Polypoid prolapse of mucosal folds can occur at various sites and in various conditions predominantly associated with strain during defecation. There are two well known types of mucosal prolapse syndrome(MPS), the inflammatory cloacogenic polyp(ICP) and the mucosal redundant polyp associated with diverticular disease(N4RPD). ICP is a mucosal prolapse of the anorectal junction and MRPD is a proximal analogue involving the sigmoid colon. We experienced two cases of eroded polypoid hyperplasia(EPH) of the rectosigmoid colon which manifested as a huge gyriform mass simulating the gross features of gastrointestinal lymphomas or other malignant tumors. The EPH consisted of confluent polypoid mucosal folds with rolled-up submucosa to form stalk, The polypoid lesion represented hyperplastic epithelium, erosion of the mucosal surface and congestive vascular ectasia of lamina propria and submucosa. To explain the whole morphologic features, the initial phenomenon should be the mucosal prolapse. Vascular stretching with ischemic erosion of the mucosal surface and compensatory epithelial hyperplasia ensue as the result. The ominous endoscopic and gross features of EPH should be kept in mind to avoid erroneous radical surgery.

To understand better the complex natural course of HBV infection, the expression patterns of HBcAg and HBsAg in the liver of 51 inactive serum HBsAg carriers (24 CPH and 27 NPD) were studied by immunohistochemical methods. The inactive serum HBsAg carriers were devided into 3 groups by the following expression patterns of serum HBeAg/anti-HBe status and tissue HBcAg and HBsAg. Pattern A (18 cases) : HBeAg+, cHBcAg+ (94.4%), mHBsAg+ (61.1%), pATTERN B (14 cases) : anti-HBe+, nHBcAg+, cHBsAg+, Pattern C (19 cases) : anti-HBe+, HBcAg-, cHBsAg+ (89.5%). There were no significant differences between CPH and NPD, lthough the core free pattern was more common in the latter. The cHBcAg was expressed in 17 of 18 (94.4%) HBeAg seropositive cases but only one of 33 cases with serum anti-HBe, suggesting that the cHBcAg is intimately related to HBeAg. Since the inactive HBsAg carriers also expressed cHBcAg and/or mHBsAg, the necro-inflammatory activity of HBV infected liver is assumed to depend on the host immune response rather than their presence alone

No abstract available.
Humans

We report a medullary carcinoma of the thyroid gland with a coexisting occult sclerosing papillary carcinoma. This rare case, in that the two types of carcinoma are completely separated and not intermixed together, is different from the previously reported mixed follicular and parafollicular cell carcinomas of the thyroid gland, so-called "differentiated thyroid carcinoma, intermediate type". The two separate tumors of the present case are undoubtedly of coincidental double primaries, and it can be a assumed that at least some of the mixed follicular and parafollicular cell carcinomas are results of collision of carcinomas derived from two embryogenetically different cell types.

Nutrition is thought to be much more important to the handicapped for their growth and development and successful management of their disease because they have much more complexed problems in physical, emotional, familial, and socioeconomic aspects. The authors determined number of erythrocytes and leukocytes, quantity of hemoglobin, hematocrit, reticulocyte, number of platelets for the survey of anemia to evaluate the nutritional status in mental and physical handicapped. Mean Corpuscular volume, Mean Corpuscular Hemoglobin and Mean Corpuscular Hemoglobin Concentration were calculated as usual according to wintrobe. Total iron binding capacity and serum iron were also measured in the hadicapped. The study group consists of total III handicapped children, who were composed of 13 first visitors to Out Patient Department, 51 hopsitalized patients in Rehabilitation Hospital, and 47 patients attending a Special Elementary School for the handicapped. Of the III subjects, 58 had cerebral plasies, 49 poliomyelitises and 4 had other orthopedic problems. Results. 1. Anemia were seen in 14 subjects, composed of 4 first visitors to O.P.D.(28.6% of all the anemias, 30.8% of all the O.P.C. subjects), 7 hospitalized subjects(50% of all the anemias, 13.7% of all the hospitalized subjects) and 3 Special School subjects(21.4% of all the anemias, 6.4% of Special School subjects). Incidence of anemia was higher in O.P.D. subjects than in the subjects of other groups. 2. Incidence of anemia by the disease entities was higher in the indivisuals with cerebral palsy, 7 in number(50% of all the anemias, 11.1% of all the cerebral palsy subjects) than in 5 those with poliomyelitis (35.7% of all the anemias, 10.2% of all the poliomyelitis subjects), or in 2 other subjects. 3. Incidence of anemia by the age was higher in the subjects below 6 years of age whose number was 5(35.7% of all the anemias, 45.5% of all the subjects below 6 years of age) than in the subjects above 9 years of age whose number was 9(64.3% of all the anemias, 11.1% of all the subjects above 9 years of age). The incidence of anemia in the subjects above 12 years of age was 17.7%(seven of the nine anemias above 9 years of age). 4. Five of the seven cerebral palsy patients with anemia were below 6 yeas of age(45.5% of all the cerebral palsy subjects below 6 years of age). All of the five poliomyelitis patients with anemia were above 9 years of age(11.1% of all the poliomyelitis subjects above 9 years of age). 5. Iron deficiency anemia was noted in 6 of 14 anemia patients(43% of all the anemias), which were composed of 2 cerebral palsy patients below 6 years of age, 3 poliomyelitises and one patients with congenital hip dislocation above 9 years of age.
Anemia* ; Anemia, Iron-Deficiency ; Cerebral Palsy ; Disabled Children ; Disabled Persons* ; Erythrocyte Indices ; Erythrocytes ; Growth and Development ; Hematocrit ; Hip Dislocation, Congenital ; Humans ; Incidence ; Iron ; Leukocytes ; Nutritional Status ; Orthopedics ; Poliomyelitis ; Rehabilitation ; Reticulocytes

