An immunoperoxdase technique in electron microscopy was used to investigate the ultrastructural site of keratinolytic proteinase (KPase) of M crosporum cans in sections of skin from guinea pigs infected with the same organism. Ultrastructurally, the KPase was present only in the cell walls of the invading dermatophytes as a continuous deposition of the electron-dense reaction product on the inner and outer aspects of the cell wall of the fungal hyphae without deposition in the keratin surrounding the invading hyphae. Our results suggest that the KPase may not play an absolute role in the invasion of dermatophytes into keratinized tissue in vivo.
Animals ; Arthrodermataceae ; Cell Wall ; Guinea Pigs* ; Guinea* ; Hyphae ; Immunoenzyme Techniques* ; Microscopy, Electron* ; Microsporum* ; Skin* ; Tinea

Additional two cases of the primary ureteral tumor with a literatural review were presented.
Ureter*

Pulmonary tumors exhibiting neuroendocrine differentiation are classified as typical carcinoid, atypical carcinoid, and small cell lung carcinoma(SCLC). Travis et al. proposed a fourth category of large cell neuroendocrine carcinoma, which is characterized by light microscopic neuroendocrine appearance, cells of large size, polygonal shape, low nuclear cytoplasmic ratio, coarse nuclear chromatin, with prominent nucleoli high mitotic rate and frequent necrosis; and neuroendocrine features by immunohistochemistry or electron microscopy. High grade neuroendocrine carcinoma (LCAC-NE) revealed aggressive clinical course. We report two cases of neuroendocrine tumors of the lung characterized by a trabecular pattern of large pleomorphic cells with frequent mitoses and wide necrosis. The frequent metastatic sites of atypical carcinoid were liver, bone and brain. One of our case is presented, at first, as an ovarian mass, which shows multifocal rosettes and revealed metastasis from lung. Both cases expressed neuroendocrine differentiation by light microscopy and immunohistochemistry. However clinical neuroendocrine symptom were not present.
Brain ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Chromatin ; Cytoplasm ; Female ; Immunohistochemistry ; Liver ; Lung* ; Microscopy ; Microscopy, Electron ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Ovary

No abstract available.
Aspergillosis*

The occurrence of sqamous cell carcinoma arising from epidermal cyst is unusual. A 54-year-old man with soft tissue mass on the back for 25 years presented an infiltrating squamous cell carcinoma within the wall of epidermal cyst. All tissue excised deserved to be examined to be axamined carefully in longterm epidermal cyst.
Male ; Humans ; Cysts

PURPOSE: This study was done to compare the diagnostic value of the Mycoplasma antibody (M- Ab) test and the cold agglutinin (CA) test from the onset of Mycoplasma pneumoniae pneumonia to its diagnosis in children. METHODS: We analyzed 48 cases of M. pneumoniae pneumonia in children who were admitted to the Pediatric Department of Ulsan Dongkang General Hospital for 1 year in 1996 which were diagnosed retrospectively by clinical findings and by both the M-Ab test and CA test on admission. RESULTS: The peak incidence of age was between 5 and 9 years, and the sex ratio of boy to girl was 1:1.1. In the 48 cases of Mycoplasma pneumonia, 13 cases (27.1%) had a duration of below 7 days from onset of disease to diagnosis; 24 cases (50.0%), 7 days to 13 days; 7 cases (14.6%), 14 days to 20 days; and 4 cases (8.3%), over 21 days. The positive rate of the M-Ab test (87.5%) was significantly higher than that of the CA test (37.5%) in the total 48 cases (P<0.01). The positive rate of the M-Ab test (92.3%) was significantly higher than that of the CA test (15.4%) in 13 cases which were above-mentioned (P<0.01). The positive rate of the M-Ab test (87.5%) was significantly higher than that of the CA test (45.8%) in 24 cases which were above-mentioned (P<0.01). The positive rate of the M-Ab test (71.4%) was the same as that of the CA test (71.4%) in 7 cases which were above-mentioned. The 4 cases which were above-mentioned, were positive in the M-Ab test only (P<0.05). No significant relationship was found between the M-Ab test and the CA test. CONCLUSION: The positive rate of the M-Ab test was higher than that of the CA test, especially in cases which had the duration of below 14 days and over 21 days from onset of disease to diagnosis, so the M-Ab test was considered more effective for early diagnosis of Mycoplasma pneumonia in chidren during that period.
Child* ; Diagnosis* ; Early Diagnosis ; Female ; Hospitals, General ; Humans ; Incidence ; Male ; Mycoplasma pneumoniae ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma* ; Retrospective Studies ; Sex Ratio ; Ulsan

