Journal of Pathology and Translational Medicine

Volume 15(2); June 1981

Etcs

A Study on the Infection Due to Group B, C and G β-hemolytic Streptococci: Young SookChoi, Yunsop Chong, Samuel Y. Lee; J Pathol Transl Med. 1981;15(2):91-99.

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Abstract: Streptococci, pathogenic to human subjects, are mostly β-hemolytic and generally belong to groups A and D. Besides group A and D, organisms belonging to B, C, and G have long been known to cause infections, but their clinical importance has not been recognized until quite recently. The incidence of fatal neonatal infections of group B has been increasing particularly during the last decade. However, there has been only a few reports on group B, C, and G infection in Korea. This study was made to determine serological group of clinical isolates of β-hemolytic streptococci by coagglutination method and to clarify the B, C, and G infection in Korea. β-hemolytic streptococci isolated from Yonsei Medical Center specimen during August 1979 October 1980 were studied and the following results were obtained. 1) A total of 414 isolates were obtained and their groups were: A 19.1%, B 6.3%, C 11.4%, G 13.7%, and nongroupable 49.5%, 2) Groups B, C, and G were most frequently isolated from the respiratory tract specimens. Excluding respiratory sources, group B was mainly isolated from the urogenital tract, and group G from various wounds. 3) Among the 126 patients, who were categorized as having definite infections, 12 yielded group B, 3 group C and 27 group G organisms. There were 8 cases each of the respiratory and urogenital tract infections, and 26 infections on various other sites. 4) From patients under 10 years of age, 50.7% of B, C, and G organisms were isolated. 8.0% of the cultures were isolated from patients 60 years and over. There was a fatal neonatal meningitis and septicemia due to group B organism. The organisms were isolated more frequently from male patients. 5) Majority of the patients who yielded the organisms were found to have underlying diseases such as tissue injury, neoplasm, tuberculosis and diabetes mellitus. It is concluded that group B, C and G streptococci cause respiratory infection not frequently, but they often invade otter sited. Patients with underlying diseases are prone to be infected by the organisms and some of them can be fatal. Therefore it is important to identify not only group A but also 5, C and G organisms.

Histopathological Study of the Jaw Cysts: Jin Kim; J Pathol Transl Med. 1981;15(2):100-109.

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Abstract: Due to the facts that epithelial rests are frequently found in jaw bones and the jaw bones are vulnerable to trauma and infection which would stimulate to proliferate epithelial rest, occurrence of various types of cysts in jaw bones is not infrequently found. However, confusion exists in classification and terminology of the jaw cysts because of uncertainty of histogenesis of the cysts. Present study is, therefore, aimed to find the most rational classification of the jaw cysts with consideration of histopathologic features, clinical characteristics, and review of literatures. The material used in this stuffy consist of 70 cases of the jaw cysts examine at the Department of Pathology Yonsei University College of Medicine for ten year period from 1970 to 1980. All specimens were fixed in 10% neutral formalin. For histologic examination, paraffin embedded blocks were cut in 6 micron thickness and sections were stained by routine Hematoxylin-Eosin method. Classification recommended by World Health Organization in 1971 and description of Robinson in 1975 was applied. Each cases were analysed with clinical, radiological and histopathological findings. 1) Of the total 70 cases, 52(74.3%) were inflammatory periodontal cyst, and 18(25.7%) were developmental cysts. The developmental cyst consisted of 13 cases of dentigerous cysts (18.6%), 3 cases of odontogenic keratocyst, one case of Primordial cyst, and one case of nasopalatine cyst. 2) The peak age incidence of periodontal cysts was in the fourth decade of life with a wide age range, and developmental cysts were usually found in the second and third decades. There was a slight male predominance with the male to female ratio being 4:3. 3) The most common location of periodontal cysts was on the anterior aspects of the maxilla, and the majority of dentigerous cysts occurred in association with impacted supernumerary teeth in the maxilla. Multiple cysts were found in 2 cases of odontogenic keratocysts. 4) The most common complaints were swelling and pain. Other symptoms included pus discharge, trismus and delayed eruption of tooth. 5) Histologic type of epithlium lining cysts showed mainly stratified squamous epithelium, and ciliated cells were found only in the nasopalatine cyst. Inflamed fibrous wall was found predominantly in inflammatory periodontal cysts. 6) Heterogenous histological features of dentigerous cysts showed keratinization in 3 cases, hyaline bodies and calcification in 2 cases and adenoameloblastoma in one case. Metaplastic mucous cells were found focally on the lining epithelium in 2 cases of dentigerous and one case of periodontal cysts. 7) One case of odontogenic keratocysts showed microcyst formation in the fibrous wall. It is considered that this finding is the histologic evidence of high recurrence rate of odontogenic keratocyst.

