Malignant rhabdoid tumor of the kidney(MRTK), an uncommon renal tumor found in children, is one of the most lethal neoplasms of early life. It was first recognized during a review of the first National Wilms' Tumor Study(NWTS) as an extremely aggressive neoplasm whose appearance often mimicks those of skeletal muscle tumors, but without histological, immunohistochemical, and ultrastructural markers of rhabdomyogenesis. Herein we present two cases of malignant rhabdoid tumor of the kidney, one occurring in a 6-month-old male baby, and the other in a 123-month-old girl. They presented a huge tender mass on the left upper quadrant of the abdomen. Microscopically, each case was very cellular and composed of sheets of round or polygonal cells with ample cytoplasm often containing eosinophilic filamentous inclusions and round vesicular nuclei with prominent nucleoli. Case 1 showed lymphomatoid pattern, but case 2 showed foci of several variant patterns associated with classic appearances. The tumor cells showed a strong reactivity for vimentin in both cases. Unusually, case 2 showed focal reactivity for epithelial membrane antigen(EMA), muscle specific actin, and smooth muscle actin. Ultrastructural study confirmed the presence of whorled bundles of intermediate filaments in paranuclear position, and a prominent nucleolus.
Child ; Male ; Female ; Humans

The preeclamptic nephropathy is characterized by swelling of endothelial cells, interposition of mesangial cells and matrix, subendothelial deposits of incompletely defined material, and thickening of the capillary walls. To determine the distribution of extracellular matrix (ECM) components in preeclamptic nephropathy, the immunohistochemical study was performed in ten renal biopsy cases using antisera to human type I, III, IV, and VI collagens, fibronectin, and laminin. In preeclamptic nephropathy, the accumulation of type IV and VI collagens, fibronectin was observed in moderate amount in the mesangium and, to some extent, in the thickened capillary walls, particularly in the subendothelial layer. In segmentally sclerotic lesions seen in six cases, the amount of type IV collagen was partly decreased, whereas those of type VI collagen and fibronectin were slightly increased. Type I collagen was expressed to a mild degree in the expanded mesangium and segmentally sclerotic lesions. The results suggest that the expression of ECM in the mesangium is increased in preeclamptic nephropathy, and the deposition of ECM components may be involved in the development and the reparative process of the characteristic glomerular lesions. The formation of sclerotic lesions may be linked to the alternative accumulation of ECM components.
Biopsy ; Capillaries ; Collagen ; Collagen Type I ; Collagen Type IV ; Collagen Type VI ; Endothelial Cells ; Extracellular Matrix* ; Fibronectins ; Humans ; Immune Sera ; Laminin ; Mesangial Cells

Normal human glomerular basement membrane (GBM) and mesangial matrix (MM) contain several different basement membrane components in varying degrees. The characteristic morphological and ultrastructural changes in patients with diabetic nephropathy are the thickening of the GBM and the expansion of the MM. In order to investigate the changes of extracellular matrix components in diabetes, the immunohistochemical localization was performed in 17 cases with different degrees using antisera to human collagen types I, III, IV, VI, fibronectin, and laminin. The following results were obtained: 1. The reactivity for collagen IV was increased in expanded MM in the diffuse glomerulosclerosis (GS). With the progression to the nodule formation, collagen IV was prominently decreased in the peripheral area of the nodules. 2. Collagen VI was increased in GBM and MM in the diffuse GS, it was especially prominent in the expanded MM. With the progression to nodule formation, collagen VI was prominently increased in the periphery of the nodules. 3. Interstitial collagen I and III were not stained in many of the cases with the diffuse GS. With the progression to nodule formation, these were slightly expressed. A lamellar pattern of positive reaction was noted at the periphery of the late nodular lesions. 4. Fibronectin was increased in GBM & MM in the diffuse GS, it was especially intense in the MM. With the progression to the nodule formation, the reactivity of antibody to the fibronectin was decreased. 5. Laminin was weakly stained along the GBM & trace in the MM, but was not changed in the nodular GS. In summary, the expanded mesangial matrix in the diffuse GS showed a markedly increased staining for collagen IV, fibronectin and collagen VI. Less intense linear staining for collagen VI, fibronectin, laminin, collagen IV and collagen III was noted along the GBM. In the nodular GS, the composition of the early nodules resembled that of the diffuse GS. However, the late nodular lesion of the nodular GS revealed decreased reactivity for collagen IV and fibronectin at the periphery of the nodule, where collagen VI and interstitial collagen I and III were increased in laminated pattern.
Basement Membrane ; Collagen ; Diabetic Nephropathies* ; Extracellular Matrix* ; Fibronectins ; Glomerular Basement Membrane ; Humans ; Immune Sera ; Laminin

