Patients with AIDS frequently present with pulmonary complications which are associated with a high mortality rate and infections are the most important cause of lung infiltrates. In addition to pneumonia caused by Pneumocystis carinii, which was noted in early reports of the syndrome, a variety of other severe pulmonary disorders may occur. Frequently more than one organism is found in a single patient and among these, combined infections of Pneumocystis carinii and cytomegalovirus are the most common. We experienced a case of combined Pneumosytis carinii and Mycobacterium tuberculosis infection as a pulmonary manifestation of AIDS in a 38-year-old man. In bronchoalveolar larvage, bronchial washing and brushing, and sputum smear specimens, Pneumocystis carinii organisms were recognized, especially in Gomori's methenamine silver stains. Transbronchial lung biopsy specimen revealed intra-alveolar frothy exudates composed of collections of Pneumocystis carinii organisms as well as several granulomas with central caseous necroses.
Mortality ; Biopsy

No abstract available.
Child* ; Cystitis* ; Eosinophils* ; Humans

There is no doubt that dopamine plays a critical role in the etiopathogenesis of schizophrenia. However, there appeared some limitations in explaining the complex phenomena of schizophrenia. Recent research data suggest that dysfunction in serotonergic system may be involved Before the dopamine hypothesis of schizophrenia became established, the interest in serotonin(5-ydroxytryptamine, 5-HT) as an etiological substrate of this illness occurred. Recently the importance and extent of 5-HT's involvement in the pathophysiology and mechanism of action of antipsychotic drug is actively investigated. In recent years, therapeutic success of clozapine and risperidones has increased attention on the interaction between the 5-HT and dopamine systems in schizophrenia. This led to the serotonin-dopamine for antipsychotic. The authors review the evidence for the role of 5-HT in schizophrenia and serotonin-dopamine interaction.
Clozapine ; Dopamine ; Schizophrenia* ; Serotonin*

Brenner tumors constitute about l.5~2.5% of all primary ovarian neoplasms and are almost always benign. It appears to derive from the surface epithelium of the ovary which undergoes metap1asia to form the urothelial-like components. we experienced a case of malignant Brenner tumor with adenocarcinoma and squamous cell carcinoma patterns in a 57-year-old woman. It was partly cystic tumor and contained a 4cm-sized gray yellow, lobulated or papillary solid mass, projecting from the cystic wall. Ultrastructurally, the solid mass was composed of malignant urothelial-like cells with focal glandular differentiation.
Female ; Humans ; Adenocarcinoma

It has been clarified that myoepithelial cells contain S-100 protein which is known to be a marker protein of neural tissue. To evaluate the participation of myoepithelial cells in the histogenesis of the salivary gland tumors, normal salivary glands and various salivary gland tumors were stained by immuno-peroxidase method. PAP kits (DAKO Co, USA) for the S-100 protein and the Cytokeratin were used and the following resulting were obtained. Acinic cells of the normal salivery gland were negative for both cytokeratin and S-100 protein. The intercalated duct cells were weakly positive for cytokeratin and S-100 protein. The normal myoepithelial cells scattered around the acini and the intercalated ducts were positive only S-100 protein. In contrast, the striated duct were positive only for cytokeratin. In plemorphic adenoma, the S-100 protein positive cells were found in solid sheets of tumor cells, in chondromyxoid areas and in areas of spindle-cell stroma as well as in the outer layer of the tubular structures. Only the inner lining of the tubules were positive for cytokeratin. In basal cell adenoma, the stromal spindle cells were strongly positive for S-100 protein and the epithelial cells weakly positive. When tubules were present within the epithelial sheets, the inner most lining cells were positive for cytokeratin. The peripheral palisaded tumor cells were negative for both substances. By immunostaining of the adenoid cystic carcinoma, S-100 protein containing cells were found focally scattered independently on the variety of histologies. The lining cells of true cystic structure were positive for cytokeratin. Immunostaining of the mucoepidermoid carcinoma demostrated that the squamous cells and the tubular epithelial cells contained cytokeraitn, whereas only a few intermediate cells were positive for S-100 protein. In Warthin's tumor there were no S-100 protein positive cells, although basally located epithelial cells of the papillae were positive for cytokeratin. These findings suggest that salivary gland tumors other than the Warthin's tumor arise from myoepithelial cells or reserve cells having dual potentiality differentating into myoepithelial and intercalcated duct cells.

We report a case of Buerger's disease manifested by a scrotal mass, in view of its rarity. A tender bean sized mass was palpated in the left scrotum of a 34 year-old male heavy smoker, who had a history of right pain two years ago which subsided spontaneously. The left testis with the paratesticular tissue was excised. Vessels of the spermatic cord and epididymis showed microscopic changes of Buerger's disease. The involved arteries and veins revealed a predominantly subacute pattern with granulomatous inflammation and Langhans' type giant cells within the thrombi.
Male ; Humans

We report a case of angiosarcoma of the jejunum in a 65-year-old female. This angiosarcoma developed 20 years after postoperative irradiation for cervical carcinoma of the uterus. Grossly, the resected jejunum showed a 8 cm long segmental hemorrhagic lesion with multiple, small hemorrhagic nodules or cysts on its serosa and mesentery. Microscopically, the wall of jejunum was infiltrated by epithelioid or polygonal tumor cells arranged in solid nests or lining irregular vascular spaces. The case is of interest that the tumor occurred in the very unusal site for angiosarcoma and the patient had a past history of irradiation for uterine cervical carcinoma 20 years ago. In addition, the resected intestine showed histologic changes of chronic irradiation effect. Therefore, this case supports the view that there is cause and effect relationship between irradiation adn angiosarcoma.
Female ; Humans ; Cysts

Ascariasis is probably the most common helminthic infestation of man, but it seldom causes severe illness. Pathologic conditions of Ascaris may be caused by adult worms, eggs or larvae. We describe a case of Ascaris egg granulomas that were found incidentally on the surface of the liver in a 75-year-old woman who had undergone a segmentectomy for an intrahepatic stone. Grossly, there were several yellowish calcific nodules of 0.4 cm in diameter on the lateral surface of the left lobe of the liver. Microscopically, the lesions were located in the hepatic capsule and consisted of fibrocalific nodules with many eggs. The eggs were round to oval, thick-shelled and measured 50~75x30~50 um. Most of the morphologically preserved eggs were fertilized eggs, but they had smooth shells without external protein coats. This case is of interest for the unusual location of the lesion, the presence of eggs without mammillation, and the association with the intrahepatic stone.
Adult ; Male ; Female ; Humans

We reviewed surgical specimens from 11 patients with diffuse neurofibroma to define the specific clinicopathologic characteristics. Ten cases were cutaneous neurofibromas and one case was an uncommon gastrointestinal neurofibroma involving the rectum. The most frequent sites of involvement were the head and neck, especially the eyelids and the periorbital areas. They usually presented as a plaque-like elevation of the skin. They primarily occured in children and young adults and positive family histories of von Recklinghausen's neurofibromatosis were obtained in 45.4%. Pathologically, the involved skin & rectum were diffusely thickened by an infiltrative growing mass, showing proliferation of short fusiform cells in the uniform matrix of fine fibrillary collagen. The characteristic prominence of Wagner-Meissner bodies (45.4%) suggests they could be associated with pathogenesis of diffuse neurofibroma. On the basis of these findings, we could confirm diffuse neurofibroma to be a distinct form of neurofibroma.
Child ; Adult ; Male ; Female ; Humans

No abstract available.
Rectal Prolapse* ; Surgical Procedures, Operative*