Synovial sarcoma most commonly affects the extremities, especially the lower thigh and knee region. However, a smaller number develops in a central or axial distribution, an area which encompasses the trunk, orofacial, cervical and parapharyngeal regions. The retroperitoneum is an extremely unusual site and has never been recorded in the literature as primary a site for synovial sarcoma. We investigated a case of retroperitoneal synovial sarcoma in a 40-year-old woman. The specimen consisted of fragmented large bulky multinodular masses separated by slit-like spaces. The tumor was 130 gm in weight. Microscopically, the tumor was composed of nests of plump ovoid to polygonal shaped cells and bundles of spindle shaped cells, which had vesicular nuclei and a small amount of cytoplasm. In some areas, there were cleft like spaces and pseudoglandular structures lined by flat or cuboidal cells. Myxoid change, collagen deposition, foci of calcification and osseous metaplasia were also present. Immunohistochemically, the polygonal cells and some of the spindle cells reacted positively for keratin. The spindle cells, especially in the perivascular area were positive for vimentin. S-100 protein and GFAP were negative in both type of cells.
Female ; Humans

A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

PURPOSE: To evaluate the specific findings of angiography for various causes of gastrointestinal bleeding. MATERIALS AND METHODS: We retrospectively analyzed 35 patients of gastrointestinal bleeding detected by angiography, between April 1987 and July 1993. There were 28 men and 7 women, 19 to 83 years old (mean, 47 years). Of these 35 cases of gastrointestinal bleedings, there were 12 gastric bleedings, 4 duodenal bleedings, 9 small intestinal bleeings, 6 ileocecal bleedings, and 4 large intestinal bleedings. RESULTS: Of 35 cases, we could diagnose the specific cause of bleeing in 13 patients (37%) by angiography. Of these 13 cases, there were 4 cases of gastric ulcers showing contrast pooling in ulcer crater, 5 cases of vascular malformations showing anomalous vascular mass with early dilated venous drainage, 2 cases of direct invasion of hepatocellular carcinoma showing invasion of hypervascular mass into small bowel, one case of pseudoaneurysm at gastroduodenal artery in a patient of acute pancreatitis, and one case of small intestinal lymphoma showing contrast pooling in a irregular dilated small intestinal lumen. CONCLUSION: in gastrointestinal bleeding, angiography is useful not only in detecting the bleeding site, but also for evaluating the specific causes such as gastric ulcers or vascular malformations.
Aged, 80 and over ; Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis* ; Drainage ; Female ; Hemorrhage* ; Humans ; Lymphoma ; Male ; Pancreatitis ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vascular Malformations

Increasing the pH of local anesthetic solution with sodium bicarbonate has been known to hasten its onset of action. This study was designed to verify the effect of pH adjustment of bupivacaine on caudal anesthesia. Forty adult male patients having caudal block for perianal surgery were randomly assigned to four groups(n=l0) as follows. Group 1: control, 0.5% bupivacaine 20ml+0.6ml saline Group 2: 0.5% bupivacaine 20 ml+0.1% epinephrine 0.1 ml+0.5ml saline Group 3: 0.5 bupivacaine 20ml+5% sodium bicarbonate 0.5ml+0.1 ml saline Group 4: 0.5% bupivacaine 20 ml+5% sodium bicarbonate 0.5ml+0.1% epinephrine 0.1 ml The pH of prepared solution of each group is 6.23+/-0.032, 5.95+/-0.028, 7.35+/-0.054, 6.92+/-0.067 respectively. The time of onset of anesthesia (time between the completion of anesthetic injection and loss of temperature sensation at S4, S5 dermatome) was significantly rapid in group 3 followed by group 4. The time of onset of surgical anesthesia (time between the completion of anesthetic injection and loss of pain sensation by pin-prick test at S4, S5 dermatome) was significantly rapid in group 3.
Adult ; Anesthesia ; Anesthesia, Caudal* ; Bupivacaine* ; Epinephrine ; Humans ; Hydrogen-Ion Concentration* ; Male ; Sensation ; Sodium Bicarbonate