Biomedical subjects
Publications and source records attributed to Je Geun Chi.
A 77-year old man living in Kyunggi-Do, Korea was surgically treated at Seoul National University Hospital on April 1981, because of acute abdomen. At laparotomy, a 1.77m long adult Taenia saginata was found both in gallbladder and in common bile duct to cause acute gangrenous cholecystitis. The relevant literature were reviewed and possible mechanisms of the disease were discussed.
Based on 16 cases of human sparganosis, a histopathological study was made. There was a striking similarity among histological features of sparganosis involving different tissues. The histological change of the affected tissues was characterized by a necrotizing and granulomatous inflammation with or without worm parasite in the lesions. There was also a remarkable polymorphonuclear leukocytic mobilization, predominantly of eosinophils, plasma cells and lymphocytes in and near the lesions. Tunnel formation lined by palisading histiocytes was another charateristic feature of the host tissue reaction. These findings were quite distinguishable from those of cysticercosis which were more localized and self-limited. Several features that were prominent in section slides of sparganum worm parasite were also noted. Laminated calcospherules found in the cytoplasm of the proliferating macrophages and giant cells were of diagnostic value of sparganosis in the absence of the worm, particularly when these were accompanied with tunnel-like lesion in the host tissue.
In order to evaluate the pathogenicity of Korean strains of Trichomonas vaginalis, an experimental inoculation of T. vaginalis into mouse peritoneal cavity was performed. Fifteen strains of T. vaginalis were selected from 53 infected cases and were cultured axenically in Roiron-Rattner medium at 37 degrees C for 48 hours. Each strain, at the dose of 0.5 ml of 1 x 10(6)/ml trichomonads, was inoculated intraperitoneally to a group of 10 mice, respectively. A total of 15 groups, consisted of 150 mice, were sacrificed on the 8th day of inoculation, and then they were thoroughly examined for the detection of the lesion. The results obtained in present study were summarized as follows: 1. Prior to inoculation, the positive rates in 2 kinds of media cultivating T. vaginalis were compared. In Johnson's CPLM medium, 65% of positive rate was obtained, and 94.2% of positive rate, the better result, was shown in the culture of Roiron-Rattner medium. 2. Overall death rate of 150 inoculated mice was 7.3% (range 0~40%), and 7 strains (46.7%) out of 15 inoculated strains were proved as fatal strain. 3. The intraperitoneal lesions produced by the inoculation of T. vaginalis were observed in the liver (20%), intestinal wall and mesentery (14%), peritoneal wall (9.3%), wall of the stomach (6.0%), and the spleen (5.3%) of 150 inoculated mice. Occasionally, the lesions were also found in the pancreas and wall of the urinary bladder. In 11.3% of inoculated mice, purulent ascites with living trichomonads could be seen. Thirteen strains (86.7%) out of the 15 inoculated strains produced the T. vaginalis-associated pathological lesions. 4. On the histopathological investigation of those lesions, intraperitoneal inoculation was characterzed by a necrotizing granulomatous inflammation, i.e., acutely necrotizing process with areas of encircling granuloma formation. Numerous free lying trichomonads were seen along the expanding margin of the lesion. Where there were free trichomonads, the reaction was usually of necrotizing. And these organisms directly eroded the vascular wall and often provoked thrombosis. From the above findings, it is considered that the Korean strains of T. vaginalis are highly pathogenic.
A pathological study was done to elucidate sequential changes of the lungs in various time intervals following experimental paragonimiasis in 15 dogs and 15 cats. The dogs and cats were fed with 30~50 metacercariae of Paragonimus westermani, and were sacrificed at 15, 20, 30, 45, 60, 90 and 120 days after infection respecively. Autopsies were performed immediately after death. Gross and microscopic examination of the lungs showed following findings: 1. There were no qualitative difference in pathological findings between dogs and cats. 2. Pathological findings were first noticed at 20 days of infection in thoracic cavity, which consisted of fibrinous plueritis along with superficial hemorrhage. Although no worm was found in the lung parenchyma at this period, juveniles were seen in pleural cavity together with turbid effusion. 3. Paragonimus juveniles were first recognized inside the lung parenchyma by 30 days of infection. This was the period when the lungs showed multiple areas of hemorrhage and probably active penetration by smaller worms. Hemorrhagic bronchopneumonia was quite pronounced from this stage through 45 days of infection. 4. Paragonimus worm cyst was essentially composed of fibrous scar and heavy inflammatory cellular infiltrate. The lining epithelial cells were first became noticed by 2 months of infection. And these epithelial cells were thought to be probably transformed alveolar lining cells rather than bronchiolar epithelial cells. As the infection progress, the cyst wall became more stabilized and often showed squamous metaplasia. 5. Fibrinous pleuritis with pleural effusion was very prominent finding in early periods of infection. Bronchiolitis and focal vascular sclerosis were often seen in experimental paragonimiasis.
