Adenosquamous carcinoma (ASC) is a rare malignant epithelial tumor in the oral cavity. It is regarded as a variant of squamous cell carcinoma (SCC) because ASC originates from the surface epithelium, has similar clinical features, and includes SCC portion which is histologically identical to the traditional form. This case report deals with two cases of ASC occurring in the oral mucosa of old male patients. Both case has tubular structures lined by cuboidal, basaloid, or small round cells under the conventional SCC component, which was reminiscent of the glandular differentiation of adenocarcinoma. On immunohistochemical studies, the glandular component of ASC showed positivity to CK-pan, CK7 and HMWCK, while the dysplastic squamous cells exhibited negativity to CK7. Accordingly, CK7 as well as morphological findings can lead towards differentiating ASC from other variants with gland-like structures, such as basaloid squamous cell carcinoma and adenoid squamous cell carcinoma.

Epithelial-myoepithelial carcinoma (EMC) is uncommon, low-grade malignant epithelial neoplasm, and composed of ductal and large, clear-staining myoepithelial differentiated cells. we found four cases of EMC patients among those who visited the dental hospital of Seoul National University from 1998 to 2008. Immunohistochemical staining with epithelial and myoepithelial marker was done to verify the characteristic biphasic cell population. In our cases, the mean age of the patients was 61.5 years, which is consistent with previous reports. However, all the patients were female, and submandibular glands were the most affected sites. This is different from other reports that parotid gland was the most affected sites. There was recurrence and metastasis to lung in one out of four cases.

Zygomycosis and aspergillosis are representative filamentous fungal infections in the sinonasal region. However, their combined form seldom occurs. This report describes one case of zygomycosis and aspergillosis occurring in a patient that did not have diabetes or any other immunocompromising conditions. The patient presented with a history of intermittent swelling and pus discharge from the gingiva of the right maxillary posterior teeth. The radiographs demonstrated a periapical radiolucency around the right maxillary first molar, together with mild haziness and mucosal thickening of the right maxillary sinus. U nder t he c linical impression o f odontogenic sinusitis, a Caldwell-Luc operation was performed. However, the final diagnosis based on microscopic examination was combined zygomycosis and aspergillosis. Previous studies of zygomycosis occurring alone describe a very aggressive clinical course, including necrosis of tissue,cranial nerve involvement and death. Our patient did not show any of these symptoms, and recovered after surgical debridement only. It can be concluded from the present case that the prognosis of fungal infections depends on the immune status of the host, rather than behavior of the fungi.

Cholesterol granuloma(CG) occurs frequently in association with chronic middle ear diseases, particularly diseases in the mastoid antrum and air cells of the temporal bone, and much less frequently in paranasal sinuses. It occurs frequently secondary to massive hemorrhage of oral and paraoral cysts. However, It has never been reported to occur solely without any association with preexisting lesion in the mandible. We experienced development of unusual cholesterol granuloma in the mandible. Seventy year old female presented diffuse hard swelling on the left mandibular area with lymphadenopathy of the left cervical lymph node. Radiographic examination showed a well circumscribed multilocular radiolucency resembling soap bubble appearance with tooth displacement and root resorption, leading to the radiogrphic impression of dentigerous cyst or odontogenic cyst or ameloblastoma. CT showed bucco-lingually undulating expansile lesion with corticated margin from the left posterior mandibular body to the anterior ramus, including #46, #47 and #48, and the mass showed slightly lower attenuation than muscle. leading to the impression of ameloblastoma. The mass after surgical excision composed of 2 sac like structures, measuring 4.0cm, and 2.7cm in diameter respectively. One sac was tightly attached to the #46, resembling dentigerous cyst. Microscopic examination showed a large number of cholesterol clefts in association with hemorrhage, hemosiderin pigments and foreign body giant cells. There was no evidence of cyst or other lesions

