Analysis of Traumatic Subarachnoid Hemorrhage due to Blunt Force Trauma on Facial Region / 대한법의학회지

Traumatic subarachnoid hemorrhage (T-SAH) is said to be typically occurred in a young, healthy, but intoxicated man who receives a minor blow, immediately collapses, and dies within minutes. Sixteen forensic cases of T-SAH were analysed in the point of time of collapse, blood alcohol level, injured site, vascular rupture sites, and sentenced servitude. Majority of the cases (12 cases) were autopsied in the department of Kyungpook National University. Two cases of National Institute of Scientific Investigation, South District Office and 1 case of Jeju National University were added. Autopsy was not done in one case. There were 14 male and 2 female victims. The peak age were their forties (7 cases) and under twenties (7 cases). The time of incident was most often at night. The survival time from the time of trauma until death indicates that 62.5% (10 victims) died immediately from the assault, 12.5% (2 victims) died within 30 minutes. Blood alcohol was detected in 11 cases (68.8%), and mean blood alcohol level was 0.16% (0.08-0.22%). The damage was generated to the facial region, especially around the jaw and below the ears (7 cases), and temporal areas (4 cases). Bleeding foci were detected in 7 cases; basilar artery (2 cases), left vertebral artery (2 cases), and right vertebral artery (3 cases). Meticulous autopsy techniques for identifying the vascular rupture sites are required. The author conclude that tremendous emphasis must be placed on the fact that fatal T-SAH can occur due to minor facial trauma and social campaign for alerting people to the danger of T-SAH is needed.

Usefulness of Immunohistochemistry in Various Types of Sudden Cardiac Death / 대한법의학회지

Postmortem diagnosis of early myocardial infarction is still a puzzling problem in forensic pathology practice, especially in sudden cardiac death. This study was undertaken to evaluate the distribution patterns of several immunohistochemical markers in various types of sudden cardiac death; 27 cases of obstructive coronary atherosclerosis (SCD-CAD) including 13 cases of critical coronary atherosclerosis, 6 cases of atherosclerotic heart disease and 8 cases of acute myocardial infarction, 26 cases of sudden cardiac death with obvious other causes (SCD-miscellaneous) including hypertensive heart disease, arrhythmogenic right ventricular cardiomyopathy, etc. and 14 cases of sudden cardiac death without any myocardial changes and/or minimal coronary atherosclerosis(SCDunknown). 10 cases of unnatural death were included in control group. Imnunohistochemical reactivity and the severity of reactivity loss were evaluated. The immunoreactivity against myoglobin and troponin C were excellent, and their reactivity loss were statistically significant in SCD-CAD compared to control group, SCD-unknown and SCD-miscellaneous (p<0.05). There were increasing pattern of loss of immunoreactivity in SCD-unknown and SCD-miscellaneous compared to control group. The pattern of expression and the severity of reactivity loss against vascular endothelial growth factor(VEGF) and basic fibroblast growth factor (bFGF) were with no differences in experimental group and control group. Immunohistochemistry may be partially useful in determination of early myocyte necrosis in sudden cardiac death, and myoglobin and troponin C may be better. But, its practical application in forensic pathology may be still limited.

A Histological and Clinical Study of the Children with Thin Glomerular Basement Membrane

PURPOSE: Thin glomerular basement membrane disease(TGBMD) is found in patients with family history of hematuria. TGBMD is autosomal dominant and is known to be one of the commonest causes of asymptomatic hematuria. This study was conducted to evaluate the histological and clinical features of patients with TGBMD. METHODS: 150 cases diagnosed with TGBMD by renal biopsy while admitted in the department of pediatrics, Kyungpook National University Hospital between January 1999 and December 2003 comprised the study group. The following parameters were retrospectively analyzed:age of onset, hematuria pattern, existence of proteinuria, process of diagnosis, laboratory findings, thickness and character of basement membrane and family history. RESULTS: The mean age at the time of diagnosis was 7.9 years. The male to female ratio was 65:77. 94 patients or 66% visited the hospital with a chief complaint of persistent microscopic hematuria. Gross hematuria accounted for 13 cases or 9%. 78 cases(55%) were found to have hematuria for the first time from a routine school urinalysis screening. The renal biopsy showed the thickness of basement membrane to be 186+/-36 nm. Focal lamellation of the basement membrane was found in eight cases. In the family history, hematuria was shown in 10 cases on the paternal side, 13 on the maternal side and none on both sides. In seven cases, hematuria was shown among siblings. No significant differences were found among the laboratory test results which were conducted at an average interval of fifteen months. CONCLUSION: TGBMD is one of the major causes of asymptomatic hematuria in children, which was diagnosed in increasing numbers since school urinary mass screening test started in 1998. In cases with familial progressive renal disease or focal duplication in the basement membrane Alport syndrome should be considered.

