Fibrous histiocytoma composed of fibroblasts and histiocytes is quite variable in histologic pattern. The biologic behavior is unpredictable by histologic ground. This tumor is well-known in subcutaneous tissue and deep soft tissue, but quite rare in central nervous system. We experienced a case of the fibrous histiocytoma involving the dura mater of spinal cord in a 26 year old female patient. In gross findings, the mass was a well demarcated, ovoid mass attached to the dura matter, and measured 2.5x1.5 cm in diameter. The cut surface was rubbery, solid, gray-white or yellow. Microscopically, the lesion consisted of polyhedral cells with round or oval nuclei and faintly eosinophilic or vaculoated cytoplasm, and multinucleated giant cells. Some giant cells were Touton-type. Composing cells were bland-looking. Mitotic figures were average 3 per 10 high power fields.
Female ; Humans

We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.
Adenocarcinoma ; Neoplasm Metastasis

A 17 year old female with Klippel-Trenaunay-Weber Syndrome is presented. Of particular interest was presence of congenital heart anomaly. The nevus flarnmeus invoIved her entire right leg and foot with hypertrophy, elongation and partial ulecration. Elongation of the right leg Iead cornpensatory vertebral scoliosis (Fig.1,2). The cutaneous temperature of affected side was higher than the other side, and. was larger on somatometry and osteometry (Table 1). On auscultation, grade III systolic blowing murmur was heard on left upper sternal border with second heart sound splitting. Electrocardiograrn revealed complete right bundle branch block (Fig. 3). Chest X-ray revealed cardiomegaly, increase 3 hilar shadaws and rnild pulmonary congestion (Fig. 4). Above mentioned signs suggests strongly secundum type of atrial septal defect. Femoral angiography didnt show arteriovenous malformation (Fig. 5). Authors experienced this rare variant of Klippel-Trenaunzy-Weber Syndrome acco- mapanying with congenital heart anamaly, and report this with review of literatures.
Adolescent ; Angiography ; Arteriovenous Malformations ; Auscultation ; Bundle-Branch Block ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Female ; Foot ; Heart Septal Defects, Atrial ; Heart Sounds ; Heart* ; Humans ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome* ; Leg ; Nevus ; Scoliosis ; Thorax

Authers observed one case of typical reactive perforating collagenosis (RPC) which did not seem to have been described in the Korean literature. A 19 year old male patient complained of a skin eruption involving his face, upper and lower extremities, and trunk in June 1973. The skin eruption appeared at the age of 10 and consisted of discrete papules of which the earliest lesion was a pinhead-sized, skin-colord papule, but it became older, it increased in size and developed a small central area of umbilication containing keratinous material. As new papules continued to develop, the older lesions regressed and disappeared with residual scar. No subjective symptom was obtained except intermittent, mild itching sensation which probably due to a irritation. The Keobner's phenomenon was observed on the dorsum of hands. He has acne vulgaris on the face with many of the individual comedones showing development into RPC. He also had a chronic maxillary sinusitis which was seemed to aggravate the skin eruption. In follow up period (about 5 months), the sinusitis was cured with operation, but the skin eruption was not improved. The family history was negative. Histopathological studies revealed typical RPC, i.e., a cup-shaped epidermal depression of which center was lacked the epidermis was noted, and through it, necrobiotic connective tissue, degenerating inflammatory- cells and collagen bundles are extruded to form a plug. Diagnosis was confirmed by clinical appearance and typical histopathologic features. The patient did not responed to topical application of 0. 1% Retinoic acid solution and Vitamin A and D.
Acne Vulgaris ; Cicatrix ; Collagen ; Connective Tissue ; Depression ; Diagnosis ; Epidermis ; Follow-Up Studies ; Hand ; Humans ; Lower Extremity ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Pruritus ; Sensation ; Sinusitis ; Skin ; Tretinoin ; Vitamin A ; Young Adult

The clinical and pathological features of a case Malignant mixed mullerian tumor of the ovary in 45 year-old female patient with a brief review of the literature are presented. She had both ovarian tumors. The masses are multilocular cystic tumor with interspersed solid component. The cystic component is filled with serous fluid. Microscopically the tumor is composed of epithelial element & intimately related mesenchymal element. The epithelial element shows the findings of adenocarcinoma of solid, glandular and papillary growth. The mesenchymal element is composed of malignant-looking stroma with cartilage formation.
Female ; Humans ; Adenocarcinoma

