This study was performed to investigate the distribution of endotoxin in various organs after intraperitoneal injection of E. coli homogenator(0111:B4, 3X10(9)cells/200g of body weight). Sprague-Dawley rats were intraperitoneally injected with E. coli homogenator and sacrificed 1 and 3 hours after injection. The lung, liver, and kidney were immunohistochemically stained with avidin-biotin complex method and observed by light and electron microscopy. On the light microscopy, granular deposits of reaction products of immunohistochemical stain were found on the cytoplasmic membrane of endothelial cells and some of parenchymal cells of all organs observed. Electron microscopic study revealed finely granular reaction products on the surface of endothelial cells and some of parenchymal cells. The pinocytotic vesicles of endothelial cells demonstrated reaction products in the early phase of experiment. The distribution of reaction products were prominent in the liver among three organs. The Kupffer cells showed the most sensitive and strongest positive reaction. The hepatocytes and endothelial cells revealed weak positive reaction 3 hours later. The alveolar macrophages of the lung were also positive from the early phase of endotoxemia, while the pneumocytes and alveolar septa demonstrated weakly positive reaction in the later phase. The capillary endothelium of the kidney revealed positive reaction from the early phase. According to above results, it is concluded that the endotoxin entered into the systemic circulation was captured in the liver and lung. And both mononuclear phagocytic system and endothelial cells could be activated or damaged by endotoxin.
Rats ; Animals

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

CD44 is a family of transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. Expression of CD44 isofonns (splice variants) has been shown to be associated with poor prognosis in several human cancers. We evaluated the expression patterns of the CD44 isofortn (CD 44 splice variant v6) in infiltrating ductal carcinoma of the breast by immunohistochemical and RT-PCR method. Paraffin embedded blocks from seventy-five cases of mastectomized samples were analyzed immunohistochemically using monoclonoal antibody against CD44v6. CD44v6 was detected in fifty-seven cases (76%) of the tumor samples. Adjacent normal myoepithelial cells and ductal epithelial cells revealed focal positive reaction to CD44v6. Thirtytwo cases (80.0%) with lymph nodal metastasis revealed overexpression of CD44v6 monoclonal antibody, but twenty-five cases (71.4%) without nodal metastasis also showed positive reaction to CD44v6 monoclonal antibody, and there is no statistically significant value. Other prognostic factors of infiltrating ductal carcinoma, such as tumor size, histologic grade and hormonal receptors did not show any significant correlation with CD44v6 expression. The RT-PCR studies for 9 cases of infiltrating ductal carcinoma showed the same band patterns both in the normal and tumor tissues. From the above results, it is concluded that the expression of CD44v6 is not a valuable prognostic marker of infiltrating ductal carcinoma of breast.
Breast* ; Carcinoma, Ductal* ; Epithelial Cells ; Glycoproteins ; Humans ; Neoplasm Metastasis ; Paraffin ; Prognosis

Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately ass- ociated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells
Biopsy ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Collagen ; Connective Tissue Cells ; Cytoplasm ; Diagnosis ; Eosinophils ; Hematuria* ; Humans ; Mesothelioma ; Pleura ; Rhabdomyosarcoma ; Solitary Fibrous Tumors

A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.

We present a case of transient acantholytic dermatosis which developed on the face of a 19-year-old Korean girl. Asyrnptomatic pinhead to miliary-grain sized brownish papules arranged in a somewhat band-like outbreak along the left side of the nose for about 3 months. Histopathologic findings were similar to Dariers disease. Immunoperoxidase staining showed that IgG was deposited on the intercellular area of keratinocytes around the suprabasal clefts. Skin lesions disappeared spontaneously in 5 weeks after a skin biopsy.
Biopsy ; Darier Disease ; Female ; Humans ; Immunoglobulin G ; Keratinocytes ; Nose ; Skin ; Skin Diseases* ; Young Adult

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.
Biopsy, Needle ; Child* ; Diagnosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Intranuclear Inclusion Bodies ; Meningioma ; Pathology, Surgical ; Sensitivity and Specificity

