To evaluate the tissue expression rate and pattenr of HBsAg and HBcAg in tumors and peritumoral livers, an immunohistochemical study was undertaken on 47 surgically resected hepatocellular carcinomas(HCCs). The results are as follows. 1. Patient's sera were positive for HBsAg in 40 cases(85.1%). In the remaining 7 cases, the tumor and peritumoral liver expressed neither HBcAg nor HbSaG, suggesting that they were caused by other etiologies than hepatitis B virus. 2. The peritumoral liver had HBsAg and HBcAg in 95.0% and 27.5% among the 40 cases, respectively. But the tumor expressed HBsAg in 50.0% and HBcAg in none. 3. The expression of HBsAg within the tumor and both HBsAg and HBcAg in the peritumoral liver tended to be more frequent in the pretreated cases before surgery. 4. Edmondson-Steiner grade IV tumors revealed a lower expression rate of HBsAg than the low grade tumors(p<0.05). Incases with cirrhosis at peritumoral tissues, HBcAg was less frequently found than in those without cirrhosis. The majority of tissue HBsAg and HBcAg was represented as groups of positive cells. These results suggest that, during the development and progression of HCCs, the HBcAg containing cells are repeatedly removed and the HBcAg negative cells are selected, because cellular expression of HBcAg is the target of host immune response.
Carcinoma, Hepatocellular

Although methotrexate(MTX) has been known to have many side effects, especially toxicity on the hemopoietic cells and the liver, it has been used as a potent anticancer drug and for the treatment of psoriasis or rheumatoid arthritis. The severity of hepatotoxicity varies from mild fatty change to chronic active hepatitis(CAH) and cirrhosis. We experienced two cases of MTXinduced CAH in patients with psoriasis, which prompted us to report in view of the absence of biopsy proven MTX hepatotoxicity in the Korean literature. Microscopically, the liver showed a distorted lobular architecture with portal fibrous expansion, piecemeal necrosis and bridging necrosis/fibrosis. The hepatic lobules revealed fatty changes of hepatocyte, focal hepatocytolysis, delicate collagen deposits along the space of Disse and the characteristically marked polyploid nuclear change of hepatocytes.
Biopsy

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

Peri-vater divertieula may interfere with the normal flow of biliary and pancreatic secretion, thus leading to pancreatobiliary diseasa and the very presence of juxtapapillary diverticulum makes cannulation technically difficult and contributes to the low success rate. In this present series, the relationship between duodenal diverticula and age, sex, and biliary-pancreatic pathology was stud.ied in 1400 patients examined with ERCP. The results are as follows. 1) Duodenal diverticula was demonstrated in 73 of 1400 patients(5, 2%). 2) The incidence of duodenal divertieular increased with age and they were more frequent in men. 3) The cannulation of one or both duct system was suecessful in 69 of the 73 patients, the success rate was 94. 5%. 4) The biliary pathology was found in 41 of the 73 patients and the pancreatic pathology in 6 of the 73 patients. The rnost common finding was biliary calculi which were demonstrated in 35 patients(47. 9%).
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Male ; Pathology

We report a case of sebaceous glands in the esophagus diagnosed by endoscopic biopsy. The patient was a 47-year-old Korean man presented with postprandial pain of several months duration. An endoscopic examination disclosed an early gastric carcinoma in the gastric antrum and a 0.4 x 0.4 cm sized irregular lobulated nodule in the middle esophagus. Microscopically, the lobule was proven to be sebaceous glands in the submucosa. Possible histogenesis of this lesion is discussed.
Case Report ; Choristoma/etiology/*pathology ; Esophageal Diseases/etiology/*pathology ; Human ; Male ; Middle Age ; *Sebaceous Glands

