Cholelithiasis is defined as the presence of stones within the lumen of the gallbladder or in the extrahepatic biliary tree. Cholecystitis, secondary to gallstones, is a common surgical disorder in Korea. Detailed microscopic descriptions, particularly the ultrastructural changes, of these diseases were not available. The goal of this study was to identify the ultrastructural alterations of gallbladder epithelium in cholecystitis with and without a stone, according to the degree of severity of inflammation, and the nature of the stone. The gallbladders of the control group, and cholecystitis cases without stone and with stone were fixed and examined with routine stain, special stain, immunohistochemical stain and trans-mission electron microscopy. The number and the volume density of the mucin containing secretary granules were not significantly increased in the calculous cholecystitis cases compared with those of the acalculous cholecystitis cases. Major findings were that the calculous cholecystitis cases showed a markedly reduced total lysosome area and volume density of the lysosome compared with those of the acalculous chole-cystitis cases. The differences between the mucin secretary granules and lysosomes, according to the degree of severity of cholecystitis and the natures of gallstones, were statistically not significant.
Humans

Bony changes about the elbow in the baseball players are common problem. Pure bony injuries occur in the elbow of the throwing arm, but most often they have some associated soft tissue counterpart. The importance to understand the elbow lesion in baseball players is that many of this lesion seem mild at onset and can often be easily managed, but permanent disability can result from the delayed or inadequate treatment. The authors have performed radiological study in 32 professional baseball players and obstained following result. 1. Among 32 baseball players we studied, twenty-four plsyers(75.0%) had 41 bony changes in the throwing elbow. 2. Forty one bony changes were classified into three groups by Slocum classificstion,;twenty nine medial tension overload injury, eleven extensor overload injury and one lateral compression injury. 3. Incidences of bony changes in each age group were 63.6#% in 20~24 years, 71.4% in 25~29 years and 100% in 30~35 years of age. 4. Incidences of bony changes in each csreer group were 63.6% in 10~14 years, 69.2% in 15~19 years and 100% in 20~25 years of career. 5. Incidences of bony changes in each position were 72.7% in the piteher and 76.2% in the fielder. 6. In conclusion, the best treatment is prevention, namely, exercise to increase the stren- gth, flexibility, and endurance of elbow musculature, which should be coupled with attention to proper mechanics of throwing. If an injury does take place, prompt treatment consisting rest, physical therapy and appropriate medicstion when indicated-should lead to a successful result in most cases.
Arm ; Baseball ; Elbow ; Humans ; Incidence ; Mechanics ; Pliability

The aims of this study were to assess the role of p53 overexpression in colorectal tumorigenesis and the association with clinicopathological features. The immunohistochemical results were semiquantitatively assessed. Expression of aberrant p53, tumor-suppressor gene product, was studied immunohistochemically using a monoclonal antibody in 11 nonneoplastic polyps, 19 tubular adenomas, 9 villous adenomas, and 48 colorectal carcinomas. Five out of 11 nonneoplastic polyps, 14 out of 19 tubular adenomas and one out of 9 villous adenomas expressed p53 protein. Seven out of 24 colorectal carcinomas without lymph node metastasis and 14 out of 24 colorectal carcinomas with lymph node metastsis expressed p53 protein. The case of more than 75% positivity of p53 in colorectal carcinoma with lymph node metastasis was seven out of 24, but that in lymph node negative group was two out of 24. In the colorectal carcinoma with lymph node metastasis group; metastatic intranodal neoplastic cells were expressed positively for p53 in 10 out of 14 cases and zero out of 10 cases in group of positive and negative expression of primary lesions, respectively. p53 protein expression was not significantly correlated with variable clinicopathologic features such as age, sex, tumor location, tumor size, differentiation and Dukes' stage. It is suggested that p53 protein overexpression could be a early event in pathogenesis of colon cancer but is not involved in progression of villous adenoma to adenocarcinoma. p53 overexpression seems to be involved in metastatic ability of colorectal carcinomas.
Adenoma ; Neoplasm Metastasis ; Cell Transformation, Neoplastic

