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

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

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

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*

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

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

BACKGROUND/AIMS: Choledochal cyst is an unusual but serious condition which most commonly affects Oriental people. And it is an unusual entity that has increasingly been encountered by ultrasonography and computed tomography scan, even if the symptoms are variable. METHODS: We reviewed 23 patients with choledochal cyst who were treated at the Department of Internal Medicine, Pusan Paik Hospital from April, 1986 to April 1995. RESULTS: 1) Age ranged from 14 years to 73 years, and sex ratio was 1:1.4 in male vs female. 2) The durations of symptoms varied from 4 days to several years. 3) The major clinical symptoms were right upper quardrant pain in 19 cases, jaundice in 4 cases, abdominal mass in 2 cases. One case had all of above three symptoms. 4) The diagnostic tools were ultrasonography(USG) in l7 cases, ERCP in 11 cases, abdominal CT in 11 cases, PTC in 6 cases and oral GB in 1 case. The eight cases(61.5%) were confirmed as anomalous junction of the pancreaticobiliary ductal system(AJPBS) among the 13 cases who had performed ERCP. 5) The choledochal cysts were classified into type I to V according to the classification of Todani; Fifteen cases were type I, six cases type IVa, one case was type II and one case was type V, respectively. 6) Excision of choledochal cyst and Roux-en-Y hepaticojejunostomy was performed in 10 cases, and choledocho-jejunostomy in 4 cases, and Whipple's operation in 2 cases. 7) The associated diseases were CBD stone in 8 cases, cholecystitis in 6 cases, intrahepatic stone in 2 cases, GB cancer in 1 case, and colon cancer in 1 case. CONCLUSIONS: ERCP should be used when choledochal cyst is suspected by USG, aiming at demonstrating both AJPBS and enabling the morphologic classification. In addition, Surgical procedures including the excision of choledochal cyst and Roux-en-Y hepaticojejunostomy may be effective to reduce mortality and morbidity related to complication of choleclochal cyst.
Busan ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis ; Choledochal Cyst* ; Classification ; Colonic Neoplasms ; Female ; Humans ; Internal Medicine ; Jaundice ; Male ; Mortality ; Sex Ratio ; Tomography, X-Ray Computed ; Ultrasonography

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

BACKGROUND: To detect active tuberculosis, clinicians usually rely on several methods those are so limited. As the prevalence rate of tuberculosis is high in Korea, culture is not so very effective in clinical use. The polymerase chain reaction (PCR) featuring rapidness and high sensitivity offers low specificity and it requires high test cost, complicated skills, expensive equipment. This study attempted to determine if the immunochromatographic assay, intended to measure antibodies using 38 kDa antigens, is valuable as a new method to diagnose active tuberculosis, by comparing it with existing acid-fast stain (AFB stain) and PCR. METHODS: The sera were collected from 31 BCG-vaccinated healthy persons and 55 patients subjected to AFB stain and PCR who visited Pohang Hospital of Dongguk University or Kyungpook National University Hospital, and then kept at -20degrees C until experiment. Fifty-five patients subjected to AFB stain and PCR were composed of 24 active tuberculosis patients and 31 non-TB patients. The evaluation of active tuberculosis was based on clinical criteria. RESULTS: The detection rate of antibody by the immunochromatographic method accounted for 83% in the active TB group, and each 6% in both the non-TB group and the healthy control group. The sensitivities of AFB stain, PCR and immunochromatographic method accounted for 67%, 88% and 83%, respectively, the specificities for 94%, 86% and 94%, respectively, the positive predictive values for 89%, 84% and 91%, respectively, and the negative predictive values for 78%, 89% and 88%, respectively. CONCLUSIONS: This suggests that the immunochromatographic method can be used for the rapid diagnostic method of active tuberculosis in an area with high prevalence value of tuberculosis like Korea. In addition, the immunochromatographic method showed the sensitivity approximate to that of PCR, the same specificity as AFB stain, and a high positive and negative predictive values. So it was expected not only to be greatly helpful for the diagnosis of active tuberculosis but also to be more useful in clinical practices because of short examination time, no special equipment and skills required, and inexpensive examination.
Antibodies ; Diagnosis* ; Gyeongsangbuk-do ; Humans ; Immunochromatography* ; Korea ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity ; Tuberculosis*