Oral verruciform xanthoma (OVX) is an uncommon benign lesion of the oral mucosa, clinically mimicking various verrucous lesions. This study aimed to describe the clinicopathological characteristics of OVX. Twenty-one patients diagnosed with OVX were collected. The patients’ age, sex, medical history, clinical features, and treatment were reviewed. Archived slides were reviewed, and periodic acid-Schiff (PAS) and immunohistochemical (IHC) staining with CD68, CD1a, and S-100 were performed. OVXs affected 13 males and 8 females (M: F=1.6:1) with a mean age of 52 ± 21 years. The most prevalent site was the gingiva (57.1%), followed by the hard palate (28.5%). The lesions presented as an asymptomatic solitary lesion with verrucous or granular surface, with exception of one case with multiple papules on the hard palate. PAS-positive granules were found in xanthoma cells in 14 (66%) specimens. IHC revealed that xanthoma cells were positive for CD68 and negative for CD1a and S-100 in all specimens. Most lesions were successfully excised, and none of the lesions have recurred. Clinicians should include OVX in the differential diagnosis of various verrucous lesions in the oral cavity to provide appropriate management.

Background/Aim: In gallbladder cancer (GBC), gender differences in incidence and mortality rates have been reported with geographic variation. However, there is little known about sex-related difference in GBC prognosis. This study compares prognostic factors according to gender for GBC. Methods: We searched clinicopathological factors in all stages of 952 GBC patients from seven medical centers in Korea. A total of 927 patients were enrolled and surgery with curative resection was performed in 499 patients. Results: Carbohydrate antigen (≥37 U/mL) was a significant prognostic factor in both females and males (odd ratio [OR], 4.30; 95% confidence interval [CI], 3.13-5.89; p<0.001). Age was a significant factor only in female patients, elderly patients were associated with low resectability and the likelihood of T-stage >2; an independent predictor of poor prognosis via multivariate analysis (OR, 1.03; 95% CI, 1.01-1.05; p=0.005, OR, 1.05; 95% CI, 1.02-1.08; p=0.002). Body mass index (BMI) also showed gender difference, and lower BMI (≤25 kg/m2) was the significant good indicator of multivariate analysis for lymph node metastasis in female patients (OR, 0.42; 95% CI, 0.23-0.77; p=0.005) but, the significant poor indicator of univariate analysis for advanced T-stage in male (OR, 2.79; 95% CI, 1.40-5.54; p=0.003). Conclusions: These results suggest that there is a possibility of gender difference in GBC prognosis. Age and high BMI were poor prognostic factors for curative resection for female GBC patients.

본 연구는 점오염원인 하수종말처리장으로부터 배출되는 물의 수질을 분석하고 배출수의 영향을 받는 어류 중 지점들에서 공통적으로 출현하는 어종인 피라미 (Z. platypus) 를 선택하여 조직학적 변화를 참조하천 지점의 수질과 어류 조직을 비교·분석하였다. 2019년 6월 27~28일 하수종 말처리장 4곳 (대전, 전주, 청주, 익산)의 채집 결과, 참조하 천에서 22종 450개체로 가장 많은 종수 및 개체수가 확인 되었다. 지점별로 5개체씩 2~3년생 피라미의 조직표본을 제작하여 아가미와 근육조직 (피부조직)을 관찰한 결과, 참조하천을 제외한 나머지 지점의 조직은 병리적인 양상을 나타내었다. 수질분석 결과, 각 WTP에서는 배출수질 기준을 준수 혹은 더 좋은 수질로 방류하고 있었다. 그러나 하수종말처리수 배출수 및 방류수계 수질에서 오염도지표를 나타내는 항목인 BOD, COD, TP, TN, SS 값이 참조하천에 비해 높은 것으로 나타났다. 빈약한 어류상과 바이오마커로 이용된 종의 조직병리학적 상태는 참조하천에 비해 낮은 수질에서 기인한 것으로 추측되며, 따라서 원인이 되는 하수종말처리장 배출수 수질개선이 이루어져야 할 것으로 사료된다.

Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.