Small round cell tumors such as neuroblastoma, rhabdomyosarcoma, Ewing's tumor, malignant lymphoma and small cell carcinoma are often confused clinically and histologically. To clarify the similarites and differences and to get more information on the histogenesis among the small round cell tumors, we examined histological, immunohistochemical and ultrastructural features of ten cases of neuroblastomas, twenty Ewing's tumors, ten embryonal rhabdomyosarcomas and twelve small cell carcinomas in children and young adults. Antibodies against desmin, vimentin, cytokeratin, neuron-specific enolase, synaptophysin, neurofilament, S-100 protein, chromogranin and HBA 71 were used in biotin streptavidin procedures. The results of the immunohistochemical and electron microscopical examinations yielded virtually identical findings in each group as followings. 1) Among the twenty cases of Ewing's tumors, eighteen cases were positive in staining for HBA-71. The staining for HBA-71 was negative in neuroblastoma, embryonal rhabdomyosarcoma and small cell carcinoma. 2) Neuroblastomas had marked interdigitating cytoplasmic processes containing many microtubules and dense-core secretory granules, however, they were sparse and rare in Ewing's tumor. 3) Embryonal rhabdomyosarcoma showed actin-myosin bundles. According to differentiation, well differentiated rhabdomyosarcoma exhibited Z-band materials and external lamina. 4) Neuroblastoma showed ultrastructural evidence of a neuronal differentiation, but neuronal differentration is a sparse and rare in Ewing's tumor. This ultrastructural feature strengthens the hypothesis that Ewing's tumor is derived not only from an undifferentiated neuroectodermal stem cell but from primitive cell of neuroectodermal origin.
Antibodies ; Biotin ; Carcinoma, Small Cell ; Child ; Cytoplasm ; Desmin ; Humans ; Immunohistochemistry ; Keratins ; Lymphoma ; Microtubules ; Neural Plate ; Neuroblastoma ; Neurons ; Phosphopyruvate Hydratase ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal ; S100 Proteins ; Sarcoma, Ewing ; Secretory Vesicles ; Stem Cells ; Streptavidin ; Synaptophysin ; Vimentin ; Young Adult

This study was performed to fine out the possible causes of primary infertility in female and to provide some diagnostic and therapeutic modalities. A total of 104 cases of endometrium in primary infertility was obtained from the pathology files of Chosun University Hospital and Kwang-ju Christian Hospital during the period of 5 years and 10 months from January, 1984 to October, 1989. The endometrial biopsies were taken on the first of menstruation and classified according to Noyes, Hertig and Rock's criteria. Histologic findings which were compatible with their normal menstrual cycle (premenstrual of late secretory phase and bleeding phase) were noted in 52 cases (50%). Abnormal 52 cases (50%) revealed deficient secretory phase in 36 case (34.6%), proliferative phase in 5 cases (4.8%), irregular proliferation and chronic nonspecific endometritis in 4 cases (3.8%), respectively, endometrial hyperplasia in 3 cases (2.9%), tuberculous endometritis in 2 cases (1.9%), and asynchronous cycle in 1 case (1%). Among the case of dissociated delay was 21 cases (20.2%) and coordinated delay was 15 cases (14.4%). Therefore, deficient secretory phase with dissociate delay was most common abnormal endometrial finding in cases of female primary infertility. The peak age distribution of the female primary infertility in this study revealed 73 cases (63.8%) in patients between the age of 25 and 29. This finding indicated that there was no significant relationship between the age distributions and the endometrial histopathologic findings.
Female ; Humans ; Biopsy