After portal vein occlusion, portal to portal collaterals (hepatopetal) develop from preexisting periportal vessels or recanalization of the thrombosed portal vein, undergo compensatory enlargement, bypass the obstructed extrahepatic occlusion and reconstitute the intrahepatic portal branches. Angiographically, collateral veins are seen as multiple tortous winding veins in the porta hepatis and are described as a cavemous transformation of the portal vein. When the common bile duct or gall bladder is compressed by collateral veins, a cholangiogram demonstrates multiple smooth intramural defects and jaundice can develop due to the partial obstruction of the bile duct. Demonstration of the cavernous transformation of the portal vein can be done by ultrasonography, abdominal computed tomography and nuclear magnetic resonance, but Doppler ultrasonography and direct or indirect portography are needed to evaluate its hemodynamic change. We present a 35-year-old female patient complaining repeated jaundice, in whom common bile duct and gall bladder varices accompanied by cavernous transformation of the portal vein and intrahepatic stones were diagnosed by ultrasonography, abdominal computed tomography, ERCP, and Doppler ultrasonograpy and confirmed by surgery. ERCP demonstrated the irregular contour of the common bile duct and gall bladder due to multiple smooth intramural defects. Doppler utrasongraphy revealed the unique flow signal of portal vasculature from the tortous vessls in the porta hepatis and from the vascular structures on the wall of the gall bladder.
Adult ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct* ; Female ; Hemodynamics ; Humans ; Jaundice ; Magnetic Resonance Spectroscopy ; Portal Vein ; Portography ; Ultrasonography ; Ultrasonography, Doppler* ; Urinary Bladder* ; Varicose Veins* ; Veins ; Wind

Pseudomyxoma peritonei is a rare disorder chracterized by abdominal distension resulting from the accumulation of a mucinous, gelatinous, translucent material which arises from rupture of pre-existing mucinous cystadenomas and cystadenocarcinomas of the ovary and mucocele of the appendix. We report 11 cases of pseudomyxoma peritonei which were diagnosed by surgical and pathological findings. The results were as follows. 1) The mean age of 11 cases was 51 years and 5 cases were male and 6 cases were female and male to female ratio was 1 to 1.2. 2) Clinical manifestations in 11 cases were abdominal distension in 5 cases (45.5%), palpable mass in 4 cases(36.6%), abdominal pain in 4 cases(36.6%), nausea in 3 cases(27.3%), weight loss in 3 cases(27.3%), diarrhea in 2 cases(18.2%), constipation in 1 case(9.0%), anal bleeding in 1 case(9.0%) and defecation difficulty in 1 case(9.0%). The duration of symptoms was 2 days to 1 year. 3) The primary sites of pseudomyxoma peritonei were ovarian cancer in 3 cases(27.2%), appendiceal cancer in 2 cases(18.2%), gastric cancer in 2 cases(18.2%), rectal cancer in 1 case(9.1%), cecal cancer in 1 case(9.1%) and unknown origin in 2 cases(18.2%). 4) Following surgical interventions were performed; right hemicolectomy in 2 cases, palliative gastrojejunostomy in 2 cases, oophorectomy in 1 case, omentectomy in 1 case and right hemicolectomy with gastrojejunostomy in 1 case. 5) The adjunctive anti-cancer chemotherapy was done in 4 cases(36.4%) by combination of actinomycin D, adriamycin, CCNU, cisplatin, cytoxan and fluorouracil, And chemotherapy only was done in 2 cases and hyperthermia was done in 1 case.
Abdominal Pain ; Appendiceal Neoplasms ; Appendix ; Cecal Neoplasms ; Cisplatin ; Constipation ; Cyclophosphamide ; Cystadenocarcinoma ; Cystadenoma, Mucinous ; Dactinomycin ; Defecation ; Diarrhea ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Fluorouracil ; Gastric Bypass ; Gelatin ; Hemorrhage ; Humans ; Lomustine ; Male ; Mucins ; Mucocele ; Nausea ; Ovarian Neoplasms ; Ovariectomy ; Ovary ; Pseudomyxoma Peritonei* ; Rectal Neoplasms ; Rupture ; Stomach Neoplasms ; Weight Loss

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

Upper gastrointestinal bleeding in cirrhotic patients is a serious emergency which is associated with high mortality. Cirrhotic patients commonly have, in additian to esophageal varices, other upper gastrointestinal lesions which accont for occasional bleeding episodes. Since the theapy of bleeding esophageal varices differs from the treatment of nonvariceal bleeding, delay and inaccuracy in determining the source of bleeding contribute ta high mortality. (continue...)
Emergencies ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Mortality