Oral malignant melanoma of the oral cavity is rare. Although the Asian population has a relatively high incidence of oral malignant melanoma in contrast to Caucasians, the clinical information in Korean has been rarely known. In addition, the clinical and histological classification of oral malignant melanoma has not been established up to now. So we investigated 26 cases of oral malignant melanomas on the basis of clinicopathological and immunohistochemical findings and reclassified the clinical and histological type. The results of this study are as followed. Oral malignant melanomas occurred at any age from 28 years to 73 years and their mean age was 58.6 years. Of 26 cases, 14 occurred in male and 12 in female. Oral malignant melanomas occurred almost in palate and/or maxillary gingiva (25 cases; 96.2%). Only one case occurred in mandibular gigiva. Oral malignant melanomas were clinically divided into macular(9 cases) and nodular type(17 cases), showing that the nodular type occurred more frequently. Oral malignant melanomas were histologically divided into in situ spreading(5 cases), invasive(13 cases), and combined type(8 cases), showing that the invasive type occurred most frequently. All cases showed positivity for S-100 and 15 cases(57.7%) for HMB-45 in immunohistochemical analysis. It was thought these results could provide basic data for the research on oral malignant melanoma in Korean and additional prospective and retrospective studies would be needed in order to find the relations with the prognosis of the patients

The support mechanisms that are involved in lymph node metastasis of oral squamous cell carcinoma remain largely unknown. Recent studies have demonstrated that tumor cells express chemokine receptors and use chemokines to metastasize to the target organ in many malignancies in humans There are few reports about the correlation between chemokin receptor CXCR-4 expression and clinicopathologic factors in oral squamous cell carcinomas. The object of this study was to evaluate the availabili ty of CXCR-4 expression as prognostic marker through correlation analysis of CXCR-4 expression in oral sq uamous cell carcinoma and its r elation to clinocopathologic factors and PCNA index. 80 we investigated CXCR-4 expression of 74 oral squamous cell carcinomas by immunohistochemistry. 44 out of 74 cases(59. 5%) showed CXCH-4 positive and 30 sampl es(40.5%) showed CXCH-4 negative. CXCH-4 expression showed statistically sig nificant correlation wi th lymph node metastasis(p=0.026) ‘ PCNA index (p=0.003) , survial rate(p=0.0003). From the results , it was suggested CXCR-4 oxpression might be useful a prognostic marker in oral squamous cell carClllomas

This research was designed to investigate changes of growth factors and bone matrix proteins during the bone healing processes using immunohistochemistry and in situ hybridization. Especially this study was focused on the changes of bone matrix and growth factors around the titanium implant. Threaded implants were introduced into the long bone of tibia. Time dependent changes of several bone associated protein and and its mRNAs were observed. Proteins investigated in this study are collagen, osteonectin(ON), osteopontin(OPN), osteocalcin(OC). Expression of the proteins were measured using immunohistochemistry. VEGF and ON were measured using in situ hybridization, and northen blot technique. Bone regeneration were observed as early as the third day of experiment. Matrix proteins and growth factors observed around implant were identical to the proteins observed in the control group. The expression of the ON, OC and VEGF were observed mainly in the osteoblast-like cell on the surface of new bone around the implant and the cells lining the margin of bone defect apart from the implant. The observation may not result from direct osteoconducting activities of titanium but by passive adsorption of extracellular factors which has bone inducing capacities. These passive adsorption results in the immobilization of the growth factors and consequent prolongation of the activities.

ISPARC (Secreted protein acidic and rich in cysteine) is detected in the bone stroma during wound-healing process. To understand the roles of SPARC in bony wound-healing process, SPARC cDNA were synthesized from rat calvarial osteoblast culture, and SPARC protein was synthesized from the cDNA. To observe the effects of SPARC protein on the differentiation of osteoblasts, bony defect were made on rat tibia, and the distributions of bone matrix related proteins and SPARC were investigated using immunohistochemistry. In the rat osteoblastic culture using untreated plastic surface, Collagen-SPARC treated surface presented higher protein synthesis than untreated surface or only collagen treated surface. SPARC synthesis in the bony defect of rat tibia was augmented by introducing SPARC to the bony defect. SPARC synthesis were increased from the center of the defect compared to the control. SPARC synthesis in cells of the center of the defect was increased and maintained for 14 days. We could conclude that SPARC introduction may affect the early bone matrix formation, including SPARC, and mineralization in bony wound healing process.

