Journal of Pathology and Translational Medicine

Volume 17(4); January 1983

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Histochemical Study of Mucin Composition of Gastric Cancer and Surrounding Mucosa: Ho guen Kim, Chan Il Park, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1983;17(4):391-398.

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Abstract: The pathologenesis of Gastric cancer is not clearly proved although some of the mucosal changes are considered to play a role in the development of cancer by many investigators. The present study is aimed to investigate the nature of mucosubstance in various gastric lesions and their surrounding mucosa to determine the possible role on the histogenesis of cancer. The material used in this study consisted of 102 cases of stomach cancer and 35 cases of benign gastric ulcer. All gastrectomized specimens are fixed in 10% neutral formalin and prepared by Swiss roll technique to examine the lesion and its surrounding mucosa. 5 sections are cut in 5 micron thickness serially from paraffin embedded blocks. For histologic examination, sections are stained by routine hematoxylin and eosin method. Sections are also stained by alcian blue at pH 2.5 for the detection of acid mucosubstance, and by alcian blue at pH 1.0 and by Spicer's diamine method(HID) for the detection of acid sulfomucin and by periodic acid-schiff(PAS) alone for the detection of neutral mucosubstances. The results are as follows: 1. Intestinal metaplasia and chronic atrophic gastritis were observed more frequently in cancers than benign gastric ulcers. Of the 102 cases of cancers, intestinal metaplasia was observed in 83(81.4%) and chronic atrophic gastritis in 42(41.2%) Of the 35 cases of benign gastric ulcers, intestinal metaplasia was observed in 19(54.3%) and chronic atrophic gastritis in 5(14.3%). 2. The intestinal metaplasia was classified as colonic and enteric types by its histologic characteristics, and the colonic type intestinal metaplasia was considered to be more closely related to the gastric cancer. In cancers, 36(43.3%) of the 83 cases of intestinal metaplasia were enteric type and the remaining 47(56.7%) were colonic type while in benign gastric ulcer, 15(78.9%) of the 19 cases of intestinal metaplasia were enteric type and the remaining 4(21.1%) were colonic type. 3. Histochemically the mucin composition of the two types of intestinal metaplasia was quite different: In sixty (95.8%) of the 62 cases of enteric metaplasia contained only acid sialomucin but in 38(95%) of the 40 cases of colonic metaplasia acid sulfomucin was also detected. In cancers 60(58.8%) of the 102 cases contained the mucosubstances intracellularly and extracellularly. Moreover, in 45 out of 60 cases contained predominantly acid sulfomucin. These results indicated that the colonic type intestinal metaplasia of gastric mucosa has close relationship to the development of gastric cancer histochemically.

Effects of Immunopotentiator (OK-432) on the Histological Changes of the Spleen: Hye Soo Lee, Shin Woong Lee, Ho Yeul Choi; Korean J Cytopathol. 1983;17(4):399-407.

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Abstract: To investigate the mechanism of function of the OK-432 as a immunopotentiator, morphological studies of the spleen was carried out. OK-432 was administered by intravenous injection in single (0.1 KE/100g of body weight) or sequential (0.01, 0.025, and 0.05KE/100g of body weight for successive 3 days) doses to sensitized with sheep red blood cell (SRBC) and nonsensitized mice. One, 3, 5, 7 and 10 days after OK-432 administration, histological examination was performed by H&E, methylgreen-pyronin(MGP), and reticulin stains. 1) In OK-432 administered group, especially in sequentially administered group, proliferation of periarteriolar lymphatic sheath with altered cellular composition from small lymphocytes to plasma cells were prominent. 2) In groups with single administration of OK-432, germinal center of the secondary lymphoid follicle was distinct in 1st day, but becomes indistinct in 3rd day, and reticular cells and tingible body macrophages(TBM) of the secondary follicle were replaced by small- and medium-sized lymphocytes, lymphoblasts and pyroninophilic cells. In the sequential doses of OK-432 administered group, germinal center composed of pyroninophilic cells was indistinct at 3rd day, but became distinct after 5 days. 3) In sequentially group, large numbers of histiocytes and plasma cells were in the marginal zone of the white pulp. 4) Splenic red pulp was not altered morphologically in experimental groups. These results showed that OK-432 affected not only the periarteriolar lymphatic sheath, but the germinal center o the secondary lymphoid follicle and marginal zone. It suggests that OK-432 may be related to humoral immunity as well as to cell-mediated immunity.