A study was made on 258 cases of cysticercosis, that were examined and diagnosed at the Department of Pathology, College of Medicine, Seoul National University during a period of 9 years from 1968 to 1976 inclusive. There were a total of 35,363 surgical specimens examined during the same period, thus revealing the relative frequency ratio of cysticercosis among surgical accessions to be 0.73%. The common sites of involvement of cysticercosis were skeletal muscle, subcutaneous tissue, breast, brain and eye in decreasing order of frequency. Painless palpable nodules were the most common initial presentation clinically. Histopathological staging was attempted based on the host tissue reaction and worm morphology. It was arbitrarily classified into early, intermediate and late stages. In general the morphology of the parasite consisted of a well preserved and compact calcospherules with intact subcuticular muscle layer in the early stage, showing a progressive deterioration of parasitic structures, finally undergoing resorptive process or mummification. The host tissue reation in the early stage was characterized by a diffuse epithelioid cell proliferation with lymphocytic and eosinophilic infiltration without capsule formation. The intermediate stage consisted of a diffuse histiocytic proliferation with well formed outer collagen capsule. The latestage revealed mostly thinned out, well collagenized capsule with scanty lymphocytic infiltration. The parasite in the well formed cyst as usually distorted and often mummified. But the hooklets were relatively preserved up to the late stage. These finding suggest that the host tissue reacts to the cysticercus worm in fairly uniform fashion, and this fashion appears to have a sequence, i.e., violent lymphohistiocytic response in the initial phase of infection, and undergoing a gradual fibrotic (encapsulating) self-limiting course, finally being stabilized by a dense, acelluar collagen capsule or collapse and absorption.
The present study was undertaken to observe the pathologic changes of the liver in albino rats with Clonorchis sinensis. Twenty five rats given 50 metacercariae respectively by mouth were autopsied at 3 days (group 1), one week (group 2), 4 weeks (group 3), 8 weeks (group 4) and 12 weeks (group 5) of infection. The following results were obtained: 1. Parasites were seen in bile ducts of group 2, 3, 4, 5 and increased in number with duration of infection. 2. The pathologic changes in the liver were prominent in intrahepatic bile ducts. Epithelial cells of bile ducts showed definite atypia and proliferation resulting in pseudostratification in group. Stratification of metaplastic squamous cells and glandular proliferation were prominent in group 3. The epithelial cells were keratinized with syncitium and cribriform formation in group 4 and almost suggestive of adenomatous hyperplasia in group 5. 3. Periductal fibrosis seen in group 4 was considerable as well as mature with hyalinized connective tissue in group 5. 4. Heavy inflammatory cell infiltrations around the affected bile ducts in group 1 became smaller in number with duration of infection. The inflammatory cells consisted of the majority of eosinophils in group 1 and chiefly plasma cells, lymphocytes and mononuclear cells in group 5. 5. Veins in portal spaces dilated markedly in group 1 became less prominent with duration of infection. 6. Although portal fibrosis increased definitely in group 3 often extended into the hepatic lobules in group 4, the changes of hepatic cells, sinusoids and central veins were negligible. Above results suggest that clonorchiasis could be a factor in inducing primary carcinoma of liver in albino rats.
In order to understand the effect of prednisolone injection on the histopathological changes of the mouse liver and the chronological changes of the worm structure of Clonorchis sinensis, when this fluke was inoculated to the mouse intraperitoneally. The recovery rate, survival rate, location and size of the inoculated worms as well as the histopathological changes of the liver were investigated for the comparison among the groups of mice, which were classified by number of worms and the duration of observation period. The result obtained were summarized as follows. 1. The recovery rate and survival rate of the worms decreased especially 28 days after the inoculation. 2. Most of worms (45.5%) were collected from the peritoneal cavity, and some of worms were found tightly adherent to the capsules of the liver, spleen, intestine and diaphragm. 3. The mean worm size after inoculation was constantly smaller than that before inoculation. 4. Remarkable atrophy in the reproductive organs of the worm, such as spermatheca, testes, vitelline gland and ovary was frequently observed at the 10th day of inoculation. 5. Histopathologically the liver failed to show any parasitic worm inside the intrahepatic biliary system. However, multiple well formed egg-containing granulomas were present along the liver capsule. These necrotic granulomas were occasionally found under the fibrotic liver capsule. Focal necrosis and focal phlebitis together with vascular dilatation were prominent features of the liver. 6. The worms recovered in the capsule of the liver were degenerated and necrotized. Usually, there were remarkable capsulitis and granuloma formation around the eggs.