Adenoid cystic carcinoma(ACC) is one of the most common malignant tumors of minor salivary glands and can also arise in a variety of sites in the head and neck including the major salivary glands, the esophagus, the lacrimal glands. ACC shows slow but relentless growth, so it shows long-term recurrence. The various reports about prognostic factors which influence the recurrence pattern are introduced but the reports about prognostic factors are rare in Korean adenoid cystic carcinoma patients. We examined 40 ACC patients who finally diagnosed at Department of Oral Pathology, Seoul National University Dental Hospital. Clinicopathologic and immunohistochemical features were reviewed and factors correlated with recurrence and survival were analyzed. The 5-year survival rate of T3,T4 stage was 31.2%, while that of the T1,T2 stage was 88.2%, and the difference 5-year survival and T stage was statistically significant. The rate of local recurrence was 20% and the rate of distant metastasis was 27.5%. Mean recurrence time were 4.8 years and 5.2 years. There was no significant difference between age, sex, T stage, TNM stage, histologic type and recurrence. But the high T stage and the solid type recurred more frequently. There was no significant difference between recurrence rate, 5-year survival rate and Ki-67, MVD expression. But the higher expression of Ki-67, MVD show the higher recurrence rate and the lower 5-year survival rate

본 연구는 연역조직 회학 방법 및 in situ hybridization 법을 이용하여 골 치유 과정중의 골성 장 반응 빛 골 기질 단백질 형성이| 관여하는 여러 성장인자 및 골기질 관련물질에 대한 변화를 알아보고자 하였으며 특히 임 플란트 배식 후 티티늄 표연과 인접한 주변 골에서 나타나는 다양한 골기질 단백질의 형성과 골 성장과 관련한 성장인지들의 변화를 관칠하고자 히였디 직경 3 -5mm의 thread - ed implan t를 백서 장골에 매 식한 후 시 간적 변화에 따른 골기질 관련 물질 및 관련 mRNA의 분포변호}를 관찰히였다 디1 상은 콜리 겐 . osteonectin(ON). osteopontin(OPN). osteocalcin (OC) 동의 분포의 변호}를 연역조직화학적 방법으로 보고 이와 힘께 골기질 형 성관련 성장인자인 VEGF와 ON 의 l알헌을 in situ hybricli za tion 법을 이용해서 관찰하였다 3일째 소견에서 는 골 내부에 형성된 나사 산과 잉프란트의 강제적인 접 촉으로 인해서 높은 접촉률을 나티내고 있었으나‘ 부위에 따라서는 혈벙으로민 둘러씨인 부분도 관칠되었 다 7일째 소견에서 는 이 같은 인위적인 접촉부위에서 골 흡수가 일어니연서 골접촉이 크게 감소하였다 7 일과 14일에서 골의 형성은 이주 낮은 정도로 나타났으마. 14 일째에 는 골 집촉의 증기기 다소 나타나지만 골 밀도는 골의 게조로 인해 김소하는 소견을 나타내 었 다 연역조직화학적 염색에서 대조균은 콜라겐이 결합조직 에 서 항상 강한 양성 반응을 보였다 반면 실험군에서는 신생 골에서 일부에 서만 약한 양성 반응을 보였다 OC은 신생골에서는 거의 관찰되지 않았으며 기존 골의 손상부위에 부분적으로 양성 만응을 보였다 OPN은 결함조직 에서 강한 양성 반응을 보였으며 신생 골의 골양 조직과 골소공 주변에서 양성반응을 나타내었다 ON은 기존골의 일 부와 신생골에서 관찰 되었다 특히 골모세포와 골세포에서 양성반응을 나타내 었다 대조군과 실험군들 간의 연역조직화학적 염색에서 의 뚜렷한 차이는 보이지 않았다 OC은 대조군에서와 마찬가지로 신생골에서는 거의 관찰되지 않았으며. 인접 골 주변부에서 부분적 으로 양성 반응을 보였다 OPN은 대 조군과 실험군 동일하게 결합조직 에서 강한 양성 반응을 보였으며 신생골의 골양 조직과 골소공 주변에서 발현되는 것도 유시하였다 ON의 말현 OJ상도 대조군의 경우와 통일하였으며 골모세포나 골세포 에서 양성 반응을 나티 내 띤 서 골질에 대해서 는 신생골이니 골 게 조 후의 골보다 석회화가 어느 정도 진행된 골 개조 이전의 골에서 뚜렷한 양성을 보였다 ON 의 발현잉상에서 연띄조직화학 염색소견과 달러 골기질 단백질의 형성과정에서 나타나는 세포내 mRNA의 발현은 임플란트에 보다 근 접힌 세포에서 발현이 증가히는 깃이 관찰되었다 이상의 결과에서 얻은 겔론은 다음과 같다 i 소형 임플린트의 떼식 시 나타나는 조직 띤응은 정싱크기 의 임 풀란트에서외 동일힌 소견을 나타내았다 2 골재생은 3일 째부터 관칠되었으며 14 일이후 골재소가 나티니 21 일까지 지속되었다 3 임플란트 주맨에서 나타냐는 골재생관련 성장인자외 골기질 단백질은 골결손으로 인한 재생 시와 동일한 소 낀을 니 타내 었다 4 띤약조직화흐l 염색소견과 달리 골기질 단백질의 형성과정에서 나타나는 세 포내 mR NA의 발현은 임플란트에 보디근접한 세포에서 발힌이 증가히는 것이 관찰되었으며 이는 임풀란트 제 료의 표면이 골형성 유도능을 가진 것이기 보다는 골형성 유도 능을 가진 세 포외 인지들이 티타늄 표띤 애 수동적으로 홉착됨으로 잔존 기간이 증가하고 이동성이 감소함으로서 나타나는 현상으로 보인다 5. 티타늄 인 플렌트의 표띤은 특띨힌 처리 없이 도 곧형성 유도른 증가시 키는 것으로 보인다