The Changes of Alveolar Layer in Experimental Asbestosis Observed by Ruthenium Red Stain: Jae Bok Park, Jae Myung Chung, Tae Joong Sohn; Korean J Cytopathol. 1983;17(4):408-411.

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Abstract: Authors had intratracheally installated asbestos fiber to albino rats and observed alveolar lining layers with ruthenium red stain. The results were as follows. 1) On the third day after installation of chrysotile asbestos, ruthenium red positive material on surface of type II pneumocytes was decreased in amount. On the fifth day that of type I pneumocytes was also decreased. On the seventh day ruthenium red positive material was significantly decreased in both type I and type II pneumocytes. Degeneration of osmiophilic inclusion body appeared on the fifth day and later it more pronounced. 2) From the above results, positivity of ruthenium red stain is parallel with degree of type II pneumocyte degradation. So the amount of ruthenium red positive material is closely depended upon functional activity of cells producing ruthenium red positive material.

Comparision of Biotin-Avidin System Method with Peroxidase-Antiperoxidase Method in Immunohistochemistry: Sang Woo Juhng, Jong Hee Shin, Chan Choi; Korean J Cytopathol. 1983;17(4):412-416.

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Abstract: Newly introduced BAS method in immunoperoxidase staining was compared with PAP method and the advantages and disadvantages of BAS method were discussed. Various dilutions of primary antisera of IgG, aFP, lysozyme, HSV II and GFA were applied to the surgical biopsy specimens of inflammatory reaction, hepatocellular carcinoma, gastric adenocarcinoma, cervical dysplasia and astrocytoma, respectively, and each specimen was stained with PAP or BAS method. The ratio of specific staining-background staining was higher in BAS method, where dilutions of the primary antisera were 4～16 times those applied in PAP method. The high dilution titers in BAS method was thought to be due to strong binding activity between biotin and avidin, and also due to lattice-like structure of ABC containing many peroxidase molecules. The main disadvantage of BAS method is endogenous avidin binding activity which can be overcome by pretreatment with avidin and biotin.

An Evaluation of KRC modified Westergren Method for Determining Erythrocyte Sedimentation Rate: Sung Man Choi, Jay Sik Kim, Jyung Myung Kim; Korean J Cytopathol. 1983;17(4):417-425.

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Abstract: The ESR studies have been studied in 57 healthy young men and 38 healthy young women by KRC modified Westergren method for the normal reference value of ESR in this laboratory, and also in 74 randomly selected patients for comparison of ESR between the KRC modified Westergren and Wintrobe method. The mean value of normal young man was 5±3.8㎜/hr and normal range was 0 to 11 ㎜/hr. The mean value of normal young woman was 13±5.1㎜/hr and normal range was 0 to 23 ㎜/hr. The mean value and upper limit of range were higher in woman than I man. In comparison of ESR of patient group, ESR by Wintrobe method was higher in normal and slightly abnormal group but in moderate abnormal and marked abnormal levels, ESR by KRC was much higher than that by Wintrobe method. This result was a same as in comparison of hematocrit-corrected ESR. The Wintrobe method seemed to be a more reliable method for the screening of chronic inflammatory conditions, especially having anemia, due to adequate hematocrit correction. However for menitoring the progress of chronic inflammatory process such as rheumatoid arthritis, KRC modified Westergren method appears to be more reliable and more convenient than Wintrobe method.

A Study on the Liver Cell Dysplasia: Hyo Jin Lee, In Sun Kim*, Moon Hyang Park, Hyo Sook Park, Seung Yong Paik*; Korean J Cytopathol. 1983;17(4):426-431.

