Pathobiological Characteristics of Intestinal and Diffuse-Type of Gastric Carcinoma-Retrospective Study of Gastric Cancers

Background: Gastric carcinomas have various pathological features. Based on patterns of growth and invasiveness, however, they fall into two types: diffuse type and intestinal type. These two types of carcinoma appear to be different in their histogenetic origins. Objectives: To analyse various types of gastric cancer reported in last five years. To compare the features of intestinal and diffuse type gastric carcinoma including gross appearance, staging, grading of tumor. Materials and Methods: This was a retrospective study of 324 gastric cancer which were surgically resected and received over 5 years. The tumors were divided into groups according to their gross and microscopic patterns. Gross appearance was classified based on Borrmann classification. Microscopic features evaluated include tumor cell type, extent of invasion, degree of maturation, formation of glandular structures, nodal metastasis. Results: Totally 320 cases of gastric cancer were received of which 218(68%) were male, 102(32%) were female. Gastric cancers are rare below the age of 30 years. Comparing the type of gastric cancer intestinal type were 269(84%), diffuse type were 24(7.5%) and other type of gastric cancer including GIST, lymphoma, mucinous adenocarcinoma were 27(8.5%). Younger patients have higher stage of lymph node metastasis in diffuse type, but not for the intestinal type. Conclusion: Gastric cancer more common in male (M:F= 2:1) and most frequently seen in 5th decade. Intestinal type constitutes the most common type of gastric tumor. Gross appearance of diffuse type was predominantly infiltrative (79%).

The Clinical Use of Routine Urinalysis

Routine urinalysis is a simple, economical, and useful test that facilitates the detection of urinary system diseases and monitoring of renal disease progression. It consists of 4 parts of specimen evaluation, gross examination, a dipstick urinalysis, and a sediment microscopic urinalysis. Urine specimens should first be evaluated in terms of acceptability, and thereafter, the gross appearance is examined for color, turbidity, and odor. In particular, a dipstick urinalysis is an easy and rapid test that provides information on the multiple physicochemical properties of the urine sample. Moreover, although a sediment microscopic urinalysis is time-consuming, it provides information on the cells, microorganisms, casts, and crystals. In the present report, the clinical significance of the routine urinalysis and the problems concerning interpretation are summarized.

Analysis of Gallstone from a Hundred Consecutive Patients with Gallbladder Stone

The gallstones from one hundred consecutive patients having stones in the gallbladder only were analyzed using both gross appearance and infrared spectrophotometry. There were 47 males and 53 females, and the sex ratio was 1:1.13. The most prevalent age was in the fifties in both sexes. Grossly, the number (and also the percentage) of cases of pure cholesterol, mixed cholesterol, calcium bilirubinate, black pigment, and combination stones were 4, 42, 23, 30, and 1, respectively. In the analysis by infrared spectrophotometry, the number of cases of cholesterol, calcium bilirubinate, and calcium carbonate stones were 44, 42, and 14, respectively. The accordance of gross appearance with infrared spectrophotometric classification was statistically significant (p=0.049). A comparison of cholesterol stones with pigment stones showed no difference based on either the sex or the age distribution, but there was a significant difference not only in terms of color, shape, and cut-surface (p=0.000) but also in terms of the number of stones (p=0.045). In conclusion, gallstone classification by gross appearance may be a rapid and relatively accurate method. Further study to standardize gallstone classification by various analytic methods is recommanded.

Correlation of Gross Appearance or RBCs Numbers with Pleural Histocytology and Pleural Fluid Carcinoembryonic Antigen Values in Malignancy Associated Pleural Effusions / 결핵

BACKGROUND: Most of malignant pleural effusions are serous but 8-33% of them are bloody. We wanted to evaluate the relationships between gross appearance and pleural CEA level or results of histocytology in malignancy associated pleural effusions. We also tried to reevaluate the meaning of CEA measurement in histocylogically proved or unproved malignancy associated pleural effusions. METHODS: We studied 98 cases of malignancy associated pleural effusions, 50 cases of histocylologically proven malignant effusions and 48 cases of histologically unproven paramalignant effusions. We had observed gross appearance and conventional laboratory values and CEA levees for pleural effusions. RESULTS: 44.9% of malignancy associated effusions were bloody(63.6% of bloody effusions were histstocytologically proven malignant effusion). 65.0% of malignancy associated pleural effusions which have RBCs numbers over 100,000/mm3 were cytologically proven malignant effusions. 72.7% of cytologically proven malignant effusions had increased pleural fluid CEA level over 10 ng/ml. 58.2% of cases with pleural CEA over 10ng/ml had positive results in pleural histocytology. There was no definable relationships between pleural fluid CEA elevation and RBCs numbers and results of pleural fluid cytology. CONCLUSION: About half of the cases with malignancy associated pleural effusions were bloody. Histocytologically proven malignant effusions were more common in bloody effusion than non-bloody effusion (63.6% Vs 38.9%). But increased red blood cell numbers was not associated with positivity of pleural histocytology. Pleural fluid CEA elevation(over 10 ng/ml) was not correlated with positive pleural histocytology. But pleural fluid CEA elevation was rare In nonmalignant pleural effusions, and than pleural CEA measurement in uncertain pleural effusions maybe helpful to distinguishes its origin.