본 연구는 SPARC(osteo n ect in) 이 석회화 물질의 형성에 밀접한 연관을 가진다는 짐 애 착안하여 골조직 재생 괴정 중의 기질-세포 상호자용에 있어 SPARC의 역할 석회화 조직 형성과 연관된 SPARC의 발현조절과 기능을 규명하고자 시행되었다 l꾀서 태자 두개관 배양세포로부터 SPARC cDNA를 합성하였으며 이를 이용하여 백서 SPARC 단백질을 합성하였다 SP때C 단맥 질을 이용해 백서 조골 세 포의 증식 에 미치는 영호노을 관찰하였다 동시 에 백서 장골에 인위적인 골결손을 형성하고 형성과정에서의 골기질 관련인자의 분포를 관찰하고 SPARC 의 분포를 in situ hyb ridiz a tion법을 이용하여 관찰하였다 백서에서 분리 합성된 cDNA 조각은 1231bp 크기 였으며 40kD 크기의 단백질을 발현하였다 백서 태자 두개관 세 포의 증식에서 SPARC과 콜라겐 으로 처리된 표띤은 콜리겐 단독으로 표면처 리된 t111 양표연보다 증가힌 세포증식과 단백질 합성 콜라겐 합성을 나티내 었다 백서 -?I-골이1 형성힌 골조직 지| 생괴정에서 SPARC을 투여힌 백서 ;<J-골의 경우 결손부 전체에 걸쳐 증가한 SPARC의 합성을 보였디 SPARC이 투여된 군에서는 질손부의 중심 에서부터 SPARC과 콜라겐의 합성이 증기한 양상을 나타내었으며 대조군과 뚜렷한 차이를 나타내었다 in siLu h yb ricli za Li o n 깨 을 이용한 관칠 에서 골결손부 중잉에 있는 세 포에서의 SPARC 발현이 증가하였으며 그 싱패는 1 4 일 까지 대 조군에 비해 높게 니티났디 이싱의 연구 에서 얻은 결론은 디음과 같다 SPARC은 콜라겐과 결합하여 백서태자 두개관세 포의 배양에서 세 포증식 및 단백질 한성 ‘ 콜라겐 합성 의 뚜렷한 증가를 나타내었으며 . 이 같은 OJ상은 SPARC 단독으로 표연 처리하였을 때 는 관찰되지 않았다. SPARC의 골절손부 투여는 골조직 의 재생을 촉진허며 초기 세 포외 기질의 합성을 증가시켰으며 특히 SP뻐C의 형성이 초기애 증가하는 앙싱 융 나타내었다 이상 의 결과로 볼 떼 SPARC의 투여는 골조직 손상회복 시 초기 골기질 형성과 석회화에 영향을 미치며 SPARC 자치1 의 형성 증가에도 영향 을 미치는것으로보인다

The adenomatoid odontogenic tumor(AOT) is a benign tumor of odontogenic epithelium characterized by slow but progressive growth and rare recurrence. Tumor growth may cause displacement of teeth rather than root resorption. The AOT appears in 3 clinicotopographic variants such as follicular, extrafollicular, and peripheral. The follicular AOT mimics a dentigerous or follicular cyst and the extrafollicular cyst does a residual cyst, globulo-maxillary cyst and lateral periodontal cyst. Although over 750 cases of AOT were reported in the literature, clinicopathologic parameters of AOT in Koreans has not been investigated. 22 cases of AOT were retrieved from the files of the department of Oral Pathology, Seoul National University Dental Hospital and their clinicopathologic findings were reviewed. The central type accounts for 95%, 72% of which are follicular. The follicular and extrafollicular varients together are more commonly found in the maxilla than in the mandible with a ratio of 4.5:1. Age distribution showed that 59% of AOTs were diagnosed in the second decade of life, and mean age was 18.5 years. The female to male ratio was 3.4:1. All variants of AOT showed identical histologic features.

