Four Cases of Childhood Systemic Lupus Erythematosus

No abstract available.

Detection of Human Papillomavirus DNA by In Situ Hybridization using Biotinylated DNA Probes in Cervical Intraepithelial Neoplasias and Squamous Cell Carcinomas

The authors examined 9 condylomas, 26 cervical intraepithelial neoplasms(CIN) and 22 invasive squamous cell carcinomas for the presence of human papillomavirus(HPV) DNA sequences by DNA-DNA in situ hybridization. In situ hybridization revealed target HPV DNA sequences mostly in the nuclei of the superficial cells from epithelium which contained either maturation or koilocytotic atypias. With the use of biotinylated HPV DNA probes 6/11, 16/18 and 31/33/35, 42 of the 57(73.7%) were positive with HPV-6/11, 23 with HPV-16/18, 32 with HPV-31/33/35 and 18 with two or more mixed probes. HPV-31/33/35 was wht most prevalent in CIN and invasive squamous cell carcinomas, follwed by HPV-16/18. The incidence of HPV DNA increased from 66.7% to 86.4% with increasing severity of the lesions from condylomas to invasive squamous cell carcinomas. Flat condyloma was most freuently accompanied by CIN.

In vitro immunohistochemical localization of S-phase cells by a monoclonal antibody to bromodeoxyuridine

Bromodeoxyuridine, an analogue of thymidine, can be detected by means of monoclonal antibodies and utilized as a marker of the S-phase of the cell cycle. In vitro immunohistochemical application of the BrdU/anti-BrdU-MAb method permits a quantitative assessment of the proliferative activity of a tissue as well as the direct location of the actively replicating cells in histological sections. In this paper, a method for the detection of the labeling index of S-phase cells in normal and neoplastic tissues with in vitro BrdU labeling and standard immunohistochemical techniques using anti-BrdU-MAb and avidin-biotin peroxidase complex is described. We have employed this method in 47 human solid tumor samples, including squamous cell carcinomas of head and neck and cervix uteri, adenocarcinomas and malignant lymphomas, and also evaluated the possible application of the BrdU labeling index to estimate the cycling S-phase cells in neoplastic cell populations. In our data, the in vitro labeling index varied greatly in an individual case (3.56-29.2%) and from an area to an area within the same case. Squamous cell carcinomas of the head and neck showed higher LI than those of the cervix uteri. A case of metastatic carcinoma to the lung from ductal carcinoma of the breast had the highest LI (29.2%), in contrast to the low LI (3.6%) in the primary ductal carcinoma of breast.

Mechanisms of Acinar Cell Deletion in Rat Pancreas Following Experimental Duct Ligation

This study was carried out to investigate the mechanisms of acinar cell deletion, leading to the pancreatic atrophy of rat pancreas after experimental duct ligation. Fifty-seven male Sprague-Dawley rats, maintained on a stock diet, weighing 200 gm, in average, were divided into 2 experimental groups. Group 1. Control group. Six rats. Abdominal cavity was opened and closed without further treatment. Group 2. Fifty-one rats. Animals were treated with partial ligation of the pancratic ducts according to the procedure developed by Hultquist followed by sequential sacrifices at: 1 hour (3 rats), 3 hours (3 rats), 6 hours (6 rast), 12 hours (3 rats) and 24 hours (8 rats); 2 days (8 rats), 3 days (3 rats), 4 days (3 rats) and 5 days (5 rats); 1 week (3 rats), 2 weeks (3 rats) and 8 weeks (3 rats); after partial ligation was extirpated and examined by both light and electron microscopy. The results obtained were as follows: Light microscopically, noted were an interstitial edema and focal necrosis of the pancreatic tissue along with fine vacuolization and depletion of the zymogen granules in the acinar cell cytoplasms and condensation of the acinar cell nucleus. These changes were observed by 2 days after ligation. At about the same time, one can observe the dense body, identified to be apoptotic body, in the acinar cell which were found to be decreased in quantity. By 5 days after ligation, no recognizable acinar cells left in the collagenous stroma except intercalated ducts. Conspicuous stroma except intercalated ducts. Conspicuous stromal hyalinization, thereafter. Electron microscopically (TEM and SEM), nuclear condensation and margination toward the nuclear membrane was noted by 6 hours after duct ligation. By 24 hors sporadic membrane-bounded apoptotic bodies appeared in the acinar cells, the number of which reaching to the peak by 3 days after ligation. These apoptotic bodies were found to be phagocytosed by either intraepithelial mononuclear phagocytes or adjoining acinar cells. It can be concluded, therefore: That orderly remodeling of pancreatic exocrine tissue during atrophy is effected by rapid deletion of acinar cells by apoptosis.