담낭암의 대표적인 조직형은 담낭 점막의 상피세포에서 기원하는 선암(adenocarcinoma)이며, 형태적 유사성에 따라 담도성(biliary), 장관성(intestinal), 위의 소와세포성(foveolar), 혹은 편평상피성(adenosquamous) 등으로 분류할 수 있다. 선암의 전암성 병변은 3가지가 있으며 1) 선종(adenoma), 2) 담도상피내종양(BilIN), 3) 담낭내 유두상 종양(intracystic papillary neoplasm)으로 구분할 수 있다. 이런 전암성 병변은 공통적으로 세포학적 이형성을 갖는 점막 상피 세포의 증식이라는 특징을 갖고 있으나, 종양 세포가 점막 아래 간질을 침습하지 않은 상태의 병변이다. 내강 내로 돌출된 폴립 모양의 병변이나 점막이 과립상으로 비후된 경우, 선종 혹은 담낭내 유두상 종양의 경우가 많으며, 육안상 확인되지 않으나 현미 경적으로 상피 세포의 이형성이 관찰될 경우 담도상피내종양에 해당한다. 이런 전암성 병변은 이형성의 정도에 따라 저등급(low), 중등급(moderate), 고등급 이형성(high grade dysplasia) 의 3등급으로 평가하고 있으며, 고등급의 경우 상피내 암(carcinoma in situ)과 동일한 병변으로 취급하고 있다. 선종과 담낭내 유두상 종양은 형태학적 특징이 중복되는 부분이 있어, 진단의 재현성을 높이기 위한 형태학적 기준 마련이 필요한 병변이다. 담낭 선암에서 보고된 가장 대표적인 분자 유전학적 변이는 KRAS, TP53과 CDKN2A가 알려져 있고 ERBB2의 증폭도 알려져 있으나, 담도암에 특이적이면서 변이율이 높은 유전자는 많지 않다. 전암성 병변에서 선암으로 이어지는 암발생 과정에서 단계적으로 발견되는 분자유전적 변이 또한 전암성 병변의 종류나 만성 담낭염, 췌담도 기형 등의 위험인자 유무에 따라 보고율이 서로 달라, 한 가지 기전으로 설명하기는 어렵다. 만성 담낭염을 선행인자로 갖는 경우 점막 상피의 증식 혹은 화생의 초기 단계에서 COX-2 과발 현이나 TP53 변이, 마이토콘드리아 DNA 손상이 발생하고, 초기 이형성 단계에서 3p, 8p 염색체의 이형접합성 소실(loss of heterozygosity, LOH) 및 HER2 증폭이 보고되고 있고, 상피내종양에서는 9p, 18q, 22q, 17p 염색체의 LOH 및 CDK2A 변이가 관찰되는 것으로 알려져 있다.

Osteonecrosis is defined as non-vital bone tissue as a result of abnormal process of osseous healing, and is caused by several reasons such as infection, radiation, and medication. Osteomyelitis, osteoradionecrosis, and medication related osteonecrosis of the jaws (MRONJ) which have necrotic bone in common are confused clinically due to similar symptoms and radiographic findings, and are difficult to diagnose definitively. Because each disease represents a separate clinical progress and requires a different treatment approach, it is very important to distinguish each disease. The aim of this study was to analyze the histopathologic features of osteomyelitis, osteoradionecrosis, MRONJ and to understand their different pathogenesis.

Desmoplastic ameloblastoma (DA) and Ameloblastic fibroma (AF) show common histopathologic features such as enamel organ like epithelial islands or cords on the background of abundant fibrous stroma. Despite their similar histopathologic features, it was reported that they have different pathogenesis and clinical behavior. The purpose of this study was to rev iew clinicopathologic features of DA and AF among Korean subjects. 7 cases of DA and 4 cases of AF were retrieved from the files of Seoul National University Dental Hospital (SNUDH), and their clinical features, radiographic findings, and histopathologic features were reviewed and compared. DA occurred in 3 males and 4 females. They occurred from 24 to 62 years of age, showing the mean age of 42.7 years. 5 of the 7 tumors occurred in the maxilla, and all of them in the anterior region, showing predilection for the maxillary anterior regions. There was no recurrence. Radiographically, they showed well demarcated unilocular or multilocular radiolucency. AF occurred in 5 males and 2 female. They occurred from 6 to 29 years of age, showing the mean age of 14 years. All tumors occurred in the mandibular molar area. Recurrence was recognized in 1 case. Although DA and AF showed similar histopathologic features, they showed different clinical behaviors. While DA showed predilection for the anterior maxilla, AF did for posterior mandible. While DA occurred mainly in adults, AF did in adolescents. Recurrence was recognized not in DA but in AF. Therefore, DA and AF should be differentiated from each other in spite of similar histopathologic findings

35 peri-implantitis recently referred for 10 years showed four types of inflammatory lesions, such as mild granulomatous lesion(n=5), severe granulomatous lesion(n=4), severe inflammatory fibrous scar tissue(n=15), severe abscess formation(n=11). However, the inflammatory lesions were usually localized at the peri-implant area accompanying compensatory hyperplasia of fibrous connective tissue. The fibrous scar and the necrotic abscess frequently occurred depend on the severity of inflammatory reaction. Among 30 cases of severe inflammatory lesions, only 2 cases involved condensing osteitis in adjacent alveolar bone. Thus, we suppose that the inflammatory progression of peri-implantitis could be partly inhibited by the hyperplastic fibrous stromal tissue stimulated by implant material. And more, the focal abscess formed around the implant can be easily drainaged through the fibrous tract of implant pathway, resulted in the chronic persistent inflammatory granulomatous lesion, that is contrast to the common socket granuloma after tooth extraction. However, depend on the degree of inflammatory reaction in the peri-implantitis the inflamed fibrous collagenous tissues, unregenerated graft materials, necrotic abscess and sequestra should be removed by surgical intervention and followed by antibiotic therapy, because the peri-implant tissue is as vivid as the normal periodontium for the inflammatory defense system. Therefore, we suggest that the inflammatory lesions of peri-implantitis be carefully treated to improve the prognosis for the following dental treatments

