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

Folliculosebaceous cystic hamartoma (FSCH) is a recently-recognized cutaneous hamar- toma composed of follicular, sebaceous and mesenchymal elements. We describe an unusual case of FSCH in a 61-year-old male, who had a relatively large, 3x2.5cm sized, smooth subcutaneous nodule on the occipital area of the scalp, an uncommon location for FSCH.
Hamartoma* ; Humans ; Male ; Middle Aged ; Scalp

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

BACKGROUND: Although atopic dermatitis (AD) is a very common disease, there is no specific diagnostic or prognostic marker for it. Minor clinical features and a few laboratory findings can be used as ancillary diagnostic criteria and reflect the present state of AD, but cannot predict the disease severity. OBJECTIVE: We performed this study to find out if there is any correlation among minor clinical features, laboratory findings such as blood eosinophil count and serum IgE levels, and the severity of AD. METHODS: One hundred patients with AD were involved in the study. They were divided into two groups by the age of 12 years; group 1(< or = 12-year-old, n=47) represented childhood AD and group 2 (> or = 12-year-old, n=53) represented adolescence and adult AD. Subsequently, the severity of AD was assessed by the SCORAD index, and then all the patients were classified into 3 subgroups; mild, moderate and severe groups. They were evaluated for 28 minor clinical features of AD. In addition, blood samples were measured for blood eosinophil count and serum IgE levels. RESULTS: The pattern of minor clinical features correlated significantly with the disease severity was quite different between the two groups, except ventral wrist eczema and eyelid eczema. Blood eosinophil count and serum IgE levels increased significantly as the SCORAD index increased. While perifollicular accentuation was a significant minor clinical feature that correlated with blood eosinophil count in the both groups, there were no minor features showing statistically significant correlation with serum IgE levels. In group 1, keratosis pilaris and infragluteal eczema appeared more frequently as all 3 variables such as the SCORAD index, blood eosinophil count and serum IgE levels, increased simultaneously. However, no minor clinical features which correlated significantly with all variables were observed in group 2. CONCLUSION: We concluded that minor clinical features such as keratosis pilaris and infragluteal eczema reflect the disease severity and can be used as an anticipating sign of severe disease, especially in childhood AD.
Adolescent ; Adult ; Child ; Dermatitis, Atopic* ; Eczema ; Eosinophils ; Eyelids ; Humans ; Immunoglobulin E ; Keratosis ; Wrist