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Abstract: The term, "liver cell dysplasia", which was proposed and defined as cellular enlargement, nuclear pleomorphism, and multinucleation of liver cell occurring in groups or occupying whole cirrhotic nodule by Anthony et al, has been considered to be premalignant condition. The authors reviewed dysplasia in 247 cases with cirrhotic or cancerous livers including non-cirrhotic and nonmalignant control group, and studied the presence of HBsAg to evaluate the relationship between HBsAg and dysplasia in cirrhosis and hepatocellular carcinoma. The results are as follow: 1) Liver cell dysplasia was found in 6 out of 132 cases (4.5%) of control group, in 2 out of 16 cases (12.5%) with hepatocellular carcinoma, 28 of 89 cases (31.5%) with cirrhosis only, and 7 out of 10 cases (70%) with cirrhosis and hepatocellular carcinoma 2) There were no age and sex differences between cirrhosis and cirrhosis with hepatocellular carcinoma, with or without dysplasia. 3) Serum HBsAg were positive in 8 out of 12 cases (66.7%) with dysplasia, whereas positive in 5 our of 16 cases (31.2%) without dysplasia.

Effect of Thiol broth and Sodium Polyanethol Sulfonate on the Growth of Salmonella typhi Exposed to Antimicrobial Agents: Chun Hee Lee, Sook Ja Park, Yunsop Chong*, Samuel Y. Lee*; Korean J Cytopathol. 1983;17(4):432-437.

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Abstract: Thiol broth and sodium polyanethol sulfonate (SPS) are reported to neutralize antimicrobial agents to support better growth of bacteria in blood exposed to antimicrobial agents. The effect has not been studied with S. typhi which is frequently the object of blood culture in Korea. In this study the effect was determined in vitro with artificial exposure of S. typhi to chloramhenicol, ampicillin, and cotrimoxazole. The following results were obtained. When chloramphenicol is present the growth of S. typhi in Thiol broth was somewhat worse than in Tryptic soy broth (TSB). In the presence of ampicillin or cotrimoxazole, the growth was better in Thiol broth and Thiol broth + SPS, and TSB and TSB + SPS, when chloramphenicol is present. The growth was slightly worse in the Thiol broth + SPS than in Thiol broth when 32㎍/㎖ of ampicillin is present; in Thiol broth + SPS than in Thiol broth when 32㎍/㎖ of cotrimoxasole is present; and in TSB + SPS than in TSB when 1㎍/㎖ of cotrimoxazole is present. It is concluded that Thiol broth neutralizes ampicillin and cotrimoxazole but not chloramphenicol and the use of Thiol broth may be beneficial if used in actual blood culture. SPS did not neutralize those antimicrobials.

Two Cases of Neurilemoma of the Tonge: Byung Chang Kim, Yun Je Jung, Gang Suk Suh, Soon Ho Kim; Korean J Cytopathol. 1983;17(4):438-441.

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Abstract: Neurilemoma of the tongue is very rare, solitary benign slowly growing neoplasm. We have recently experienced 2 cases of neurilemoma of the tongue which occurred in 20 year old female and 22 year old male. They complained of a painless mass on the left side of the tongue base and on the right anterior margin of the tongue respectively. Grossly the tongue mass of the first case measured 1×0.8×0.5㎝ in dimension. The cut surface was homogeneous gray white in color with no necrosis and hemorrhage. Microscopically, this tumor was composed of spindle cells with long ovoid nuclei. The nuclei were arranged in palisades that were separated by fibrillar cytoplasmic processes. There were also noted Verocay boidies. Grossly, the submitted tumor mass of the second case was consisted of three fragments which were divided by surgeon, averaging 0.7×0.5×0.5㎝ in dimension. The cut surface was homogeneous gray white in color with firm-consistency. Microscopically the neoplasm was made up to spindle cells with ovoid nuclei. A few rows of palisading nuclei enclosed spaces filled with ribbed collagen, forming Verocay bodies.

A Case of Tinea Versicolor Caused by Fusarium sp.: Kyung Ja Han, In Sook Chung, Sang In Shim, Chong Moo Lee; Korean J Cytopathol. 1983;17(4):442-446.

