Journal of Pathology and Translational Medicine

Volume 16(3); September 1982

Etcs

On the Origin of Plasma Cells: Young Che Kim; Korean J Cytopathol. 1982;16(3):353-360.

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Abstract: There have been many postulations about the origin of the plasma cell namely, lymphocytic origin, reticum cell origin and adventia cell origin, etc. Early reports on the plasma cell origin were chiefly on morphologic observations of the resemblance between the plasma cell and the lymphocyte or the intermingled appearance of the two kinds of cells in an inflammatory lesion. The first experimental study on the origin of the plasma cell was performed by Fagrareus (1948) with a conclusion that the reticum cell was the origin of the plasma cell. At the present time, the B-lymphocytic origin of the plasma cell is the most prevailing hypothesis based on various arounds such as in vivo animal experiments, congenital immune-deficiency diseases, and in vitro transformation study of lymphocyte culture. The trends have led many researchers to make an attempt to classify lymphoid tissue tumors into the T-lymphocytes series or the B-lymphocyte ones. According to the theory of the B-lymphocyte origin, the transformation of sensitized B-lymphocytes into plasma cells takes place by meeting an antigen in the peripheral lymphoid tissue such as lymph nodes and spleen. If so, the bone-marrow origin of multiple myeloma and the starting of plasmacytoma in the soft tissue can not be explained reasonably. The confirmation of both defect of plasma cell and lymphocyte in the agammaglobulinemia is also disputable. This brief review was intended to sum up our experimental investigations conducted so far on the origin of plasma cells. The outline is as follows: 1) A whole-body X-ray (400R) irradiation of experimental animalt(rabbits, rats) induced marked regressive changes in the entire lymphoid tissue, causing destruction of mature lymphocytes, proliferation of macrophages within the first few days, and proliferation of plasma cell-series in the next few days. The proliferation of plasma cell series was preceded by an antecedent proliferation of reticular cells and proplasma cells the morphological process of direct transformation of reticular cell into a plasma cell series could be confirmed electronmicroscopically and autoradiographically both in the thymus of rats and in the bursa Fabricius of chickens. 2) A similar erocess of changes due to X-ray irradiation also took place in rats infused with cortisone, DOCA and in adrenalectomized rats. 3) In experiments, where rabbits were inoculated with sensitzed thoracic duct cells or with thoracic duct B-cells combination with antigen into the anterior eyer chambers, a sequential microscopic observation of the smear of the anterior chamber fluid disclosed no transformation lymphocytes into mature plasma cells, 4) In experiments in which both thoracic duct cells and thoracic duct T-cells were inzeeted into the subcutaneous tissue in the back of rabbits, temporal plasmacytopoiesis were induced around the small vessels near the muscle coat or hair follicles, but the injection of UV-irradiated thoracic duct cells could not induce any new building of plasma cells. The plasm-acytopoiesis was supported by in toto newly formed reticular tissue. 5) Newly formed plasma cells in the subcutaneous tissue showed positive IgG fluorescence reaction. 6) The newly formed plasma cells in the follicles of the bursa Fabricius after a whole body X-irradiation (400R) showed also positive IgG fluorescence reaction. The results suggest that plasma cells originate from local reticular cells and those cells are able to produce immunoglobulin. Therefore, it can be concluded that lymphocytes (including T-lymphocytes) have inducing effect in the formation of plasma cells

A Study on Enzyme Linked Immunosorbent Assay (ELISA) for Detection of IgM Antibodies to Cytomegalovirus: Dong Hee Cho, Hyon Suk Kim, Kyung Soon Song, Samuel Y. Lee; Korean J Cytopathol. 1982;16(3):361-366.

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Abstract: Human cytomegalovirus(CMV) is the most common cause of congenital infection, which results mainly central nervous system sequelae. CMV infection can cause various diseases such as CMV monoucleosis, hepatitis, and CMV-associated Guillain Barre's syndrome. Also it may constitute a serous problem for immunosuppressed individuals such as recipients of organ transplants and cancer patients. The accurate diagnosis of CMV infection is very important. For the diagnosis of viral disease the serologic tests are usually used. The presence of specific IgM antibodies in serum indicates recent infection and can be used for rapid laboratory diagnosis from a single serum specimen taken early in the illness. Study subjects consisted of 304 blood samples requested for CMV antibody test in Yonsei University Medical Center from August in 1981 to March in 1982. The results are summarized as follows; 1) The seropositive cases for CMV IgM antibody in 304 blood samples were 26(8.5%) by ELISA. 2) The seropositive cases include 14 infants, 7 children, and 5 adults. 3) The clinical conditions of seropositive cases include 8 neurological disorders, 5 liver disorders, 5 renal disorders, 1 lymphoma, and 6 miscellaneous disorders. 4) The titer of CMV IgM antibody in seropositive cases ranged from 1:40 to more than 1:160. The ELISA technique seems to be relatively simple, sensitive and reliable method for serological diagnosis of CMV infection and for screening of the general population.