Diurnal changes of lysosomes including ultrastructural changes of phagosomes and acid phosphatase reactions in phagosomes, as well as diurnal biochemical changes in cathepsin D activity, were studied in the retinal pigment epithelium (RPE) of the rabbit. The rabbit was maintained on a natural light-dark cycle over seven days in fall and was sacrificed at various times during the day and night. The number of lysosomes or phagosomes in the RPE was the highest at 1.5 hours after exposure to sunlight (8:00 AM), and thereafter decreased with time. Three types of phagosomes were observed and acid phosphatase reactions were different in each type of phagosome; the fresh phagosomes were negative or positive, lamellar bodies positive, and dense bodies partially positive. The biochemical activity of cathepsin D was the highest at 8:00 AM, and this was consistent with the time of peak in phagocytic activity in the RPE. This report shows that phagocytic activity in the RPE occurred in the early stage after exposure to sunlight, and that fresh phagosomes were sequentially degraded to lamellar or dense bodies. Cathepsin D activity also increased, and this was consistent with the phagocytic activity in the RPE.
Acid Phosphatase/metabolism ; Animals ; Cathepsin D/metabolism ; Cell Count ; Choroid/metabolism/ultrastructure ; Circadian Rhythm/*physiology ; Lysosomes/*metabolism/ultrastructure ; Phagosomes/*metabolism/ultrastructure ; Pigment Epithelium of Eye/*metabolism/ultrastructure ; Rabbits

A 3-year-old boy with Wilms' tumor had unusual severe hypertension, polydipsia, polyuria, and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour (normal supine 0.15-2.33 mg/ml/hour) and 120.1 ng/dl (normal supine 1 to 16 ng/dl), respectively. His hypertension, varied from 150/90 mmHg as high as 240/180 mmHg, was not effectively controlled by antihyperensive drugs. Because of concern for the complications of hypertension, a right nephrectomy was performed on the sixth hospital day. At laparotomy, there was no evidence of mechanical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined within the renal capsule without involvement of the renal blood vessels at the hilum. Histopathologically, it was characteristic Wilms' tumor of favorable histology. On electron microscopy, the tumor cells contained many electron dense secreting granules in the cytoplasm, suggesting that the tumor itself was the source of the renin and cause the clinical manifestations. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.
Abdomen ; Aldosterone ; Blood Vessels ; Child* ; Child, Preschool ; Cytoplasm ; Humans ; Hypertension* ; Hypokalemia* ; Kidney ; Laparotomy ; Male ; Microscopy, Electron ; Nephrectomy ; Physical Examination ; Plasma ; Polydipsia* ; Polyuria* ; Renal Artery ; Renin ; Wilms Tumor*

BACKGROUND: Apart from devaluing the basic skills of history taking and clinical examinations, the indiscriminate use of STAT tests is increasing in hospital practice. The purpose of this study is to evaluate the appropriateness of the STAT test requests in a tertiary care teaching university hospital. METHODS: We assessed the reasons for the STAT test requests on 644 patients (inpatients 338, emergency room patients 215, and outpatients 91), totaling 1,681 requests, during a 2 week period (between August 8 to 22, 1996) by discussing with the clinicians and nurses and/or reviewing the patient's records. RESULTS: Of 1,681 requests, 779 (46.3%) were considered inappropriate according to the criteria used to define categories. Inappropriate requests were detected in 45.1% (265/588) in wards, 49.0% (446/910) in the emergency room, and 37.2% (68/183) in the out patient department. The frequency of requests during the day showed two peaks: the first between 10 and 11 a.m., and the second between 3 and 4 p.m., which appears to indicate that the STAT tests are often requested for the convenience of the physician rather than true need of the patients. CONCLUSIONS: Many STAT tests are requested for reasons other than true emergencies. Inconsiderate, wasteful, and disruptive STAT test requests imposed an extra burden on the laboratory and resulted in a delay of reports on other true STAT or routine tests. Strategies to reduce the number of inappropriate STAT tests should be established in order to reserve the emergency service for situations of true need.
Emergencies ; Emergency Service, Hospital ; Humans ; Outpatients ; Tertiary Healthcare