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Abstract: Fusarium species belong to the class Deuteromycetes, order Moniliales. They are common saprophytes, and plant pathogens. In human, Fusarium species rarely cause opportunistic infection such as keratomycosis and onychomycosis. Tinea versicolor caused by Fusarium species are rarely found in burned patient. Recently, we experienced a case of tinea versicolor caused by Fusarium species in 7 years old boy. The patient visited to the dermatology department because of a large skin ulceration with severe itching sensation and pain on the anterior aspect of the left thigh. Seventeen months prior to this entry, he had a fracture of left femur by traffic acident, and immobilized with cast for 2 months. When the cast was removed military sized erythema accompanying itching sensation on anterior aspect of left thigh was noticed. It aggrevated progressively. Skin biopsy and fungus culture were done. Skin biopsy material showed eroded epidermis, invasion of fungal hyphae into the lower dermis, and chronic granulomatous inflammation, consistent with fungal granuloma. Serial fungus culture studies revealed whitish filamentous colonies on Sabouraud dextrose agar at room temperature. There was a slight orange-yellow pigment on the reverse, which turned brown with age. Microscoscopically, the organism manifested numerous, sickle-shaped, fusiform, multiseptate macroconidia, consistent with Fusarium species.

Thymic Carcinoid Tumor -Report of a case-: Kyo Young Lee, Ki Hwa Yang, Won Il Kim, Sun Moo Kim, Chong Moo Lee; Korean J Cytopathol. 1983;17(4):447-451.

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Abstract: Carcinoid tumor is very rare primary tumor in the thymus, first described by Rosai and Levine in 1972. Before Rosai and Levine, it was diagnosed as epithelial tumor of the thymus or bronchial adenoma-like tumor of the mediastinum. Recently the authors experienced a case of primary thymic carcinoid tumor diagnosed by histopathologic, histochemical, and electronmicroscopical study. A 54 years old policeman was admitted for surgical intervension, because of a chest mass that was detected in routine chest x-ray. He had been well being until the mass was found. On admission, physical examination was all within normal limit. Laboratory findings were within normal limit, except the fasting blood sugar was 141㎎/㎗, and postprandial sugar, 225㎎/㎗. An exploratory thoracotomy was performed, and an anterior mediastinal mass was easily removed. During the operation, any metastatic mass or other abnormalities were not observed. The mass was a well encapsulated multilobulated mass, measured 12.0×6.5×7.0㎝ and weighing 280gm. On cut section, it revealed homogeneous tan gray lobulated cut surface with firm consistency. Any necrotic and hemorrhagic areas were not found grossly. Microscopially this tumor consisted of diffuse pattern of monomorphic cells, or rosette-forming area, and ribbon-like arranged areas. Argyrophil stain revealed scattered argyrophil cells, and argentaffin stain was negative. Electronmicroscopic study revealed some membrane-bounded electron dense granule which were measured 50-150nm, in the cytoplasm. That were consistent with neurosecretory granules, found in the carcinoid tumor of the foregut.

Teratoma of the placenta -Report a case and a review of literatures-: Che Kyung Moon, Dong Wha Lee, Duk Yong Kang; Korean J Cytopathol. 1983;17(4):452-456.

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Abstract: Placental teratoma is extremely rare and a few cases have been described. Because of the extreme paucity of material, there is the uncertainty of origin and the apparent controversy regarding diagnostic criteria. We experienced a case of placental teratoma and reported here with brief review literatures. This case was a primigravida aged 26 years. At 42 weeks of gestation, she delivered 3150gm normal male baby and the tumor was noted between chorionic and amnionic membrane. The tumor was oval round and completely covered with whitish wrinkled skin except the stalk portion. Microscopically, the tumor was surfaced by mature skin with skin appendages. Deeper tissue was composed of a variety of mature structures including adipose tissue, smooth muscle, lymphoid tissue, blood vessels, cartilage and bony tissue, nerve fibers, ganglion cells and glial tissue. The distinction between the tumor and fetus amorphus was made on the absence of umbilical cord and the total organization failure of the tissue, in particular axial skeleton.

Plasmacytoma of the Lung -Report of a case-: Kyo Young Lee, Eun Joo Suh, Won Il Kim, Sang In Shim, Chong Moo Lee; Korean J Cytopathol. 1983;17(4):457-461.

