The correlation of metaplasia to dysplasia and carcinoma in the gallbladder has attracted the attention of many investigators. We mapped and examined a total of 263 cholecystectomized gallbladders to analyze the mucosal changes in the carcinogenesis of the gallbladder. Stones were present in 59.7%, hyperplasia in 28.5%, metaplasia in 55.5% (gastric 37.6%, intestinal 17.9%), dysplasia in 17.1% (low grade 9.1%, high grade 8%) and carcinoma in 7.6%. Metaplasia was more frequently identified in the stone-positive group (62.4%) than in the stone-negative group (45.3%) (P<0.05). Especially, the incidence of intestinal metaplasia was significantly higher in the stone-positive group. Dysplasia and carcinoma were more frequent in the metaplasia-positive group (dysplasia 26.7%, carcinoma 11%) than in the metaplasia-negative group (dysplasia 5.1%, carcinoma 3.4%) (P<0.05). Their incidences were significantly higher in the intestinal metaplasia than in the gastric metaplasia. Forty four percent of the dysplasia-positive cases were associated with carcinoma in the adjacent mucosa but carcinoma was absent in the dysplasia-negative cases. Hyperplasia did not reveal any significant correlation with metaplasia, dysplasia and carcinoma. These results suggest that gallstone is causally related to the metaplasia in the gallbladder and the metaplasia-dysplasia- carcinoma sequence exists in the gallbladder.
Adenocarcinoma* ; Carcinogenesis ; Gallbladder* ; Gallstones ; Humans ; Hyperplasia* ; Incidence ; Metaplasia* ; Mucous Membrane ; Research Personnel

Twenty cases of gallbladder cancers were examined using 5 mm stepwise tissue sections. We analyzed the clinicopathologic findings of the early (stage 1, II) and advanced carcinoma (stage III, IV, V) and those of carcinoma with or without metaplasia in the tumor. We also performed CEA and p53 immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. The results were as follow: 1) All of the early carcinomas (n=5) were incidentally diagnosed after the resection for the gallstone. They were compared to advanced carcinoma (n=15) in the absence of the lymphatic or angioinvasion, recurrence, metastasis and death. 2) Metaplastic and non-metaplastic carcinoma did not reveal any difference of the clinicopathologic findings except age distribution. 3) CEA and p53 were positive in preneoplastic and malignant lesions. The extent of staining was related to the degree of the atypia. From the above results, an early detection of gallbladder cancer is very important for the prognosis of the patients. Since preoperative diagnosis is difficult, thorough pathologic examination of routinely resected gallbladder is necessary for the early diagnosis. CEA and p53 immunohistochemical staining may be helpful in the differential diagnosis of non-neoplastic and neoplastic lesion of the gallbladder.
Age Distribution ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Gallbladder Neoplasms* ; Gallbladder* ; Gallstones ; Humans ; Metaplasia* ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; Recurrence

Porokeratosis are characterized by distinct clinical findings of a keratotic ridge that corresponds to the cornoid lamella on histology and has well defined potential for malignancy. We report a case of basal cell carcinoma(BCC) arising in linear porokeratosis in a 77-yearold man.
Carcinoma, Basal Cell* ; Porokeratosis*

A case of lichen nitidus in 23 years old male was described. This is the first case report in Korea. The clinical and histopathological study revealed characteristic features of the disease. Authors reviewed therapeutic experience and reports of the literaturea.
Humans ; Korea ; Lichen Nitidus* ; Lichens* ; Male ; Young Adult

A case of toxic epidermal necrolysis (TEN) was presented in 46 year-old male patient. The characteristic skin lesions of TEN were developed after some medictions and tetanus anti-toxin (TAT) injection due to trauma. Probably, the cause of the disease was drugs, TAT injection or trauma inself. On the pathologic findings, lower epidermis and dermo-epidermal cleavage were noticed. He was treated with massive antibiotics and steroid. About 7 days after therapy, much improvement achived. However foul odorous yellowish discharge was noticed since 20 days of hospitalization. Wide debridement of necrotic tissue was carried without improvement. Patient expired on 48th hospital day due to sepsis and impending hepatic coma.
Anti-Bacterial Agents ; Debridement ; Epidermis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Male ; Middle Aged ; Odors ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Tetanus

Incontinentia pigmenti is an uncommon genodermatosis. It affects female infants predominantly, described first by Bardach in l925, with the diagnosis of systematized nevus and Bloch in 1926, and Sulzberger in 1928 rnore compIetely. Skin lesions are characterized by 3 stages such as vesicobullous, verucous and finally pigmentary lesions and leave brownish pigmentation on the extremities and trunk. Hesides skin lesions some ectodermaI and mesodermal organs are affected and show developmental abnormalities. We experienced a case of incontinentia pigmenti in a 45-day-old female infant and present it with the review of literature. She showed extensive vesicobullopustular eruption with linear and reticular pigmentation on the extremities and trunk. Clinical and histopathologic findings of these lesions are compatible with Bloch-Sulzberger type of incontinentia pigmenti.
Diagnosis ; Extremities ; Female ; Humans ; Incontinentia Pigmenti* ; Infant ; Mesoderm ; Nevus ; Pigmentation ; Skin

