Primary gallbladder carcinoma is generally assumed as uncommon but dismal malignancy. Only sporadic studies about pathologic features of the gallbladder carcinoma have drawn pathologists attention especially in association with cholelithiasis. Currently, we have focused much on the role of metaplastic changes in diseased gallbladders including cholecystitis with or without cholelithiasis, and raised its implication in the development of benign or malignant neoplasm. The authors reviewed 34 cholecystectomy cases with primary gallbladder carcinoma, and their histologic findings were analyzed with reference to the association of metaplastic changes both in tumor and adjacent nonneoplastic mucosal epithelium. Association with gallstones and metaplastic changes in the surrounding nontumorous mucosa is more frequent in intestinal typen than in non-intestinal type (P<0.05). Gallstones may play a role of irritant stimuli to the gallbladder mucosa which can be eventually reconstructed with more resistant cell type. And the subsequent increase in absorptive capacity and accumulation of carcinogenic substance may result in malignant transformation of (reserve) cells in replication zone. At this time we can assume that association of cholelithiasis and presence of metaplastic changes are in parallel relationshop in intestinal type adenocarcinoma. Intestinal type adenocarcinomas are usually papillary (72.7%) especially in superficial portion, but deeper area also shows infiltrative growth focally. This finding is comparable to intestinal type gastric carcinoma which represents frequently a polypoid and papillary growth pattern. With these results, as in the gastric carcinoma it is strongly supported that intestinal metaplasia may play a major role as a precancerous lesion in a minor group of the gallbladder adenocarcinoma. Controlled prospective study on biological behavior of intestinal type adenocarcinoma should be followed with more cumulative cases.
Adenocarcinoma

The diagnosis of carcinoma in situ of urinary bladder is difficult in that the symptoms and cystoscopic findings are nonspecific. The cytology of urine could be helpful for diagnosis of carcinoma in situ of urinary bladder. We present a case of bladder washing cytology of carcinoma in situ. A 54 year old man presented with dysuria for 1 year. Cystoscopic findings revealed multifocal reddish trabeculated lesions. The bladder washing cytology revealed rather uniform tumor cells which were singly scattered or forming syncytium in the clean background. The nuclei were round to oval with inconspicious nucleoli. The cystoscopic biopsy revealed typical histologic features of carcinoma in situ of urinary bladder.
Biopsy ; Carcinoma in Situ* ; Diagnosis ; Dysuria ; Giant Cells ; Humans ; Middle Aged ; Urinary Bladder*

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

Spirochetes were isolated from the midgut of Ixodes persulcatus ticks captured at Chungju, Korea and identified as Borrelia afzelii strains by polymerase chain reaction. To determine the pathogenicity of the B. afzelii strains isolated in Korea, the microbiological and pathological features of Lyme disease were observed in C3H/He mice after intraperitoneal inoculation of the fresh isolate of B. afzelii strain. The results are summarized as follows 1) The Borrelia were detected in the tissues of heart, spleen, kidney, urinary bladder and knee joint within 7 days after inoculation of infection by dark field microscopic examination. The isolation rate from heart, urinary bladder and joint was significantly higher than the rate from spleen, kidney, and blood samples. 2) The Borrelia was detected in heart muscle by indirect immunofluorescent antibody test. 3) Antibody to the Borrelia was detected as early as one week after inoculation. 4) The marked tropism of the Borrelia was observed in myocardial, urinary tract and joint tissue. The main pathological features are inflammation in tissues of heart, kidney, joint and urinary bladder. From these results, the Borrelia afzelii strain isolated in Korea were determined as pathogenic strain.
Animals ; Borrelia burgdorferi Group* ; Borrelia burgdorferi* ; Borrelia* ; Chungcheongbuk-do ; Heart ; Inflammation ; Ixodes ; Joints ; Kidney ; Knee Joint ; Korea* ; Lyme Disease ; Mice ; Myocardium ; Pathology ; Polymerase Chain Reaction ; Spirochaetales ; Spleen ; Ticks ; Tropism ; Urinary Bladder ; Urinary Tract ; Virulence*