Electron Microscopic Examination of Neurohistological Changes Following Narcotics Injection on Peripheral Nerve of Rats / 대한마취과학회지

We have already reported good effect of meperidin and pentazocin as the sole agent for spinal anesthesia. The present study was undertaken to examine toxic effects of pentazocin and meperidine on peripheral nerve tissue. 11 rats were divided into three groups i.e. pentazocine, meperidine and control group. The sciatic nerves of adult rats were exposed and injected with pentazocin 0.5ml(15mg) or meperidine 0.5ml (25mg). Two specimens of normal nerve and another two specimens injected with normal saline 0.5 ml were used as the controIs. The nerve was examined under electron microcopy at 24 hours, 48 hours, 1 week and 4 weeks after the injection of each of the drugs. A total of twenty injections were carried out in 11 rats. The results were as follows: The pentazocien group revealed hydropic changes in the mitochondria and ER of axon and Schwann cell but the degree of injury was not significant and was reversible. The meperidine group showed hydropic changes that were not significant but the specimen taken at one week revealed severe axonal and myeline changes, admixed with fat globules and Schwann cell with severe fatty changes in the cytoplasm. Although most of the above mentioned changes may reverse, it is not certain yet that pentazocin and meperidine are free of toxicity on nerve cells until further study is done to find the causes of the severe histolgical changes which were shown in the one week specimen with demerol.

Neurophysiologic - Histological Changes Following Injection of Morphine , Meperidine , Pentazocine on Sciatic Nerve of Dogs / 대한마취과학회지

The authors have already reported good local anesthetic effects of meperidine and pentazocine clinically in patients scheduled for various surgeries, followed by experimental evaluation of toxic effects of two drugs on the sciatic nerve of rats. Intraspinal (spinal, epidural) morphine as well as other narcotics administration has been widely used and well established for pain control. The action mechanism of intraspinal narcotics has been well defined, and meperidine and Pentazocine have been reported to be used as a sole agent for spinal anesthesia. We assurned that the action mechanism of subarachoid meperidine or pentazocine might be different to some extent from that of morphine. This investigation was primarily undertaken to examine the difference in action between meperidine and morphine and also to evaluate neurotoxic effects on sciatic nerve of dogs. Adult Korean dogs were chosen as exoerunebtak abunaks because it is easy to observe physiologic activity with responses and to avoid of manipulating trauma. The dogs were intubated and anesthetised with halothane and nitrous oxide. The sciatic nerve of the dogs was exposed and stimulated by a nerve stimulator to observe myoneural response and then injectied with 1% morphine 0.5 mg (Group 1), 5% meperidine 25 mg (Group 2) and 3% pentazocine 15 mg (Group 3). The dog was carefully observed in recovery room to see the myoneural activity After 1 week, 1 month or 2 months of careful observation, a specimen was taken under reanesthesia at 1 week, 1 month and 2 months after the careful obaervation, When the sciatic nerve was stimulated by a nerve stimulator, the normal muscle twitch was observed clearly in Group 1 with themorphine injection but was not observed in Group 2 with meperidine and Group 3 with pentazocine injection. Complete motor paralysis was noticed in Group 2 and 3 during the recovery period which lasted about 90 minutes, almost the same as the duration of drugs for spinal anesthesia, No complications were noticed in the 3 group during the periods of one week one month and two months. All specimens were examined and no abnormal findings were observed in the 3 groups. All specimens of the 3 groups were investigated under electrom microscopic examination and they revealed mild vacuolizations scattered in axon and ummyelinated nerves on the only some of the specimens and these were not significant. Severe nerve damage which was seen in the meperidine group of a preliminary experiment was not observed in this study. As a result of this investigation, we have not observed significant toxic effects microscopically or fuctioually.