Many oncogenes and tumor supressor genes have been identified and studied in colorectal carcinoma. Among them, p53 is a tumor supressor gene and its mutation is frequently noted in human tumors. E-cadherin is a cell adhesion molecule and associated with tumor differentiation. CD44 is a cell surface glycoprotein that plays a role in cell migration and metastasis. nm23 is a gene known to lower metastatic potential of tumors and has been proposed to be a metastasis supressor gene. Tumor angiogenesis is required for the expansion of the primary tumor and metastasis and its degree is related to the potential of malignancy. We studied the expression of p53, E-cadherin, nm23, CD44 and tumor angiogenesis in 36 cases of colorectal adenocarcinomas. They were compared with previously known prognostic factors such as the stage, tumor size, depth of invasion, differentiation, presence of lymphatic or venous invasion, the lymph node and distant metastasis. The results were as follows. 1) The expression of p53 was not significantly associated with any prognostic factors. 2) The expression of E-cadherin was significantly associated with tumor differentiation. In the well differentiated adenocarcinomas, its expression was higher than in the poorly differentiated adenocarcinoma. 3) The expression of nm23 was also significantly associated with tumor differentiation. In carcinoma with lymph node metastasis, the expression of nm23 was reduced, but statistically it was not significant. 4) The expression of CD44 was higher in tumors with lymph node metastasis than in tumors without lymph node metastasis, but it was not statistically significant. 5) The degree of microvessel density was significantly associated with lymphatic invasion. According to the above results, the expression of E-cadherin and nm23 are related to the differentiation of the tumor and tumor angiogenesis is related to the lymphatic invasion of the colorectal adenocarcinoma.
Adenocarcinoma* ; Cadherins* ; Cell Adhesion ; Cell Movement ; Colorectal Neoplasms ; Genes, vif ; Humans ; Lymph Nodes ; Membrane Glycoproteins ; Microvessels ; Neoplasm Metastasis ; Oncogenes ; von Willebrand Factor

Serum zinc is an essential element in men and animals. Recently on the dermatologic fields, the serum and the skin levels and the roles of zinc have been studied especially in acne vulgaris, but the results were controversial. So to confirm the previous reports and for evaluation of the relationship between the various aspects of acne vulgaris and the serum levels of zinc, the serum levels of zinc were measured by atomic absorption spectrophotometer in 13 healthy controls and 46 patients with acne vulgaris. In the healthy controls, their mean values of zinc were 0.843+0.251 ppm in total, 0.920+0.219 ppm, in females and 0.777+0.260 ppm in males. There was no statistical difference attributable to sex. In the 46 patients with acne vulgaris, their mean value of zinc was 0.741+0.195 ppm. There was no significant difference in the mean serum zinc level compared with the controls. In the males with acne, the mean va1ue of zinc was 0.727+0.166 ppm, and 0.748+0.208 ppm in females with acne. There was no significant statistical difference between males and females with acne. And females, but not males, with acne had significantly lower serum zinc levelss than controls of the corresponding sex. (p<0.1) By clinical severity, classifying the 46 patients with acne vulgaris into three groups: mild type (only comedones), moderate type (comedones with pa.pules) and severe type (includes pustules, comedones, and papules, etc.), the serum zinc levels of each group were 0.774+0.185 ppm, 0.7880. 200 ppm and 0.666+0.176 ppm. The significant statistical difference was found only in the severe type of acne compared with the healthy controls (p<0.05). Also classifying the patients into three groups (acute, moderate and chronic types of acne) by duration of acne, the serum values of zinc were 0.738+0.158 ppm, 0.692+0.283 ppm and 0.769+0.241 ppm, respectively. Only in the moderate type of acne, the mean serum level of zinc was significantly reduced compared with the control group (p<0.1)
Absorption ; Acne Vulgaris* ; Animals ; Female ; Humans ; Male ; Skin ; Zinc*

A 35-year-old housewife was diagnosed with onychomycosis and treated by oral terbinafine, 250mg/day, for 4 months. Clinically all infected nails improved gradually. However, her left great toe-nail was not improved thereafter. At that time the proximal end of the onychomycotic lesion was marked with surgical blade, and terbinafine therapy was continued for four weeks. However, the onychomycotic nail was not improved, and the scratch mark passed by the proximal end of the infected nail. Therefore, we detected the resistance to the therapy and switched the medication to itraconazole 100 mg/day and then another scratch mark was done at the proximal end of the onychomycotic lesion. After another 2 weeks the infected nail went along with the scratch mark distally, and showed clinical improvement. After 8 weeks therapy of itraconazole, she was cured clinically and mycologically. The fungal culture was identified as Aspergillus sydowii.
Adult ; Aspergillus* ; Humans ; Itraconazole ; Onychomycosis*

To evaluate usefulness of MR in assessment of tumor response to the chemotheraphy, we prospectively studied cases of cervical carcinoma with more then 2.5cm in diameter or stage IIb or more. Three courses of chemotherapy were performed with cisplatin and 5 F-U. MR images were obtained both before and after chemotherapy. Nine of 13 patients were undertaken radical hysterectomy after chemotherapy and MR examination. MR volumetry, stage and depth of stromal invasion were compared before and after chemotherapy. And in 9 patients who underwent radical hysterectomy, comparison of pathologic and MR imaging findings were also done. @ES The results were following. @EN 1) All tumors dectrased in volume (m=80.5%). 2) Five tumors (38.5%) reduced in stage, IB→CIS(1); IIA→CIS(1), IIA→IB(2), IIB→IB(1). 3) Depth of stromal invasion in MRI correlated well with that of histo-pathologic specimen in 7 of the 9 patients. Conclusively MR imaging is useful in assessement of tumor response to chemotherapy.
Cisplatin ; Drug Therapy* ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Prospective Studies