Studies on Anaerobe Infection: Use of Gas Liquid Chromatography for Anaerobe Identification: Hee Joo Lee, Ae Ja Park, Yunsop Chong, Samuel Y. Lee; J Pathol Transl Med. 1981;15(2):110-118.

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Abstract: Anaerobic bacteria are organisms that could grow only in the abscence of free oxygen. Therefore it is very difficult to culture the organisms. Anaerobic infections are often neglected not only because of the difficulty of cultivation but also of identification which require analysis of fattyacids. As the isolates in Korea have not been subjected to fatty acid analysis, our knowledge in anaerobe infections are very limited. This study was conducted to identify clinical isolates of anaerobes accurately with the use of gas liquid chromatography(GLC) and to determine the relationship between anaerobe species and the infection. Clinical specimens obtained at YUMC during the period of September 1979-August 1980 were cultured anaerobically and the anaerobes isolated were identified with GLC if necessary. Clinical conditions were reviewed retrospectively. Following results were obtained. 1) A total of 342 anaerobic organisms were isolated from 282 clinical specimens. Most frequently isolated anaerobes were Pc. asaccharolyticus, Ps. anaerobius, S. intermedius, Cl. perfringens, B. fragilis and B. melaninogenicus. 2) Anaerobes were most frequently isolated from specimens of thorax, abdomen and soft tissue wound. 3) With the review of 118 available patients' records, it was found that most frequent clinical conditions were appendicitis with peritonitis, wound infection following GIT cancer surgery, empyema, lung abscess, and infection of umblicus of new-torn and soft tissues. 4) Only 18.4% of the specimens yielded anaerobes alone, and the remaining 81.6% yielded both anaerobes mixed with aerobes. 5) With the use of GLC, up to 94.4% and 94.1% of isolates unidentifiable by conventional methods, were satisfactorily identified during the periods of September 1979-May 1980 and June 1980-August 1980 respectively.

Studies on Ornithine Amininotransferase from Human Tissues: Man Soo Song; J Pathol Transl Med. 1981;15(2):119-123.

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Abstract: The properties of ornithine aminotransferase, which catalyzes the transfer of S-NH2 group of ornithine to α-ketoacids were characterized in the post-mortem human tissues. The enzyme was distributed in all human tissues tested especially high in small intestine and its activity was increasing in liver and kidney but decreasing in small intestine with age. The intestinal enzyme being reactive with α-ketoglutarate, glyoxylate, pyruvate and oxaloacetate in decreasing order was very heat-unstable but its inactivation by heat-treatment was partially prevented by the presence of pyridoxal phosphate. The enzyme was completely inhibited by p-hydroxy-mercuritenzoate, suggesting that SH-group of enzyme protein is essential for catalytic action.

Bacteriological Investigation of the Bile and A Review Eleven Cases of Acalculous Cholecystitis: eong Ok Kang, Myoung Hee Ahn, Seung Haham Park, Ki Hong Kim; J Pathol Transl Med. 1981;15(2):124-129.

