The author studied 11-cases of adenocarcinoma of the stomach confirmed by gastrofiberscopic biopsy before in order to differentiate between differentiated and undifferentiated adenocarcinoma by scanning electron microscope. Light and transmission electron microscopie examination were done, too. Seven of them are differentiated accompanied by severe intestinal metaplasia and four of them are undifferentiated with rearly focal intestinal metaplasia. Two of the undifferentiated cases shows focal tubular differentiation on the superficial region of the mucosa. Microvilli on the free border are long, regular on the differentiated type but in state of variable loss of microvilli under the transmission electron microscope. Number and density of the mucous granules are variable. Scanning electron microscopic examination shows prominent disorganization of the folds, cellular pleomorphism and pleomorphic microvilli are suggestive of early marker of neoplastic transformation. The size of them are 0.6 micrometer and 1.2 micrometer on the differentiated type respectively. Disorganization of the folds is an important differential point between differentiated and undifferentiated type on the lower power examination. Development of folds, furrow, and hemispheric colliculi are more porminent on the differentiated adenocarcinoma. Presence of striated border, partial or complete loss of microvilli and intestinal metaplasia on the undifferentiated and differentiated adenocarcinomas are consisent with origin from common precursor cells.
Adenocarcinoma ; Biopsy

The authors studied the lung injury induced by endotoxemia and the effects of proteolytic agent on the lung changed by endotoxemia. Sprague-Dawley rats were intraperitoneally administrated with a single dose of endotoxin (4 mg/kg, E. coli 025 : B6 lipopolysaccharide) or with endotoxin and gabexate mesilate (200 mg/kg), a proteolytic agent, concomitantly. Rats of each group were scarificed at 9, 18, and 27 hours after injection. Light and electron microscopic examination were done. The results obtained were summarized as follows: Light microscopic exmination revealed congested capillaries and neutrophilic infiltration in both groups. Electron microscopic findings were interstitial and alveolar neutrophilic infiltration, endothelial swelling with increased pinocytotic vesicles and cytoplasmic process formation, and interstitial edema. Decrease of osmiophilic bodies in the type II pneumocytes had appeared at 9 hours after endotoxin injection. These changes were increased in severity at 18 hours and 27 hours after endotoxin injection. In the group of concomitant treatment of gabexate mesilated and endotoxin, there was no edema at 9 hours after injection. After 18 hours welling of endothelial cell and interstitial edema had appeared. However, the severity of the edema was markedly decreased. Type II pneumocytes showed well preserved osmiophilic bodies. According to these results, it is considered that administration of gabexate mesilate can significantly redeced the lung injury induced by endotoxemia.
Rats ; Animals

A papillary adeno-carcinoma of the renal pelvis is very rare tumor and mostly diagnosed by histopathologic findings. A 10-years-old female was admitted to Fatima Hospital with Rt. flank pain and intermittent gross hematuria.Herein, we report a case of papillary adeno-carcinoma of the renal pelvis.
Adenocarcinoma ; Female ; Flank Pain ; Humans ; Kidney Pelvis*

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

The purpose of this study is to investigate the morphologic changes of the sinusoidal endothelial cells and the associated structures of the cirrhotic rat liver induced by repeat intraperitoneal injections of N-diethylnitrosamine (DEN) (100 mg/kg/week). One day to 6 weeks later, rat livers were observed under the light, transmission and scanning electron microscopy, and immunostained with laminin antibody. Two weeks after DEN treatment, the fibrillar material in Disse's space was noted, and then a basement membrane-like structure was found at 4 weeks after treatment. Laminin was detected in perisinusoidal areas after 4 weeks. Laminin was strongly positive on the fibrous septum and in the sinusoidal wall of cirrhotic nodules after 6 weeks of treatment. The diameters and numbers of sinusoidal endothelial fenestrations did not change significantly until 2 weeks. They decreased within 4 weeks, and then the sinusoidal endothelium was poorly fenestrated at 6 weeks after DEN treatment. These results suggest that as fibrosis develops in cirrhosis, the deposit of extracellular matrix such as laminin within Disse's space is a major contributing factor in the structural alteration of sinusoidal endothelial cells, and the capillarization of the sinusoidal endothelial cells may be a contributor to impairment of the hepatic function in cirrhosis.
Rats ; Animals

The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.
Anterior Cruciate Ligament* ; Arthroscopy ; Cartilage, Articular ; Humans ; Incidence ; Knee ; Knee Joint ; Range of Motion, Articular ; Rupture* ; Sports

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 report on a patient with transient global amnesia (TGA) showing increased tiny signal intensities at the head of both hippocampi on diffusion-weighted image (DWI) performed on the second day after the onset of symptoms. The T1-weighted image using 3-tesla magnetic resonance imaging (MRI) showed no signal changes, but the T2-weighted image showed slight signal changes at the same portion of both hippocampi. Single photon emission computed tomography (SPECT) performed on the 4th day after the onset of TGA showed no perfusion abnormalities. This patient experienced an extreme emotional stress before the onset of TGA, and the patient's TGA started by a simultaneous Valsava-like maneuver. We discuss the venous congestion/ischemia hypothesis for TGA. This case confirms that DWI is a sensitive and useful tool for evaluating the early stage of TGA.
Amnesia, Transient Global* ; Brain Ischemia ; Head* ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Perfusion ; Stress, Psychological ; Tomography, Emission-Computed, Single-Photon

Primary uterine leiomyosarcomas are very rare malignant tumors and the related MR findings have been the subject of only a few case reports. We describe the MR findings of two cases of histologically confirmed primary leiomyosarcoma, correlating these pathologic findings.
Leiomyosarcoma

The Ewing's sarcoma comprises approximately less than 10 percent of malignant bone tumors and 5 percent of allbone tumors, occures in almost all bones of the body, and presents a widely divergent roentgenographicmanifestations. The tarsal bones are involved only 2 percent in the Ewing's sarcoma. Two cases experienced byauthors and ten cases published in literatures of Ewing's sarcoma of the tarsal bone were analizedretrospectively. The result were as follows; 1. Of tarsal bones, the calcaneus was 7 cases, the talus 4 cases,cuneiform 1 case. 2. Female was affected more commonly than male, the ratio being 4 to 1 in the tarsal bones. 3.About sixty percent of total case in the tarsal bones had evidence of diffuse sclerotic pattern. All the cases ofthe talus had evidence of diffuse sclerotic pattern. 4. The diseases to be considered in differential diagnosisare as follows: avascular necrosis, tuberculous osteomyelitis, osteosarcoma, and pyogenic osteomyelitis. 5. Thediffuse sclerosis radiographically showed a close relation with dead bone resulting from avascular necrosis due totumor infiltration histologically. Periosteal reactive new bone and osteoid deposition on the dead bone were alsocorrelated with diffuse sclerosis. 6. Because it is difficult to differentiate sclerotic lesions in the tarsalbones by radiographic methods alone, all such lesions should be subject to biopsy as early as possible.
Biopsy ; Calcaneus ; Female ; Humans ; Male ; Necrosis ; Osteomyelitis ; Osteosarcoma ; Sarcoma, Ewing ; Sclerosis ; Talus ; Tarsal Bones