We present a case of localized mucosal hyperplasia of the stomach. The resected stomach contained four large, short stalked polyps, three of which were located in the anterior wall of body and the other in the posterior wall. In addition, numerous small sessile polyps were also scattered in the anterior and posterior fundic walls. Microscopically, the abnormally thick mucosa, carrying with it the muscularis mucosae and a thin core of loose fibrous tissue comprised the polyps by intraluminal infolding of widening of mucosal area. Abundant vasculature of the rugal pattern was prominent in the submucosa. The above findings suggest that the histogenesis of the polyps is related to both hyperplastic thickening and widening of mucosal areas in rugal pattern in the background of inverted distribution pattern of intestinal metaplasia.

Fourteen total cystectomy specimens with primary carcinoma of urinary bladder were investigated to illustrate the overall prevalence and nature of mucosal changes adjacent to the overt carcinoma and to clarify the distribution pattern and extent of carcinoma in situ in regard with multiplicity, histological type and depth of invasion of the macroscopically visible tumor mass. Of 14 cases subjected to this study were 12 cases of transitional cell carcinoma of varying degree of differentiation and invasion, one adenocarcinoma, and the another one with no grossly detectable tumor but history of previous cystoscopic removal of papillary transitional cell carcinoma. Each specimen was processed by a histotopographic technique developed by authors, an easy access to reconstruct the mucosal changes using reconstruction paper. For the histological grading and staging of the overt carcinomas, Ash's and Collins' classifications were applied, respectively. Carcinoma in situ (CIS) was found in 10 out of 11 cases with overt urothelial carcinoma of urinary bladder and one case with no grossly visible neoplasm, in which cystoscopic removal of papillary carcinoma was carried out previously. Distribution pattern of CIS was mostly circular (group I) or arborizing (group II) , located around the overt carcinoma within 0.5 to 2.0cm., but not beyond 3.0cm. from its margin. Correlation between multiplicity of overt carcinomas and presence of CIS was evident together with irregularity of its distribution, but no significance was found with gross appearance, histological grading or with staging.
Adenocarcinoma ; Carcinoma in Situ* ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Classification ; Cystectomy ; Mucous Membrane* ; Prevalence ; Urinary Bladder*

Moderate to severe unilateral ptosis has previously been treated with levator resection or frontalis sling and cosmetic double fold in the opposite eyelid. This method often resulted in undesirable asymmetrical lid lag phenomenon in down gaze. From December 1991 to December 1994, we treated 65 cases of unilateral ptosis with frontalis sling or levator resection, and simultaneously cosmetic frontalis sling have been performed in the unaffected normal eyes of 41 patients and cosmetic double fold have been performed in the unaffected normal eyes of 11 patients. After 6 months of operation, authors survey the patients content. The number of cases of content were 4(36.36%) in 11 cosmetic double fold group and 31(75.6%) in 41 cosmetic frontalis sling group. The content after cosmetic frontalis sling was higher than cosmetic double fold. Asymmetrical lid lag phenomenon on downward gaze which is inevitable complication postoperatively was reduced by means of cosmetic frontalis sling of unafeected normal eye in unilatral ptosis. The authors expect that the patient will be more satisfied with the result of symmetrical lid lag in down gaze after cosmetic frontalis sling of unaffected normal eye in aesthetic aspect.
Eyelids ; Humans

Three cases of lipomas associated with heavy talc deposits are reported in local inhabitants near a fiber glass factory. Pathologic and mineralogical analysis by polarizing microscopy, scanning and transmission electron microscopy with energy dispersive X-ray analysis and X-ray diffraction of mass were done. Simultaneously, we performed an epidemiological survey and a mineralogical study of disposed fiber glass from waste site and ground water. All tumors consisted of mature fat tissue containing an abundant birefringent talc fibers and particles under polarized light. The concentrations of the fibers were 494.7, 6.7 and 50.7 million fibers per gram of dry tissue. The fibers were needlelike with rectangular fractured ends, up to 17 micrometer in length and 0.5 micrometer in diameter. EDX and X-ray diffraction analysis of the fibers showed that 71 to 100% of the fibers were magnesium silicate, talc. We also identified magnesium silicate fibers in the fiber glass from the waste site and in the ground water which were similar to talc fibers in lipomas,. We concluded that fibrous talc, a component of fiberglass waste, might be associated with the development of lipomas via unknown exposure route.
Environmental Exposure ; Foreign Bodies ; Glass ; Groundwater ; Lipoma* ; Magnesium ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Fibers, Myelinated ; Silicates ; Talc* ; X-Ray Diffraction

No abstract available.