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Abstract: A rare case of solitary plasmacytoma of the lung in a 66-year-old woman is presented. The diagnosis was made after a pneumonectomy for the presence of a mass in the left lung. The light microscopic, ultrastructural and immunohistochemical studies were done. Microscopic examination revealed sheets of well differentiated plasma cells interspersed with markedly atypical plasma cell. Peroxidase-antiperoxidase staining and immunofluorescent studies showed the neoplastic plasma cells to be producing a monoclonal immunoglobulin (Ig M, kappa). Ultrastructural examination showed neoplastic plasma cells packed with rough endoplasmic reticulum cysternae which were markedly dilated and filled with homogeneous, moderately electron-dense material. A brief review of the literature was done.

Congenital Cystic Adenomatoid Malformation of the Lung -An autopsy case-: Jin Hee Sohn, Woo Ho Kim, Je Geun Chi, Sang Kook Lee; Korean J Cytopathol. 1983;17(4):462-466.

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Abstract: Congenital cystic adenomatoid malformation (CCAM) of the lung is a rarest form of the congenital pulmonary cystic disease. This lesion was initially introduced in the English literature by Chin & Tang in 1949. Thereafter, many other cases were reported. In Korean literature, nine cases were reported previously. Recently we have experienced a case of CCAM born with generalized edema associated with maternal hydroamnios. This premature baby was delivered at 30 weeks of gestation. At autopsy, right lower lung showed a large cystic mass which had a connection to the bronchus. This mass compressed the superior vena cava and the right atrium. Microscopically the cystic mass was characterized by coarsely trabeculated pattern with numerous cystic spaces that were lined by respiratory epithelium or tall columnar epithelium. Gland-like spaces or alveolar spaces that are lined by simple cuboidal or columnar epithelium with occasional mucus-producing cells were also noted. Bronchial mucous gland and cartilage were not found. Other lobes of lung and the remaining organs did not show any specific anomalies.

Acinar Cell Carcinoma of the Pancreas -A case report-: Jae Bok Park, Yong Jin Kim, In Soo Suh; Korean J Cytopathol. 1983;17(4):467-471.

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Abstract: Most of nonendocrine pancreas carcinoma are originated from duct cell. Acinar cell carcinoma of the pancreas is a are malignancy. It is characterized by acinar or tubular structures composed of abundant granular cytoplasmic cells. resembling normal exocrine glands of the pancreas. Ultrastructurally, the neoplastic cells contain homogeneously dense zymogen granules enclosed by their membranes and abundant RER in the cytoplasm. A case of acinar cell carcinoma of the pancreas is encountered in 54-year-old male patient. An electron microscopic examination of the tumor with a review of literature was done.

Hydranencephaly (An autopsy case report): Jin Sook Jeong, Jong Eun Joo, Sook Hee Hong, Gun Chi Je*; Korean J Cytopathol. 1983;17(4):472-476.

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Abstract: Hydranencephaly is characterized by absence of cerebral hemisphere forming unilocular sac, intact meninges and a rather normal skull vault. The wall of the sac is coposed of meninges and some of dense glial tissue and the sac is filled with cerebrospinal fluid. This anomaly is considered to be the result of secondary destruction of a brain after having developed to a certain degree of maturation, and accordingly should be distinguished from anencephaly that is always associated with acrania. We report a case of hydranencephaly in a still-born female delivered after 38 weeks gestation from a 33 year-old multipara woman who was uneventful during this preganancy. She measured 4.1㎏ in weight and 54.0㎝ in height. There was no anomalies on external examination except for an enlarged head, 40㎝ in occipito-frontal circumference. The brain was changed to unilocular sac showing remnants of cerebrum, midbrain, and cerebellum on the floor of the cranium. The sac was filled with xanthochromic cerebrospinal fluid, about 600㏄ in toto, and was walled off by intact meninges and skull bone. Microscopically, the thin membranous wall of the sac consisted of leptomeningeal layers closely connected with inner glial tissue. The cerebellum and remaining brainstem as well as spinal cord were preserved. No other internal anomalies were found.

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