Angiogenesis, the induction of new capillaries and venules, is associated with tumor growth. This study was designed to determine whether cervical carcinomas are angiogenic, and to investigate whether tumor angiogenesis can serve as a prognostic factor in cervical carcinoma. Surgical specimens of 47 cervical carcinomas were immunohistochemically stained specifically for endothelial cells with factor VIII-related antigen to identify all vessels. Microvessels were counted from photographs of 200x microscopic fields. In addition, thirty-seven cases were studied by immunohistochemical means using the monoclonal antibodies for PCNA and for Ki-67 to determine tumor cell proliferation rates in cervical carcinomas. The microvessel count(MVC), the PCNA labelling index, and the Ki-67 index were calculated and compared with known prognostic factors and disease free survival rates in cervical carcinomas. A wide range in the MVC count(range 12-100 mean=38.2+/-19.2), the PCNA labeling index(8-69% mean=33.6+/-15.2%), and in the extent of Ki-67 staining(0-43% mean=10.3+/-10.5%) was observed, indicating considerable variation of tumor angiogenic activity and tumor growth rates. This study showed statistically significant correlations in disease free survival rates with both lymph node status and the microvessel count. However, there was no significant difference in disease free survival rates between tumor stage, age, the PCNA labelling index, and the Ki-67 index.
Antibodies, Monoclonal ; Capillaries ; Cell Proliferation ; Cervix Uteri* ; Disease-Free Survival ; Endothelial Cells ; Female ; Lymph Nodes ; Microvessels ; Proliferating Cell Nuclear Antigen ; Venules ; von Willebrand Factor

No abstract available.
Humans ; Microcomputers* ; Stomach Neoplasms*

OBJECTIVE: SCC-Ag(Squamous Cell Carcinoma Antigen) is a tumor marker for patients with squamous cell carcinoma of the uterine cervix. It has shown that the SCC-Ag was well related with the response of cancer therapy and course of cervical cancer. The aim of this study is to investigate whether the presence of pelvic lymph node metstasis can be predicted by the measurement of the preoperative SCC-Ag levels in the patients with early staged squamous cell carcinoma of cervix. METHODS: The preoperative serum SCC-Ag levels were measured in 45 patients with stage I-II squamous cell carcinoma of cervix undergoing radical hysterectomy from September 1995 to December 1997. The serum SCC-Ag levels were analyzed for the clinicopathologic characteristics and other prognostic factors using univariate and multivariate analysis. RESULTS: The serum SCC-Ag levels of the patients exhibited pelvic lymph node metastasis were above 4.8ng/ml. An elevated preoperative serum SCC-Ag level, and tumor size were independent predictors for the presence of lymph node metastasis(p<0.01). CONCLUSION: The determination of the preoperative serum SCC-Ag levels provides a new prognostic factor in early staged cervical cancer.
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Uterine Cervical Neoplasms

The pelvis is a ring structure with strong ligamentous support. This support includes the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrospinous and sacrotuberous ligaments. Since the pelvis is a ring, disruption of any protion of the ring is always associated with disruption in another portion of the ring. Massive pelvic disruption is an important and often life threathening injury. It is usually due to a motor vehicle accident, a fall from a height, industrial injury, and so on. The authors reviewed 28 cases of unstable pelvic fracture treated at the orthopaedic department of Catholic Medical Center during the period from January 1975 to December 1980, and the injury was classified according to the Pennal and Tiles method, and analyzed the clinical data as to the cause of mechanical violence, type of fracture and treatment, post-traumatic pelvic instabilities, and the results. The persistant post-traumatic pelvic instability was assessed by physical examination, and Chamberlain and Trostlers stress Roentgen view of the pelvis. The clinical results obtained were as follows: 1. The incidence of the unstable pelvic fracture was 17.7% (28) of all pelvic fractures (158). The incidence of injury in male was approximately 5 times more frequent than female, and most of the patients were in the 3rd to 5th decade of their life. The causes of injury were road accident (54%), coal mine accident and fall from a height in orders. 2. The four-rami fracture with posterior disruption due to the lateral compression injury was the most common type of unstable pelvic fractures. 3. In conservatively treated patients, the pelvic instability persisted in 37.5% (6 in 16 cases) of the cases and all of them necessitated the joint stabilizing operation. Twelve cases were treated operatively. Among them, performed operations include wiring of symphysis pubis in 2 and sacroiliac joint fusion in 4 within 4 weeks after injury. But for the other 6 cases in which pelvic instability persisted in spite of the sufficient conservative treatment, sacroiliac joint fusion or sacroiliac joint fusion together with a symphyseal plate fixation were done. 4. Satisfactory results was obtained in 62.51% (10 in 16 cases) of nonoperated cases, and 91.7% (11 in 12 cases) of operated group. Authors consider that the most important step in the management of traumatic pelvic instability are; firstly the early recognition of the correlation of the fracture-fragments; the fracture mechanism, and the possible presence or the post-traumatic pelvic instability, and secondly finalizing the therapeutic plan. Early surgical stabilization of the duration of the treatment and the residual disability.
Clinical Study ; Coal ; Female ; Humans ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Motor Vehicles ; Pelvis ; Physical Examination ; Pubic Bone ; Sacroiliac Joint ; Violence

