The heart, 500g in weight, with subacute myocarditis associated with granulomatous myocarditis may be a good model for the study on the pathophysiologic mechanism of cardiac failure. Furthermore, the clinical data of this case is enough to clarify his all clinical course from admission to death due to cardiac failure. So, we analyzed the clinical data, histologic findings, and morphometric pattern of histologically intact myocardial cells and inflammatory reaction to investigate the pathophysiologic mechanism of the cardiac failure. The results were summarized as follows. 1. Clinically, the heart showed cardiac failure of diastolic phase and abnormal conduction system related to sudden cardiac death. However, it might be adapted to the relatively stable wital signs due to pericardial positive pressure by slowlyprogressed pericardial effusion. 2. The distribution pattern of area of intact myocardial cell area and inflammtion reaction showed relatively even spread of inflammatory reaction and extremely decreased area of myocardial cells to about 21% of total heart. So, its contractility might be decreased below to the 21% of the normal cardiac contractility. 3. The mechanism of the cardiac failure in myocarditis may be sudden inflammatory involvement of conduction system and/or extremely decreased myocardial cell volume due to inflammatory destruction. 4. Morphometric analysis may be a useful objective method to grading the severity of old and recent form of myocarditis. From the above results, the cardiac failure of myocarditis is influenced by the adaptability at the inflammatory abnormality of the conduction system, contractility of injured myocardial cells, and compensation activity of pericardial effusion.
Cell Size ; Compensation and Redress ; Death, Sudden, Cardiac ; Heart ; Heart Failure* ; Myocarditis* ; Pericardial Effusion

Coronary artery calcification(CAC) is found frequently in the atheromatous plaques CAC is known to have increased frequency above 40 years. CAC without evidence of atherosclerosis in young adults is quite rare, however, CAC combined with aneurysms in young adults have been infrequently reported in patients with a past history of a Kawasaki disease in child. We report an autopsy case showing CAC and aneurysm in the absence of macroscopically identified atherosclerotic lesions in a healthy 23-year-old man. The autopsy examination revealed aneurysmal dilatation of the right coronary artery which was connected with calcified lesion. A calcified lesion of the left anterior descending coronary artery was aslo noted. Microscopically, aneurysmal wall was non-specific except for hyalinized wall and foci of calcification. A striking histologic finding of calcified mass was ring calcification along the wall of the coronary artery. Antecedent Kawasaki disease in the past was suggestive as other reports.
Aneurysm* ; Atherosclerosis* ; Autopsy ; Child ; Coronary Vessels* ; Dilatation ; Humans ; Hyalin ; Mucocutaneous Lymph Node Syndrome ; Plaque, Atherosclerotic ; Strikes, Employee ; Young Adult*

Aortic dissection may be considered the result of a discrepancy between the strength of the aortic wall and the intramural pressure. And factors that predispose to aortic dissection may include systemic hypertension, cystic medial necrosis, Marfan's syndrome, atherosclerosis, disease of aortic valve, pregnancy, giant cell arteritis, hyperthyrosis, disease of aortic valve, pregnancy, giant cell arteritis, hyperthyroidism, and blunt chest trauma. A few of aortic dissection may extend retrograde toward the aortic valve and involve the coronary arteries. Coronary artery occlusions due to mural dissection are an uncommon but well documented cause of myocardial infarction. Although rare, extramural hematoma compressing the coronary artery is another cause of myocardial infarction. At autopsy of 43 years old male who had no critical external wound, pericardial sac was distended and contained 400ml of dark red and clotted blood. Examination of the aorta revealed only minute atherosclerosis, intact aortic valve, and patent coronary ostia. 0.5cm sized aortic rupture was noted at the 3.5cm distal to the aortic valve. DeBakey type II aortic dissection was found to involve the ascending aorta and brachiocephalic trunk. Three intimal tears were 1.5cm, 8cm. 11.5cm distal to the aortic valve and two false lumens which had intact area between them extended 3.5cm distal to the third intimal tear and proximally in a retrograde fashion to the aortic root. Microscopically, sections of aorta showed relatively intact arrangement of smooth muscle and elastic fibers, except mild vascular ectasia and scattered several foci of the small sized aggregation of foamy histiocytes, and there was no evidence of cystic medial degeneration in aorta. Sections of both coronary arteries did not show mural dissection or atherosclerosis. Sections of right atrium and sinus node showed inflammatory reaction, extensive replacement of myocardium by active fibrous tissue consistent with infarction. There was no histologic evidence of myocardial infarction in the walls of other chambers or septum of the heart. We believe that extramural compression of the artery to sinus m\node by the dissecting hematoma was the cause of myocardial infarction involving the right atrium and the sinus node.
Adult ; Aorta ; Aortic Rupture ; Aortic Valve ; Arteries ; Atherosclerosis ; Autopsy ; Brachiocephalic Trunk ; Coronary Vessels ; Dilatation, Pathologic ; Elastic Tissue ; Giant Cell Arteritis ; Heart ; Heart Atria ; Hematoma ; Hemodynamics* ; Histiocytes ; Humans ; Hypertension ; Hyperthyroidism ; Infarction ; Male ; Marfan Syndrome ; Muscle, Smooth ; Myocardial Infarction* ; Myocardium ; Necrosis ; Pregnancy ; Sinoatrial Node ; Thorax ; Wounds and Injuries

