We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.
Adenocarcinoma ; Neoplasm Metastasis

We report a case of morphea profunda in a 21-year-old male who had diffuse brown sclerotic plaques on his extremities. Laboratory findings showed peripheral eosinophilia and an increased titers for anti-DNA and anti-nuclear antibodies. Histopathologic findings showed diffuse fibrosis and a thickening of the lower dermis and subcutaneous tissue. He has been treated with hydroxychloroquine 400mg per day and the sclerosis of the skin improved.
Antibodies ; Dermis ; Eosinophilia ; Extremities ; Fibrosis ; Humans ; Hydroxychloroquine ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Subcutaneous Tissue ; Young Adult

This study was carried out to investigate the ultrastructural changes of lens fiber cells, length of gap junctions, and distribution of proteoplycans in cataractous lens. The cataract was induced by stabbing the posterior surface of the lens with 25 gauge needle. The lens were obseved by electron microscopy with estimation of the gap junction. Alcian blue stain was performed for examination of proteoglyscas. The results were as follows. Characteristic changes of the cataractous lens fiber cells were swelling and condensation of the cytoplasm, alterations of cytoplasmic granules including changes of density and size of cytoplasmic granules, and formation of microfibrills, high electron-dense amorphous substance, electron-dense particles, variably sized globular bodies, and multilamellar bodies. The lengths of gap junctions were 2.51+/-1.09um in control and 1.06+/-0.33um in cataractous lens fiber cells(P<0.001). Proteoglycans showing high electron-dense amophorous substance were distributed in the intercellular spaces along the cytoplasmic membrane in control group, but disapperaed in cataractous lens fiber cells. According to these results, it is conceivalble that the changes of the gap junctions and proteoglycans were closely related to the pathogenesis of cataract.
Alcian Blue ; Cataract* ; Cell Membrane ; Cytoplasm ; Cytoplasmic Granules ; Extracellular Space ; Gap Junctions ; Microfibrils ; Microscopy, Electron ; Needles ; Proteoglycans

No abstract available.
Stomach

No abstract available.
Aneurysm* ; Kidney* ; Renal Artery*

Minimal Change Disease (MCD) is the most common primary nephrotic syndrome in children. Some suggested that tumor necrosis factor-alpha (TNF-alpha) are involved in the pathogenesis of MCD. This study was done to see changes of plasma and urinary TNF-alpha, and its effect on determination of permeability of glomerular basement membrane (BM) contributed by heparan sulfate proteoglycan (HSPG). Study patients consisted of 19 biopsy-proven MCD children aged 2-15 years old. Both plasma and urinary TNF-alpha were measured. Employing the Millicell system, TNF-alpha was screened for the permeability factors. We examined whether TNF-alpha regulated BM HSPG gene expression and HS synthesis in the glomerular epithelial cells (GECs). Urinary TNF-alpha during relapse was also significantly increased (364.4+/-51.2 vs 155.3+/-20.8, 36.0+/-4.5 ng/mg.cr) (p<0.05). However, the negative results were obtained in the permeability assay using the Millicell system. No difference was seen in BM HSPG gene expression and HS synthesis in the GECs. Therefore, it seems that TNF-alpha may not play a disease-specific role in the pathogenesis of MCD.
Child ; Epithelial Cells* ; Gene Expression ; Glomerular Basement Membrane ; Heparan Sulfate Proteoglycans ; Humans ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Permeability* ; Plasma ; Recurrence ; Tumor Necrosis Factor-alpha*

A 63 year-old man was admatted to our hospital because of dulI epigastralgia. Upper G-I series reveaied the generalized thickened, tortuous mucosal folds in the stomach and duodenal bulb, Two ovold large pits on the antrum were observed endoscopically, Tha relevant literatures on the subject were reviewed.
Humans ; Middle Aged ; Pylorus* ; Stomach

PURPOSE: The study was done to introduce the new small incision sutureless extracapsular cataract extraction (ECCE) surgical technique and its safety using phaco prechopper. METHODS: After 4.5 mm scleral frown incision from 2 mm surgical limbus, continuous curvilinear capsulorhexis and complete hydrodissection, nucleus was divided into 2 fragments with phaco prechopper which is special forceps for nuclear divider in the bag. One piece of lens was drawn into anterior chamber from capsular bag using Sinskey hook and removed it with Wilder lens loop (size:4 x15 mm) from anterior chamber. The other piece of lens was removed with the same method. To evaluate the safety of new method compared to phacoemulsification (P.E), analysis of the serial changes of the corneal endothelial cell density, hexagonal pattern and mean cell sizes before and 3months after the operation in 40eyes (ECCE group : 20eyes, P.E group : 20eyes) was made. RESULTS: There were no significant complications such as posterior capsular rupture, vitreous loss, capsulorhexis tear but transient corneal edema was found. The mean percentage of corneal endothelial cell loss was 9.05+/-6.5% in ECCE group and 9.80+/-6.7% in the P.E group. CONCLUSIONS: This new method is safe, easy and does not require expensive instrumentation. It can be of great help for the phaco beginners to practice capsulorhexis, hydrodissection and the use of phaco system. We think it is an alternative method for phacoemulsification in cataract surgery.
Anterior Chamber ; Capsulorhexis ; Cataract ; Cataract Extraction ; Cell Size ; Corneal Edema ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Phacoemulsification ; Rupture ; Surgical Instruments

General endotracheal anesthesia with mechanical ventilator is a common anesthetic practice since introduction of various anesthetic ventilator. A mechanical not only deoreases workload but also allows the anesthesiolosist to better nonitor and manage the patient during the operation. However, acoidental complications can be encountered during the wse of ventilator as with all other modern equipments. Several authors have described that increased pulmonary pleasure from poaitive pressure ventilation mar lead to alveolar rupture with subsequent dissection of air along the vascu- lar structure of the lung into the hilum and then into the tissue plane of the mediastinum. We report a case of pneumomediastinum, pneumoperitoneum and subcutaneous emphysema without pneumothorax which occured during discoidectomy under the endotracheal ventilator anesthesia.
Anesthesia ; Humans ; Lung ; Mediastinal Emphysema* ; Mediastinum ; Pleasure ; Pneumoperitoneum* ; Pneumothorax* ; Rupture ; Subcutaneous Emphysema* ; Ventilation ; Ventilators, Mechanical*

No abstract available.
Child* ; Humans ; Meningitis* ; Scrub Typhus*