Most of malignant melanoma of skin had occurred in transformation from benign nevi(Webster, 1944), especially most frequently from junctional nevi of them. which was characterized by flat surface, dark-brown color and hairlessness(Ackermen, 1948) Blumberg (1972) introduced five levels of hietologic invasion of malignant melanoma described by Clark et al. Morton(1970) reported various measures of treatment such as surgery combined with radiotherapy or with chemotherapy or with recent immunotherapy with good result. The authors recently experienced 24-yeas old male soldier patient with malignant melanoma on hypothenar region of right palm. The pathologic investigation including electronmicroscopical aspect was carried out and are presented. Treatment consisted of the resections of right axillary lymph nodes and the lesion in situ on the hypotherar region of right hand, pedicle skin graft to right hand from abdomen, and immediate postoperative immunotherapy with intradermal injection of 1.0 cc. of B.C.G. daily on extensor surface of both thighs in turn, which lasted for about 3 months duration to find good result.
Abdomen ; Drug Therapy ; Hand ; Humans ; Immunotherapy ; Injections, Intradermal ; Lymph Nodes ; Male ; Melanoma ; Military Personnel ; Nevus ; Radiotherapy ; Skin ; Thigh ; Transplants

No abstract available.
Forearm*

Expression of the nm23 and E-cadherin proteins has been studied in a number of tumors. Reduced expression of the nm23 and E-cadherin proteins seems to be associated with metastasis or disease progression in some tumors, including breast carcinoma. To assess the role of nm23 and E-cadherin in tumor differentiation and metastasis of breast carcinoma, immunohistochemical staining for the nm23 and E-cadherin proteins was performed in paraffin embedded tumor samples from 86 breast carcinomas. The results were as follows: 1) Expression of the nm23 protein in breast carcinoma was strong positive in 32 cases (37.2%), weak positive in 26 cases (30.2%), and negative in 28 cases (32.6%) of the cases. Expression of the nm23 protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 2) Expression of the E-cadherin protein in breast carcinoma was strong positive in 50 cases (58.1%), weak positive in 24 cases (27.9%), and negative in 12 cases (14%) of the cases. Expression of the E-cadherin protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 3) There was a statistically significant correlation between the expression of the nm23 protein and the E-cadherin protein in breast carcinoma (p<0.05). These results suggest that the expression of the nm23 and E-cadherin proteins is related to tumor differentiation, and may also be an useful prognostic factor in breast carcinoma.
Breast Neoplasms* ; Breast* ; Cadherins* ; Disease Progression ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

Primary biliary cirrhosis, a chronic, progressive, and often fatal cholestatic liver disease, is characterized by destruction of intrahepatic bile ducts, portal inflammation and scarring, and the eventual development of cirrhosis and liver failure. We reviewed four cases of primary biliary cirrhosis primarily suspected with peritoneoscopic liver biopsy specimens. All patients were female and their age ranged from 29 to 50 years(median age: 43.8 years). Presenting symptoms were typically pruritus and/or upper abdominal discomfort. On physical examination, interus was presented in 3; hepatomegaly in 3; chronic liver disease stigmata in one. Co-existing autoimmune diseases such as Hashimoto' thyroiditis and Sjoegren' syndrome were found in 2 cases. Biochemical tests of liver function revealed a cholestatic pattern. An antimitochondrial-antibody test was positive in 2 out of 3 patients(75%). Increase levels of serum immunoglobulins, especially of IgM, were evident in 3 cases. Histologic staging(Ludwig et al.) disclosed stage I lesion in one, stage III in two, and stage IV in the remaining one.
Female ; Humans ; Biopsy

Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal function are not evaluated with there methads. 99mTc-DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluoted by ineasuring the counts of renal radioactivity and concomittant evaluation of renal morphology could be passible with the analog imapes of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidndys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with nonvisualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and correspondings to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%, 18.4%, 7.9%, 12%, 4.1%, 3.4% respectively.
Abscess ; Fibrosis ; Fistula ; Fluspirilene ; Humans ; Kidney ; Pelvis ; Radioactivity ; Retrospective Studies ; Succimer* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Tuberculosis, Renal* ; Ureter

Primary extranodal lymphoma of the liver is very rare, approximately thirty-one cases having been reported in the literature. We report one case of primary malignant lymphoma of the liver in a 26-year-old female, who was presented with palpable abdominal mass on the epigastrium for about 40 days. Laboratory findings revealed no specific abnormalities. Peripheral lymph nodes or spleen were not palpable. An abdominal ultrasonogram revealed a huge mass involving the entire left lobe of the liver. Left lateral segmentectomy of the liver was done. The resected lateral portion of left lobe of the liver showed a large solitary mass, 12 cm in the greatest dimension, with a yellowish gray fleshy solid cut surface. Though light microscopic feature was compatible with primary malignant lymphoma, diffuse large cell type, intermediate grade by the working formulation, undifferentiated carcinomas including hepatocellular carcinoma, plasmacytoma, and pleomorphic sarcomas could not be completely ruled out. Thus, marker studies and electron microscopic examination were performed. Immunoperoxidase stains for common leukocyte antigen was positive, and the Leder stain for myeloid granule was negative. Electron microscopic stuids revealed findings of neoplastic lymphoid cells, consistent with malignant lymphoma. Primary lymphoma of the liver has only rarely been reported, and its natural history is unclear. Many of the reported cases have been large cell lymphomas, as in this case.
Female ; Humans ; Carcinoma, Hepatocellular

NO abstract available.
Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lymphocytes* ; RNA, Messenger* ; Transforming Growth Factor beta

No abstract available.

The villous adenoma of the duodenum is a rare disease and a considerable portion of the cases are known to be associated with malignancy. Although the diagnosis can be made with duodenoscopy, some cases showed false negative rate for malignancy detection with endoscopic biopsy only. So Whipple's operation is preferred than local excision. We experienced a case of tubulovillous adenoma involving ampulla of Vater, which recurred after local excision. So we report a case of tubulovillous adenoma involving ampulla of Vater with relevant literature.
Adenoma* ; Adenoma, Villous ; Ampulla of Vater* ; Biopsy ; Diagnosis ; Duodenoscopy ; Duodenum ; Rare Diseases

PURPOSE: We compared the contrast enhancement patterns of hepatocellular carcinomas(HCC), hemangiomas, and metastasis on two phase imagings to determine the value of two phase dynamic CT in the differential diagnosis. MATERIALS AND METHODS: Two phases spiral volumetric CT scan were obtained 45 seconds and 6 minutes after bolus injection of contrast material in 106 patients. A bolus of 100 mL of nonionic contrast material was administered intravenously at a injection rate of 2 mL/sec. RESULT:In Hepatocollular carcinoma, 47% were totally hyperdense and 30% were totally hypodense in early phase, and 82% were totally hypodense in late phase. In hemangioma, 90% were peripherally hyperdense in early phase, 52% were isodense and 27% were totally hyperdense in late phase. In metastatic liver malignancies, 65% were hypodense and 32% were peripherally hyperdense in early phase, and 79% were hypodense in late phase. CONCLUSION: Two phases spiral volumetric CT scaning is considered to be heplful in the differential diagnosis of hepatic tumors.
Diagnosis, Differential* ; Hemangioma ; Humans ; Liver ; Neoplasm Metastasis ; Spiral Cone-Beam Computed Tomography ; Tomography, Spiral Computed*