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Abstract: Many studies have been reported by various observers on the bacteriology of acute and chronic cholecystitis. But only a few have reported in Korea. The purpose of the present investigation was to analyse the incidence of bacteria in acute and chronic cholecystitis and to define the predisposing factors of acalculous cholecystitis. Bacterial studies of the bile were made in 47 patients with acute and chronic cholecystitis who were operated upon on the Han Yang University Hospital during the 6 year period from 1975 to 1980. The following results were obtained. 1) In 95 cases of bile culture, total 77 strains of bacteria were isolated. The bacterial flora consisted of E. Coli 38 strains, Proteus 7 strains, Enterobacter 5 strains, Pseudomonas 4 strains, Klebsiella pneumoniae 4 strains, Enterococci 4 strains, Gram negactive nonfermentative bacilli 3 strains, Coliform bacilli 3 strains, Serratia 2 strains, and Providencia, Aerotacter, Alkaligenes faecalis, Staphylococcus epidermidis each one strain respectively. 2) In total 47 patients of cholecystitis, 76.6% were culture-pcstive. In 30 cases of chronic cholecystitis, 76.7% were culture-positive and in 17cases of acute cholecystitis, 76.5% were culture-positive, 3) Acalculous cholecystitis was 23.4% (11 cases), and hypochorhydria, cholangitis, liver abscess, pancreatic abscess, Ascaris lumbricoides, Clonerchis sinensis were regarded as predisposing factors.

The Influences of Prolonged Venous Stasis and Blood Sample Standin on Laboratory Results: Koo Weon Jeong, Hea Ran Park, Myong Joon Cho; J Pathol Transl Med. 1981;15(2):130-135.

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Abstract: The influences on the laboratory results by venous stasis and standing blood samples were studied. The results were: 1) By 3 minutes of venous stasis, the statistically significant for Hb, Hct and RBC (P<0.05). The biochemical data showed significant differences for K, T. Prot, T.Bill, Alk. Pho. and Chol (p<0.05). 2) Biochemical data revealed statistically significant changes for Na, K, Creat and Gluc after 12 hours of standing blood samples in refrigerator and for Na, K, BUN, Creat, T. Prot, Alb and Gluc after 24 hours of storage. The laboratory results are greatly influenced by minute careless pre-lab. sample handlings and the necessities of such prelaboratory cares are discussed.

A Study on the Origin of Plasma Cell (Demonstration of Plasma Cell of the Thymus Following Whole Body X-irradiation by Immunofluorescent Antibody Technique): Young Che Kim, Sang Ho Kim, Soo Young Lee; J Pathol Transl Med. 1981;15(2):136-141.

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Abstract: It is generally accepted that the plasma cells are transformed from mature lymphocyte through antigenic stimulation, but the origin of the plasma cell is still of dispute. Many authors in our institute, since 1964, have reported that the plasma cell is derived from the reticular cell, by means of autoradiography and electron microscopy, based on the study of the thymus after whole body irradiation cortisone treatments and adrenalectomy. An attempt was made to observe whether IgG was produced by the proliferated pyroninophilic cells in the thymus following whole body X-irradiation or not, and the proliferating mode of the IgG-producing cells by means of immunofluorescent microscopic observation. Normal Sprague-Dawley rat-serum IgG was purified, and anti-rat serum IgG-rabbit immunoglobulin was prepared. Immunofluorescent microscopic observation was made on the thymus from the rat 12, 36, 48, 72 and 96 hours following whole body X-irradiation. The result was as follows; IgG was appeared to be produced by the proliferated pyronlnophilic cellssin the thymus, and the IgG-producing calls were appeared in colony-formation.

A Study of Histopathological Type of Gastric Carcinoma Among Koreans: H.B. Moon, D.W. Rayng*, K.H. Yoon, J.Y. Yoo*, K.H. Cho; J Pathol Transl Med. 1981;15(2):142-150.

