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

No abstract available.
Animals ; Horns* ; Nevus, Sebaceous of Jadassohn*

No abstract available.
Erythema*

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

Recently diabetic neuropathy has been postulated to occur from reduced availability of neurotrophic factor. This experiment was performed to identify the effect of nerve growth factor on dorsal root ganglia (DRG) in the strepto-zotocin-induced diabetic rat using morphometry and immunohistochemistry. The results obtained are as follows : 1. Unlike in the diabetic group where the type A and B cells were significantly decreased in their total numbers and sizes, these cells were normal in NGF-administered diabetic group. 2. Numbers of cells immunoreactive with SP and CGRP were also significantly decreased in the diabetic group. However, the NGF-administered diabetic group did not show any reduction in the number of these cells. 3. Mean sizes of cells immunoreactive with SP and CGRP cells were reduced in the diabetic group by 18.1% and 26.6% respectively (P<0.01). On the other hand, in NGF-administered diabetic group, mean sizes of SP-immunoreactive cells were increased (10.5%) which was not statiatically significant, and those of CGRP-immunoreactive cells were decreased (18%) compared to the control group (P<0.01). 4. In the diabetic group, many of nerve cell bodies showed some degenerative characteristics including neuron-satellite cell interface of irregular shape, the presence of a number of vacuoles and dense bodies, and nucleus of irregular contour. However, NGF-administered diabetic group exhibited neuron-satellite cell interface of regular form, many neurofilaments and neurotubules, and normal intracellular organelles. These results suggest that administration of NGF protects spinal ganglion cells from morphometric and morphological changes which are associated with a streptozotocin -induced diabetic neuropathy.
Animals ; B-Lymphocytes ; Diabetic Neuropathies ; Ganglia, Spinal* ; Hand ; Immunohistochemistry ; Nerve Growth Factor* ; Neurons ; Organelles ; Rats* ; Streptozocin ; Vacuoles

Epithelioid angiosarcoma has recently been described as a variant of angiosarcoma, based on its pathologic feature which is characterized by epithelioid or histiocytoid morphology of the malignant tumor cells. We report a case of epithelioid angiosarcoma on the lower back of a 65-year-old man. The patient had several, variable-sized, pedunculated, fungating masses. On histopathologic examination, the tumor was chiefly composed of solid sheets of atypical epithelioid cells with prominent eosinophilic cytoplasm, a large vesicular nuclei, and occasional intracytoplasmic vacuoles. Primitive vascular spaces, and a cleft with malignant cells and proliferating vessels were also found in some areas. The reticulum stain and immunohistochemical stain using factor VII-related antigen and CD 31 were focally positive in the tumor. He was treated by wide surgical excision.
Aged ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Hemangiosarcoma* ; Humans ; Reticulum ; Vacuoles

Trichofolliculoma is a benign, highly structured harmartoma of the pilosebaceous unit characterized by one or more large cystic follicles with smaller radiating follicular structures. This benign neoplasm appears in middle age and rarely occurs prior to early adult life. We report a case of congenital trichofolliculoma in a 10-day-old female neonate noted from birth.
Adult ; Female ; Humans ; Infant, Newborn ; Middle Aged ; Parturition

PURPOSE: Emergency medical service (EMS) providers often care for pregnant women at risk for out-of-hospital delivery and born-before-arrival neonates. As the increase in mortality and morbidity from out-of-hospital delivery is well established, this study sought to determine whether a delivery and neonatal care education program could impact the knowledge and practice of EMS providers. METHODS: EMS providers working in the southeast Gyeonggi province in South Korea received an education program for out-of-hospital delivery and neonatal care. The program consisted of a pretest, didactic, mannequin training, and posttest. Six months after the education program a follow-up survey was administered. A paired t-test was then used to compare pretest and posttest scores. Overall, 56 EMS providers completed the study. RESULTS: The pretest average score was 80.4 and the posttest average score was 92.9 (p<0.001). The percentage of correct answers on each question was relatively and equally elevated in the posttest, regardless of the participant's certification. Participants expressed their satisfaction with the education program and this appraisal was maintained in the 6-month follow-up survey. CONCLUSION: These results suggest that EMS providers can benefit from a didactic and training session regarding out-of-hospital delivery and neonatal care. Further studies are needed, however, to develop the reliability and validity of the test and to determine its clinical applications.
Certification ; Delivery, Obstetric ; Education* ; Emergencies* ; Emergency Medical Services* ; Female ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Infant, Newborn ; Manikins ; Mortality ; Pregnant Women ; Reproducibility of Results ; Republic of Korea

OBJECTIVE: The purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews. METHODS: A standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales. RESULTS: A single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch. CONCLUSIONS: Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable.
Alveolar Process ; Dental Occlusion ; Dentition* ; Periodontal Ligament ; Tooth ; Weights and Measures

Tufted angioma is a rare benign vascular neoplasm that usually occurs in children. It appears as an erythematous, purplish, indurated papule or plaque on the trunk or neck. Although it can have variable clinical manifestations, the annular or serpiginous configuration of lesions resembling tinea infections has rarely been reported. A 47-year-old woman presented with an erythematous plaque enlarging by peripheral extension to form polycyclic or serpiginous figures on her left chin and buccal cheek for 7 months without any subjective symptoms. Tinea faciale was considered as the initial clinical diagnosis, but repeated KOH tests were all negative; therefore, skin biopsy was performed. Histopathology revealed discrete circumscribed foci of capillaries scattered throughout the dermis showing a cannon ball appearance, compatible with tufted angioma. Clinical features showed considerable improvement after 2 sessions of intense pulsed light and pulsed-dye laser (5 repetitions) without any complications. Herein, we report a rare case of polycyclic variant of tufted angioma, which developed in a woman in her 5th decade.
Biopsy ; Capillaries ; Cheek ; Child ; Chin ; Dermis ; Diagnosis ; Diagnosis, Differential ; Female ; Hemangioma* ; Humans ; Middle Aged ; Neck ; Skin ; Tinea* ; Vascular Neoplasms