Journal of Pathology and Translational Medicine

Volume 11(1); April 1977

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A Clinico-Pathologic Study in Adenomyosis and Endometriosis: Eu Han Kim, Dale Lee, Seung Yong Paik; J Pathol Transl Med. 1977;11(1):1-6.

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Abstract: The author performed clinico-pathologic study of adenomyosis and endometriosis from 446 cases of hysterectomized uterus which were operated during January 1971- December 1975. The results are summarized as following. 1. Adenomyosis was noted in 74 cases (16.6%) among 446 cases of hysterectomized uterus. 2. The most frequent age group of the adenomyosis was 41-45 showing 24 cases (32.4%) and that of endometriosis was noted on age group 31-35 revealing 6 cases (30%) among total 20 cases. 3. The most frequent chief complaints among 74 cases of adenomyosis and 20 cases of endometriosis were irregular uterine bleeding (31 cases) and lower abdominal pain(29 cases) 4. Most cases of adenomyosis and endometriosis were operated under the preoperative diagnosis as uterine myoma (43 cases, 45.7%) and only 2 cases were diagnosed, preoperatively, as adenomyosis. 5. Most of cases were noted among multipara and the ratio of multipara to nullipara was 8 : 1. 6. Histologic picture of the endometrium of hysterectomized uterus was mostly in proliferative phase (24 cases, 32.4%) and cystic hyperplasia was infrequently (7 cases, 9.5%) noted. Histologic picture of the adenomyosis revealed cystic hyperplasia in 52.7% (39 cases), proliferative phase in 28.4% (21 cases) and secrectory phase in 12.2% (9 cases). That of endometriosis disclosed secretory phase in 45% (9 cases), endometrial hyperplasia in 25% (5 cases) and proliferative phase in 15% (3 cases). 7. Among 74 cases of adenomyosis, oophorectomy was performed in 63 cases and histologic picture of the ovaries revealed follicular cyst in 27 cases (42.9%) and hyperplasia of cortical stroma in 23 cases (36.5%). 8. About half cases of edometriosis were located in ovaries (11 cases) and other sites such as pelvic peritoneum, uterine cervix, oviduct, regional lymphnode, abdominal wall, operative scar, appendix, mesentery were infrequently noted.

The Effects of Cortisone and Estrogen on the Functional and Morphological Modification of the Reticuloendothelial System of the Rats Treated with Methylcellulose: Kang Hyuk Yoon; J Pathol Transl Med. 1977;11(1):9-22.

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Abstract: Because cortisone has a depressive effect on the RES, while estrogen has stimulating effect on it, it was thought to be of interest to compare the two hormones with regard to the effect on modification of the reticuloendothelial organs of the rats treated with methylcellulose. The phagocytotic activity was assessed by carbon clearance method, and the morphological investigation was carried out on the reticuloendothelial organs, liver and spleen. The results obtained were as follows. 1. In the methylcellulose-treated group, the phagocytotic activity was shown, to be decreased as compared with that of the normal rats. There was marked proliferation of macrophages phagocytosed methylcellulose, but no increase in acid phosphatase activity, PAS positive granules and hemosiderin granules was noted. 2. In the methylcellulose plus cortisone-treated group, the phagocytotic activity was shown to be more decreased than that of methylcellulose or cortisone-treated group. The liver stowed slight fatty metamorphosis and more markedly increased activity of phosphatase, but relatively normal architecture was maintained. The spleen showed conspicuous regressive changes such as atrophy of the follicles, necrosis and marked reduction in hemosiderin granules. 3. In the methylcellulose plus estrogen-treated group, cellular and functional alterations of the reticuloendothelial organs seemed to be similar to those of methylcellulose-treated group. From these results, it may be concluded that cortisone influences markedly the functional and cellular modification of the reticuloendothelial organs of the rats treated with methylcellulose. On the contrary, however, estrogen dose not.

The Precision of Normal Ranges Determined by Means of Random Samples from Normal Populations: Chang Soo Chung; J Pathol Transl Med. 1977;11(1):23-48.

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Abstract: This study was undertaken to lay down some definite criterion for the evaluation of the precision of abnormal range determined by means of a random sample form a normal population. There are two types of abnormal range. In the first type an abnormal range is set up unilaterally and in the second type bilaterally in a normal distribution. In the first type an abnormal range sized 100α% is assumed to be set up on the right side in a normal distribution N(μ, δ²). In the parametric method to determine the normal range is to estimate the lower limit of the abnormal range sized 100α% by

were and s are the mean and standard deviation of a n-sized random sample from a normal population N(μ, δ²) and K_α is the value defined as follows:

where Φ(u) is the standardized normal distribution N(0.1²). Y₁is a random variable which varies from sample to sample and is distributed normally with mean

and variance

since and s are stochastically independent and the former is distributed normally with parameters (μ, δ²/n) and the latter with parameters (c₁δ, (c₂δ)²), where c₁=1-1/4n and c₂=1/. Then, the upper and lower limits of the middle 100p%-range of Y₁denoted by Y₁₍₊₎(Χ_p) and Y_1(-)(Χ_p) are easily obtained by the following formulas:

where Χ_p is the square root of 100p%-fractile of Χ²-distribution with d.f.1, that is, Χ_p²(1) and . Now, let us estimate the 100α%-size of the abnormal range by u₁₍₊₎(Χ_p) and u_1(-)(Χ_p) which are obtained by the following transformation,