Ionizing radiation has brought powerful aids to medical practitioners, but it has also brought new and bewildering problems. Radiation in the form of systemically administered radionuclides or external radiation may produce such abnormal reactions in the musculoskeletal system as growth disturbances, myelofibrosis, radiation osteitis, necrosis of bone, exostosis, pathologic fracture, and on rare occasion malignant tumors. The incidence of postirradiation sarcoma was quite rare and there were some histologic hypes of postirradition sarcoma. Of them, incidence of osteosarcoma and fibrosarcoma is most common, although there is some difference between each reports. The authors have experienced recently two cases of postirradiation fibrosarcoma developed in sacrum. In one case, the patient was 55 years old female and the latent period was about 12 years. In another case, the patient was 67 years old female and the latent period was about 15 years. In these cases, they received radiation therapy due to cervical cancer of uterus. They had nerve roots compression symptoms and recieved operation of nerve roots decompression. The diagnosis was confirmed by core bone biopsy. A clinical analysis of these cases is to be reported with review of references.
Biopsy ; Decompression ; Diagnosis ; Exostoses ; Female ; Fibrosarcoma ; Fractures, Spontaneous ; Humans ; Incidence ; Musculoskeletal System ; Necrosis ; Osteitis ; Osteosarcoma ; Primary Myelofibrosis ; Radiation, Ionizing ; Radioisotopes ; Sacrum ; Sarcoma ; Uterine Cervical Neoplasms ; Uterus

Numerous cause of the carpal-tunnel syndrome have been reported, but we could not find a reference for tuberculosis of the median nerve causing this syndrome. Therefore, we are presenting the case report of this rare condition as another cause of the carpaltunnel syndrome.
Carpal Tunnel Syndrome ; Median Nerve ; Tuberculosis

Cystic hypersecretory lesions of the breast are rare. These breast lesions include cystic hypersecretory hyperplasia (CHH), atypical CHH, and cystic hypersecretory carcinoma (CHC). The characteristic features are dilated ducts and cysts filled with thyroid colloid-like eosinophilic secretion. Only seven cases of invasive CHC have been reported in the literature. Here, we report an additional case of invasive CHC. The histologic features of the tumor showed both micropapillary intraductal carcinoma and focal high-grade invasive carcinoma in a background of CHH. This case suggests that cystic hypersecretory breast lesions encompass a spectrum of pathologic lesions including CHH, atypical CHH, CHC, and invasive CHC.
Breast Neoplasms/*pathology ; Carcinoma/*pathology ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Cell Differentiation ; Eosinophils/pathology ; Female ; Fibrocystic Disease of Breast/pathology ; Human ; Hyperplasia ; Immunohistochemistry ; Middle Aged ; Neoplasm Invasiveness

Hypertrophic cardiomyopathy (HCMP) is characterized myofiber hypertrophy and structural remodeling with changes in the proportion of the muscular, vascular, and interstitial compartments. A study was done to determine the structural remodeling patterns and the role of microvasculature of hearts in HCMP. Forty-two postmortem hearts were analyzed including 14 from patients who died of HCMP (group 1), 8 patients with HCMP but who died from extracardiac causes (group 2), 10 patients with ischemic heart disease (group 3), and 10 normal adult hearts (group 4). Macro- and microscopic examination, immunohistochemical study using CD34 antibody, and morphometric studies using image analyzer were performed. Mean cardiac weight and wall thickness were significantly higher in the HCMP group. Myocardial hypertrophy, and a variety of myocardial disarray and fibrosis involved the whole area of the left ventricles with HCMP. The percentage areas of microvessels were 6.40 0.7 in group 1, 5.90 0.6 in group 2, 4.98 0.3 in group 3, 4.85 0.4 in group 4, respectively, and the numbers of microvessels were 198.0 20.7 in group 1, 230.0 22.3 in group 2, 211.7 11.2 in group 3, and 236.4 11.4 in group 4, respectively (mean SE). The percentage area of microvessels was significantly higher in group 1 than in other groups. However, the number of microvessels in that group was lower than in the other groups, although it was statistically insignificant. Since flow-dependent vasodilation is preserved in HCMP, we considered flow-dependent vasodilation the cause of the discrepancy between the area and the number of microvessels. Ischemic changes observed in chronic HCMP and related heart failure were considesed to be due to the relative deficiency of the coronary flow compared to the increasing cardiac mass.
Adult ; Cardiomyopathy, Hypertrophic* ; Fibrosis ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Hypertrophy ; Microvessels ; Myocardial Ischemia ; Vasodilation

