasite itself against to the anticysticercus antibody were observed. Materials stained immunohistochemically were consisted of 21 soft tissue cysticercosis with or without parasite. The results were as follows: 1) IgG producing plasma cells were most frequent (45.8+/-18.7) and followed by IgM (14.3+/-0.43) and (4.3+/-5.71). Number of IgG plasma cells were more frequently accompanied in the presence of cysticercus (55.9+/-17.7) than in the absence of parasite (39.7+/-17.1). 2) The mean+/-S.D. of plasma cells positive to the anticysticercus antibody were 28.2+/-18.7. And anticysticercus antibody producing plasma cells were more frequent in the presence of cysticercus (49.2+/-5.16) than in the absence of parasite (15.2+/-9.46). 3) Antigenicity of the cysticercus was strong in inner layer(#) followed by tegument(+) and fibrous layer(-). 4) Therefore, it could be suggested that antibody against to the cysticercus is mainly produced by IgG plasma cells and antigenicity of the worm is strong in the inner layer of cyst wall. In addition, there is a possibility of assisting the diagnosis of cysticercosis with anticysticercus antibody by immunohistochemically.
Cysts