The estimates of the 100α%-size of the abnormal range by Y₁₍₊₎(Χ_p) and Y_1(-)(Χ_p) denoted by â₁(Χ_p) and â_1(-)(Χ_p) correspondingly are

Hence

where

Accordingly, it can be stated that 100p% of the estimated values of the 100α%-size of the right abnormal range are between â₁₍₊₎(Χ_p) and â_1(-)(Χ_p). By the same argument it could easily be varified that 100p% of the estimated values of the same size of a left abnormal range are between the same limits. It is evident that by the formula(1.7.1) we can evaluate the precision of the estimate by a n-sized random sample of the 100α%-size of the abnormal range set up unilaterally in a normal distribution. Now the second type of normal range is considered. This type is assumed to be characterized by bilateral abnormal ranges with equal size of 100α% set up on both the right and the left side in a normal distribution N(μ, δ²). In this case the upper and lower limits of the normal range are estimated

where and s are the mean and standard deviation of a n-sized random sample which are distributed normally with parameters (μ, δ²/n) and (c₁δ, (c₂δ)²), correspondingly. So the point Y(,s) follws a two dimensional normal distribution with correlation coefficient o. If the closed domain which is defined by the contour ellipse, E(Χ_p), corresponding to the probability p determined by Χ_p²(2) in the s-plane is denoted by
A(Χ_p),

where Χ_p is the square root of Χ_p²(2). Now let us standardize the two variable and s by the follwing transformation,

then the point U(u₁, u₂) follows the standardized two dimensional normal distribution with correlation coefficient o. If the closed domain which is defined by the contour ellipse, E’(Χ_p)_γ corresponding to the probability p determined by Χ_p²(2) in the u₁u₂-plane is denoted by A’(Χ_p)_γ again

Here it is worthy of note that there is one to one correspondance between Y∈A(Χ_p) and U∈A’(Χ_p) and that E’(Χ_p) is a circle with radius Χ_p and center (0,0) in the u₁u₂-plane. By the inverse transformation of (2.3)

Substituting these for and s in the equiations (2.1.1) and (2.1.2)

For the estimation of the 100α%-size of each abnormal range set up bilaterally, it is necessary to standardize
Y_(±) by using μ and δ as follows:

where the symbols t_(±)(u₁, u₂) indicate the standardized deviates of Y_(±). If the estimates of the 100α%-size of the abnormal range set up bilaterally by Y∈A(Χ_p) and U∈A’(Χ_p) that corresponds to Y∈A(Χ_p) are denoted by â_(±)(Y∈A(Χ_p) and â_(±)(U∈A’(Χ_p), correspondingly, then

By summing (2.8.1) and (2.8.2) a new function of U(u₁, u₂),

is introduced to estimate the 100(2α)%-size of the abnormal ranges. Since E’(Χ_p) is a circle with radius Χ_p and ceter (0,0) t_(±)(U∈E’(Χ_p))-equivalent to t_(±)((u₁, u₂)∈E’(Χ_p))-can be expressed in terms of polar coordinates by putting u₁=Χ_pcosΘ and u₂=Χ_psinΘ as in the following:

By substituting these for the end values t_(±)(u₁, u₂) in the integrals (2.8.1), (2.8.2) and (2.8.3), these become

and

Examining the variation of the function of Θ, â(U∈E’(Χ_p), it is found that the function has the minimum value at the point (Χ_p, π/2)∈E’(Χ_p) and the maximum value at the point (Χ_p, 3π/2)∈E’(Χ_p) and that

that is,

Now it is evident that by the formula (2.11.1) we are able to evaluate the precision of the estimate by a n-sized random sample of 100(2α)%-size of the abnormal ranges set up bilaterally in a normal distribution. At the end of this paper, tables are provided which are available for the evaluation of the precision of estimates of normal or abnornal ranges by random samples from normal populations.

Electron Microscopic Study on the Plasmacytogenesis in the Autotransplanted Spleen: Sun Moo Kim; J Pathol Transl Med. 1977;11(1):49-55.

