Cyclins are the regulatory subunits of cyclin-dependent kinase and play an important role in cell proliferation. Many tumors, such as colon, breast and gastric carcinomas are known to be involved in the deregulation or amplification of cyclins, especially cyclin E, which involves the restriction point of G1-S transition. We investigated the expression of cyclin E in benign and malignant epithelial tumors of the gallbladder and compared the results with the activity of cell proliferation by the Ki67 antigen using immunohistochemical staining. Cyclin E was expressed in the adenocarcinoma tissue in 33.3% of patients (4 out of 12 cases), whereas only one out of 8 cases of adenoma expressed cyclin E (12.5%). There was a correlation between cyclin E expression and the Ki67 labeling index. These results suggest that the high expression of cyclin E in adenocarcinoma of the gallbladder is related to a high rate of cell proliferation.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism* ; Adenoma/pathology ; Adenoma/metabolism* ; Adult ; Aged ; Cyclin E/metabolism* ; Female ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/metabolism* ; Human ; Immunohistochemistry ; Male ; Middle Age

Varieties of telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. This study is intended to find out: 1) the diagnostic accuracy and reproducibility rate according to the input devices and the video signals; 2) any potential technical problems of the telepathology system; 3) any possible physical and psychological impacts. We devised a virtual telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total fifty-five surgical pathology cases from 11 different organs were selected. Three pathologists were involved in making diagnoses. The resulting diagnostic accuracies were: 1 CCD camera with composite video signal was 86.2%; 3 CCD camera with composite video signal was 93.1%; 3 CCD camera with component video signal was 95.0%. The 3 CCD camera with component video signal resulted in 95.0% diagnostic accuracy and was superior to 1 CCD camera with composite video signal. Some technical problems noted during this study were: the visual field of the virtual telepathology system was smaller by 43% than that of microscope; the difference of cell sizes between microscope and monitor; low resolution of image. Some physical and psychological symptoms were noted.
Cell Size ; Diagnosis ; Pathology, Surgical ; Telepathology* ; Visual Fields

The serous cystadenoma of the pancreas is a rare lesion that is usually found incidentally. It is mostly observed as a spongy microcystic mass but rare variants such as macrocystic, unicystic, or multicentric are also seen. We recently experienced a unique case of unicystic serous cystadenoma mimicking a pseudocyst. It was grossly a unilocular cyst with surrounding dense fibrosis resembling a pseudocyst. Microscopically, the cyst was partly lined by low columnar-to-cuboidal cells with clear cytoplasm containing glycogen.
Adult ; Case Report ; Cystadenoma, Serous/pathology* ; Cysts/pathology* ; Diagnosis, Differential ; Female ; Human ; Pancreatic Diseases/pathology* ; Pancreatic Neoplasms/pathology*

PURPOSE: To investigate the clinicopathologic effects of cyclosporine A (CsA) in children with diseases characterized by mesangial immunoglobulin A deposits such as immunoglobulin A nephropathy (IgAN) and Henoch-Schonlein purpura nephritis (HSPN). METHODS: We retrospectively reviewed the clinicopathologic outcomes of 54 children (IgAN, 36; HSPN, 18) treated with CsA. The starting dose of CsA was 5 mg/kg per day, and it was administered in 2 divided doses. The degree of proteinuria and pathologic changes in renal biopsies were evaluated before and after CsA treatment. RESULTS: The mean protein to creatinine ratio decreased from 3.7+/-1.5 to 0.6+/-0.4 (P<0.001), and 32 (59.2%) children achieved complete remission of proteinuria after 1-year CsA treatment. Among the 54 children, 24 maintained normal renal function and 25 exhibited microscopic hematuria or proteinuria at the end of CsA treatment. In the HSPN group, 3 children whose initial biopsies indicated class IIIb disease showed class II disease on follow-up, and the follow-up biopsies of 2 children who had class II disease indicated the same class II disease. In the IgAN group, cortical tubular atrophy occurred in 1 child, and no child with IgAN had cortical interstitial fibrosis or tubular atrophy after 1-year CsA treatment. No significant complications were found in the children treated with CsA. CONCLUSION: Our findings indicate that CsA treatment is effective and beneficial in reducing massive proteinuria and preventing progression to end-stage renal failure in children with glomerular diseases characterized by IgA deposits, such as IgAN and HSPN, within 1 year of treatment.
Atrophy ; Biopsy ; Child* ; Creatinine ; Cyclosporine* ; Fibrosis ; Follow-Up Studies ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulins* ; Kidney Failure, Chronic ; Nephritis* ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Retrospective Studies

