Equine motor neuron disease (EMND) is a spontaneous neurologic disorder of horses, which results from the degeneration of motor neurons in the spinal cord and brain stem. An 8-year-old Jeju pony gelding presented with weight loss, muscle tremors, frequent recumbence, low head carriage, sweating, and standing with four limbs close together. The gelding has been on the same stable and limited access to pasture for several years. The gelding has been fed with dried hays and commercial concentrated feeds. Laboratory test revealed very low serum vitamin E level (0.14 ${\mu}g/mL$; reference range > 1.5 ${\mu}g/mL$), mildly elevated creatine kinase (402 IU/L; reference range 119-287 IU/L) and aspartate aminotransferase (876 IU/L; reference range 226-336 IU/L). Oral glucose absorption test showed decreased glucose absorption. Histopathologic examination using a biopsy specimen from sacrocaudalis dorsalis medialis muscle revealed atrophic and hypertrophic muscle fiber, centralization of nucleus, degenerating and necrotic muscle fibers. Taken together, the gelding was diagnosed as EMND. After oral vitamin E administrated for 5 weeks, the gelding showed normally improved stance, decreased periods of recumbency, improved head carriage and weight gain except consistent tremors. This is the first report that successfully treated EMND case occurred in a Jeju pony in Korea.
Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.
Evaluation of the resected margins of the frozen section during breast-conserving surgery can determine the presence of cancer cells in a short time and have a significant impact on the scope of surgery and the prognosis of the patient. However, breast tissue is composed of adipose tissue, which affects the accuracy of the test. In this study, a new method was applied to the resected surface of the frozen section in which wiping the surface of the frozen section block with alcohol was expected to expose the parenchyma to the surface as the adipose tissue would melt momentarily. Indeed, of the total of 98 cases, 37 cases showed a better exposure ratio of the parenchyma in the improved frozen section test than in the previous frozen section test. Of the 37 cases with increased visibility of parenchymal sections obtained by this method, two cases of ductal carcinoma in situ (DCIS) were detected. Although there are limitations such as turnaround time (TAT), the diagnostic accuracy of histopathologic examination of the frozen section may improve through this method and may have a direct impact on patient safety, and should therefore be researched further.
Purpose: Malignant Mixed Mullerian Tumor (MMMT) of the uterine corpus is one of the very uncommon and the most lethal tumors in the uterus. The aim of this study was to evaluate the role of FDG PET in detecting distant metastasis and residual and/or recurrent disease. Methods: Ten patients who underwent FDG PET for detecting distant metastasis and recurrence were included. focal FDG accumulation was regarded as abnormal. We also reviewed serum CA 125 levels, anatomical images, and histopathoiogical examination. Results: Three patients of 10 FDG PET showed abnormal FDG uptake. One had high serum CA 125 levels and high fractions of carcinomatous element on histopathologic examination. FDG PET showed metastatic lesions in unexpected locations, which could not be detected by anatomical images. Another had normal serum CA 125 levels with high sarcomatous element and CT could only detect a few lesions. The other had high serum CA 125 levels and also had high carcinomatous element. Seven patients who had no abnormal uptake on FDG PET had no clinical evidence of recurrence during the follow up period ($51.7{\pm}12.2$ months). The mean disease free intervals of these 7 patients were $36.4{\pm}6.0$ months. Two patients with abnormal findings had never become disease-free condition during the follow up period ($6.0{\pm}4.2$ months. Conclusion: FDG PET could be a useful modality for unexpected distant metastasis and follow up tool in patients with MMMT.
The present study was performed to investigate the effect of iohexol-ethanol mixture and barium-ethanol mixture on the induction of transcatheter renal artery embolization in healthy 18 dogs, which were divided into two groups of 9 dogs and the 9 dogs were divided into 3 subgroups of 3 dogs. The renal artery embolization was undertaken unilaterally with the dose of 1.5, 2.0, and 3.0 ml/kg iohexol-ehtanol mixture and with the dose of 0.2, 0.4, and 0.8 ml/kg barium-ethanol mixture. And serum chemistry on 0, 1,3, 7, and 14 days, intravenous pyelography on 7days, angiography on 14 days, and histopathology on 14 days were evaluated. Serum BUN and creatinine concentration of two groups with iohexol-ethanol mixture and barium-ethanol mixture administration were mildly increased a t 1 day after injection of embolic materials and then returned to baseline. No significant changes in BUN and creatinine levels occurred in any of dogs. In all dogs with the dose of 1.5 ml/kg iohexol-ethanol mixture, the renal arteries were not embolized. All dogs with the dose of 3.0 ml/kg died. In all dogs with the dose of 2.10 ml/kg, the treated arteries were completely occluded. In barium-ethanol mixture administered group, the renal artery in one dog with the dose of 0.2 ml/kg was not embolized. In all dogs with the dose of 0.8 ml/kg, the renal arteries were completely embolized, but loac overembolization occured in two dogs. All animals with the dose of 0.4 ml/kg had effective embolization and no evidence of radiopaque barium opacity in systemic arteries distal to the renal-artery was found. All embolized kidneys were shrunk and decreased in size in gross examination and were shown diffuse necrosis in histopathologic examination. In the present study, renal arteries were embolized with the dose of 2.0 ml/kg iohexol-ethanol mixture or 0.4 ml/kg barium-ethanol mixture. And it is considered that the dose had a satisfactory embolic effect.
