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.
Carcinosarcoma*

No abstract available.
Myoepithelioma* ; Trachea*

We have reviewed ovarian mature cystic teratomas with features of chronic thyroiditis that were diagnosed at the department of pathology, Seoul National University Hospital during 7 years, 1984-1991. Twenty three case(8%) containing thyroid tissue among 285 ovarian mature teratomas were available for histopathologic examination. Among these, 4 cases(1.4%) showed lymphocytic infiltration with lymphoid follicle formation. These four cases were examined according to the strict histologic criteria of autoimmune thyroiditis and reactive non-autoimmune thyroiditis for the purpose of differentiation of pathogenesis. Two cases were similar to autoimmune in nature and the other two cases simply seemed to reflect reactive features to adjacent stimulating elements. In conclusion, thyroid tissue present in ovarian cystic teratoma may have histologic features of chronic thyroiditis of either autoimmune or non-autoimmune origin.

No abstract available.
Birth Certificates* ; Parturition*

No abstract available.
Ferritins*

Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.
Actins ; Adipose Tissue ; Aged ; Angiomyolipoma* ; Blood Vessels ; Cytoplasm ; Desmin ; Eosinophils ; Epithelioid Cells ; Estrogens ; Female ; Giant Cells ; Glycogen ; Hamartoma ; Humans ; Keratins ; Kidney* ; Melanosomes ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Receptors, Progesterone ; Tuberous Sclerosis ; Vimentin

OBJECTIVE: Multiple birth implicates the important health and social problems such as preterm birth, low birth weight, high perinatal mortality, and increased medical cost. This study was performed to investigate the multiple birth rate in Korea using the birth certificate data. METHODS: Retrospective review and analysis of data from Korean birth certificate in 1996. RESULTS: Multiple birth rate was 1.4% of total births(683,043 cases). Mean birth weight was 3.29+/-0.47kg for singleton birth and 2.57+/-0.58kg for multiple birth. Mean gestational age was 39.56+/-1.32 weeks for singleton birth and 37.47+/-2.41 weeks for multiple birth. Rate of low birth weight (< 2.5kg) was 14 times higher for multiple birth compared with that of singleton birth, and rate of preterm birth(< 37 weeks) was 10 times higher. Multiple logistic regression analysis was performed to examine the relationship between multiple birth and selected variables including maternal age, job and birth order. As the odds ratio(OR) was 2.47(95% CI: 2.34 - 2.59, p<0.001) for the second birth, and 5.31(95% CI: 4.99 - 5.65, p<0.001) for the third and over birth compared with the first birth, there was a significant correlation between multiple birth and birth order. CONCLUSIONS: Based on the birth certificate data in 1996, the incidence of twin and higher order multiple birth was 1.7%, and a significant correlation between multiple birth and birth order was revealed. Further studies are necessary to elucidate the etiology and prognosis of multiple birth and the developmental problems from birth to adolescence.
Adolescent ; Birth Certificates* ; Birth Order ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Logistic Models ; Maternal Age ; Multiple Birth Offspring* ; Parturition* ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Prognosis ; Retrospective Studies ; Social Problems ; Twins

OBJECTIVE: The purpose of this study was to identify the regions of the brain associated with recurrent nocturnal chronic hypoxic episodes in patients with untreated obstructive sleep apnea syndrome (OSAS) using low-resolution electromagnetic tomography (LORETA) and quantitative electroencephalography (QEEG). METHODS: Nocturnal polysomnograph (NPSG) and subsequent morning electroencephalograph (EEG) were measured in 20 subjects with OSAS. Mild (n=10 ages 39.5+/-12.1 years) and severe (n=10 ages 41.7+/-13.6 years) right-handed male OSAS subjects were selected by interview and questionnaires including the NPSG, Beck Depression Inventory, Beck Anxiety Inventory, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. The LORETA and QEEG were compared between the severe and mild OSAS groups by frequency bands (delta 1-3 Hz, theta 4-7 Hz, alpha 8-12 Hz, beta1 13-18 Hz, beta2 19-21 Hz, beta3 22-30 Hz, and total 1-30 Hz) made by spectral analysis during resting with the eyes closed. RESULTS: The LORETA analysis showed decreased alpha activity at the right posterior cingulate gyrus (Brodmann area 23) in cases with severe OSAS compared to mild OSAS (p<0.05). For the QEEG, the absolute power of the alpha activity (8-12 Hz) was decreased in P3 (p=0.047), PZ (p=0.039) and O2 (p=0.04) in cases with severe OSAS compared to mild OSAS cases. The LORETA and QEEG analyses had similar results with regard to band, activation and location. CONCLUSION: The decreased activity of the alpha frequency in the right posterior cingulate gyrus, in patients with severe OSAS compared to those with mild OSAS, suggests that chronic repeated short-term hypoxia during sleep, in OSAS, could provoke cortical brain dysfunction associated with cognitive dysfunction such as memory and attention.
Anoxia ; Anxiety ; Brain ; Depression ; Electroencephalography ; Gyrus Cinguli ; Humans ; Hypoxia, Brain ; Magnets* ; Male ; Memory ; Surveys and Questionnaires ; Sleep Apnea, Obstructive*

Twin-twin transfusion syndrome is attributed to an unbalanced blood flow between the donor and the recipient twin, but the exact pathophysiology remains incompletely understood. Despite active prenatal management, fetal twin-twin transfusion syndrome is still associated with a substantial residual perinatal mortality and morbidity. The donor twin progressively becomes anemic, growth restricted, oliguric and has oligohydramnios, where as the recipient becomes plethoric, polyuric and has polyhydramnios and in the most severe cases develops cardiomegaly, congestive heart failure and hypertension. We report a case of severe systemic hypertension developed in recipient twin.
Cardiomegaly ; Female ; Heart Failure ; Humans ; Hypertension* ; Oligohydramnios ; Perinatal Mortality ; Polyhydramnios ; Pregnancy ; Tissue Donors