Biomedical subjects
Publications and source records attributed to S H Tsung.
The case of an infant with endocardial fibroelastosis and a coexistent anomalous right coronary artery that originated from the pulmonary trunk is presented. The causal relation between the two conditions is discussed.
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Primary mucinous adenocarcinoma of the prostate is rare. It is necessary to exclude extraprostatic primary sources, particularly from the gastrointestinal tract and the urinary bladder. Immunoperoxidase stain can serve the purpose of differential diagnosis. Usually, the presence of mucin in prostatic carcinoma is associated with a less aggressive tumor.
We have described a case of primary choriocarcinoma of the mediastinum and reported the results of electron microscopic and immunohistochemical studies. In the past, the prognosis of this tumor was poor, despite aggressive chemotherapy. Results of the recently developed protocol using intensive therapy with cisplatin-containing agents are promising.
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Malignant fibrous histiocytoma occurs most commonly in the extremities and trunk, but rarely in visceral organs. This report documents a case of malignant fibrous histiocytoma arising in the terminal ileum. Following surgical resection, there is no evidence of recurrence or metastasis in this patient after one-year follow-up studies.
A 37-year-old man was found to have classic malacoplakia of the rectum after three courses of chemotherapy for stage IV Hodgkin's disease. Sigmoidoscopy with excisional biopsy was performed because of rectal bleeding. The biopsy specimen of the rectal lesion showed focal extensive granulomatous changes with large macrophages containing round, dense Michaelis-Gutmann bodies. Electromicroscopy demonstrated calcifying spheres with laminated concertric structures (Michaelis-Gutmann bodies) and coliform bacillus in the cytoplasm of macrophages (Von Hansemann bodies). Review of the literature revealed that association of malacoplakia with Hodgkin's disease has never been documented, although it has been reported to be associated with conditions such as malignancy, organ transplantation, collagen disease, and leukemia. The possible role of immune disturbance as an underlying cause of malacoplakia is discussed.
A case of stone-like calcification of renal cell carcinoma is presented. The pattern of calcification in relation to prognosis of renal cell carcinoma is discussed.
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I measured total creatine kinase (CK; EC 2.7.3.2) activity and isoenzyme pattern in normal and neoplastic tissues. CK activity was detected in all of them examined. In various tumors it was greater than, less than, or the same as that in normal tissue, no clear correlation being seen between total activity and growth rate or degree of differentiation. In several cases, there was a greater proportion of the CK-MM isoenzyme, and 15 of 53 cases showed an atypical CK-MM band. The atypical CK-MM band, also reported by others, might be an insensitive and nonspecific tumor marker. The CK-BB isoenzyme, ubiquitous in neoplastic tissues, might accordingly be a nonspecific marker. Total CK activity was very low in most tumor tissues. Presumably a bulky tumor or an advanced stage of malignancy is a requisite to release of routinely detectable CK-BB into the circulation.
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The urinary sediment cytology is described in a case of malakoplakia involving the urinary bladder and the renal pelvis. The cytologic alterations are unique and can replace the invasive procedure such as biopsy.
The effect of gastrointestinal surgery on serum creatine kinase activity was studied in 30 patients. The MB isoenzyme was demonstrated in sera of 30% of the patients and BB isoenzyme in 23%. MB content varied from 0.8 to 10.3% of the total creatine kinase activity, and the BB content from 0.6 to 18.4%. The CK-BB was probably of gastrointestinal origin, since gastrointestinal tract contains high CK activity with BB isoenzyme predominating. A cardiac origin for the observed serum CK-MB isoenzyme increase would seem the most likely, although no patients showed evidence of electrocardiographic changes. Increased CK-MB activity has been observed in myocardial ischaemia without infarction.
Total creatine kinase (CK) activity and isoenzyme distribution were determined in normal and tumour of gastrointestinal (GI) tract. Total CK activity per gram wet tissue appeared to be markedly reduced in malignant tumour tissue, yet it was raised in benign tumour tissue. CK-BB was the predominant isoenzyme in both normal and tumour tissue of GI tract. Alteration of isoenzyme pattern was noted between the normal and tumour tissue. In one patient, macro-CK was found in tissue homogenate.
The sudden, unexpected death of four young athletes and the findings in their hearts at the time of necropsy were studied. Two athletes had anomalous left coronary origin from the anterior valsalva's sinus. In these cases, the sharp left-ward passage of the coronary artery along the aortic wall may cause the entrance into the left coronary system to be slit-like. There may be an increased expansion of the pulmonary artery and aorta with increased cardiac activity during exercise. Consequently, the left coronary artery may stretch and form a flap-like closure of the orifice of the left coronary, with sudden, fatal myocardial ischemia. The third young athlete had hypertrophic cardiomyopathy that could account for his sudden death; however, the cause of sudden death of the fourth could not be explained despite careful studies.