The potential for nerve regeneration and recovery of its function exists in the presence of a suitable pathway for regenerating axon and endoneurial tube can serve as nerve conduit for regenerating axon in fresh nerve graft. But value of degenerated nerve as donor nerve has not been established till now. This experiment assessed the chronologic influence of fresh and degenerated nerve graft on axonal growth for 10mm gap of sciatic nerve in rabbit and how long degenerated nerve was ahle to serve as a nerve conduit microscopically. Electromicroscopically, the regenerating axons which were ohserved in the degenerated nerve graft had more abundant unmyelinated fibers and revealed abundant collagen fibers in the endoneurium. And these regenerating axons became gradually surrounded with newly developed basal lamina and decreased the collagen fibers at l2 week of degenerated nerve graft. Histologically, myelinated axons which were observed in central area of the degenerated nerve graft at 8 week of degenerated nerve graft were relatively thinner, but a definite structural difference of regenerating axons was not found except reduction of number compared with those of tresh nerve graft. The numher of myelinated axons was 6,072+/-l42 in normal sciatic nerve, 4,479+/- 157 in fresh nerve graft group, and 2,968+/-168 in the degenerated nerve graft group. Difference of the number of myelinated axons between fresh and degenerated nerve graft group was significant stati stically(P<0.05). These results showed that the ability of a degenerated nerve graft as a passage for the regenerating axons and it can be employed as one of the favorable nerve conduits.
Axons ; Basement Membrane ; Collagen ; Humans ; Myelin Sheath ; Nerve Regeneration ; Peripheral Nerves ; Sciatic Nerve* ; Tissue Donors ; Transplants*

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.
Age of Onset ; Autoimmunity ; Classification ; HLA Antigens* ; HLA-A Antigens ; Humans ; Melanocytes ; Skin ; Vitiligo*

There have long been a lot of controversies on the treatment of unstable thoracolumbar spine fracture, and the role of decompression is also controversial. Compression of the neural elements by retropulsed bone fragments can be relieved indirectly by the reduction with posterior instrumentation or directly by the exploration of the spinal canal through a posterolateral or anterior approach. There is no universal agreement about the indications for each of these method. Authors analyzed the result of 24 cases of thoracolumbar spine fracture which had been operated by anterior decompression and Kaneda instrumentation from the February 1990 to May 1993 at Inha general hospital. The results were as follows: 1. The most common cause of injury was falling from a height, 20 cases (83.3%). And the 12 cases were in the 4th decade, with an average age of 37.7 years. 2. According to McAfee classification, there were 7 stable(29.2%) and 15 unstable bursting fractures(62.5%). And the most common level of injury was L1(11 cases, 45.8%). 3. Neurologic status was improved one or more grade(Frankel grade) in 21 cases except one case of complete paraplegia. 4. The average correctional angle of kyphotic deformity was 13.1° immediate postoperatively, and the loss of correction(average, 6.7°) was observed during the follow-up period. 5. The segmental instability was found at the level below the fusion in three cases during the follow-up period. 6. There was neither failure of instrument, dislodgement of graft bone nor lateral wedging during the follow-up period.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Hospitals, General ; Methods ; Paraplegia ; Spinal Canal ; Spine ; Transplants