Among the precancerous lesions, dysplasia of the uterine cervix and adenoma of the colon have been widely studied in terms of genetic alterations. However, little has been performed regarding phenotypic alterations of the precancerous lesions. We investigated the relationship among cellular proliferation, clonality, immortality and histopathologic grading of the squamous epithelial lesions of the uterine cervix. Proliferation index (PI) was calculated based on the ratio of the epithelial cells positive for proliferating cell nuclear antigen to the total epithelial cells. Clonality was assayed by X-linked HUMARA polymorphism. For immortality assay, PCR-based TRAP (telomeric repeat amplification protocol) was done and telomerase processivity was calculated by comparison with the positive control. PI increased gradually as the lesions advanced from dysplasia to invasive carcinoma. Among informative case, all of the carcinoma in situ showed monoclonal pattern (7 of 7). Among invasive squamous cell carcinoma, 6 cases showed monoclonal pattern and 2 cases polyclonal pattern. TRAP reaction was positive in 92.6% (25 of 27) of dysplasia (high grade: 14 of 15; low grade: 11 of 12), 95.0% (19 of 20) of carcinoma in situ, 100% (9 of 9) of microinvasive carcinoma, and 92.9% (13 of 14) of invasive carcinoma. It was also positive in 12 of 12 samples of chronic cervicitis or squamous metaplasia near the lesions of dysplasia. There was no difference in TRAP positivity among the dysplasia, carcinoma in situ and invasive carcinoma, whereas telomerase processivity showed significant correlation. These results suggest that proliferative activity and telomerase processivity may be progressive events in oncogenesis, although telomerase activation may be an early event.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; Colon ; Epithelial Cells ; Female ; Metaplasia ; Proliferating Cell Nuclear Antigen ; Telomerase ; Uterine Cervicitis

Alleles and genotype frequencies and its distribution pattern for three STR loci; CSF1PO, TPOX, and TH01 were analyzed for the evaluation of the useful-ness of STR loci in the individual identification. STR CSF1PO locus showed 7 allele types and 18 genotypes. However, 3 of 7 allele types are related to 84.3% of population and 4 of 18 genotypes are related to 67.6% of population. Heterozygosity is 70.6%. STR TPOX locus showed 5 allele types and 12 genotypes. However, 2 of 5 llele types are related to 81.92% of population and 3 of 12 genotypes are related to 78.4% of population. Heterozygosity is 65.7%. STR TP01 locus showed 5 allele types and 13 genotypes. However, 2 of 5 llele types are related to 78.9% of population and 3 of 13 genotypes are re-lated to 71.6% of population. Heterozygosity is 68.6%. From the above results, CSF1PO, TPOX, and TH01 loci have small numbers of allele types and genotypes. Many population is included into the specific allele types and genotypes. So, statistical analysis of allele and genotype frequency may have risks of misinterpretation of negative results to positive results. To remove the statistical errors, more than three STR loci have to be used in individual identification and the distribution pattern of the frequency of allele types and genotypes have to be analyzed in the STR loci.
Alleles ; Genotype

Injury is generally defined as morphological changes due to physical or chemical stress, inflammatory or repair process, or secondary events of the other disease. In the nontraumatic injuries of the lung, direct physical effects to the lung such as contusion or rupture of the lung must be excluded. So, the types of nontraumatic injuries of lung are all pathologic changes of lung except for congenital anomalies; infectious of inflammatory disease, aspiration induced injuries, environmental or occupational lung disease, postoperative pulmonary changes, poison or drug induced toxic injuries, radiation injury, etc...
Contusions ; Lung Diseases ; Lung* ; Radiation Injuries ; Rupture