Immunohistochemical Application of Leukocyte Common Antigen and Epithelial Membrane Antigen in the Diagnosis of Large Cell Undifferentiated Tumors

A total of 42 cases undifferentiated large cell tumors were stained by immunoperoxidase techniques using antibodies against leukocyte common antigen (LCA) and epithelial membrane antigen (EMA). In 18 of the 21 cases studied, initially diagnosed as malignant lymphoma or Hodgkin's disease, reactivity with monoclonal anti-LCA (and noreactivity with monoclonal anti-EMA)indicated that the tumor was a lymphomas. The remaining 3 cases gave the reverse reaction pattern and therefore were classified as carcinoma. One out of 16 cases diagnosed as undifferentiated carcinoma proved to be a case of mialignant lymphoma in 5 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases and 3 of these proved to be large cell lymphoma; the remainders, undifferentiated carcinoma. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells may result in much greater diagnostic accuracy.

Immunohistochemical Application of Leukocyte Common Antigen and Epithelial Membrane Antigen in the Diagnosis of Large Cell Undifferentiated Tumors

A total of 42 cases undifferentiated large cell tumors were stained by immunoperoxidase techniques using antibodies against leukocyte common antigen (LCA) and epithelial membrane antigen (EMA). In 18 of the 21 cases studied, initially diagnosed as malignant lymphoma or Hodgkin's disease, reactivity with monoclonal anti-LCA (and noreactivity with monoclonal anti-EMA)indicated that the tumor was a lymphomas. The remaining 3 cases gave the reverse reaction pattern and therefore were classified as carcinoma. One out of 16 cases diagnosed as undifferentiated carcinoma proved to be a case of mialignant lymphoma in 5 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases and 3 of these proved to be large cell lymphoma; the remainders, undifferentiated carcinoma. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells may result in much greater diagnostic accuracy.

Adenocarcinoma of Urinary Bladder: 2 cases report

Two cases of adenocarcinoma of the urinary bladder with clinical and pathological features, and brief review of the literatureare presented. Case 1: The patient, a 52 year-old man, was admitted to this hospital because of intermittent painless total gross hematuria for 15 years. Cystoscopy was done, and showing a cauliflower mass with broad based diffuse infiltrating lesion at the right anten or portion of bladder. TUR-B was performed. Microscopically, the lesion consisted of colonic metaplastic epithelium with atypical glands and cystic dilatation and adenocarcinoma. Case 2: The patient, a 52-year-old woman, was admitted to this hospital because of total painless gorss hematuria for 1 year. Cystoscopy was done showing a sessile diffuse mass with ulceration on the dome area. Total cystectomy was performed. Grossly, the tumor showed an ulcerative tumor mass with elevated nodular margin at the dome of the bladder. Microscopically, the lesion consisted of anaplastic glands with back to back arrangement and branching glands through the entire thickness of the bladder wall.

Multiple Primary Malignant Tumors: 39 cases

Thirty nine cases of multiple primary malignant tumors examined at the Department of Pathology, Keimyung University School of Medicine during the period from November 1974 through March 1986 were analysed clinicopathologically. The findings are as follows: 1) Thirty nine cases had synchronous lesion and six cases metachronous lesion. The second primary malignancy occurred mean 4.7 years after the first malignancy in patients with metachronous lesion. 2) The age at diagnosis of the first malignancy ranged from 26 to 76 years, the average being 51.8 years. The male-female ratio was slightly less than 1:1.2. 3) The most commonly involved site in multicentric origin was gastrointestinal tract (44.4%) with all adenocarcinoma and the second urogenital system (29.6%). In cases of different tissues or organs (11 cases), ovary was the most frequent site (5 cases), followed by cervix (4 cases). 4) Multiple primary malignant tumors of urogenital system were all eight cases and six cases among them (75%) had smoking and drinking habits. 5) The detailed informations about possible environmental, familial and host factors necessary for the investigation of multiple primary tumors were lacking in most cases. Therefore, the history taking with special attention to these factors must be carefully recorded. And also, we suggest that in the high-risk individuals, careful follow-up and thorough search for early cancer detection or prevention should be taken.