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Abstract: This study was designed to investigate to incidence of histopathologlcal type of stomach cancer by WHO classification among Koreans. Total 831 cases of gastric carcinoma were evaluated and the possible relationship of each histopathological type with age, sex, degree of invasion and metastasis, etc. was analysed. The results obtained were as follows. 1) The overall incidence of gastric carcinoma was 4.5% among total biopsy specimens, which was seemed to be increased annually. 2) Histologically, adenocarcinoma was most common type (73.1%) and undifferentiatecl carcinoma was next in order of frequency (25.6%). Among the cases of adenocarcinoma, incidence of subclassified type was as follows in order of frequency; tubular type(50.3%), mucinous type(10.2%), signet ring cell type(9.6%) and papillary type (2.4%). 3) Male to female ratio for gastric carcinoma was 2.14 : 1. 4) The mean age of gastric carcinoma patients was 52.4 years, which was 53.7% years in male and 49.7 years in female. 5) Compared to other histopathological types, signet ring cell carcinoma, mucinous carcinoma and undifferentiated carcinoma were more frequently observed in female, of which mean age was lesser than of other types. 6) Incidence of early cancer was only 8.8% among 419 gastrectomized cases. Serosal involvements were, however, occurred in 39.6% of all gastrectomized cases and this high degree of invasion was more frequently observed in signet ring cell carcinoma, mucinous carcinoma and undifferentiated carcinoma. 7) Incidence of metastasis in gastric carcinoma was 72.9% among 218 specimens. However, there was no appreciable correlation between frequency of metastasis and histological types. 8) Combination of one major histological type with other minor ones was shown in 31.3% of gastric carcinomas. But, the interrelationship between histological types in combined patterns was not correlated each other and randomly distributed.

A Statistical Study of Tumors Among Koreas (mainly in Honam area): Jang Sihn Sohn, Dong Kyu Chung; J Pathol Transl Med. 1981;15(2):151-159.

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Abstract: A statistical analysis of tumor was carried out on the basis of histopathological diagnosis of the Presbyterian Medical Center during 17 years from 1963 to 1979. 1) In this study, the total number of tumor patients was 11,953,2957 (24.7%) benign and 8,996 (75.3%) malignant. 2) The male to female ratio for all malignant tumors was 1.5 : 1. 3) Age distribution of malignant tumor was as following, 31.0% between 51 years to 60 years, 29.0% between 41 years to 50 years, 15.5% between 61 years to 70 years. 4) Frequent organs involved by malignant tumor was in the order of stomach(32.1%), uterine cervix(11.9%), liver(6.6%), lymph node(5.7%), luog(5.0%). In the male, the order was stomach, liver, lung, Iymph node and rectum. In the female, it was in the order of uterine cervix, stomach, breast, rectum and thyroid. 5) Histopathological classification of all malignant tumor was in the order of adenocarcinoma(49.6%), epidermoid carcinoma(30.9%), hepatocellular carcinoma(6.8%), infiltrating ductal carcinoma(2.9%), undifferentiated carcinoma (2.5%). 6) The most common benign tumor was polyp(21.8%). 7) Frequency of stomach carcinoma was much higher than other report.

Effects of Fractionated CCl4 Pretreatrnents on the Hepatotoxicity of CCl4: Sam Im Choi, Joo Yong Yoo; J Pathol Transl Med. 1981;15(2):160-165.

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Abstract: The effects of fractionated CCl4 pretreatments on the hepatotoxicity of CCl4 were studied. Rats were pretreated twice with subcutaneous injections of CCl4 (0.05m1/100g, 0.1m1/100g) and saline (0.1-0.2m1/100g). At 72 hours after pretreaments, 0.2m1/100g of CCl4 was given intraperitoneally, and the animals were sacrificed 24 hours later. Functional and morphological alterations of the liver were as follows. 1) Pretreatnlents of rats with CCl4 (especially in 0.1m1/100g) results in a significant increase in SGOT, SGPT and Alk-Pase level, and a decrease in serum cholesterol level. 2) Rats pretreated with CCl4 showed more extensive fatty degeneration and necrosis of the hepatocytes and PAS-positive granules in the tepatocytes were decreased more intensively than in saline-pretreated rats. 3) In the CCl4-pretreated rats(especially in 0.1m1/100g), Acid-PaBe activity was markedly increased, but Alk-Pase activity was decreased in the hepatic tissue. There was any difference in ATPase activity of the hepatocytes were not observed in each group of rats.

Gastric and Retroperitoneal Epithelioid Leiomyosarcoma -light and electron microscopic observations-: Young Jin Kim, Woon Sup Han, Ok Kyung Kim; J Pathol Transl Med. 1981;15(2):166-170.