An Evaluation of the Clinical Application of Serum Cholylglycine Measurement in Hepatobiliary Disease: Chang Hyun Rhim, Hong Sup Yoon, Oh Hun Kwon, Kui Nyung Yi, Samuel Y. Lee; Korean J Cytopathol. 1982;16(3):367-375.

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Abstract: There have been a number of so-called liver function tests in our routine clinical work, yet their capabilities are so limited that a new and more sensitive liver function test is highly desirable. Sherlock and Walshe (1948) were reported highly elevated serum bile acids in hepatobiliary diseases for the first time. Since then a number of investigators reported various conditions with elevated serum bile acids. Serum cholylglycine levels in 25 normal control subjects and 98 patients with abnormal liver function tests were determined by RIA method and the results were compared with conventional liver function tests. The following results were obtained. 1) The mean CG concentration in the fasting sera of normal control subjects was 10.7±8.9ug/㎗(mean±SD) and no difference was noted between male and female. 2) Significantly elevated serum CG levels were observed in 94 patients among of 98 patients with various hepatobiliary diseases. Among the hepatobiliary diseases the highest serum CG level was seen acute viral hepatitis. During the course of recovery from acute viral hepatitis, the decline of serum CG values was more rapid than other liver function test. 3) In the diagnosis of chronic persistent hepatitis, the serum CG test was less sensitive than AT, or ALT test, while it was more sensitive than the tests of ALP or total bilirubin. 4) Serum CG test was very sensitive in the diagnosis of chronic active hepatitis and cirrhosis. The test was considered valuable in the differential diagnosis of chronic active hepatitis from chronic persistent hepatitis. 5) The mean serum CG concentration in the postprandial sera of normal control subjects was 35±22ug/㎗(mean±SD) and no difference was noted between male and female. Serum CG values of the patients with hepatobiliary diseases were higher in the 2 hour postprandial samples than the fasting samples whether the fasting serum CG values were normal or not. However, the increment of serum CG values after meal was more pronounced among the patients with hepatobiliary diseases. 6) There was a good linear correlation between the level of serum CG and total bilirubin in hepatobiliary diseases. From this study it is concluded that serum CG test is a valuable and sensitive test in the diagnosis of various hepatobiliary diseases.

Comparative Sequential Changes of Blood Stored in ACD and CPD: Hae Ran Moon, Dae Won Kim, Jung Soon Goo, Jin Q Kim, Han Ik Cho, Sang In Kim; Korean J Cytopathol. 1982;16(3):376-380.

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Abstract: Blood was taken from four health volunteer donors into plastic bags containing Citrate-Phosphate-Dextrose (CPD) and Acid-Citrate-Dextrose (ACD) anticoagulant and stored in blood bank refrigerator. Blood pH, HCO3, ammonia, plasma K, and Na were measured on 0,1,2,3,6,10,14,16 and 21 day of storage. Blood pH and HCO3 decreased an plasma K and blood ammonia increased in both ACD and CPD blood with storage. Blood pH, ammonia and plasma K levels became significantly higher in CPD blood than in ACD but HCO3 and Na did not show any significant changes.

A Study on the Quantative Serum Alpha-Fetoprotein Concentrations by Radioimmunoassay: K.E. Cheong, M.J. Cho, S.J. Son, C.S. Lee*; Korean J Cytopathol. 1982;16(3):381-389.

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Abstract: The serum concentrations of alpha-fetoprotein were measured by radioimmunoassay technic in 72 patients with primary hepatoma, 39 patients with other liver diseases and 28 patients with other various malignant cancers including 12 patients with liver metastasis and were compared with those in 30 normal adults. The following results were obtained: 1) The serum AFP concentrations in normal adults were in a range 0 to 86 IU/㎖ with a mean value of 16.2±10.7 IU/㎖. 2) 72 patients with primary hepatoma showed serum AFP concentrations in a range of 28 to over 4000 IU/㎖, 68 patients(94.4%) and 57(79.2%) patients with greater than 100 IU/㎖ and 400 IU/㎖ respectively. 3) In the 44 patients with primary hepatoma, serum AFP concentrations higher than 400 IU/㎖ was noted in 94.1% of serum HBs Ag positive patients and in 62.9% of HBs Ag negative ones, which showed statistically significant difference in serum AFP concentrations in regard to the occurrence of HBs Ag. 4) Liver scanning showed a cold area in 56(91.8%) of 61 patients with primary hepatoma, there was no significant difference in serum AFP positivity (AFP>400 IU/㎖) in presence of cold area on liver scan. 5) Pathological classification of 21 patients with primary hepatoma were 19 of hepatocellular carcinoma and 2 of cholangiocellular carcinoma, all patients with hepatocellular carcinoma were serum AFP concentrations higher than 400 IU/㎖, but 2 cholangiocellular carcinoma were lower than that.