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

Fibro-osseous lesion(FOL) has been known a lesion that normal bone is replaced by cellular fibrous connective ti ssue and nonfunctional bone, FOL has been classified and revised by several investigators and World Health Organization(WHO) , For correct diagnosis and treatment, it is necessary to classify FOL precisely, Compared to the class ificat ion by WHO in 1992‘ the new version of 2005 makes it simpler to classify , Therefore, the aim of this study is classifying FOL by the WHO classification in 1992 and compare it with the new ve1'sion in 2005 The material was 1'e tl‘ ieved f l'om the cases which were diagnosed as FOL from 1992 to 2005 in the Department of Oral Pathology, Yonsei University College of Dentistl'Y, Clinical, rad iological and pathological observations were conducted for this study Comparing WHO classifi cation in 1992 with the one in 2005, there were no differences regarding clini cal, radiological a nd hi s tological f indings in each classified disease entity of both osteogenic neoplasm and non neoplastic bone lesion , Hence, the new classification by WHO in 2005 would be a useful yardstick for correct diagnosis and treatment , For the differential diagnos is between osteogenic neoplasm and non neoplastic bone lesion, it is important to observe the degree of cell ularity microscopi cally and definiteness of the border radiographically,

Nowaday many researches has proved that glutaradehyde(GA) is more excell ent medicament in vital p띠 potomy practice than formocresol (FC) . But a number of dental practitioner prefer to use formocresol in vital pulpotomy procedure todays And thus author reeva luate proper ties of gluteraldehyde and formocresol through implantation into epidermis and trypsin digestion after f ixation at 2% buffered glutar aldehyde and Burkley's formocresol solution.. And then prepared t issues were s tained by H&E a nd Masson-TI’ ichome method. GA showed definite fixative zone and γery low diffusi ble property in epi dermis and pulp t issue as glutaraldehyde and formocresol were compared. GA r epresented exceedingly lower antigenici ty than FC GA fixation exhibited more resistibility to trypsin digestion than FC. As considering these results‘ it concluded that GA would be extremely supe ri 이 . medicament to formocresol in vital pulpotomy proce

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

사료를 통한 benzo(a)pyrene이 조피볼락, Sebastes schlegeli의 lipid peroxidation (LPO), superoxide dismutase(SOD)활성과 간 조직의 병변 현상에 미치는 영향을 연구하기위해 0 (대조구), 0.5, 1.0, 1.5, 2.0 mg kg-1 농도의 사료를 조제하여 30일간 급이하였다. LPO는 2.0mg kg-1농도구에서 전 실험기간 동안 유의적으로 증가하였고, SOD 활성도

World Health Organization(WHO) revised the classification of neoplasms and other tumours related to odontogenic apparatus in 1992. The aim of this study was to classify the odontogenic tumors of Korean according to the WHO Histologic classification. A total of 271 cases were reviewed for the study which were diagnosed as odontogenic tumors at the department of Oral Pathology, Yonsei University College of Dentistry for the period from Jan. 1997 to March 2003. Clinical and pathology reports were reviewed & radiographic feature were examined. The following results were obtained : 1. Among 271 cases, 269 cases(99.3%) were diagnosed as benign odontogenic tumors, and the remaining 2 cases(0.7%) were malignant tumors, which were diagnosed as odontogenic ghost cell carcinoma and squamous cell carcinoma ex odontogenic cyst. 2. Four cases were not able to classify into the WHO classification. All of them were belonged to mixed odontogenic tumors; two cases of adenomatoid odontogenic tumor with calcifying epithelial odontogenic tumor, one case of adenomatoid odontogenic tumor with odontoma, odotogenic cyst and one case of ameloblastoma with immature odontoma. 3. The most frequent odontogenic tumour was odontoma(45.2%), followed by ameloblastoma (29.2%), odontogenic fibroma(9.2%) 4. One case of atypical amelobalstoma and one case of calcifying odontogenic cyst with ameloblastic fibroma were not able to subclassify histologically. 5. Male to female ratio of odontogenic tumors was 1.2:!. Odontogenic tumors mainly occured in the first and second decade, occurred twice as much as in the mandible than in the maxilla 6. The odontogenic tumors was discovered by routine oral x-ray examination, whereas the chief complaint of ameloblastoma were swelling, pain. 7. Ameloblastoma, adenomatoid odontogenic tumor, calcifying odontogenic cyst and odontoma were related to the impacted teeth and tooth displacement. The root resorption was frequently observed in ameloblastoma and calcifying odontogenic cyst.