Mechanisms of Experimental Pulmonary Fibrosis Following Paraquat Toxicity

This study was carried out to investigate the intricate mechanisms of intraalveolar fibrosis, leading to the alveolar structural remodeling, of rat lungs treated with paraquat. Sixty-three male Sprague-Dawley rats, maintained on a stock diet, weighing 200.0 gm, average, were divided into 4 experimental groups. Group 1. Control group (10 rats). Intraperitoneal injections of 2-4 ml normal saline only. Group 2(13 rats). 10, 20, 25, 30 and 40 mg per kg of body weight was administered intraperitoneally. Animals were sacificed 5 hours. 1 and 3 days after paraquat treatment. Group 3(16 rats). 20, 25, 30 and 40 mg per kg of body weight was administered to the animal, and animals died 2-5 days after paraquat administration. Group 4(24 rats). The same amount of paraquat was administered to the animal as in the group 2. Animals were sacrificed 1, 2, 6, 8 and 10 weeks after paraquat treatment. Sacrificed animal lung was examined by gross, light-microscopic, immunohistochemical, ultrastructural observation, along with cellular and chemical analyses of bronchoalveolar lavage fluid. The results were as follows: Grossly, 6 rats of chronic stage (1-10 weeks survival) developed multiple wedge-shaped scars on both lungs. These scars were situated mainly along the bronchial trees, blood vessels and subpleural regions. Light microscopically, the salient features found of the chronic stage lungs were intraalveolar fibrosis. Intraluminal buds or polypoid masses projecting into the alveolar lumen and ducts. Elsewhere, loose connective tissue masses were found to fuse together to alveolar wall, obliterating the alveolar spaces with resultant severe alveolar structural remodeling. Immunohistochemically, fibronectin was found in the center of intraalveolar buds and polypoid mass, projecting into the alveolar lumen, and in the adjacent proliferating alveolar macrophages. An attempt to measure the amount of fibronectin in the bronchoalveolar lavage fluid failed. Electron microscopically, the chronic stage lung revealed marked proliferation of both alveolar macrophages and fibroblasts in the alveolar spaces, the latter containing actin-like microfilaments and collagen fibers arranged in bundles and spirals. In areas, myofibroblasts and smooth muscle cells also present. Cellular analysis of the bronchoalveolar lavage fluid in chronic stage lungs revealed no significant findings. It can be concluded, therefore: That intraalveolar fibrosis of the paraquat-treated lungs of the rat is probably mediated by intraalveolar migrations of the interstitial cells, the main task force being the connective tissue cells, passing through the defects created in the epithelial lining surface to its basement membrane, which were inflicted upon the alveolar wall by paraquat toxicity. Fibronectin, released by activated alveolar macrophages, may be responsible for the migrations of fibroblasts and myofibroblasts into the alveolar spaces to form the intraalveolar fibrosis with subsequent alveolar structural remodeling,

Immunohistochemical Demonstration of Fibronectin in Paraquat-Induced Interstitial Fibrosis of Adult Human Lung

We studied distribution of fibronectin in paraquat-induced adult fibrotic lung by indirect immunofluorescence and indirect immunoperoxidase methods, using affinity-purified antifibronectin IgG peroxidase conjugates and antifibronectin IgG FITC conjugates. In contrast to the relative paucity of staining in normal lung, there was a marked increase in interstitial staining for fibronectin in this fibrotic lung. This marked alterations in the apparent amounts and distribution of fibronectin in fibrotic human lung suggest its involvement in the cellular events accompanying human lung fibrosis.

Carcinoma In Situ of the Urinary Bladder with Transitional Cell Carcinoma of Prostate: A Histopathologic Study and Mapping of the Urothelial Lesions

A 63-year-old male patient with extensive carcinoma in situ of the urinary bladder was found to have unsuspected transitional cell carcinoma of the prostate. Mapping of the totally embedded radical cystectomy specimen demonstrated diffuse, multifocal, epithelial abnormalities, ranging from mucosal atypia to the nonpapillary carcinoma in situ with extension to the urethra, prostatic ducts and glands, seminal vesicles and ureter, probably reflecting individual urothelial susceptibility in reaction to carcinogenic stimulus. The importance of prostatic assessment in the evaluation of the patient with carcinoma in situ of the urinary bladder is emphasized.

