A case of papillary adenoma of the gallbladder in a sixty seven-year-old female with varietise of epithelial components in metaplastic nature is presented. This adenoma was bordered by hyperplastic epithelium with intervening Paneth cells and enterochromaffin cells, but goblet cells were rarely participated, as with focal epithelial change resembling gastric foveolar epithelium and aggregation of antral type mucous glands. Based on its morphologically distinct type of gallbladder adenoma and histogenetic point of view, we propose this neoplasm to be designated as a metaplastic adenoma or polyp, and the relationship of various metaplastic changes to adenoma or carcinoma is discussed.
Female ; Humans ; Adenoma

Secondary tumor of the stomach is rare when metastatic involvement is defined as an extragastric tumor invading the muscularis, submucosa or mucosa and the only serosal implant is excluded. Recently, authors experienced a case of metastatic squamous cell carcinoma of the stomach in the pyloric antrum from the uterine cervix. The patient was a 57-year-old female who received a simplified Wertheim's operation followed by irradiation for squamous cell carcinoma of uterine cervix in stage IIb, and 2-1/2 years later she presented gastric symptoms, for which subtotal gastrectomy was carried out. The gastric lesion simulated primary adenocarcinoma of Borrmann type III, but differed in the following macroscopic characteristics. Firstly, Bormann classification is not applicable; secondly, mucosal ulcerations appear irregular and multicentric; thirdly, flaskshaped ulceration and broad based penetration are evidet; fourthly, submucosal tumor-growth pattern is conspicuous in bulk of areas; and fifthly, circumferential/semicircumferential growth is manifested. The above features should also be differentiated from those of malignant lymphoma and leiomyosarcoma.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

Unstable Colles' fractures have an inherent capacity for loss of reduction or shortening, or both. The istability can be recognized by the presence of much comminution, severe dorsal angulation(20 degrees or more), or extensive intra-articular involvement. It is difficult to align the fracture fragments and to maintain the reduction. In twenty-nine patients with unstable Colles' fracture from Jan. 1982 to Mar. 1984, several invasive methods were used. The results were as follows: 1. Among 147 patients with Colles' fractures 29 patients(19.7%) had unstable fractures. 2. Colles' fracture was occurred more frequently in women(77%) and in 6th and 7th decades(56%). Unstable fractures showed no significant age and sex related propencity. 3. Mechanism of injury caused unstable Colles' fractures were fall on the outstretched hand(25 patients), traffic accident(3 patients) and crushing injury(1 patient). Open fractures were shown in 4 patients among the unstable fractures. 4. Most of the unstable fractures were comprised of type VII and VIII(49%) but type I and II fractures with marked comminution or displacement also showed instability. 5. Complications were such as, redisplacement of the fractures, temporary neuropathy of the median nerve, compartment syndrome, Sudeck's atrophy, and shoulder-hand syndrome. 6. Overall assessments showed excellent in 4 patients, good in 16 patients, fair in 7 patients and poor in 2 patients. 7. Overall results were mainly correlated with initial severity of the injury and anatomical restoration of the fractures.
Atrophy ; Colles' Fracture ; Compartment Syndromes ; Fractures, Open ; Humans ; Median Nerve ; Radius ; Reflex Sympathetic Dystrophy

Sixty amputees who had traumatic amputations due to industrial accidents were examined on their phantom limb and phantom pain phenomena and the following results were obtained. 1. Fifty-three (93%) of sixty amputees experienced phantom limb and twenty-four (40%) experienced phantom pain. The incidence of phantom pain in the lower limb amputation (59%) is greater than that of upper limb amputation (29%). 2. Amputees with asthenic body status gave higher incidence (56%) of phantom pain than those with muscular body status (20%). None of amputees with obese body status experienced phantom pain. 3. The sensation of strong current and cramping were most predominant sensations in the phantom pain. 4. Twenty-eight (93%) of thirty amputees had experienced painless phantom limb longer than four months. 5. Six (55%) of eleven upper limb amputees with phantom pain experienced pain sensation at the tips of fingers and nine (69%) of thirteen lower limb amputees with phantom pain experienced pain at the great toe. 6. Fifty-three (88%) of sixty amputees experienced telescoping of the lost limb and twenty-three (38%) of sixty amputees experienced jerking movement of the stump. 7. In fifty-four (90%) of sixty amputees, trigger zones triggering pain in the phantom limb were found in the healthy part of the body. 8. Twenty-two (40%) of fifty-five male amputees experienced burning sensation in the phantom limb associated with urination, defecation or ejaculation. 9. Cold temperature was predominant, aggrevating factor of the phantom pain. Fitting prosthesis and alcohol intake were predominant, relieving factor of the phantom pain.
Accidents, Occupational ; Amputation ; Amputation, Traumatic ; Amputees ; Burns ; Cold Temperature ; Defecation ; Ejaculation ; Extremities ; Fingers ; Humans ; Incidence ; Lower Extremity ; Male ; Muscle Cramp ; Phantom Limb ; Prostheses and Implants ; Sensation ; Toes ; Upper Extremity ; Urination