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Abstract: Two cases of epithelioid leiomyosarcomas are presented. Recently epithelioid leiomyosarcomas are distinguished from the benign epithelioid leiomyosarcomas. Both benign and malignant forms of epithelioid smooth muscle tumor have been designated as leiomyoblastomas which were noncommittal term in implying either benignity or malignancy. The one of our cases was gastric epithelioid leiomyosarcoma and the other was epithelioid leiomyosarcoma of the retroperitoneum. They were composed of a mixture of round epithelioid and spindle cells, which have clear cytoplasm in many cells. The gastric epithelioid leiomyosarcoma had more than five mitoses/10 HPF, areas of compact hypercellularty of small size and 15cm in maximum diameter of the mass. Although the retroperitoneal tumor had infrequent mitoses, the tumor showed extensive necrosis and 20cm in largest diameter. These findings were considered as strongly suggestive findings of malignancy at the site of retroperitoneum. Ultrastructural findings of both tumors were some amounts of rough endoplasmic reticulum, vacuoles of varying size, fibrillar structures in the cytoplasm, and occasionally basement membrane-like structure at the cell junctions.

Carcinoma Arising in Mid1ine Ectopic Thyroid -including thyroglossal duct remnant-: Ja J. Jang, Je G. Chi; J Pathol Transl Med. 1981;15(2):171-174.

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Abstract: Midline ectopic thyroid, as the only functioning thyroid, is very rare and used to be thought that these thyroid remnants do not undergo malignant transformation. We experienced a case of carcinoma arising in midline ectopic thyroid (representing the total thyroid mass) including thyroglossal duct remnant in a 20 year old man. The cervical mass was explored and removed under the impression of thyroglossal duct cyst. The mass was located in thyroid cartilage area and was connected to the hyoid bone by a fibrous tract. The tumor was ovoid and well encapsulated. It measured 3.5×4×4 cm in maximum dimension. Microscopically, the vast majority of the mass consisted of hyperplastic and involutional thyroid follicles admixed with dense collagen fibrosis. There were foci of infiltrative solid nests of small follicles within fascia and skeletal muscle. The follicular lining cells showed moderate cellular atypism. A well encapsulated thyroid nodule adjacent to hyoid bone revealed disorganised follicles with atypical, vesicular lining cells. Several ductal structures lined by stratified squamous epithelium were also encountered in the hyoid bone level, representing thyroglossal duct remnants. The histological features of the carcinoma seen in this case suggested the follicular carcinoma rather than papillary carcinoma.

Congenital Retroperitonial Teratoma -an autopsy case-: Ok Hwa Kim, Woon Sup Han, Ok Kyung Kim; J Pathol Transl Med. 1981;15(2):175-179.

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Abstract: The retroperitoneal teratoma is a rare congenital childhood tumor, which comprises about 5% of all childhood teratomas above the pelvis. This may be either uni-or bilateral, and about 15% of all retroperitoneal teratomas have a malignant component. Authors observed a case of congenital retroperitoneal teratoma, that was found at the autopsy of female stillbirth who died during the delivery at pregnancy 37 weeks due to fetal distress apparently because of protruding abdomen. The fetus had a larger abdominal circumference(44 cm) than the head circumference (28 cm). At autopsy a large abdominal retroperitonial tumor, measuring 15×13×8cm in size and 650gm in weight with overlying the transverse colon was found. Abdominal organs such as the liver, spleen, and intestine were displaced laterally by the tumor. Grossly the tumor was a relatively solid, yellowish, lobulated mass intermixed with soft white-grey tissue, cartilage, and cysts contains jelly like material. Microscopically the tumor was composed of mature elements of ectodermal, endodermal, and mesodermal origins with some immature tissue of neuroepitherial elements.

Two Cases of Xanthogranulomatous Pyelonephritis: Hyung Bae Moon, Kang Hyuk Yoon; J Pathol Transl Med. 1981;15(2):180-184.

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Abstract: Xanthogranulomatous pyelonephritis is a rare form of chronicpyelonephritis, characterized by yellow masses macroscopically, and infiltration of foamy lipid-laden macrophages, mononuclear cells and rare giant cells microscopically. The disease is often misdiagnosed as other renal diseases such as renal tuberculosis or renal cell carcinoma. We have recently experienced two cases of xanthogranulomatous pyelonephritis in 24- and 53-year-old Korean females.

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