The present study was undertaken to observe the changes of hepatocyte and biliary epithelium in the liver of guinea pigs infected with C. sinensis. Ten guinea pigs infected with 500 metacercariae of C. sinensis each were reared for 11 weeks. After sacrifice, the liver tissues were processed both for conventional light microscopy and for electronmicroscopy. The following results were obtained by light and electronmicroscopic observation of these tissue preparations. 1. The dilatation of bile ducts with chronic inflammatory cell infiltration and fibrosis, and flattening of lining epithelium were observed by light microscopy. Bile duct showed a single low columnar or cuboidal epithelium and subepithelial small round cell infiltration. Papillary proliferation, adenomatous hyperplasia and increase of goblet cells in the subepithelial glands were also noted in some areas of bile ducts. Occasionally, small fibrous nodules in the portal tract replacing bile ducts, surrounded by a heavy infiltrate of small round cells and neutrophils were observed. 2. On light microscopic examination, no cellular damages were seen in the liver cells except mild fatty degeneration. 3. Electronmicroscopic examination of the biliary epithelium revealed increased mucin granules, cytoplasmic projection into lumen, decreased microvilli and obstruction of bile canaliculi. Indistinct and/or irregular appearances of intercellular lateral interdigitation were observed in most of biliary epithelium. 4. On the electronmicrographs of hepatocytes, dilation of endoplasmic reticulum(ER) and destruction of cristae in some mitochondriae were prominent features. Disappearance of cytoplasmic organells and dilatation of bile canaliculi were also monitored. 5. Endothelial cells in the sinusoids were remained intact.
The present experimental study was undertaken to observe the chronological change of the worm structure of Clonorchis sinensis and the pathological findings of the liver when this fluke was inoculated to the mouse intraperitoneally. The recovery rate, survival rate, location and size of the inoculated worms as well as the pathological changes of the liver were investigated for the comparison among the groups of mice, classified by number of worms and the duration of experiment. The results obtained were summarized as follows: 1. The recovery and survival rates of the worms decreased especially 28 days after the inoculation. 2. Most of worms (90.l percent) were collected from the peritoneal cavity and some of worms were found tightly adherent to the capsules of the liver, spleen, stomach, intestine and diaphragm. There were no worms recovered penetrated in the parenchymes of these organs. 3. The mean worm size after inoculation was smaller than that before inoculation. At the 10th day after the inoculation, the shrinkage of posterior portion of the worm body was observed. 4. Remarkable atrophy in the reproductive organs of the worm, such as spermatheca, testes, vitelline glands and ovary was frequently observed at the 10th day of inoculation. 5. Histopathologically the liver failed to show any parasitic worm inside the intrahepatic biliary system. However, multiple well formed egg-containing granulomas were present along the liver capsule. These necrotic granulomas were occasionally found under the fibrotic liver capsule. Focal necrosis and focal phlebitis together with vascular dilatation were prominent features seen in the liver. The bile duct in the liver showed mild dilation of the lumen, flattening of epithelial cells and periductal small round cell infiltration. Neither adenomatous hyperplasia nor portal fibrosis was seen in the whole experimental groups. Foci of intralobular micro-granulomas were found in some experimental animals. 6. The worms recovered in the capsule of the liver were degenerated and necrotized. Usually, there were remarkable capsulitis and granuloma formation around the eggs.
Dysmyelinating diseases, or leukodystrophies, encompass a wide spectrum of inherited neurodegenerative disorders affecting the integrity of myelin in the brain and peripheral nerves. Most of these disorders fall into one of three categories-lysosomal storage diseases, peroxisomal disorders, and diseases caused by mitochondrial dysfunction-and each leukodystrophy has distinctive clinical, biochemical, pathologic, and radiologic features. Magnetic resonance (MR) imaging has become the primary imaging modality in patients with leukodystrophy and plays an important role in the identification, localization, and characterization of underlying white matter abnormalities in affected patients. MR imaging has also been extensively used to monitor the natural progression of various white matter disorders and the response to therapy. Although the MR imaging features of leukodystrophy are often nonspecific, systematic analysis of the finer details of disease involvement may permit a narrower differential diagnosis, which the clinician can then further refine with knowledge of patient history, clinical testing, and metabolic analysis.
The authors describe a case in which a tailgut cyst occurred at an unusual location in a 22-year-old woman referred for abdominal discomfort and urinary frequency. The left abdomen contained a palpable mass, found at imaging studies to be a homogeneous, unilocular and cystic, and anterior to the left kidney. After surgical excision, it was shown to be a tailgut cyst.