Experiences in International Quality Control for Coagulation(1980～1981): Dae Won Kim, Kyou Sup Han, Myung Hee Lee, Hae Ran Moon, Jung Soon Goo, Myoung Hee Park, Han Ik Cho, Sang In Kim; Korean J Cytopathol. 1982;16(3):390-397.

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Abstract: The Department of Laboratory Medicine, Seoul National University Hospital has had an opportunisity to participate in "The International study group for anticoagulant control" which has been organized by "National(U.K.) Reference Laboratory for Anticoagulant Reagent and Control" for 2 years since 1980. Four trials have been performed a year for Prothrombin time, Partial thromboplastin time, Factor VIII assay, Fibrinogen, Antithrombin III and Thrombin time in various combinations. Over 345 laboratories in England and over 80 laboratories from overseas have participated in this program. Based on the cumulative experiences with this international quality control for coagulation, the following experiences were obtained. 1) Except for a few test items of some trials, our laboratory obtained relatively satisfactory results. 2) Large variety of laboratory techniques and reagents were used in each laboratory. 3) Percent deviation was used to estimate the reliablity of interlaboratory results in prothrombin time in second and prothrombin ratios. 4) Many laboratories interpreted the results of prothrombin activities(%) differently because of the different therapeutic ranges used in different laboratories. This result indicated the need for urgent measure to provide a uniform basis of laboratory control of clinical dosage of anticoagulant drug. 5) British Comparative Thromboplastin was found to be sueful for calibration of home-made and commercial thromboplastins. Nationa(U.K.) Reference Lab Standardized Reagent was more sentive than other partial thromboplastin reagents in detection of abnormality. 6) Except for Prothrombin time and Partial thromboplastin time, the results were evaluated by histogram, showing very wide distribution of results among participants. This indicates that these times have much room for improvement.

Squamous Cell Carcinoma Arising in Cystic Teratoma of Ovary -An Analysis of 5 Cases-: Yoon Seong Lee, Geung Hwan Ahn; Korean J Cytopathol. 1982;16(3):398-403.

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Abstract: Although cystic teratomas of dermoid cysts of the ovary are almost always benign tumors, the development of malignancy deserves emphasis. Five cases of squamous cell carcinoma arising in cystic teratoma were analyzed. They comprised 3.3% of 121 ovarian malignancies, and 1.4% of 284 cystic teratomas. The patients' age ranged form 54 years to 76, with the mean age of 62.2 years. The presenting symptoms were low abdominal mass, particularly rapid growing recently, low abdominal pain or discomfort, voiding difficulty, or vaginal discharge. Three cases involved right ovary and two left. The tumors were larger than benign cystic teratoma; the mean diameter of the tumors was 19.9㎝. Cut surface of the malignancies was cystic with areas of sold tumefaction or protuberance, or partly cystic and partly solid. Microscopically all the tumors showed squamous cell carcinoma of varying degree of differentiation besides teratomatous elements. Differential diagnosis between benign cystic teratoma and squamous cell carcinoma arising in cystic teratoma was studied an discussed in detail.

Assay of Urinary 5-Hydroxyindole-3-acetic acid(5-HIAA) by High-Performance Liquid Chromatography with Ultraviolet Detection: Jin Q Kim, Han Ik Cho, Myoung Hee Park, Kyou Sup Han, Hae Ran Moon, Dae Won Kim, Kyung Dong Kim, Ha Seung Jung, Sang In Kim; Korean J Cytopathol. 1982;16(3):404-410.

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Abstract: 자외선 測程器가 부착된 液體크로마토그라피를 利用하여 尿中 5-HIAA를 分析定量하는 方法을 개선 및 고안하고 그 평가와 함께 소개하였다. 종래 사용되어 오던 colorimetry 法과의 비교 연구에서 탁월한 상관관계가 있음이 관찰되었고 檢査 신뢰도에 있어서 본 方法이 우수한 것으로 판단되었다. 본 HPLC 法에 의한 설정된 정상한계치(‘cut-off value)는 13.0mg/24hr. urine이다. 새로운 정밀 分析 기술의 하나로 각광받고 있는 HPLC 法을 임상 檢査에 利用할 경우 高度의 精度를 갖는 檢査결과를 얻을 수 있을 것으로 생각되었으며 국내에서 그 첫 시도로 적용된 본 方法이, carcinoid 증후군 진단에 매우 有用한 지표가 되는 尿中 5-HIAA 定量에 있어서 간단하고 정확하며 매우 감수성이 높은 檢査法이라는 결론을 얻었다.