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Abstract: Recently serial experimental studies on the transformations of reticular cells into plasma cells were reported by co-workers in our department. They confirmed histologically the transformation in the thymus from irradiated rats; in the spleen and lymph node from adrenalectomized rats and treated with cortisone or DOCA; in the transplanted spleen; and also autoradiographically in the spleen and the lymph node from the rats treated with cortisone, DOCA or from adrenalectomized rats. It is a well known fact that the plasma cell is most easily differentiated from the lymphocyte by the characteristic feature that is richness of rER in the cytoplasm. Thus the author applied electron microscopy to this study. Materials find Methods ; Albino male rats, weighing approximately 200 gms, were used. The transplantation of the spleen were performed by the Cameron and de Saram method. The experimental rats were divided into 10 groups. The transplanted spleen were histologically (H & E, methyl green pyronin, van Gisson) and electron-microscopically observed.
Results
; Within 3 days implanted spleen fragments became almost completely necrotic but splenic capsule, trabecauae and reticular tissues were remained. The beginning of regeneration usually started subcapsularly. At the 4th day the invasion of newly formed capillary accompanied with fibrous tissue appeared extracepsularly, and then appeared subcapsularly. The regenerative cells appeared at first in the subcapsular reticular tissue and they were characterized by round oval vesicular nuclei with abundant cytopiasm. These cells were localized in the subcapsular area forming cell clusters and were strong1y pyroninophilic and quite separated topographically from other leukocytes such as and small lymphocytes, neutrophils which were found around capillaries. These colonized cells had many mitochondria and rER in their cytoplasm, and were strongly indicative of young plasma cells. Such colonization was numerous and, with progress of regeneration, the same colonization of young plasma cells appeared in the newly formed splenic cord. In parallel with progress of regeneration, most cells became mature plasma cells. The cells in the colonization showed electron-microscopically successive transitional pattern from the reticular cells to young or mature plasma cells.
Conclusion
; In the autotransplanted spleen, it was confirmed light and electron-microscopically that the plasma cell arises from the reticular cell in the regenerative spleen.

Hashimoto’s Thyroiditis with Massive Ossification (A case report): Hee Kyung Kim, Hyun Sook Chi, Moon Ho Yang, Hoong Zai Joo, Chae Koo Lee; J Pathol Transl Med. 1977;11(1):57-60.

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Abstract: A case of Hashimoto’s thyroiditis occuring in a 58 year old female is presented, and its pathologic and clinical characteristics are briefly summarized. Severe ossification is an unusual histologic picture, and its pathogenesis is also briefly discussed.

A case Report of Extramedullary Myeloblastic Transformation of Chronic Myelocytic Leukemia: Hyun Sook Chi*, Eui Keun Ham, Sang Kook Lee, Chae Koo Lee*; J Pathol Transl Med. 1977;11(1):61-66.

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Abstract: Enlargement of lymph nodes is rare in chronic myelocytic leukemia. Generlized lymphadenopathy may occur in association with the conversion of the chronic leukemia to a morphologically acute form (blastic transformation) due to infiltration into or proliferation within nodes of myeloblasts. The following case report describes a 23 years old male patient in whom myeloblastic infiltration of generalized lymph nodes were demonstrated one month before blastic transformation of the bone marrow and eleven months after treatment of chronic myelocytic leukemia.

A case of Carotid Body Paraganglioma Arised from the Cervical Region: Kang Hyuk Yoon, Sang Woo Juhng; J Pathol Transl Med. 1977;11(1):69-72.

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Abstract: A case of carotid body paraganglioma in the right cervical region of 26-year-old unmarried woman is presented with review of the relevant literatures. Clinically, she complained of a palpable neck mass and the carotid body paraganglioma was not considered until the histopathological examination of the excised mass was done.

Myelophthisic Anemia: Sook Hee Hong, Myung Woo Lee, Choon Won Kim, Ki Hong Kim; J Pathol Transl Med. 1977;11(1):75-83.

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Abstract: The authors here present two cases of myelophthisic anemia due to metastatic carcinomas from uterine cervix and stomach in HYUH on March and June, 1976, respectively. The following observations are made. 1. Immature myeloid and erythroid cells are present in peripheral blood in both cases, and the quantities of immature white blood cells are 10% and 19% of total white blood cells, respectively, and those of immature red blood cells are 4 and 12 cells per 100 white blood cells, respectively 2. Red blood cell counts and hemoglobins are very decreased in both cases to 3.4gm% and 4.7gm%, respectively. 3. Abnorma1 red blood cell morphologies in peripheral blood such an anisocytosis, tear drop poikilocytosis, polychromatophilia, are observed in both cases. 4. Platelet counts are very decreased in both cases to 6,000/mm3 and 64, 000/mm3, respectively, and large platelets are often observed. 5. Total white blood cell counts are 8,700/mm3 in both cases and the ratio of myeloid to lymphatic element is normal in both cases. 6. In case 1, eosinophil is 20% of total white blood cells. The cause of this relative eosinophilia may be probable due to carcinomatosis or irradiation, or both. 7. Reticulocyte count is 3.6% in case 1. 8. Bone merrow examinations show a metastatic squamous cell carcinoma in case 1 and a metastatic adenocarcinoma in case 2. 9. Primary tumors of these two patients with myelophthisic anemia are considered as squamous cell carcinoma of the uterine cervix in case 1 who, about three and half years ago, were received a total hysterectomy and irradiation due to cervical carcinoma, and adenocarcinoma the stomach in case 2 which is confirmed by U.G.I. study. 10. Radiologic studies are negative for bony metastases in both cases.

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