No abstract available.
Glomerulonephritis*

ln an attempt to clarify the dual origin histiocytes and to reclassify histiocytic proliferative disorders according to their immunohistochemical properties, normal histiocytes and histiocytes in selected proliferative disorders were stained using the peroxidase-antiperoxidase method for lysozyme, 1-antichymotrypsin and for S-100 protein. The proliferated histocytes of cosinophilic granutoma and Letterer-siwe disease were strongly immunoreactive for S-100 protein. In histiocytic medullary reticulosis (HMR) and in histiocytic lymphoma, all three markers were found within the tumor cells. ln fibrous histiocytoma and in juvenile xanthogranuloma, only a few weakly immunoreactive cells for S-100 protein were observed. lnflammatory malignant fibrous histiocytoma(MFH) (Xanthosarcoma) and xanthoma were immunoreactive for 1-antichymotrypsin and lysozyme respectively. ln MFH of the storiform -pleomorphic type and in atypical fibroxanthoma, stains using all of the histiocytic markers were negative. These results suggest that eosinophilic granuloma. Letterer-Siew disease, fibroxanthoma and juvenile xanthogranloma are proliferative disorder of T-zone histiocytes; HMR and histiocytic lymphoma are those of pluripotential stem cells capable of dual histiocytic differentiation; xanthoma and xanthosarcoma are monocytic proliferative disease; and MFH of the storiform-pleomorphic type and atypical fibroxanthoma are not true histiocytic diseases.
Histiocytes/*metabolism ; Human ; Immunohistochemistry ; Reticuloendotheliosis/classification/*metabolism/pathology ; S100 Proteins/metabolism ; Support, Non-U.S. Gov't

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative

Acute hydrops of the gallbladder is described in one patient who had mucocutaneous lymph node syndrome. During the course of her illness, acute addominal pain, vomiting and right upper guadrant tenderness were developed. Diagnosis was readily made with ultrasonography, and the patient was followed with this te-chnique. We managed her conventionally without surgical intervention. The galbladder returned to normal size within about 3 weeks. Related literatures are briefly reviewed.
Diagnosis* ; Edema* ; Gallbladder* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Ultrasonography ; Vomiting

We experienced two unusual cases of tumor-like polypoid lesions involving the rectosigmoid colon. They could not be readily classified into any well known polypoid tumors of the rectosigmoid colon, but appeared to have some similarities to the previously documented "eroded polypoid hyperplasia (EPH)". A collective review of our seven cases of solitary rectal ulcer syndrome (SRUS), which proved to be due to paradoxically over-reactive muscle tone of the puborectalis, was performed, and clinicopathologic comparisons between EPH and SRUS were carried out. They shared histopathologic characteristics such as vascular congestion, crypt hyperplasia, and eroded surface, but they were different from each other in clinical symptoms, location of lesions and gross features. Furthermore, in one EPH case there was an altered much profile which was similar to that seen in SRUS and complete rectal prolapse. Conceivably, the pathological features of both EPH and SRUS were thought to have a possible connection with mucosal prolapse syndrome (MPS). Considering that MPS is a group of diseases encompassing SRUS and the related disorders of the colorectum and the anus, it is speculated that EPH of the rectosigmoid colon might be the proximal analogue of SRUS, a mucosal prolapse of the more distal colon.
Adult ; Aged ; Case Report ; Colonic Polyps/*pathology ; Comparative Study ; Female ; Human ; Hyperplasia ; Intestinal Mucosa/*pathology ; Male ; Manometry ; Middle Age ; Rectal Diseases/*pathology ; Rectum/*pathology ; Sigmoid/*pathology ; Syndrome ; Ulcer/pathology