Sarcoidosis can affect two or more members of the same family, and the reported occurrence of such familial sarcoidosis is variable from 0.5 to 14%. Recently we have experienced familial sarcoidosis affected mother and daughter, for the first time in Korea. Mother was diagnosed as Stage II sarcoidosis 4 years ago by transbronchial lung biopsy and cervical lymph node biopsy with compatible BAL finding in our hospital. This time, the daughter was admitted with bilateral hilar enlargement and anterior uveitis. Even though she had positive tuberculin skin test and atypical BAL finding(lymphocyte: 61%, CD4/CD8: 1.22). Transbronchial lung biopsy and mediastinal lymph node biopsy revealed noncaseating epithelioid granulorna without AFB. Slit lamp examination of the eyes showed severe anterior uveitis. Systemic steroid therapy was started due to progressive uveitis with antituberculous medication.
Biopsy ; Humans ; Korea* ; Lung ; Lymph Nodes ; Mothers ; Nuclear Family ; Sarcoidosis* ; Skin Tests ; Tuberculin ; Uveitis ; Uveitis, Anterior

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

A total of 51 cases of pleomorphic adenoma was obtained from the pathologic files of Chosun University hospital from january, 1980 December, 1989. The studies of clinical, microscopic, immunohistochemical, and electronmicroscopic examination showed the following results. The peak age incidence of the pleomorphic adenoma in this study was in the 5th decade and no significant difference in the incidence between male and female patients was observed. The most common histologic type of myoepithelial data showed positive reactions of the myoepithelial cells to cytokeratin and S-100 protein in the solid, myxoid, and chondroid area. The electronmicroscopic examination of the myoepithelial cells revealed myofilaments, dense bodies, desmosomes, and basement membrane suggesting epithelial origin of these cells. In conclusion, the pleomorphic adenoma seems to be derived from epithelial component and the variable stromal change may be derived from modified myoepithelial cells considering the results of immunohistochemical and electron microscopic study.
Female ; Male ; Humans ; Incidence ; Adenoma

Lipid cell tumors of the ovary are among the rarest of the functional ovarian neoplasms. Recently, authors experienced a case of lipid cell tumor of the left ovary in a 19 year old female, who presented with amenorrhea and hirsutism for 4 years. Grossly, the ovary was well encapsulated, and measured 6.5x6x4.5 cm. Cut surface show homogenous yellowish bulging neoplastic tissue and peritheral displaced normal ovarian tissue. Microscopically, neoplastic cells were composed of rounded and polyhedral cells, arranged in nests seperated by rich vascular networks. On the basis of the author's findings and the evidence available in the literature, we determined this case as ovarian lipid cell tumor.
Female ; Humans

A 55 year old male complain right shoulder pain and right upper quadrant pain about three months. He was a heavy alcoholism. Highly selective angiography, CT scan and operation findings suggest primary malignant neoplasm of the liver. Right hepatic lobectomy and partial diaphragmectomy was done under impression of heaptocellular carcinoma. The specimen measured 15x11x9 cm and disclose relatively hard and nodular mass devoid of cirrhotic changes. Cut surface show unilobar large mass measuring 11x8x6 cm and bearing brightly yellow discoloration and multifocal hemorrhagic necrosis. Histological characteristics were diffuse proliferation of large neoplastic cells with ample cytoplasm, containing granular materials, erythrophagocytosis, neutrophagocytosis and hemosiderin pigments. Atypical and bizarre mitosis and multinucleated giant cells bearing abundant erythro and neutrophagocytosis were frequently seen. The large or vesicular nuclei were irregular, with occasional deep indentations and revealed sharply defined nuclear membrane, coarse chromatin and conspicious nucleoli. Ultrastructurally the cytoplasm of neoplasltic cells had lysosomal granule, phagolysosome, phagocytized material and residual bodies. Immunohistochemical stains for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin and lysozyme showed positive reactions, but, alpha fetoprotein, cytokeratin, S-100 protein, factor VIII, complement 3 receptor and carcinoembryonic antigen were negative. Alpha-naphtyl acetate esterase activity in paraffin embedded tissue ribbon showed negative reaction. These findings show compatible with primary malignant lymphoma, true histiocytic type, (histiocytic sarcoma, Kupffer cell carcinoma) of the liver.
Male ; Humans