The p16 gene encodes an inhibitor of the cyclin-dependent kinase, which inactivates cyclin-dependent kinase and contro1s the cell cycle progression, The 10ss of p16 expression or overexpression has been reported in many kinds of tumors, Both p16 and PCNA regu1ates cell cycle progression at the Gl/8 checkpoint, Although many researches about the p16 expression in ora1 cancer have been carried out, there are few studies about the corre1ation between p16 ex pression and pro1iferation of ora1 cancer cells The object of this study was to eva1uate the avai1ability of p16 as ear1y diagnostic factor and prognostic factor through corre1atión ana1ysis of p16 expression in ora1 squamous cell carcinoma and its re1ation to PCNA index and clinicopatho1ogic factors 80 we investigated p16 immunohistochemica1 expression of 83 ora1 squmaous cell carcinomas, and obtained the resu1ts as followed, 18 out of the 83 cases(21, 69%) showed p16 positive and 65 samp1es(78,31%) showed p16 negative, Whi1e the mean va1ue of PCNA indices of p16 positive cases was 65,94 ::t 18,32, that of PCNA indices at p16 negati ve ones 54,79 ::t 18, 39, This difference between them showed statistica1 sígnificance, (P=O, 030) p16 positive group was 12/60(20, 0%) of well differentiated tumors and p16 negative group was 6/23(16, 1%) of moderate1y or poor1y differentiated tumors, This difference did not show statistica1 significance. (P=O. 372) From the resu1ts above, it was suggested p16 expression is re1ated to PCNA index in ora1 squamous cell carcinomas.

ReαlITent aphthous stomatitis (RAS) appears to be one of the most common oral diseases. However, the defmitive etiology of RAS is not well established, though many etiologic faαors have been suggested and examined. The present study was petformed to investigate the association between HIA and Korean recurrent aphthous stomatitis pa디ents. πle proportions of class 1 and class II HIA types expressed in 49 Korean subjects affected by recurrent aphthous stomatitis (RAS) and in 50 healthy controls were deteffi1Í11ed by microlymphocytotoxicity test. 까le sig띠ficance of the data was analyzed by chi-square test and Fisher' s exact test. πle proportions of HIA-Cw1 and -DR9 antigens were significantly higher in RAS pa디ents (p(0.05), whereas those of HIA-DR4 and -DQ2 antigens were significantly lower (p(0.05). 까le odds ratio (OR) were 2.8 for HIA-Cw1 and 2.7 for -DR9. πle etiologic fractions (EF) were 0.262 and 0.193, respectively. The results s맹gest that, in Koreans, there Í$ a sig띠ficant relation between HIA antigens and RAS. Genetic faαors ， reflected in the HIA type, may play an in1portant role in the development of RAS.

Alterations in cell surface receptors and adhesion molecules which regulate cell-cell and cell-matrix interactions have been 뻐plicated in tumor processes. In order to investigate the effect of integrin expression on the invasiveness of oral sqllamous cell carcinoma, integ띠1 expression in the celllines such as SCC-4, SCC-9, SCC-15, and SCC-25 was analyzed, and the comparison between cell adhesion assay towards extracellular matrix proteins and in vitro invasion assay following inhibition of the functional domain of the integrins using blocking antibodies against the specific integrins 낀 nd Arg-Gly-Asp (RGD) peptide were carried out. The expression of integrin a 2, a 3, a 6 was detected in all oral squamous cell carcinoma celllines. In contrast, the expression of a vß6 integrin is detected in SCC-4 and SCC-9, not in SCC-1 5 and SCC-25. 까1e adhesion of SCC-4 cell line to collagen 1, laminin, and fibronectin was significantly reducecl by σeatment with a 3-, a 6-, and a vß6-blocking antibody, respectively (p (0.05). 꺼.1e invasion of SCC-4 cell line throllgh Matrigel was significantly reduced by treatment with v 6-blocking antibody and RGD pepticle (p(0.05). These results sllggested that specifìc integrins play an in1portant role in the process of adhesion and invasion of oral squamous cell carcinoma cells and the expression of a vß6 integrin is believed to the enhance its invasivene잃.