Proliferating and Malignant Brenner Tumors of the Overy: Report of 2 cases

Two unusual and rare forms of Brenner tumor are reported and the literatures are reviewed. The one, "proliferating" Brenner tumor, morphologically resembling low grade papillary transitional cell carcinoma of urinary bladder and regarded as a third variant intermediate between the benign and malignant forms; the other, malignant Brenner tumor of right ovary, corresponding to grade III transitional cell carcinoma of urinarybladder with areas of invasive squamous cell carcinoma and benign Brenner tumor of left ovary, combined with bilateral cystic teratomas. These tumors give additional support to the concept that Brenner tumors are composted of epithelium of urinary tract(urothelial) type.

Squamous Cell Carcinoma a arising in A Subcutaneous Dermoid Cyst: A case reported

The development of carcinoma in a subcutaneous dermoid cyst is a rare event. We report a 54-year-old Korean woman in whom excised subcutaneous dermoid cyst showed squamous cell carcinoma in the cyst wall.

Carcinosarcoma of the gallbladder: Report of a case

Carcinosarcoma, often referred to as "malignant mixed tumor" is a rare neoplasm, but this tumor occurs in various organs, including the gallbladder. We report herein a carcinosarcoma of the gallbladder which consisted of adenocarcinomatous and undifferentiated sarcomatous ares, the latter differentiating towards abundant osteoid and calcified but nonlamellated bony trabeculae formation. There are 18 reported cases of this type tumor of the gallbladder in the literature.

Classification of Gallstones and their Characteristics

Total 481 cases of gallstones from Korean patients operated at Keimyung University Dongsan Hospital during the last 6 years were classified by macroscopic view according to the classification of Sato, et al and reviewed with a special reference to age, sex, and kinds and sites of gallstones. Gallstrones were present predominatly in the age of 50-60 years, the average 52. Sex ratio (M:F) was nearly equal, being 1:1.05. Gallbladder was the most frequent site, comprising 53.2%, followed by common bile duct, 23.3% and intrahepatic location, 3.7%. Macroscopic classification revealed pigment gallstones in 53.0% (calcium bilirubinate, 41.8%; black, 11.2%); cholesterol gallstones in 36.2%, of which mixed stone being 33.1%. Cholesterol gallstones occurred predominantly in 50-60 years of age with a prediletion to females. On the contrary, elderly persons more than 60 years of age had calciu bilirubinate stones. No sex difference was found in the calcium bilirubinate stones. Eightly-six percent of cholesterol gallstones were present in the gallbladder only. Common bile duct stones were mostly composed of pigment gallstones in 80.4%.

Metastatic Ovarian Carcinoma: Clinicopathologic analysis of 33 cases

Thirty three cases of metastatic ovarian carcinoma were analysed cilincopathologically. The patient's age ranged from 20 to 68 years, the average being 44.3. Most ovarian tumors were bilateral and asymmertically enlarged, firm and occsaionally multicystic. Histologic examination revealed adenocarcinoma in 31 cases, of which Krukenberg tumors in 14; squamous cell carcinoma in 2. The most common primary site was gasrtointestinal(75.8%), followed by genital, breast and gallbaldder. Most Krukenberg tumors were originated from poorly differentiated adenocarcinoma of stomach. The ovarian and primary carcinomas were synchronously diagnosed in 15 cases, while in 3 cases the primary carcinoma was not round until the ovarian tumor had been removed.