Epidermal Cyst in the Renal Pelvis: A Case Report with Review of the Literature

We report here on a case of an epidermal cyst arising in the kidney. This cyst occurred in a 61-year-old woman with a past history of several attacks of ureteral stones and she received treatments of extracoporeal shock wave lithotripsy and open nephrolithostomy. On the intravenous pyelogram, a relatively well demarcated, 5x5 cm-sized lesion with calcification was detected in the renal pelvis and calices. The lesion was removed by percutaneous nephrolithotomy. Histologically, the lesion had the same morphologic feature as a typical epidermal cyst arising in the skin. It has been postulated that the intrarenal epidermal cyst arises either from epidermal remnants or it results from traumatic implantation of transformed epithelium. Considering the past history of the patient, it might well be suspected that the present case occurred as a result of traumatic implantation of metaplastic squamous epithelial cells. We report here on a very interesting case of an epidermal cyst in the renal pelvis with a review of the relevant literatures.

Medical Students' Attitudes Toward Autopsy and the Effect of Their Attitudes Following a Forensic Pathology Course

BACKGROUND: The autopsy is a special surgical operation on a dead body to discover its cause of death. The autopsy is necessary for forensic uses, and it is also of great importance for educating students regarding medical uncertainty. METHODS: To evaluate medical studentsO attitudes toward autopsy and the effect of their attitudes following a forensic pathology course, a questionnaire with 25 items that addressed the usefulness of autopsies and discomfort reactions was used. One hundred eighty nine medical students from 3 medical schools in Daegu participated in this study. RESULTS: The medical students showed a high perception of an autopsy's principles, but the medical students were reluctant to become personally involved, despite being more aware of the necessities of the autopsy in forensic cases. Acceptance for the necessities of the autopsy for medical students who took the forensic pathology course was increased, but most of discomfort reactions were not improved. CONCLUSIONS: One way to fulfill the role of forensic pathology as an inspector for human rights and to retain the very special source of knowledge that autopsies represent would be to provide medical education that lead to reconciliation of the discomfort feelings.

Sudden Death from Cardiac Sarcoidosis: A Case Report

Sarcoidosis is a systemic granulomatous inflammation with an unknown cause. The commonly involved sites are the lymph nodes, lungs, skin, eyes, and heart. Although cardiac involvement in sarcoidosis is rarely detected clinically, it is reported in 20-50% of autopsied sarcoidosis patients. Cardiac involvement is one of the most severe conditions of sarcoidosis and may cause sudden death. We report a case of a sudden death due to a massive cardiac sarcoidosis in a 43-year-old man. The microscopic examination revealed an extensive noncaseating granulomatous inflammation in the mediastinal lymph nodes and the heart with no evidence of myocyte necrosis. A special stain and molecular study excluded the possibility of other causes such as fungi or mycobacterium. The authors concluded that the cause of death was attributed to arrhythmia due to a cardiac sarcoidosis with massive involvement of the conduction system.

Henoch-Schonlein Nephritis in Korean Children: Renal Outcome and Prognostic Factors / 대한신장학회잡지

Purpose: This retrospective study has been undertaken to find out the clinical outcome of children with Henoch-Schonlein nephritis and its relationship with initial clinical presentations and/or renal pathologic findings. METHODS: Study population consisted of 54 children with HS nephritis who have been admitted to the Pediatric department of Kyungpook University Hospital from 1993 to 2003, and biopsy was done with indications of heavy proteinuria (1 g/m2/day) lasting over 1 month, nephrotic syndrome, and persistent hematuria and/or proteinuria over 1 years. Patients were clinically divided into 3 groups; isolated hematuria, hematuria with proteinuria and heavy proteinuria (including nephrotic syndrome). Biopsy findings were graded from I-VI according to International Study of Kidney Disease in Children. RESULTS: Mean age of presentation was 7.9+/-2.7 years and slight female predominance was noted (24 boys and 30 girls). Histopathologic grading showed grade I in 5, grade II in 17, grade III in 29, and grade VI in 3 cases. Clinical outcome at the follow- up period less than 4 years (45 cases) and more than 5 years (18 cases) showed normal urinalysis in 17 (38%) and 10 (56%), persistent isolated hematuria in 14 (31%) and 1 (5%), hematuria with mild proteinuria in 14 (31%) and 7 (39%), respectively. No patients persist heavy proteinuria more than 3 years. Clinical outcome according to histopathologic grading showed that normalization of urinalysis was significantly lower in grade III when compared to grade II (p<0.05). Disappearance of proteinuria takes significantly longer in children with crescent formation (p<0.05). CONCLUSION: The majority of children with mild HS nephritis had good prognosis. The severity of histopathologic grade was well correlated with improvement of urinalysis. Our study suggests that renal biopsy provides a valuable prediction of prognosis even in mild HS nephritis without renal functional impairment.

