No abstract available.
Contraception*

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

OBJECTIVE: To understand the regulatory mechanism of apoptosis by pro- and anti-apoptotic genes in the cyclic human endometrium. METHODS: Each case of endometrial status was classified by Noyes criteria, and grouped into early proliferative(n=13), late proliferative(n=14), early secretory(n=15), and late secretory phases(n=15). Expression of bcl-2, and bax were assessed by Northern blot and immunohistochemistry in relation to apoptotic index by TUNEL. Results: Apoptotic index showed increasing tendency as progressing to the late secretory phase, which phase showed significantly higher apoptotic index compared to the other phases(p<0.05). The intensity of bcl-2 8.5kb transcript by Northern blot was highest in the late proliferative phase significantly(p<0.05), decreasing to nadir in the late secretory phase. In contrast to bcl-2 expression, bax mRNA expression was highest in the late secretory phase significantly(p<0.05). Both the relative ratio of bcl-2 8.5kb transcript and bcl-2 5.5kb trascript to bax showed that the ratio was higher in the early, and late proliferative phase, but, reversed in the late secretory phase. Both the immunoreactivity of bcl-2 and bax proteins could be detected in the basal, functional, and stromal layers of endometrium. The immunoreactivity of bcl-2 protein was more prominent in the proliferative phase, however, bax protein was more prominent in the secretory phase. CONCLUSION: This study suggests that apoptosis could be regulated by the relative dominance of bcl-2 or bax expression in the human endometrium. Thus, bcl-2 and bax expressions might be one of the possible mechanism in the regulation of normal menstruation.
Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Northern ; Endometrium* ; Female ; Humans* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Menstruation ; RNA, Messenger

To establish new criteria to determine the depth of bladder cancer as well as to obtain the findings of each stage of bladder cancer we reviewed high resolution MR images of 18 bladder cancer patients including seven cases (26%) with superficial bladde4r wall invasion. All MR scans were done before biopsy or surgery. Multiple layers of the bladder wall (inner black, middle white, outer black) were demonstrated in 11 cases out of a total 18 cases. Thickening of the middle layer caused by tumor infiltration or edema of lamina propria was seen in 8 of 12 patients with stage T2 or greater, and was suggestive of superficial muscle invasion when multiple layers were demonstrated. Disruption of outer layer (as well as inner layer) and external protrusion of tumor itself were indicative of perivesical invasion. When multiple layers were not demonstrated, the depth of tumor invasion could not be judged. High resolution MR imaging can depict submucosal invasion, muscle invasion, and perivesical invasion secondary to bladder cancer.
Biopsy ; Edema ; Humans ; Magnetic Resonance Imaging* ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Child* ; Humans ; Infant* ; Intussusception*

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.

No abstract available.
Choledocholithiasis*

BACKGROUND: Routine renal function tests are not sensitive enough to detect early renal complication of diabetes. To detect the complication as soon as possible, we measured urine N-Acetyl-beta-D-glucosaminidase(NAG) and evaluated in comparison with microalbumin and beta2-microglobulin(beta2-MG). METHODS: 87 patients with type II diabetes visited Catholic University Hospital of Taegu Hyosung during the period October 1995 to March 1996. We collected 24 hour urine samples and measured NAG, albumin excretion rate (AER), beta2-MG. urinalysis, BUN, creatinine(Cr) Cr clearance(CrCl), fasting and 2 hour postprandial blood sugar and hemoglobin A1c. RESULTS: The average age of the patients was 53+/-15 years old and their average disease duration was 5.8+/-5.0 years. Abnormal rates of each renal function tests were as follows : NAG/gCr 52.1%, AER 51.7%, CrCl 42.5%, BUN 18.4%, beta2-MG 13.8% and creatinine 6.9% in order. From 36 patients whose AER was within normal limit, 13 of them(36.1%) showed increased level of NAG/gCr. Of 38 patients with increased NAG/gCr results, the 31 patients (81.6%) recorded abnormal results of renal function tests. Among 87 patients studied 60 patients(68.5%) showed increased level of NAG/gCr or AER results. Compared with AER test alone. the combined tests with NAG/gCr increased 16.8% of detection rates of renal complication in type II diabetes. CONCLUSION: Urine NAG/gCr and AER tests were very useful for detecting the early renal complication of type n diabetes. As increase of NAG/gCr suggest the proximal tubule damage, it is necessary to have further evaluation about the proximal tubule damage of renal complication in type II diabetes.
Acetylglucosaminidase* ; Blood Glucose ; Creatinine ; Daegu ; Fasting ; Humans ; Urinalysis

Although measurement of cerebral blood flow by radioactive - isotope method became popular, there is still no report of study on the cerebral blood flow in Korea. Auther studied the regional cerebral blood flow in 28 normal Korean adults and and 76 patients including 14 cases of essential hypertension, 11 cases of heart diseases (coronary artery disease, valvular diseases and A-V block), 14 cases of brain diseases(cerebral thrombosis and cerebral insufficiency), 22 cases of head trauma and 15 cases of miscellaneous medical diseases. The regional cerebral blood flow was measured by intravenous in jection of (99m)Tc-DTPA 15-20Ci and by taking serial cerebral angiograms with CGR Gamma Tome 7000 and was analized by computer Imac 7310. The results were as follows: 1) The average regional cerebral blood flow of normal Korean adult was 50.0+/-5.89mg/100g /min. with range of 41-60ml/100g/min. 2) In most cases of essential hypertension the regional cerebral blood flow was within normal limit except rare case which was considered to have impaired autoregulation of cerebral blood flow. 3) In patients with myocardial infarction, valvular heart diseases with congestive heart failure and complete A-V block, there was markedly reduced cerebral blood flow. The reduced cerebral blood flow increased after the improvement of congestive heart failure and after the implantation of pacemaker. 4) In patients with cerebral thrombosis with infarction and cerebral insufficiency with symptoms of dizziness, headache or blurred vision, the cerebral blood flow was considerably reduced. However in acute encephalits the cerebral blood flow was increased. The measurement of cerebral blood flow by radioactiveisotope method is considered to be accurate, easy and useful clinical test to evaluate brain diseases and function.
Adult* ; Arteries ; Brain ; Brain Diseases ; Craniocerebral Trauma ; Dizziness ; Headache ; Heart Diseases ; Heart Failure ; Heart Valve Diseases ; Homeostasis ; Humans ; Hypertension ; Infarction ; Intracranial Thrombosis ; Korea ; Myocardial Infarction ; Thrombosis