Squamous cell carcinomas and adenosquamous carcinomas are rarely originated from the stomach, thus the limited and sporadic informations about their clinico-pathologic characteristics as well as histogenesis have been elucidated. Six cases of primary squamous cell carcinoma (3 cases) and adenosquamous carcinoma(3 cases) in the stomach were examined during a period of 4 years from 1981 to 1984. After pertinent review of both clinical data and morphology through extended histotopographic study performed on 4 cases, their clinicopathologic characteristics were described. Male to female sex ratio was 4 : 2 and average age was 58.6 years. Clinical presentations or physical findings were not different from those of adenocarcinoma. Tumor masses of all cases were located in the body or phloric antrum. In all cases except for the early gastric carcinoma, each tumor was larger than 8 cm in long axis, and showed expansile and intraluminal endophytic growing tendencies with sharp margin. Simple Borrmann's macroscopic classification was applicable to none of 6 cases because of irregular and multicentric ulceration pattern and occasional submucosal growth which were reminiscent of those in submucosal tumors such as malignant lymphoma and leiomyosarcoma. Virtually four out of all six cases were diagnosed as submucosal tumor at the time of radiological examination. Microscopically three cases were composed of pure squamous cell carcinoma and remaining three contained both adeno and squamous components. Metastatic regional lymph nodes revealed only squamous element in case of pure squamous cell carcinoam, while both components were identified in adenosquamous carcinomas. Surrounding non-tumors mucosa exhibited moderate to severe degree of intestinal metaplasia accompanied by multifocal mucin pool formation. Growth pattern and surrounding mucosal changes as with older age prevalence of these tumors might express the biological behavior of intestinal type of gastric carcinoma.
Female ; Male ; Humans ; Neoplasm Metastasis

Fifty three surgically resected gallbladders(49 cases of chronic cholecystitis with or without cholelithiasis, 4 cases of incidentally resected gallbladders) and 14 autopsy cases were subjected to the histotopographic analysis to identify the nature and distribution of metaplastic mucosal changes, and to determine the possible histogenesis of these mucosal lesions and diagnostic implication as a parameter of chronic cholecystitis. 1) Antral type glands were demonstrated in 47(88.7%), goblet cells in 19(35.8%) and surface epithelial changes in 27(50.9%) of total surgical specimens, indicating the benign metaplastic changes of the gallbladder mucosa toward the gastric or intestinal type. 2) Topographic distribution illustrated the extension of antral type gland to the middle and upper one third portions of the gallbladder mucosa in 37 cases, each. Goblet cells in the middle and upper one third of the mucosa were demonstrable in 13 cases(68%) an 8 cases(42%), respectively. 3) Average age by degree of extension was 50.0 years in Grade O-I, 50.1 years in Grade II and 56.4 years in Grade III. 4) Among 53 surgically resected gallbladders, gallstone was found in 31 cases, in which was a significant correlation between the distribution of metaplastic changes by degree of extent and cholelithiasis. 5) There was no statistical significance between incidence of metaplastic changes of the gallbladder and degree of inflammatory reaction by means of chronic and/or acute inflammatory cell infiltration and Rokitansky-Aschoff sinus formation. 6) Only two out of fourteen autopsy cases demonstrated focal and spotty presence of goblect cells. It is of authors assumption that the lining epithelium of the gallbladder undergos various types of metaplastic changes in the diseased conditions, in which cholelithiasis is included as one of preceding factor. And also, the diagnostic implication of epithelial metaplasia as an expression of chronic cholecystitis is discussed.
Incidence

No abstract available.
Osteochondroma*

Although we made a comparision of fingertip dermatoglyphic patterns between R7 patients with atopic dermatitis(Femals: 54, Male: 35) and 73 their families without atopic dermatitis, no significant results were obtained. So, we compared secondly our results of 2 groups with those of two thousand nonatopic, normal Koreans, as control. Results are as follows: ] In comparison with control, a significant increase in the ulnar loop pattern was detected in families(p<0, ()5), not atopic dermatitis. p. No significant differ ence between right hands and left hands in all three g f OUpS. In atopic dermatitis and control groups, 1 st and 4 th digits showed mostly whorl pattern, and 3 rd and 5 th digits had more ulnar loop pattern than others. Rut families had mostly ulnar loop pattern at all digits except 4 th digit, wl..orl pattern. 4. Each of atopic dermatitis, family and control group had 13, 79% (whor1: 8. 05% ulnar loop: 5 75%), 15. 49p; (whorl: 4. 23%, ulnar loop: 11. 27%), 15. 78%(whorl: 8, 52% ulnar loop: 7. 1 %, arch: 0. 05%), of same dermatoglyphic pattern on all ten digits. Especially, ulnar loop pattern in fanilies was detected significantly higher than other two groups(p<0. 05). Average incidences of bilateral symmetry of pattern type between right and left digits were 78.57%, 74. 67% and 78.74% respectively in atopic dermatitis, family and control group.
Dermatitis, Atopic* ; Dermatoglyphics* ; Hand ; Humans ; Incidence ; Male

Cutaneous protothecosis sometimes poses diagnostic and therapeutic problems. Isolation of the causative organism may not be successful and spores may be mistaken for other skin diseases unless the characteristic sporangia are detected in tissue sections. Because there are few cases, the optimal therapy is still being debated. On Liebs crystal violet staining we found charateristic purplish dots in Prototheca spores; these correspond to the amyloplasts or dense bodies found under electron microscopy. The isolated organisms were inhibited in vitro by itraconazole, amphotericin B, ketoconazole, and amorolfine and we were able to successfully treat two patients with itraconazole.
Amphotericin B ; Gentian Violet* ; Humans ; In Vitro Techniques ; Itraconazole* ; Ketoconazole ; Microscopy, Electron ; Plastids ; Prototheca ; Skin Diseases ; Sporangia ; Spores

Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.
Diagnosis ; Humans ; Radiculopathy ; Skin Temperature ; Thermography