Stargardt's disease is a heredo-macular dystrophy which evidences itself by reduced visual acuity, bilaterally, slowly progressive lesion, and by color blindness starting in youth. The diagnosis of Stargardt's disease is usually made by biomicroscopy and fluoresceine angiography which show many irregular shaped, small yellowish flecks. According to Fishman, the characteristic prolonged time to obtain adequate rod amplitude in dark-adapted electroretionography is advisable for differential diagnosis of Stargardt's disease. We didn't find the abnormal finding of dark-adapted electroretinography in two patients of Stargardt's disease. So, more studies will be needed for electroretinography of Stargardt's disease.
Adolescent ; Angiography ; Color Vision Defects ; Diagnosis ; Diagnosis, Differential ; Electroretinography ; Fluorescein ; Humans ; Visual Acuity

Congenital vertical talus is dufficult to correct and tends to recur. Reduction of the deformed talon-avicular joint is rarely possible by conservative means alone and consequently surgical reduction is usually necessary. The technique of Kumar, Cowell and Ramsey(TAL, capsular release, open reduction of navicular, and K-wire fixation) was combined with or without tendon transfer using Tibialis anterior(Grice operation) in 11 feet of seven children(bilateral in four) under the age of four(2 girls and 5 boys), and followed them for average 41 months. Three of them were combined with cerebral palsy, syringomyelia, and multiple joint stiffness with camptodactyly. In preoperative radiograms, all of their tali are so distorted plantarward and medially as to be almost vertical. The talus was in an equinus position also but to a lesser degrees. The forefoot was dorsiflexed at the midtarsal joint and the navicular lay on the dorsal aspect of the talar head. Seven feet are corrected normally after operation, but four feet were recurred and soft tissue releasing techniques combined with extraarticular subtalar arthrodesis or triple arthrodesis were planned after their skeletal maturity.
Arthrodesis ; Cerebral Palsy ; Female ; Foot ; Head ; Humans ; Joint Capsule Release ; Joints ; Syringomyelia ; Talus ; Tendon Transfer

Long segmental fixation with TSRH posterior instrumentation for 19 patients who had unstable thoracolumbar fracture was performed between October 1992 and April 1995. The patients were followed for an average of 22 months. Measurements of the deformity angle, kyphosis, vertebral height, and the intervertebral angle were made. The patients were divided into 2 groups according to configurations of instruments for lower segmental fixation. For one group, only hooks were used, and for the others group pedicular screws and lateral offset hooks were used together at the same segment. Therefore, the purpose of this study is to anlyze the correctability following long segmental fixation and to compare one segmental fixation using both screws and lateral offset hook systems with two segmental fixation using hook systems for distal fixation. There was an overall correction of kyphosis at follow-up of 6.9degrees (27.1%) after a loss of 4.3degrees from operative correction. Overall correction of deformity angle was 8.2degrees (32.2%). Loss of vertebral height at final follow-up was 4.4%. And loss of intervertebral angle was 2.0degrees at follow-up. There was no difference of overall results between the hook group and the pedicular screw with lateral offset hook group. However, there was a significant improvement of the correction of kyphosis and restoration of vertebral height in patients who underwent operation within 7 days after injury, as compared to delayed operation. Therefore, the timing of surgery is the most important factor in order to correct the deformity caused by unstable thoracolumbar fractures. There was no significant loss of correction and no metallic failure. Therefore, rodding long with the method of one segment distal fixation using screws and lateral offset hook together can provide excellent correctability, maintenance of correction, preservation of distal lumbar joints, prevention of implant failure and complication.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Kyphosis

No abstract available.
Gestational Trophoblastic Disease*

A button battery inserted in the nose of children is an unusual foreign body which is capable of causing extensive tissue damage, resulting from electrical and chemical burns. We report a case of button battery in the nose of a 4-year-old boy presenting with unilateral nasal discharge, and necrosis in the septum and turbinate of the right nasal cavity. Mercury level in concentrated urine was within normal limit. Microscopic examination disclosed extensive liquefaction necrosis with calcification and fibrosis. Numerous dark brown to black granules were noted in the elastic and collagen fibers and interstitium. Dark-field examination of the section revealed brilliantly refractile granules. Polarized microscopy failed to show the granules. Most brown pigments reacted to prussian blue. Tissue mercury analysis yielded a mercury content of 8.01 ppm. We report this case to emphasize the hazards of button battery impaction and to draw attention to the significance of the problem through histopathologic examination.
Child, Preschool ; Human ; Male ; Nasal Cavity/pathology* ; Nasal Cavity/immunology ; Power Sources/adverse effects*