Expression of p53 and Vascular Endothelial Growth Factor mRNA in Angiogenesis of Non-Small Cell Lung Carcinoma

BACKGROUND: Angiogenesis is one of the most important factors in the progression and me-tastasis of malignancies. Angiogenesis is a multistep process requiring the interaction of numerous factors able to stimulate the growth and development of new vessels. But, understanding of the mechanism involved in VEGF expression is unclear. METHODS: Expressions of p53 and VEGF, and neovasculiarization were examined in 19 cases of surgically resected non-small cell carcinoma of the lung by the immunohistochemical staining. Furthermore, VEGF mRNA expressions were quantified in all cases using the real-time quantitative RT-PCR. These results were compared with clinicopathologic parameters such as histologic grade and stage. RESULTS: Tumors with high aberrant p53 expressions showed significantly higher VEGF mRNA ex-pressions and microvessel counts than those with low p53 expressions. Expressions of p53 as well as VEGF and micovessel counts were closely associated with the tumor stage, but not with the histologic grade and other clinical parameters. CONCLUSIONS: These results suggest that aberrant p53 expression may play a role in the regulation of VEGF expression and may be involved in controlling angiogenesis in non-small cell carcinoma of the lung.

A Study on the Association of Thin Glomerular Basement Membrane Abnormality with Minimal Change Nephrotic Syndrome

PURPOSE: Thin glomerular basement membrane nephropathy (TGBMN) is recognized as the leading cause of microscopic hematuria in both children and adults. However thinning of glomerular basement membrane (TGBM) has been found in healthy adult and also is known to be associated with various renal diseases such as Alport syndrome, IgA nephropathy and mesangial proliferative glomerulonephritis. The association of TGBM with minimal change nephrotic syndrome (MCNS) has been very rare so that the present study was undertaken to determine the relationship between TGBM and MCNS. METHODS: The study population consisted of 49 children with biopsy-proven MCNS who have been admitted to the pediatric department of Kyungpook University Hospital during the past 5 years from 1997 to 2001. Group I consisted of 8 children associated with TGBM and Group II 41 children without TGBM. Various parameters such as age of illness, duration from discovery of illness to the time of biopsy, family history of hematuria and other laboratory tests were compared between these two groups and the following results were obtained. RESULTS: Age distribution showed slightly older age in Group I (7.1+/-3.5 years) compared to Group II (4.8+/-2.9 years). However this was not statistically different (P=0.056). Family history of hematuria was noted in 2 cases in Group II. Though statistically not significant, hematuria was seen in 2 out of 8 cases (25%) in MCNS children with TGBM, compared to 7 out of 41 cases (17%) with MCNS children without TGBM. Other parameters such as BUN, creatinine, 24 hours urine protein excretion, serum protein, albumin, cholesterol, and T4/T8 ratio, showed no difference. Also renal biopsy finding showed no significant difference and the thickness of glomerular basement membrane in Group I was 188 30 nm. CONCLUSION: TGBM was found in 8 out of 49 children with MCNS (16.3%). And this high frequency of occurrence indicates that these association is not an incidental findings. Typical clinical findings of TGBMN was not noted in all of the 8 children with MCNS associated with TGBM, suggesting that thinning of glomerular basement membrane (TGBN) is secondary to rather than the cause of MCNS.

Arrhythmogenic Right Ventricular Cardiomyopathy as a Cause of Sudden Unexplained Death

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.

Asymptomatic Primary Hematuria in Children

Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately ass- ociated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells

Henoch-Schonlein Nephritis Children

PURPOSE: This retrospective study has been undertaken to find out the clinical outcome of children with HS nephritis and its relationship with initial clinical presentation and/or renal pathologic finding. PATIENTS AND METHODS: Study population consisted of 59 children with HS nephritis who have been admitted to the Pediatric department of KyungPook University Hospital from 1987 to 1999, and biopsy was done with indications of heavy proteinuria ( > 1 g/m2/day ) lasting over 1 month, nephrotic syndrome, and persistent hematuria and/or proteinuria over 1 year. Patients were divided clinically into 3 groups ; isolated hematuria, hematuria with proteinuria and heavy proteinuria (including nephrotic syndrome). Biopsy findings were graded from I-V according to International Study of Kidney Disease in Children (ISKDC). RESULTS: Mean age of presentation was 8.1+/-3.0 years and slight male proponderance was noted ( 33 boys and 26 girls ). Histopathologic grading showed Grade I ; 2, Grade II ; 44, and Grade III ; 13 cases. Clinical outcome at the follow-up period of 1-2 years (49 cases) and 3-4 years (30 cases) showed normal urinalysis in 15 ( 30.6% ) and 18 cases ( 60.0%), persistent isolated hematuria in 20 ( 40.8% ) and 2 cases ( 6.7 % ), hematuria with proteinuria in 11 ( 22.5% ) and 8 cases ( 26.6% ), and persistent heavy proteinuria in 3 ( 6.1% ) and 2 cases ( 6.7% ) respectively. Clinical outcome according to histopathologic grading showed the frequency of normalization of urinalysis being lower in Grade III compared to grade I or II. Clinical outcome according to initial clinical presentation showed no relationship to the normalization of urinalysis at follow-up periods. However, 15-20% of children with initial heavy proteinuria showed persistent heavy proteinuria ( 3 out of 20 cases at 1-2 years, and 2 out of 10 case at 3-4 years of follow-up periods). CONCLUSION: The majority of children with HS nephritis (histopathologic grade I, II, III) improved within 3-4 years, and persistent heavy proteinuria was seen only in a few of children with initial clinical presentation of heavy proteinuria.