PURPOSE: Sentinel lymph node (SLN) biopsy is a useful method for assessing axillary nodal status and selecting axillary dissection in breast cancer patients. The goals of our study were to evaluate the detection rate of SLN and determine the accuracy of SLN biopsy in predicting axillary nodal status using technetium radiolabeled sulfur colloid and isosulfan blue dye. METHODS: Between January and August 2001, 55 breast cancer patients with clinically node negative results underwent SLN biopsy from the Department of Surgery at Ajou University Hospital. Both technetium radiolabeled sulfur colloid and isosulfan blue dye were used to guide SLN biopsy. SLN biopsy was always followed by a complete axillary dissection. The histopathology of SLNs determined from frozen sectioning and serial sectioning was compared with that of the nonsentinel nodes evaluated with routine Hematoxylin and Eosin stain. RESULTS: The overall SLN detection rate was 85.4% (47 of 55 patients). The staging accuracy of SLN biopsy was 97.9% (46 of 47 patients), the sensitivity 92.3% (12/13), the false negative rate 7.7% (1/13), and the negative predictive value 97.1% (34 of 35). CONCLUSION: Our study was a pilot study for SLN biopsy. SLN biopsy was more effective when a combination of technetium radiolabeled sulfur colloid and isosulfan blue dye were used. The results of our study support the hypothesis that SLN biopsy is an accurate predictor of axillary nodal status. SLN biopsy may be applicable to early breast cancer patients and thereby allow the omission of routine axillary dissection in selected cases.
Antimony* ; Biopsy ; Breast Neoplasms* ; Breast* ; Colloids* ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Lymph Nodes ; Pilot Projects ; Sentinel Lymph Node Biopsy* ; Sulfur ; Technetium

PURPOSE: This study was performed to evaluate the impact of microvessel density (MVD), a reflection of tumor angiogenesis, and microvascular invasion (MVI) on the prognosis of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissue sections of RCC from 81 patients who had undergone radical nephrectomy were stained immunohistochemically for CD34, which decorate endothelial cells, in order to assess MVD and MVI. The immunostaining results of MVD and MVI were compared with the clinicopathological variables. RESULTS: Twenty-two patients had either synchronous or metachronous metastases and fourteen patients died during the follow-up. MVD was significantly correlated with only metastasis (synchronous or metachronous; p=0.020). MVI was significantly correlated with tumor size (p=0.005), TNM stage (p<0.001), T stage (p<0.001), M stage (p=0.001), and metastasis (synchronous or metachronous; p=0.007). MVD was not significantly associated with MVI (p=0.232). The survival rate of patients with higher MVD or MVI-positive tumors was significantly lower than that of patients with lower MVD or MVI-negative tumors, respectively (p<0.0001, p=0.0002). Multivariate analyses indicated that tumor size, M stage and MVI were independent prognostic factors for cancer-specific survival. MVD was not an independent factor. CONCLUSIONS: MVD and MVI were associated with metastasis and a worse prognosis in RCC, which suggests that tumor angiogenesis and MVI may play an important role in the progression of RCC. MVI was an independent prognostic factor for cancer-specific survival.
Carcinoma, Renal Cell* ; Endothelial Cells ; Follow-Up Studies ; Humans ; Microvessels ; Multivariate Analysis ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Survival Rate ; Veins

The pathogenetic mechanism of nonatopic asthma has not yet been defined. The idea of a possible involvement of autoimmunity in the pathogenesis of nonatopic asthma has been proposed by earlier studies. To evaluate the possible involvement of autoimmune response against bronchial epithelial cell in the pathogenesis of nonatopic asthma, we measured circulating autoantibodies to cultured human bronchial epithelial cell (BEAS-2B cell line) using enzyme-linked immunosorbent assay. We used stored serum samples form 38 age-matched healthy controls, 26 adult patients with atopic asthma, 16 adult patients with nonatopic asthma, and 12 adult patients with systemic lupus erythematosus. Levels of IgG autoantibodies to bronchial epithelial cell were significantly higher in patients with nonatopic asthma (mean+/-SD of absorbance values; 0.135+/-0.030) and systemic lupus erythematosus (0.293+/-0.181) than in healthy controls (0.112+/-0.016) and patients with atopic asthma (0.116+/-0.031) (p<0.05). This study showed that levels of circulating IgG autoantibodies to bronchial epithelial cell were increased in adult patients with nonatopic asthma. Further studies are needed to evaluate the possible involvement of autoimmune mechanism in the pathogenesis of nonatopic asthma.
Adult ; Asthma/*immunology ; Autoantibodies/*blood ; Bronchi/*immunology ; Cells, Cultured ; Epithelial Cells/immunology ; Human ; Hypersensitivity/immunology ; IgG/blood