No abstract available.
Erythema*

Solar urticaria is a rare disorder in which immediate erythema and wheals are induced by ultraviolet or visible irradiation. This condition usually occurs in the third and fifth decades of life and is very rare in childhood. A 3-year-old girl presented with a history of an erythematous rash which had occurred on the face and neck, immediately after exposure to sunlight for one month. A diagnosis of solar urtiacria was made on the clinical reviews and phototest. Other photosensitive disorders could be excluded by the clinical and laboratory findings. She was treated with ketotifen and sun protection showing good early results.
Child* ; Child, Preschool ; Diagnosis ; Erythema ; Exanthema ; Female ; Humans ; Ketotifen ; Neck ; Solar System ; Sunlight ; Urticaria*

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

BACKGROUND: Linear lichen planus (LLP) and Lichen striatus (LS) are rare disorder that can be confused because they can share similar clinical and histopathologic features. OBJECTIVE: The purpose of this study was to evaluate the characteristic differences and common features between the two disorders histopathologically. METHODS: We reviewed the clinical records of patients who had been diagnosed as LLP or LS in our dermatology clinic during the 15-year period between 1985 and 1999. We classified twenty seven cases, which were differentiated from other possible linear dermatoses, into LLP and LS on the basis of clinical features, and then compared them histopathologically, and appreciated the characteristic differences or common features of the two disorders. RESULTS: In cases diagnosed as LLP clinically, epidermal changes were mainly composed of hyperkeratosis (78%), acanthosis (78%), basal degeneration (78%), granular layer thickening (67%) and saw-toothed appearance of rete ridges (44%). In dermis, colloid bodies (78%), band-like inflammatory cell infiltration with pigmentary incontinence (78%) were strik-,ting findings. In cases with clinical features of LS, parakeratosis (50%), dyskeratotic cells scattered in the epidermis (61%) and intercellular edema (39%) were noted in the epidermis. Dermal cellular deposits were focally band-like infiltration(89%), more frequently perivascular in-filtration (83%) and often involved deep dermis (50%), hair follicles (44%) and eccrine glands (22%) in contrast to LLP. CONCLUSION: This study presents a comparative histopathologic features of LLP and LS. Three cases of LLP with overlapping histopathologic features suggest the possibility that there may be an intermediate form between either end of a spectrum, LLP and LS.
Colloids ; Dermatology ; Dermis ; Eccrine Glands ; Edema ; Epidermis ; Hair Follicle ; Humans ; Lichen Planus* ; Lichens* ; Parakeratosis ; Skin Diseases

A 71-year-old woman was presented with 5-year history of recurrent, multiple, painful or tender, erythematous plaques on her lower limbs accompanied by fever and arthralgia. Histopathological findings showed a dense infiltration of mature neutrophils in the upper and mid dermis without leukocytoclastic vasculitis. These clinical and histopathological findings were consistent with Sweet's syndrome. The laboratory investigations demonstrated elevated ESR and IgA gammopathy, but no leukocytosis or neutrophilia. Her eruption revealed good responses to systemic steroid therapy. We herein describe a patient with Sweet's syndrome without leukocytosis, probably associated with a benign IgA gammopathy.
Aged ; Arthralgia ; Dermis ; Female ; Fever ; Humans ; Immunoglobulin A* ; Leukocytosis ; Lower Extremity ; Neutrophils ; Sweet Syndrome* ; Vasculitis

Multiple cerebral infarction developed in a 36-year-old woman with adenocarcinoma of the right lung with direct cardiac invasion. Neurological examination and brain MRI showed findings of ordinary infarction. Transesophageal echocardiography showed left atrial pedunculated mass which was the potential source of embolism. We report a rare case who had such multiple spontaneous tumor emboli large enough to result in clinically detectable cerebral infarction.
Adenocarcinoma ; Adult ; Brain ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Embolism ; Female ; Humans ; Infarction ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplastic Cells, Circulating ; Neurologic Examination