PURPOSE: Endoscopic variceal sclerotherapy(EVS) has been considered the mainstay therapy for bleeding esophageal varices in adults. However, recent data have shown that endoscopic variceal ligation is just as efficacious and has fewer complications than EVS. Although there are many reports concerning EVL in adults, only a few studies have been done of children. METHODS: We performed EVL in 9 children under 6 years of age(mear age, 2.5 year) with esophageal varices. Outcome was assessed with respect to survival, rebleeding, and complications. RESULTS: The causes of portal hypertension were 3 cases of congenital hepatic fibrosis, 3 cases of biliary atresia, 2 cases of portal vein thrornbosis, and one case of portal vein fibromuscular dysplasia. The age at diagnosis ranged from 10 months to 6 years. The patients underwent a mean of 2.6+/- 0.7 sessions of EVL(ranging from two to four). The numbers of bands per person were 5.6+/-1.8, and the numbers of bands per session were 2.2+/-1.0 Two complications of esophageal rebleeding were noted, and none of the cases experienced symptoms of esophageal stenosis, nor gastroesophageal reflux. CONCLUSION: EVL is safe and effective in controlling variceal hemorrhage in children with portal hypertension, regardless of etiology. The cornplication rate is low and EVL is an acceptable and perhaps preferable altemative to EVS in children with esophageal varices. But regular periodic examination for recurrence of varices after eradication should be required.
Adult ; Biliary Atresia ; Child* ; Diagnosis ; Esophageal and Gastric Varices* ; Esophageal Stenosis ; Fibromuscular Dysplasia ; Fibrosis ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation* ; Portal Vein ; Recurrence ; Varicose Veins

PURPOSE: Chlamydia trachomatis (C. trachomatis) is a well known cause of non-gonococcal urethritis (NGU). No other microorganism has been shown to cause any larger proportion of the remaining NGU cases. As a possible causative organism of NGU, we wanted to evaluate the detection rate of Mycoplasma genitalium (M. genitalium) and its role in NGU using polymerase chain reaction (PCR). MATERIALS AND METHDS: From June 1998 to July 2000, we examined a total of 116 men. Of these men 70 had symptoms and signs compatible with urethritis and 46 were for normal control. In the patient group, two urethral discharge or swab specimens were collected. One was used for Gram stain to detect Gram negative intracellular diplocci. The other was subjected to PCR for C. trachomatis and M. genitalium. In the control group, urethral swab specimen was used to detect C. trachomatis and M. genitalium by PCR based assay. RESULTS: Gonococcal urethritis (GU) was diagnosed in 14 cases (20.0%). Detection rates of M. genitalium and C. trachomatis in urethritis group were 8.6% (6/70), 18.6% (13/70). M. genitalium and C. trachomatis were detected in 7.1% (1/14), 14.3% (2/14) of GU and 8.9% (5/56), 19.6% (11/56) of NGU. Detection rate of M. genitalium in chlamydia-negative NGU was 11.1% (5/45). No patient positive for M. genitalium had a simultaneous chlamydia infection. In control group with no urethral symptom or sign, M. genitalium and C. trachomatis were not detected at all. Compared with chlamydia- positive NGU, M. genitalium-positive urethritis exhibited higher recurrence rate. CONCLUSIONS: M. genitalium was detected in 8.9% of NGU and 11.1% of non-chlamydia NGU. This study suggests that M. genitalium may be one of the causative organisms in NGU. Further studies will be necessary to define its role in NGU.
Chlamydia Infections ; Chlamydia trachomatis ; Humans ; Male ; Mycoplasma genitalium* ; Mycoplasma* ; Polymerase Chain Reaction ; Recurrence ; Urethritis*

This study represents the immune reaction pattern of gastric carcinoma, based on the morphologic characteristics of regional lymph nodes in the cases of stomach carcinomas. The materials were obtained from the resected specimens from 100 carcinoma patients. We chose Tsakraklides' method in classification of the structure of lymph node, which are as follows: lymphocyte predominance, germinal center predominance, unstimulated and lymphocyte depletion. The incidence was as follows: lymphocyte predominance 45, germinal center predominance 32, unstimulated 21 and lymphocyte depletion 2. In the lymph nodes of peptic ulcer, lymphocyte predominance pattern was most common. The reactivity of lymph nodes is suppressed proportionally to the severity of cancers, thus the advanced case of cancer exhibited lymphocyte depletion pattern which suggests exhaustion of immune reaction. The lymphocyte predominance pattern was frequent in superficial type and expanding type of gastric carcinoma. The cancer metastasis of lymph node in lymphocyte predominance was smaller than the other type of lymph nodes, while metastasis increased progressively higher with the orders as following: lymphocyte predominance, germinal center predominance, unstimulated and lymphocyte depletion.
Incidence ; Neoplasm Metastasis

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital