Clinical and Histopathological Review of 229 Cases of Ranula / 华中科技大学学报（医学）（英德文版）

The purpose of this paper was to evaluate the relationship between the thrombosis and secretory duct dilation,lesion size,clinical types,nature (primary or recurrent) and duration of illness in the development of ranula.A total of 229 cases of sublingual gland cysts were treated with surgical resection from Jan.1990 to Feb.2010.The patients' data were investigated on histopathological findings,size of ranula,the clinical types,nature of ranula (primary or recurrent) and duration of illness.Sections from the paraffin-embeded blocks were HE-stained.CK expression was immunohistochemically detected.Among 229 cases the incidence of venous thrombosis was 58.52％.The incidence of venous thrombosis with or without duct dilation was 73.25％ and 26.39％ respectively,with a significant difference between the two groups (P＜0.005).The incidence of venous thrombosis of ranulas with diameter larger or less than 3 cm was 72.22％ and 46.28％ (P＜0.005).The incidence of venous thrombosis of oral ranula,plunging ranula and mixed ranula was 49.37％,77.19％ and 85.71％ respectively,with a significant difference found between oral and plunging or mixed ranula (P＜0.01).The incidence of venous thrombosis in ranula patients with duration of illness longer or less than 3 months was 69.77％ and 51.75％ (P＜0.01).The incidence of venous thrombosis with recurrent and primary ranulas was 51.85％ and 64.85％,without a significant difference noted between them (P＞0.05).It is concluded that the formation of venous thrombosis was related to the dilation of secretory duct,lesion size,clinical types,duration of lesion but formation of venous thrombosis was not related to the nature (primary or recurrent) of ranulas.

Pancreatic Exocrine and Endocrine Cell Differentiation during Pancreatic Regeneration / 한양의대학술지

Pancreatic tissue is maintained by a simple proliferation of the preexisting cells in adulthood, whereas, they are dynamically derived from precursor/ stem cells from ductal epithelia during prenatal life. It has been known that tissue regeneration rarely occurs in the normal adult pancreas, particularly in the human pancreas. However, regeneration can be experimentally induced in the adult pancreas in response to various tissue injuries such as partial resection, pancreatitis by obstruction of the duct, and chemical insults. Regenerating pancreatic tissue shares a common morphogenic feature of "neogenic regeneration" in all regenerating animal models. Neogenic regeneration occurs at the site of tissue injury by forming small tubular structures with elongated epithelial cells (ductules) which grow to form pancreatic ducts and acini. The endocrine cells, including insulin secreting beta cells, are also derived from these ductules. As a sequential process of neogenesis, the regenerating tissue becomes heterogeneous in composition. Some areas were composed by tubules and ductules in surrounding loose connective tissue while others were denser with differentiating acini derived from tubules or ductules. Such neogenic regeneration mimics tissue development during fetal pancreatic organogenesis. In the process of pancreatic neogenesis, we found unique expressions of bioactive proteins such as nestin and clusterin as morphogenic factors. It is likely that the stem/precursor cells could be recapitulated and regenerated to functional cells, including endocrine and exocrine pancreatic cells with acinar and ductal cells during neogenic regeneration of the pancreas.

Superficial Cutaneous Mycoses in Korea / 한양의대학술지

Superficial cutaneous mycosis is mycotic infection of the epidermis of the skin, and one of common dermatoses in Korea. They have close relationship between host (human) and fungi. Their clinical patterns and incidence, and their causative fungi may change with social environments and life patterns. Since 1945, GNP has been increased explosively, more than 243 folds, and economic developments brought abrupt changes of social environments and life patterns in Korea. Furthermore, there had been great social events during this period; Korean War in 1950-1953, the Asian Game in 1986, the Olympic Game in 1988 and the World Cup in 2002. Those events gave much chances for dermatophytes to move and change. Tinea pedis is the most common dermatophytosis and has been increased from 26% of all dermatophytosis in late 1950s to 40.9-42.2%. And tinea unguium(onychomycosis) has been increased as tinea pedis does; Its proportion was 2.8% in late 1950s, and 17% in 1990s. The patients with tinea pedis have high family infection rate and also have high coexisting dermatophytosis. The most common isolate was Trichophyton(T.) rubrum, followed by T. mentagrophytes and Epidermophyton floccosum. Tinea capitis showed the most dramatic changes; its incidence was the highest just after Korean war and decreased abruptly since 1970s. Microsporum(M.) ferrugineum was the most common isolates till 1970s, and abruptly decreased and now nearly disappeared. Trichophyton(T.) violaceum was isolated in Cheju island. After Korean war, T. schoenleinii was isolated from favus and is disappeared. M. canis was isolated for the first time in 1959 and has been the most common isolates since late 1970s. T. verrucosum was isolated in 1986, and T. tonsurans was isolated for the first time in 1995 and spread among wrestlers, Judo players and Korean wrestlers. It might be imported by wrestlers with sport exchanging program. In cidence of tinea cruris was dramatically changed and was 5% of all dermatophytosis in 1940s, and 26.6-39.1% in 1990s. Those changes might be related to change of life patterns. Proportion of cutaneous candidiasis among superficial cutaneous mycosis was 1.9% in 1960s, 6.7% in 1973, 14.6% in 1976-1985, and 7.4% in 1989-1992. Proportion of pityriasis versicolor among superficial cutaneous mycosis was 12.1% in 1973, 7.7% in 1976-1985, and 7.7% in 1989-1992. Research for Malassezia have been increasing since late 1990s and that will bring us many new informations.

Clinical Patterns and Prognostic Factors of Ischemic Colitis / 대한소화기내시경학회지

BACKGROUND/AIMS: Colonic ischemia is recognized as the most common vascular disorder of the intestines in the elderly. The severity of the disease may vary considerably with the prevalent benign transient forms, being amenable to conservative treatments and the severe gangrenous forms, requiring surgery. Correct diagnosis is usually made after the ischemic episode is over and colonic ischemia is frequently misdiagnosed. The aim of this study is to identify the clinical patterns and prognostic factors of ischemic colitis. METHODS: We found 60 patients with nonoccusive ischemia of the large intestine. We analyzed age, sex, symptoms, signs, associated disease, location, endoscopy, hematologic, histologic, radiologic finding and treatment, retrospectively. RESULTS: The mean age was 60.2+/-16.3 years. The most common symtoms were abdominal pain or bloody diarrhea. The most common sign was diffuse abdominal tenderness. The most common hematologic findings were anemia and leukocytosis. Associated medical illnesses were diabetes, rhematoid arthritis and cerebrovascular accident, et al. Both computed tomography (CT) and endoscopy were useful diagnostic tools. The most common involved site was sigmoid colon. 46 patients were treated conservatively and 14 patients were managed surgically. CONCLUSIONS: Male gender, those with rebound tenderness, severe anemia, right or total colon involvement as well as rheumatoid arthritis had a poor prognosis. Both CT and endoscopy were useful in predicting prognosis.

Clinical Patterns and Prognostic Factors of Ischemic Colitis / 대한소화기내시경학회지

BACKGROUND/AIMS: Colonic ischemia is recognized as the most common vascular disorder of the intestines in the elderly. The severity of the disease may vary considerably with the prevalent benign transient forms, being amenable to conservative treatments and the severe gangrenous forms, requiring surgery. Correct diagnosis is usually made after the ischemic episode is over and colonic ischemia is frequently misdiagnosed. The aim of this study is to identify the clinical patterns and prognostic factors of ischemic colitis. METHODS: We found 60 patients with nonoccusive ischemia of the large intestine. We analyzed age, sex, symptoms, signs, associated disease, location, endoscopy, hematologic, histologic, radiologic finding and treatment, retrospectively. RESULTS: The mean age was 60.2+/-16.3 years. The most common symtoms were abdominal pain or bloody diarrhea. The most common sign was diffuse abdominal tenderness. The most common hematologic findings were anemia and leukocytosis. Associated medical illnesses were diabetes, rhematoid arthritis and cerebrovascular accident, et al. Both computed tomography (CT) and endoscopy were useful diagnostic tools. The most common involved site was sigmoid colon. 46 patients were treated conservatively and 14 patients were managed surgically. CONCLUSIONS: Male gender, those with rebound tenderness, severe anemia, right or total colon involvement as well as rheumatoid arthritis had a poor prognosis. Both CT and endoscopy were useful in predicting prognosis.