The correlation of metaplasia to dysplasia and carcinoma in the gallbladder has attracted the attention of many investigators. We mapped and examined a total of 263 cholecystectomized gallbladders to analyze the mucosal changes in the carcinogenesis of the gallbladder. Stones were present in 59.7%, hyperplasia in 28.5%, metaplasia in 55.5% (gastric 37.6%, intestinal 17.9%), dysplasia in 17.1% (low grade 9.1%, high grade 8%) and carcinoma in 7.6%. Metaplasia was more frequently identified in the stone-positive group (62.4%) than in the stone-negative group (45.3%) (P<0.05). Especially, the incidence of intestinal metaplasia was significantly higher in the stone-positive group. Dysplasia and carcinoma were more frequent in the metaplasia-positive group (dysplasia 26.7%, carcinoma 11%) than in the metaplasia-negative group (dysplasia 5.1%, carcinoma 3.4%) (P<0.05). Their incidences were significantly higher in the intestinal metaplasia than in the gastric metaplasia. Forty four percent of the dysplasia-positive cases were associated with carcinoma in the adjacent mucosa but carcinoma was absent in the dysplasia-negative cases. Hyperplasia did not reveal any significant correlation with metaplasia, dysplasia and carcinoma. These results suggest that gallstone is causally related to the metaplasia in the gallbladder and the metaplasia-dysplasia- carcinoma sequence exists in the gallbladder.
Adenocarcinoma* ; Carcinogenesis ; Gallbladder* ; Gallstones ; Humans ; Hyperplasia* ; Incidence ; Metaplasia* ; Mucous Membrane ; Research Personnel

Twenty cases of gallbladder cancers were examined using 5 mm stepwise tissue sections. We analyzed the clinicopathologic findings of the early (stage 1, II) and advanced carcinoma (stage III, IV, V) and those of carcinoma with or without metaplasia in the tumor. We also performed CEA and p53 immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. The results were as follow: 1) All of the early carcinomas (n=5) were incidentally diagnosed after the resection for the gallstone. They were compared to advanced carcinoma (n=15) in the absence of the lymphatic or angioinvasion, recurrence, metastasis and death. 2) Metaplastic and non-metaplastic carcinoma did not reveal any difference of the clinicopathologic findings except age distribution. 3) CEA and p53 were positive in preneoplastic and malignant lesions. The extent of staining was related to the degree of the atypia. From the above results, an early detection of gallbladder cancer is very important for the prognosis of the patients. Since preoperative diagnosis is difficult, thorough pathologic examination of routinely resected gallbladder is necessary for the early diagnosis. CEA and p53 immunohistochemical staining may be helpful in the differential diagnosis of non-neoplastic and neoplastic lesion of the gallbladder.
Age Distribution ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Gallbladder Neoplasms* ; Gallbladder* ; Gallstones ; Humans ; Metaplasia* ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; Recurrence

Pemphigus vulgaris is serious mucocutaneous bullous disease and is rarely reported in this country. The authors had observed a patient with pemphigus vulgaris from its early stage to the autopsy, including a total of five admissions. The patient had satisfactorily responded to low doses of prednisolone (60mg/day) initially and high doses (up to 180mg/day) later, but the patient died unexpectedly during admission. Autopsy finding revealed extensive soft tissue abscesses in both gluteofemoral regions from which Pseudomonas aeruginosa was cultured.

Many oncogenes and tumor supressor genes have been identified and studied in colorectal carcinoma. Among them, p53 is a tumor supressor gene and its mutation is frequently noted in human tumors. E-cadherin is a cell adhesion molecule and associated with tumor differentiation. CD44 is a cell surface glycoprotein that plays a role in cell migration and metastasis. nm23 is a gene known to lower metastatic potential of tumors and has been proposed to be a metastasis supressor gene. Tumor angiogenesis is required for the expansion of the primary tumor and metastasis and its degree is related to the potential of malignancy. We studied the expression of p53, E-cadherin, nm23, CD44 and tumor angiogenesis in 36 cases of colorectal adenocarcinomas. They were compared with previously known prognostic factors such as the stage, tumor size, depth of invasion, differentiation, presence of lymphatic or venous invasion, the lymph node and distant metastasis. The results were as follows. 1) The expression of p53 was not significantly associated with any prognostic factors. 2) The expression of E-cadherin was significantly associated with tumor differentiation. In the well differentiated adenocarcinomas, its expression was higher than in the poorly differentiated adenocarcinoma. 3) The expression of nm23 was also significantly associated with tumor differentiation. In carcinoma with lymph node metastasis, the expression of nm23 was reduced, but statistically it was not significant. 4) The expression of CD44 was higher in tumors with lymph node metastasis than in tumors without lymph node metastasis, but it was not statistically significant. 5) The degree of microvessel density was significantly associated with lymphatic invasion. According to the above results, the expression of E-cadherin and nm23 are related to the differentiation of the tumor and tumor angiogenesis is related to the lymphatic invasion of the colorectal adenocarcinoma.
Adenocarcinoma* ; Cadherins* ; Cell Adhesion ; Cell Movement ; Colorectal Neoplasms ; Genes, vif ; Humans ; Lymph Nodes ; Membrane Glycoproteins ; Microvessels ; Neoplasm Metastasis ; Oncogenes ; von Willebrand Factor

No abstract available.
Female ; Humans

PURPOSE: To evaluate surface configuration of intervertebral disc on three dimensional CT. MATERIALS AND METHODS: Three dimensional surface images reconstructed from CTscans(1 mm thick) of 20discs in 14 healthy adults were reviewed. Disc surface was classified into peripheral and central zones in contact with consecutive peripheral ring and central endplate. Local irregularity incidence, pattern in radial, concentric, or mixed form, size, location, and extension were observed. Incidence and severity ranges in 4 grades of general irregularity, and peripheral width relative to central radius were evaluated. RESULTS: Normal disc mostly showed smooth surface with few display of small local irregularity(6/20) which was mainly radial in pattern(4/5), posterolaterally located(4/6), and confined within peripheral zone(5/6). General irregularity displayed(5/20) was all grade I and peripheral width was 0.82 of central radius. CONCLUSION: Normal disc shows smooth surface but few may display small local irregularity maybe due to very early degenerative change.
Adult ; Humans ; Incidence ; Intervertebral Disc* ; Radius

No abstract available.
Dislocations* ; Joints*

Total hip replacement arthroplasty is one of the excellent treatment modalities of adult hip joint disease. But those who have severe dysplasia of the hip usually require augmentation of acetabular bone stock in order to carry out the total hip replacement arthroplasty and technical difficulties are often encountered in estabilishing an adequate acetabular bed for the prosthesis. From July 1988 to January 1990, we attempted to treat patients of dysplastic hip by bipolar endoprosthesis with acetabular bone graft using femoral head autograft in 8 patients and then reviewed these cases. The mean follow up period was 3 years ranging from 1 year and 10 months to 3 years and 10 months. The results obtained were as follows : 1. All the bone grafts were united well(average bone union time : 5.3 months). 2. According to Gerber and Harris' classification, there was no evidence of resorption of the graft in 1 case, and there were minor resorption in 5 cases, moderate resorption in 1 case, and major resorption in 1 case. 3. The average preoperative Harris hip score was 47.5 points and the average Harris hip score at last follow up was 79.0 points. 4. Because of the high rate of graft resorption and component migration, bipolar endoprosthesis with acetabular bone graft was not to be recommended as a reconstructive procedure for the dysplastic hip which have segmental bony deficiency in the acetabulum.
Acetabulum ; Adult ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Autografts ; Classification ; Follow-Up Studies ; Head ; Hip Joint ; Hip ; Humans ; Prostheses and Implants ; Transplants

No abstract available.
Aneurysm, False ; Child ; Humans ; Iliac Artery

No abstract available.
Hip Joint* ; Hip*