There are many ways to evaluate the learning achievement of medical students. We are familiar with the problems related to the traditional laboratory course practical examinations of pathology and histology courses, which deal with morphology heavily. In order to overcome the limitations inherent to the traditional evaluation methods, we used Internet for the written and practical examinations for the pathology course. Two tests were conducted on the internet with thirty medical students. Each student used his/her personal computer, which was connected to Local Area Network(LAN), in the computer laboratory. The examinee entered the Pathology Department home page(address: http://ajoupath. ajou.ac.kr) and took their tests made up of descriptive and multiple choice questions including related gross and microscopic images. Common Gateway Interface(CGI) program of Perl language was used for automatic scoring and analysis of the multiple choice questions. The server computer in the Pathology Department scored the results instantaneously upon the answer selection and push down of the "send" button by the examinee. Furthermore, the computer program was capable of providing data regarding how many students got the correct answer and the degree of difficulty for each item. The students were requested to provide hand-written descriptions for the questions requiring descriptive answers, because of the technical limitation. We believe that the tests on the internet were performed successfully. The "dreadful" old fashioned examination using timer were no longer needed because high quality gross and microscopic images on the monitor were available for the examinee. We believe that the internet is very useful for the comprehensive evaluation of the medical students' learning achievement.
Education, Medical ; Humans ; Internet* ; Learning* ; Microcomputers ; Pathology ; Students, Medical

Lung toxicity associated with cyclophosphamide use is a rare but serious side effect, that may result in a fatal course. However no such cases have been reported in Korea, so clinicians would not be alert to this adverse effect. We recently experienced a woman with Wegener's granulomatosis and idiopathic pulmonary fibrosis. This patient had been administered 12 grams of cyclophosphamide for 4 months. At that time of admission, She felt aggravating dyspnea on exertion for 2 weeks. Her chest x-ray and high resolution CT revealed aggravated reticular opacities and ground glass appearances. Dyspnea was improved and ground glass appearances on HRCT was disappeared after discontinuation of cyclophosphamide. We diagnosed this case as cyclophosphamide-induced pneumonitis and report it with a brief review of the literature.
Cyclophosphamide* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Female ; Glass ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung* ; Pneumonia ; Thorax ; Wegener Granulomatosis*

Acute interstitial nephritis is an important cause of acute kidney injury and most often induced by drug therapy. Entecavir is a potent antiviral agent approved for chronic hepatitis B. The antiviral therapy in chronic hepatitis B management is important because it reduces viral replication and liver injury, prevents development of complications, such as liver cirrhosis and hepatocellular carcinoma, and thus improves patient's survival. The advantage of entecavir is its safety profile, particularly in patients with renal dysfunction. Although doses of entecavir are needed to be adjusted for patients with renal dysfunction, there has been no known renal toxicity of the drug itself. Here we report a patient with chronic hepatitis B and normal renal function who developed acute kidney injury due to tubulointerstitial nephritis after 10 months of entecavir therapy. Renal biopsy showed not only acute changes of interstitial nephritis such as marked cortical infiltration with lymphoplasma cells and neutrophils, mesangial matrix expansion, eosinophilic granular casts and degenerative epithelial cells within tubular lumen but also chronic changes, minimal tubular atrophy and interstitial fibrosis. After immunosuppressant therapy with steroids and mycofenolate mofetil, the patient's renal function improved.
Acute Kidney Injury ; Atrophy ; Biopsy ; Carcinoma, Hepatocellular ; Eosinophils ; Epithelial Cells ; Fibrosis ; Guanine ; Hepatitis B, Chronic ; Humans ; Imidazoles ; Liver ; Liver Cirrhosis ; Nephritis, Interstitial ; Neutrophils ; Nitro Compounds ; Steroids