Background: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. Material and Method: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at $-70^{\circ}C$ without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. Result: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. Conclusion: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.
Purpose : In order to understand in vivo radiation damage modifying of bFGF on jejunal mucosa, bone marrow and the effect of bFGF on the growth of transplanted mouse sarcoma 180 tumor in mice. Materials and Methods : Mice were treated with $6\;{\mu}g$ of bFGF at 24 hours and 4 hours before exposing to 600 cGy, 800 cGy and 1,000 cGy total body irradiation (TBI), and then exposed to 3,000 cGy local radiation therapy on the tumor bearing thigh. Survival and tumor growth curve were plotted in radiation alone group and combined group of bFGF and irradiation (RT). Histologic examination was performed in another experimental group. Experimental groups consisted of normal control, tumor control, RT (radiation therapy) alone, $6\;{\mu}g$ bFGF alone, combined group of $3\;{\mu}g$ bFGF and irradiation (RT), combined group of $6\;{\mu}g$ bFGF and irradiation (RT). Histologic examination was peformed with H-E staining in marrow, jejunal mucosa, lung and sarcoma 180 bearing tumor. Radiation induced apoptosis was determined in each group with the DNA terminal transferase nick-end labeling method ($ApopTag^{\circledR}$ S7100-kit, Intergen Co.) Results : The results were as follows 1) $6\;{\mu}g$ bFGF given before TBI significantly improved the survival of lethally irradiated mice. bFGF would protect against lethal bone marrow syndrome. 2) $6\;{\mu}g$ bFGF treated group showed a significant higher crypt depth and microvilli length than RT alone group (p<0.05). 3) The bone marrow of bFGF treated group showed less hypocellularity than radiation alone group on day 7 and 14 after TBI (p<0.05), and this protective effect was more evident in $6\;{\mu}g$ bFGF treated group than that of $3\;{\mu}g$ bFGF treated group. 4) bFGF protected against early radiation induced apoptosis in intestinal crypt cell but might have had no antiapoptotic effect in bone marrow stem cell and pulmonary endothelial cells. 5) There was no significant differences in tumor growth rate between tumor control and bFGF alone groups (p>0.05). 6) There were no significant differences in histopathologic findings of lung and mouse sarcoma 180 tumor between radiation alone group and bFGF treated group. Conclusions : Our results suggest that bFGF protects small bowel and bone marrow from acute radiation damage without promoting the inoculated tumor growth in C3H mice. Improved recovery of early responding normal tissue and reduced number of radiation induced apoptosis may be possible mechanism of radioprotective effect of bFGF.
Chung Eun Ji;Lee Yong Hee;Kim Gwi Eon;Suh Chang Ok
Radiation Oncology Journal
/
v.15
no.4
/
pp.369-377
/
1997
Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.
Background: In addition to clinical and radiographic findings, a histopathologic examination is important in the diagnosis of sarcoidosis. This study evaluated the diagnostic usefulness of a scalene node biopsy in patients with suspected sarcoidosis. Material and Method: We studied 35 patients who underwent scalene node biopsy because of suspicion of sarcoidosis on a chest x-ray and a computerized tomogram between 2001 and 2009, regardless of symptoms. Result We studied 15 men and 20 women whose mean age was $41.51{\pm}11.21$ years (25~64). Three among the 35 were diagnosed with tuberculosis and 27 with sarcoidosis, resulting in a diagnostic yield of 84.4%. The mean lymph node diameter size was 1.3 (${\pm}0.12$) (0.3~3.6 cm) cm. We divided the group of participants according to stage - whether on chest x-ray the lung was affected or not (stage 0, 1 and stage 2, 3). We divided lymph node sizes as well - whether they were larger than 1 cm or smaller than 1 cm. For these subgroups, there were no significant differences in diagnostic yield (p=0.604) (p=0.084). There were no complications or mortality. Conclusion: Scalene node biopsies are simply done under local anesthesia, without major complications. They have a high diagnostic yield regardless of the stages of the disease and lymph node size. We conclude that scalene node biopsy is a good alternative to other biopsy methods in sarcoidosis.
A 10-year-old, castrated poodle dog presented with a cough for 2 weeks, and the cough initially developed since very young age. On radiographs, pneumothorax was noticed by characteristics of radiolucent area without pulmonary markings along the thoracic wall and diaphragm, retracted lung lobes from the thoracic wall and severely decreased volume of the left cranial lung lobe with disconnected bronchus. Computed tomography (CT) findings identified several pulmonary air-filled cysts and collapsed lung with abnormal shape and non-tapered end of bronchus, bronchioles at the accessory lobe and left cranial lobe. Also, pneumothorax, pneumomediastinum and subcutaneous emphysema were found. Imaging diagnosis was the spontaneous pneumothorax caused by ruptured emphysematous bullae associated with congenital bronchial cartilage abnormality or bronchial tree malformation. On surgery, hypoplasia of the left cranial lobe, right middle lobe, and accessory lobe with a bulla where air was leaking was identified. The accessory lobe was partially resected and bronchial cartilage hypoplasia was confirmed by histopathologic examination.
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