An Ultrastructural Study on the Changes of Tubular Epithelial Cells of the Kidney after Intravenous Administration of Paraquat: Yong Jin Kim, Byung Heon Kim, Tae Jung Sohn; Korean J Cytopathol. 1982;16(3):411-416.

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Abstract: The authors studied the ultrastructural changes of rat kidney following intravenous administration of paraquat, utilizing intravenous injection of saline for control. Thirty eight Sprague-Dawley rats were divided into three groups (two as control group, eighteen as experimental group I and the rest eighteen as experimental group II). Control group was received 1㎖ of saline, experimental group I was received 20㎎/㎏ of paraquat and experimental group II was received 40㎎/㎏ through tail vein. Each of three animals was sacrificed 12, 24, 36, 48, 60 and 72 hours after administration to the group I and II, respectively. Each of two animals was sacrificed 72 hours after saline injection in the control group. Then both kidneys were extracted out and observed light and electron microscopically. The results were summarized as follow: Light microscopically, the renal tubular epithelial cells revealed slight congestion and edema without other significant pathologic changes. Electron microscopically, ultrastructural changes were usually confined to mitochondria. All proximal and distal convoluted tubular epithelial cells showed moderate mitochondrial swelling with decrease of cristae, vacuolation and increased electron density of matrix in 24 hours after in group I. In the group II, changes were similar but more severe. The results obtained in this experiment suggested that mitochondria were the main intracellular organ affected by paraquat, and that these mitochondrial changes were considered to be reversible.

Coexistence of HBsAg and Its Antibody -a Review of 152 cases-: Think You Kim, Wha Soon Chung, Choon Won Kim, Seung Hahm Park, Ki Hong Kim; Korean J Cytopathol. 1982;16(3):417-425.

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Abstract: The co-occurrence of both HBsAg and anti-HBs together in the same serum is an unusual serologic pattern. It has been accepted as the presence of circulating immune complex with optimal proportion and new subtype infection. We suppose that there may be also circulating free forms of antigens and antibodies of same subtype other than immune complex, and they may be a kind of seroconversion. Based on the serological and clinical data observed from May 1981 to April 1982 at the Han Yang University Hospital, the following findings were obtained. 1) The frequency of coexistence was 5.6% (152/2,715). 2) The most frequent case was 13 times during 10 months. 3) Male to female ratio of coexistence was 1.8:1 and approximately 80% of the cases occurred from the 3rd to 5th decade of age in male. 4) The serum GPT level was normal in 40% of cases and the serum total bilirubin level was normal or below 2.5㎎/㎗ in 72.5% of cases. 5) There were symptoms and signs in 80% of patients. 6) The incidence of coexistence according to the diagnosis confirmed by liver biopsy was highest in chronic active hepatitis as 23.8%. 7) All the HBsAg negative and HBeAb negative was in 56 cases(57.2%), HBeAg negative and HBeAb positive was in 30 cases(30.6%). Both HBeAg and HBeAb negative sera were observed in 11 cases(11.2%), and the both were positive in 1 case.

Pathogenic Fungi of Keratomycosis -Analysis of 8 cases-: Dae Won Kim, Jung Soon Goo, Jin Q Kim, Kyou Sup Han, Kyu Man Lee, Myoung Hee Park, Han Ik Cho; Korean J Cytopathol. 1982;16(3):426-429.

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Abstract: Fungal infection of the eye, especially keratomycosis is relatively uncommon, however recently presents seriously increasing problem with increased topical use of steroids and antibiotics. During the period from 1978 to 1981, fungi recovered from corneal scrapings of the 8 patients with keratomycosis were 3 cases of Fusarium species, and one each case of Geotrichum candidum, Sepedonium species, Aspergillus species, Cephalosporium species, and Alternaria species. Among these, to our best knowledge, Geotrichum candidum and Sepedonium species have not been reported in Korean literature.

Aneurysmal Bone Cyst Secondary to Primary Bone Lesions: Yong Koo Park, Young Hee Park, Jung Dal Lee; Korean J Cytopathol. 1982;16(3):430-433.

