Peripheral cementifying fibroma is histomorphologically similar to the central cementifying fibroma, but this lesion is unique to the gingival mucosa and is only rarely seen in edentulous area. In most instances, it arise from interdental papilla, with 80% occurring anterior to molar region. This lesion appears to involve the maxilla and mandible equally, demonstrates the highest occurrence rate during the second decade of life, and affects female more frequently than male, with 4.3:1 to 3:2. Peripheral cementifying fibroma presents as firm, pedunculated or sessile mass with an intact or ulcerated surface depending on the presence of trauma. Microscopically, it reveals a highly cellular mass of connective tissue containing numerous plump, proliferating fibrolasts and several forms of calcification. Effective treatment requires deep excision, which includes the ligament and periosteum, followed by a thorough root scaling of the adjacent teeth. A reveiw of the literature and a report of a case of peripheral cementifying fibroma are presented.
Connective Tissue ; Dental Scaling ; Female ; Fibroma* ; Gingiva ; Humans ; Ligaments ; Male ; Mandible ; Maxilla ; Molar ; Mucous Membrane ; Periodontal Ligament* ; Periosteum ; Tooth* ; Ulcer

BACKGROUND/AIMS: According to the recent research, mutations in the HBV pre-S region may have an impact on the progression of hepatitis B virus(HBV)-related liver disease. The aim of this study was to clarify the frequency and location of naturally occurring mutations in the pre-S region of HBV, and their possible effects on the clinical course of HBV-associated chronic liver diseases. METHODS: HBV DNA was extracted from the sera of 15 patients (8 with liver cirrhosis and 7 with hepatocellular carcinoma). The pre-S sequence was amplified via polymerase chain reaction, subcloning and sequenced. RESULTS: All patients had point mutations in the pre-S region. Nine of 10 mutation sites (90%) in the pre-S1 region, and 4 of 5 mutation sites (80%) in the pre-S2 region were identical in both liver cirrhosis and hepatocellular carcinoma. Deletions were detected in seven patients (4 with liver cirrhosis and 3 with hepatocellular carcinoma). Among the 4 patients with liver cirrhosis, three had deletion in 5'-end of the pre-S2 region and one spanning the 3'-end of the pre-S1 to 5'-end of the pre-S2 region. All 3 patients with hepatocellular carcinoma had deletions in 5'-end of the pre-S1 region, and two patients had simultaneous deletion spanning the 3'-end of the pre-S1 to the 5'-end of the pre-S2. CONCLUSION: The pre-S mutants were frequently detected in HBV-associated liver cirrhosis or hepatocellular carcinoma and the point mutations or deletions in the pre-S gene were clustered in specific regions.
Carcinoma, Hepatocellular* ; DNA ; Hepatitis B ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Point Mutation ; Polymerase Chain Reaction

PURPOSE: The clinical benefits of intravesical electrical stimulation (IVES), in patients with increased residual urine or reduced bladder capacity, have been reported. However, studies on the underlying mechanism of IVES have been limited to the Adelta afferent in healthy rats. This study investigated the changes in the calcitonin gene- related peptide (CGRP) and substance P (SP) expressions, in the lumbosacral dorsal root ganglia (DRG) and the bladder of spinalized rats, to determine the effect of IVES on the C fiber afferent nerve. MATERIALS AND METHODS: Forty Sprague-Dawley rats were divided into normal controls (n=10); IVES treated normal rats (n=10); spinalized rats (n=10) and IVES treated spinalized rats (n=10). The IVES was performed for 2 weeks (5 days a week), 3 weeks after the spinalization in the spinalized animals. All animals had their DRG removed at the lumbosacral (L5-S1) level. Changes in the CGRP and SP, at the DRG and bladder, were measured by western-blot analysis. RESULTS: The relative density of the CGRP and SP following spinalization was significantly higher than those in the controls in both the DRG and the bladder. However, IVES in the spinalized rat significantly decreased the relative density of the SP, in both the DRG and the bladder, compared to the rats with spinalization alone. IVES in the spinalized rats significantly decreased the relative density of the CGRP, in the DRG only, compared to the rats with spinalization. CONCLUSIONS: IVES significantly reduced the CGRP and SP levels in the DRG of spinalized rats, but only the SP levels in the bladder. CGRP and SP are the main factors contributing to the hyper-excitability of the micturition reflex following spinal cord injury. These results suggest that the bladder C fiber afferents are also involved in modulating the micturition reflex with IVES.
Animals ; Calcitonin ; Diagnosis-Related Groups ; Electric Stimulation* ; Ganglia, Spinal ; Humans ; Nerve Fibers, Unmyelinated ; Neuropeptides* ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Specific Gravity ; Spinal Cord Injuries ; Substance P ; Urinary Bladder* ; Urination ; Visceral Afferents

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.
Biopsy ; Endoscopy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Male ; Papilloma*