Ultrastructural Changes in the Exocrine and Endocrine Cells of Rat Pancreas in Endotoxin Shock

This study was carried out to investigate the morphological changes in the exocrine and endocrine glands of rat pancreas treated with endotoxin. Thirty-five male Sprague-Dawley rats, maintained on a stock diet, weight 200.0 gm. average. were divided into two experimental groups. Group 1. Control group. Five rats. Intraperitoneal infections of 0.3 ml normal saline only. Group 2. Endotoxin-treated group. Thirty rats. 7.6 mg of endotoxin per kg. of body weight was administered intraperitoneally. Each of 5 experimental animal was sacrificed 30 minutes, 1, 2, 4, 6 and 8 hours after endotoxin treatment, followed by examinations of histochemical, light and electron microscopy of both transmission and scanning modes. The results were as follows: A. Light microscopic findings: A mild interstitial edema and hyperemia were noted 1-hour after endotoxin treatment. Cytoplasmic vacuolization at 2-hour level(2-hours after endotoxin administration), diminished staining quality of both endocrine and exocrine cells at 6-hour level. B. Electron microscopic examination: a. Transmission electron microscopy. The acinar cells of pancreas showed a mildly increased pre-lysosome at 30-minute level. At 1-hour level, appearance of secondary lysosome was noted in addition to the findings of mitochondrial swelling and decreased cristae; disarray and vacuolization of the RER; vacuolar change of Golgi apparatus. At 6-hour level, post-lysosomes. The changes in the endocrine glands were similar to the findings of exocrine glands just described with time lag of 1 to 2 hours. The endothelial cells of capillaries show swelling and pinocytotic vesicle formation, protrusion of the cytoplasmic processes into the capillary lumen and increased heterochromatin at 1-hour level. These findings became more prominent as time lapses. The lumen of the endothelium tends to be narrowed, filled with fibrin and other blood cell components which later terminated with occasional complete occlusion by the formation of thrombi. b. Histochemical study: Primary lysosomes of the control group revealed a strong reaction of the acid phosphatase whereas the endotoxin treated group with less reactivity limited in the peripheral zones of the lysosomes. Secondary lysosomes with partial reactions. However, the pre-lysosomes and post-lysosomes failed to demonstrate any acid phosphatase activity at all. c. Scanning electron microscopy. The endothelial cells of the capillaries, arterioles and venules demonstrated increased microvillous activity, broad bled formation, cytoplasmic protrusion into the luminal spaces and microthrombi formation at 1-hour level. Six-hour level onward there noted a junctional disruption and partial detachment from the subendothelium of the wall. It can be concluded, therefore: When the endotoxin enters the blood stream, it elicits endothelial injury followed by both exudation with resultant edema of the surrounding tissue and concomitant vascular occlusions due to thrombosis. This vascular occlusion, in turn, causes ischemic degenerative change of the cells of exocrine and endocrine glands of the pancreas which are followed by digestions of degradational materials from the injured cells through the lysosomal phagocytic system. Besides the above pathogenetic pathway, one can not rule out the possibility of the direct effects of the endotoxin to the cells of exocrine and endocrine cells of the pancreas also so rendered.

A Case of Large Chondroblastoma Occupying Middle Cranial Fossa

Chondroblastoma is a benign occurrence bone tumor arising most often in the epiphyses of long bone and its occurance in skull is rare. The authors recently encountered a case of large chondroblastoma occupying middle cranial fossa. The clinical presentation, reoentgenographic appearance, gross and microscopic characteristics, surgical treatment, differential diagnosis, and the rapeutic result are presented. A 27 year old male patient was admitted to the Department of Neurosurgery, Keimyung University Hospital because of progressive diffuse swelling in right temporal area of 4 months duration. In physical examination, nontender, firm, nonmovable diffuse mass in right temporal area and bean sized polypoid mass in the anterior and superior wall of the right external auditory canal were noted. Plain skull X-rays showed lytic defect in the right temporal squama, base of middle cranial fossa, sphenoid ridge, a part of petrous bone and anterior fossa with rather sharp, but not sclerotic margin. Brain CT scan showed a lentiform nonhomogeneous slight high density mass with scattered calcification in the entire middle cranial fossa, and the tumor enhanced slightly. Selective external carotid serial angiogram revealed complete obstruction of external carotid artery just behind the origin of lingual artery without tumor staining. Right temporal craniectomy was performed with nearly total curetting of tumor mass grossly. The histological diagnosis was chondroblastoma. The patient was discharged with good result.