An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

No abstract available.
Kidney Transplantation*

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

Fibrocystic disease of the breast has been generally regarded as a disorder due to either excess hormonal stimulation or an exaggerated proliferative response by hypersensitive breast epithelium. The unique lobular lesion-adenosis- and its variants have been regarded as non-neoplastic and non-preneoplastic glandular hypertrophy and hyperplasia, and have different organoid patterns and origins. We have examined a total of 242 cases previously diagnosed as 'fibrocystic disease' at the Department of Pathology with the purpose of clarifying the variants of adenosis in detail and refining the infinitely large 'fibrocystic disease' classification as non-proliferative fibrocystic change and proliferative disorders, such as epitheliosis and atypical hyperplasia. In this study, 224 cases (92.5%) were nonproliferative disease, mostly adenosis (40.1%), and 18 cases (7.5%) were proliferative disease, which consisted of moderate to florid hyperplasia and epitheliosis.
Adult ; Breast/*pathology ; Cell Division ; Female ; Fibrocystic Disease of Breast/*pathology ; Fibrosis ; Human ; Hyperplasia ; Retrospective Studies ; Risk Factors ; Support, Non-U.S. Gov't

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography

Pityriasis lichenoides Chronica is a cutaneous disorder of unknown etiology and characterized pathologically by vasculitis and clinically by its marked chronicity and lack of specific treatment. Emollient-phototherapy is a recently introduced effective treatment for psoriasis. The authors treated 3 patients with pityriasis lichenoides chronica by the emollient-phototherapy technic with quite satisfactory results.

Kimura's disease is an uncommon, chronic inflammatory disorder of unknown etiology that is seen in an endemic form in the Orient. It usually presents as a mass in the subcutaneous tissue of the head and neck region or the major salivary glands, and is often associated with a regional lymphadenopathy. The patients have peripheral blood eosinophilia and elevated IgE levels but are otherwise usually healthy. We encountered the case of a 33-year-old man who had a soft tissue mass in his left distal arm which was diagnosed as being Kimura's disease.
Adult ; Arm* ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Lymphatic Diseases ; Neck ; Salivary Glands ; Subcutaneous Tissue

OBJECTIVE: Aneurysms of vertebral artery and its branches make up approximately 3% of all intracranial aneurysms. As the aneurysm have an intimate relationship with lower cranial nerves and medulla, surgical management of the aneurysms are one of the challenging neurosurgical problems. The authors analyzed the management outcomes for aneurysms arising from vertebral artery and its branches. METHODS: At the authors' institution between May 1989 and Jan. 2000, 42 patients were treated with transcranial and endovascular surgery for aneurysms of vertebral artery and its branches. The medical records and neuroimaging studies of the patients were reviewed retrospectively. RESULTS: Forty two patients were comprised of 28 female and 14 male patients aged from 26-80 year old(mean:51.8). Of the 42 patients, 37 patients(88%) had subarachnoid hemorrhage. Of the 37 patients with subarachnoid hemorrahge, 35 patients(95%) were in good neurological status(Hunt Hess grade I-III), 2 patients(5%) in poor grade(H-H grade VI-V) before operation. Location of the aneurysm were 16 in vertebral artery, 12 in vertebro-PICA junction, and 14 in the peripheral PICA. Twenty nine patients were treated with transcranial surgery and 13 patients with endovascular surgery. The management outcome of the transcranial surgery was:Glasgow outcome scale(GOS) I and II ; 24, GOS III ; 2, GOS IV ; 1 and GOS V (death) ; 2. The causes of mortality related to transcranial surgery were rebleeding after failure in clipping in one and suspected brainstem infarct in one. Morbidity was attributed to vasospasm(3), lower CN palsy(7, including temporary dysfunction) and pseudomeningocele(1). The management outcome of the endovascular surgery was:Glasgow outcome scale(GOS) I-II ; 9, GOS III ; 1, GOS IV ; 1, and GOS V (death) ; 2. The causes of mortality related to endovascular surgery were sepsis from pneumonia(1) and vasospasm(1). There were one cerebellar infarct and one lateral medullary syndrome. CONCLUSION: Excellent and good surgical results can be expected in 80% of the patients with aneurysms of vertebral arery and its branches. The outcomes of endovascular surgery in treating vertebral artery aneurysm were satisfactory and endovascular surgery may offer a therapeutic alternative especially in vertebral dissecting aneurysm.
Aneurysm* ; Aneurysm, Dissecting ; Brain Stem ; Cranial Nerves ; Female ; Humans ; Intracranial Aneurysm ; Lateral Medullary Syndrome ; Male ; Medical Records ; Mortality ; Neuroimaging ; Pica ; Retrospective Studies ; Sepsis ; Subarachnoid Hemorrhage ; Vertebral Artery*

PURPOSE: To investigate the effects of intravesical high dose epirubicin instillation, the effect of epirubicin was compared with that of Bacillus Calmette-Guerin (BCG) instillation on the recurrence and progression of superficial bladder cancer. MATERIALS AND METHODS: Between September 1999 and February 2002, a total of 174 patients, who received an 8-week course of high dose epirubicin (80mg/50ml) or a 6-week course of BCG, following a complete transurethral resection for superficial bladder cancer, were followed up. The recurrence-free survival (RFS) and progression-free survival (PFS) rates were analyzed in each groups. RESULTS: There were no significant differences in the overall RFS and PFS between the two groups. In the high risk group, the RFS of the BCG group was significantly higher than that of the epirubicin group (p=0.014), whereas there was no significant difference in the PFS. In the intermediate risk group, there were no significant differences in the RFS and PFS. However, when those patients with a previous history of bladder cancer were excluded, the RFS was significantly higher in the epirubicin group (p= 0.0036). The incidence of local complications was higher in the high dose epirubicin group, but most of these were mild and self-limiting. CONCLUSIONS: Intravesical high dose epirubicin instillation in the high risk superficial bladder cancer group had no benefit over that of BCG instillation in terms of RFS and complications. However, high dose epirubicin could be a good alternative for patients in the intermediate risk group and, so it would seem, for those with a first occurrence.
Bacillus* ; Disease-Free Survival ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Prospective Studies* ; Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*