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Abstract: Six cases with aneurysmal bone cysts secondary to primary bone lesions are reported. The primary bone lesions include giant cell tumor (3 cases), fibrous dysplasia (2 cases) and non-ossifying fibroma (one case). The pathogenesis, clinical significance and histologic feature of the secondary aneurysmal bone cysts are discussed.

Primary Adenocarcinoma of Urinary Bladder Associated with Cystitis Glandularis -Report of a Case with Special Emphasis on the Identification of Borderline Lesion as a Histogenetic Significance-: Woo Ho Kim, Yong Il Kim; Korean J Cytopathol. 1982;16(3):434-437.

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Abstract: A case of primary adenocarcinoma of urinary bladder associated with cystitis glandularis in a forty-year-old man is presented. Urothelial mucosa near the neoplasm was diffusely manifested with an advanced degree of metaplastic change of intestinal type, which transformed into a form of borderline lesion or adenomatous growth and apparently into adenocarcinoma. The nature and diagnostic significance of such an intermediate lesion in the urinary bladder were discussed.

Rhabdomyosarcoma of Prostate: Chae Won Lee, Sun Kyeung Lee; Korean J Cytopathol. 1982;16(3):438-440.

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Abstract: A case of embryonal rhabdomysarcoma arising from the prostate is reported and a review of literatures related to this case in presented. The patient, a 41-year-old Korean man, was admitted to Busan National University Hospital with a complaint of dysuria. The examination revealed a hard mass in left lobe of the prostate extending to prostatic urethra. The gross specimen cosisted of a prostate and a polypoid mass. The mass in left lobe of the prostate was 3×3 cm and was ill-defined. The cut surface was grayish white, fish flesh in appearance. The mass of the prostatic urethra was 2.7×1.5cm. The external surface was smooth and nodular. The cut surface was similar to that of the prostate. Microscopically, the masses were confirmed to be an embryonal rhabdomyosarcoma. Eighteen month later, the tumor was recurred.

Testicular Rhabdomyosarcoma -3 Cases of Embryonal Rhabdomyosarcoma-: Ho Jong Chun, Myung Hee Lee, Jae Hong Suh, Young Jin Park, Je G. Chi*; Korean J Cytopathol. 1982;16(3):441-448.

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Abstract: 횡문근 육종은 일차적으로는 영아와 소아에 그리고 이차적으로는 청년기에서 흔하게 발생하는 종양으로서 예후가 매우 불량한 악성종양중의 하나이다. 이들 횡문근 육종은 신체 어느 장기 또는 조직에서 발생할 수 있는데 특히 남성생식기, 두부, 경부, 식도, 담도 및 뇌막등에서 발생한다. 저자들은 최근 조선대학교 의과대학 병리학교실에서 검색한 1례와 서울대학교 의과대학 병리학교실에서 검색한 우측고환에서 발생한 횡문근육종 2례를 경험관찰하였기에 이를 보고하였다. 증례1은 16세된 남자환자로서 환자는 6개월 동안 우측고환에서 점진적으로 커지는 종양을 인지할 수 있었으며 어떠한 증상을 호소하지 않으면서 입원 10일전에 점차 압통을 느껴왔을 뿐이었다. 환자는 제 2번, 3번 요추부위에 해당되는 후복벽에 전이된 종양을 확인하였으며 치료는 근치 고환 척제술을 받았으며, 화학요법(Vincristine 1.36㎎ I.V 1day Actinomycin D 0.23㎎ 5days CTX 150㎎ 7days for 6times, interval 21days)과 방사선 치료(total irradiation, 6.900rads/'77. Dec. 17th～'78. Feb. 7th)를 받았다. 종양의 크기는 4×6×8㎝. 이었으며 할면은 매끄러웠고 여러 부위에서 낭성변성을 보였다. 현미경상으로 분명한 횡문을 가지고 있는 방추형의 세포를 볼 수 있었다. 치료 후 환자는 4년 동안 현재 건재하고 있다. 증례 2는 20세 남자로서 입원 18개월 전부터 점차 커지는 우측 과환으로 종양조직을 갖는 고환의 크기는 9×9×6.5㎝ 있었다. 조직검사상 호산성 세포질을 갖는 이형성의 방추형 세포를 볼 수 있었다. 증례 3은 21세 남자로서 우측고환의 종양으로 그 크기는 12×9×7㎝ 크기였으며 여러 곳에서 낭성변성을 보였다. 현미경 소견상 호산성 세포질과 크고 불규칙한 핵을 갖는, 다양한 크기를 갖는 세포들로 구성되었다. 환자는 단지 고환 척제술만 받았으며 8개월이 지난 현재까지 건강하게 지내고 있다.

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