OBJECTIVE: To evaluate exercise capacity of subacute stroke patients with nonambulatory exercise stress test and to determine whether reduced exercise efficiency is associated with functional performance. METHOD: Experimental design was prospective and observational study. Eighteen patients with moderate to severe impairment after recent stroke performed exercise stress test by repeated knee flexion and extension exercise using isokinetic dynamometer. Work rate, oxygen consumption, heart rate were assessed during exercise stress test. The dynamic response, the ratio of change in oxygen uptake to change in work rate, was measured for correlation with FIM (Functional Independence Measure) scores. Occupational therapist recorded FIM scores on the day of transfer to inpatient rehabilitation unit and on discharge. Age-matched healthy group also performed exercise stress test in same settings. RESULTS: The patients group who had similar dynamic response with age-matched healthy group showed higher FIM scores than the patients group having higher dynamic response. CONCLUSION: Nonambulatory exercise stress test could be effectively used in subacute stroke patients and the ratio of change in oxygen uptake to change in work rate was a useful variable to reveal low exercise efficiency in subacute stroke patients who had a abnormal skeletal muscle metabolic capacity.
Exercise Test ; Heart Rate ; Humans ; Inpatients ; Knee ; Muscle, Skeletal ; Observational Study ; Oxygen Consumption ; Oxygen* ; Prospective Studies ; Rehabilitation ; Research Design ; Stroke*

Intrathoracic kidney is a very rare congenital anomaly in development of the kidney. It was firstly described by Mikulics in 1922. More than 130 cases were reported in the world. Most of the patients have no clinical problem and discovered incidentally in chest X-ray. We have experienced a case of intrathoracic kidney in a 48-year-old female who was admitted due to recurrent calculous cholecystitis. Intrathoracic mass lesion was noted in the plain chest film and confirmed as intrathoracic kidney by chest computed tomography and intravenous pyleography. We report a case of intrathorcic kidney with brief review of literature.
Adult* ; Cholecystitis ; Female ; Humans ; Kidney* ; Middle Aged ; Thorax

PURPOSE: The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas. METHODS: Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0~113) months for mucinous adenocarcinomas and 32 (0~130) months for non-mucinous adenocarcinoma. RESULTS: Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P<0.001), frequent family history (P<0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P<0.001), and common peritoneal seeding at diagnosis (P<0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant. CONCLUSIONS: Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Appointments and Schedules ; Chungcheongnam-do ; Colon* ; Colorectal Neoplasms ; Diagnosis ; Follow-Up Studies ; Humans ; Mucins* ; Neoplasm Metastasis ; Prognosis* ; Rectum* ; Recurrence ; Retrospective Studies ; Survival Rate

Hepatic eosinophilic abscess is a very rare disease which has been reported in fascioliasis, and some gastrointestinal malignancy. We experienced 5 cases with hepatic eosinophilic abscesses which were caused by unknown etiology, confirmed by liver biopsy, from 1990 to 1994. The chracteristics of the cases including clinical menifestations, serologic findings, ultrasonography and abdominal computerizes tomogram(CT) were summerized. They had no characteristic findings except eosinophilia in clinical menifestations and they showed various ultrasonographic and CT findings which are different from the radiologic findings of liver abscesses by bacterial or amebic infection. We think that hepatic eosinophilic abscess must be included in differential diagnosis of all hepatic tumors.
Abscess* ; Biopsy ; Diagnosis, Differential ; Eosinophilia ; Eosinophils* ; Fascioliasis ; Liver ; Liver Abscess ; Rare Diseases ; Ultrasonography

BACKGROUND/AIMS: Adenomatous polyp was a precancerous lesion and it's removal was the secondary prevention of colorectal cancer. So we evaluated: age, sex, gross findings (Yamada type, size, number), histologic types, the incidence of coexisting cancers. METHODS: We analyzed the 125 patients with colon polyps who underwent colonoscopic polypectomy from March 1993 to Febrary 1998 in Pusan Paik hospital Inje university. RESULTS: The male to female ratio was 1:0.43, and the polyps were most common in sixth decade. Abdominal pain was the most common symptom (34.4%). On occult blood examination, 25.5% of the patients with colorectal polyp had positive finding. According to Yamada classification, type IV is 49 patients (39.2%) and type III is 47 patients (37.6%). The most common size was 0.5 cm to 1.0 cm, and single polyp was noted in 68 cases (54.4%). Among patients with colon polyps, 6 cases had coexisting colon cancers, and 1 case was diagnosed as adenocarcinoma. Histologically, the numbers of adenomatous polyp and hyperplastic polyp were 74 (59.2%) and 17 (13.6%). Retention polyps were commom under the age of 20 years, but adenomatous polyps were common over the age of 40 years. Five cases diagnosed as adenomatous polyps on forceps biopsy were proven as nonadenomatous polyps on polypectomy sections. CONCLUSIONS: Among patients with colon polyps, 6 cases had coexisting colon cancers and 1 case was diagnosed adenocarcinoma but, did not reach statistical significance. The result of this study suggested that forceps biopsy results were different with polypectomy biopsy results, so we therefore recommands polypectomy as primary treatment for all colonic polyps.
Abdominal Pain ; Adenocarcinoma ; Adenomatous Polyps ; Biopsy ; Busan ; Classification ; Colon* ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Female ; Humans ; Incidence ; Male ; Occult Blood ; Polyps* ; Retrospective Studies* ; Secondary Prevention ; Surgical Instruments

Hepatitis C was known to be associated with many autoimmune disease, but the pathophysiology was not well understood. Antiphospholipid antibodies, which are autoantibodies detected to negatively charged phospholipids, are sometimes detected in infectious diseases, including sypilis and autoimmun diseases, such as systemic lupus erythematosus and unknown etiology. A few reports suggested that there is a relation between primary antiphospholipid syndrome and hepatitis C. We recently experienced a case of primary antiphospholipid syndrome with chronic hepatitis C in 20 years old womam who developed cerebral infartion. A brief review of related literature is presented.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Autoantibodies ; Autoimmune Diseases ; Communicable Diseases ; Hepatitis C ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Lupus Erythematosus, Systemic ; Phospholipids ; Young Adult