This is to describe a neonatal hepatitis with pericellular hepatic fibrosis and Mallory bodies in a sero-positive infant for IgM anti-CMV. A necropsy of the liver revealed severe heaptocellular swelling with many intracytoplasmic hyaline bodies, pronounced fibrosis of a creeping type, bile stasis with ductular proliferation, and the lack of parenchymal regeneration. These microscopical changes of the liver resembled those of Indian Childhood Cirrhosis (ICC). In the present case the patient's serum IgM anti-CMV is the only clue for the etiological diagnosis.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans

We report a case of Buerger's disease manifested by a scrotal mass, in view of its rarity. A tender bean sized mass was palpated in the left scrotum of a 34 year-old male heavy smoker, who had a history of right pain two years ago which subsided spontaneously. The left testis with the paratesticular tissue was excised. Vessels of the spermatic cord and epididymis showed microscopic changes of Buerger's disease. The involved arteries and veins revealed a predominantly subacute pattern with granulomatous inflammation and Langhans' type giant cells within the thrombi.
Male ; Humans

To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.
Infant ; Adult ; Male ; Female ; Humans

One of the most common symptoms in gynecologic disorders is an abnormal utirine bleeding, of which dysfuncyional uterine bleeding (DUB) is frequently encountered. DUB is defined as an endocrinologic imbalance of the axis of hypothalamus-pituitary-ovary-endometrium without organic diseases such as a neoplasm, and inflammation, a pregnancy, a trauma, Although the correct diagnosis of DUB depends on various assessements such as a menstrual cycle, basal body temperature, endocrine assay, vaginal cytology and endometrial histology, in many circumstances pathologist have only the endometrial histology with trivial clinical information to make a diagnosis. Therefore, the present study was aimed at assessing the pattern of the endometrium as precisely as possible. The histologic pattern was classified according to the Handrickson and kempson classification (1980). The authors also attempted to correlate the non-neoplastic metaplasia with the endometrial histology. The material consisted of 447 cases of endometrial curettage specimens diagnosed clinically as DUB during recent 4 years. The histologic examination was carried out through the routine formalin fixed-paraffin embedding method, followed by hematoxylin-eosin staining in routine and other special staining as required. The following results were obtained; 1) The pattern of the endometrium in DUB was predominently the proliferative type (239 cases, 65.55%). Of these 293 cases, 144 were of the abnormal proliferatrive phase, and particulary most were the disordered proliferative phase. The remaining 154 cases (34.45%) were found to have secretory endometrium, of which 50 cases belonged to the abnormal secretory type. Most of the cases shewing abnormal secretory patterns appeared dyssynchronous or underdeveloped. 2) Of the 361 patients with DUB for whom the clinical records were available, 197 (54.57%) were non-ovulatory and 118 (32.69%) were ovulatory. 3) Non-neoplasic metaplasia was found in 87 cases, of which ciliiated and papillary types were most common. The endometrium was of the proliferative phase in 73.56% of the cases with metaplasia, and the disordered proliferative pattern showed a particular correlation with the metaplasia (44 cases). 4) Among 63 postmenopausal DUB patients, 52 (82.53%) appeared to have the proliferative endometrium, and in particular 23 (36.51%) had the disordered proliferative endometrium.
Pregnancy ; Female ; Humans

Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

Leiomyomatosis peritonealis disseminata is a rare benign condition characterised by the occurrence of multiple leimyomas scatterred throughout the peritoneal cavity, giving the clinical impression of a wide spread malignant tumor. The histopathology of leiomyomatosis peritonealis disseminata is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Three cases with malignant transformation were described among previous reported fifty cases. Many of the early reports described the disorder in premenopausal women, and now the histogenesis is considered to be a metaplastic change by abnormal tissue response to the relatively or absolutely elevated female sex hormone. We report a case of leiomyomatosis peritonealis disseminata, which was diagnosed by multiple scattered submucosal and subseroal leimyomas of stomach, small bowel and colon, combined with advanced gastric cancer in a 58 years old man, Multiple submucosal tumors of the stomach combined with advanced gastric cancer were demonstrated by fibergastroscopy, upper gastrointestinal barium study and abdominal ultrasonography. During radical subtotal gastrectomy multiple submucosal and subserosal tumors of stomach, and subserosal tumors of small bowel and colon were observed and these tumors were confirmed as leiomyoma without malignant potential.
Barium ; Colon ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Peritoneal Cavity ; Stomach ; Stomach Neoplasms* ; Ultrasonography

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

To evaluate the effect of preoperative treatment on proliferative activity and prognosis of the hepatocellular carcinomas(HCCs), fifty-three surgically resected HCCs were studied. Twenty cases were treated preoperatively and thirty-three were not treated before surgery. The proliferation index(PI, % of proliferating cell nuclear antigen positive cells) of the remaining cancer cases(35.41). Although PI was similar among gross types and among histologic grades, tumors of the expanding type and of the histologic grade I revealed distinctly low PI in pretreated cases. Two-year survival rate was not significantly different between pretreated and not-pretreated cases(67.4 vs 52.7). But the differences between gross types(p<0.05) and between histologic grades(p<0.01) were significant. Total necrosis of tumor occurred in five pretreated patients, all of whom were alive during two-year follow-up. Smaller HCCs showed better prognosis(p<0.01). Although PI appeared not correlated well with the two tear survival rate, the pretreated HCCs preoperative modalities induce tumor necrosis, but do not reduce the proliferative activity of tumor cells significantly, and that pretreatment does not affect the long-term prognosis of HCCs except for the accasions of total necrosis of tumor.
Carcinoma, Hepatocellular

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

No abstract available.
Chondromatosis, Synovial* ; Knee Joint* ; Knee* ; Osteoarthritis*