Clinical Course of IgA Nephropathy in Children

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.

The Effects of Angiotensin Converting Enzyme Inhibitor on Progressive Glomerular Sclerosis

Almost all advanced glomerular diseases have glomerular sclerotic changes to varying degrees whatever causes their primary glomerular disease are. Pathogenesis of these sclerosis has been thought of as the hyperfiltration in the primary glomerulosclerosis due to development of glomerular hypertension in each insulted glomeruli. This background gave the theoretical bases for antihypertensive therapies for supporting chronic renal insufficient patients. Angiotensin converting enzyme (ACE) inhibitor, one of the antihypertensive drugs, has received attention recently for its effectiveness. The aims of this study determined the effects and mechanism of the ACE inhibitor, enalapril, on the glomerulosclerosis in FGS/NgaKist mice, which was an animal model of chronic renal failure by generating spontaneously heavy proteinuria and progressive glomerulosclerosis. Five-week-old FGS/NgaKist mice (n=38) were assigned to four groups. Group 1a (n=6) and group 2a (n=8) fed with a vehicle, were sacrificed at the end of 10 weeks and 15 weeks, respectively. Group 1b (n=12) and 2b (n=12) received enalapril (100 mg/L) in drinking water for 5 weeks and 10 weeks from 6th week of age respectively, and were sacrified on the same day as the control groups. Doses of enanapril were maintained to 2 mg/kg/day by measuring the amount of water consumption. In enalapril groups 1b and 2b, systemic blood pressure (74.7 14.0 mm Hg, 74.3 15.9 mmHg) were significantly lower than control group 2a (116.1 4.6 mmHg, P<0.001). Similarly, degree of proteinuria lowered in enalapril group 2b versus control group 2a (0% and 50.0%, P<0.001). Glomerulosclerosis percentage significantly decreased (P<0.001) (group 1b and 2b; 1.9 6.5, 5.6 7.0 vs control 1a and 2a; 32.8 15.5, 31.4 13.8). Glomerulosclerosis score also decreased (P<0.001) (group 1b and 2b; 0.02 0.08 vs control 1a and 2a; 0.48 0.12, 0.30 0.14). The immunofluorescent staining of enalapril groups showed negative for mesangial deposition of IgG, IgA, IgM, and C3 which were positive in control groups. Immunohistochemical staining with TGF-beta1 was negative in enalapril groups and sclerotic glomeruli both enalapril groups and control groups. These results support that the ACE inhibitor has a renoprotective effect on glomerulosclerosis not only by decreasing the blood pressure but also by suppressing the immune deposits on glomeruli.

Effect of Unilateral Renal Perfusion of Cyclosporine and Mitomycin on Rat's Kidney

Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.

Hypertension, Polydipsia, Polyuria, and Hypokalemia Associated with Renin-Secreting Wilms' Tumor in a Child

A 3-year-old boy with Wilms' tumor had unusual severe hypertension, polydipsia, polyuria, and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour (normal supine 0.15-2.33 mg/ml/hour) and 120.1 ng/dl (normal supine 1 to 16 ng/dl), respectively. His hypertension, varied from 150/90 mmHg as high as 240/180 mmHg, was not effectively controlled by antihyperensive drugs. Because of concern for the complications of hypertension, a right nephrectomy was performed on the sixth hospital day. At laparotomy, there was no evidence of mechanical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined within the renal capsule without involvement of the renal blood vessels at the hilum. Histopathologically, it was characteristic Wilms' tumor of favorable histology. On electron microscopy, the tumor cells contained many electron dense secreting granules in the cytoplasm, suggesting that the tumor itself was the source of the renin and cause the clinical manifestations. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.

Prognostic Value of CD44v6 Isoform in Infiltrating Ductal Carcinoma of Breast

CD44 is a family of transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. Expression of CD44 isofonns (splice variants) has been shown to be associated with poor prognosis in several human cancers. We evaluated the expression patterns of the CD44 isofortn (CD 44 splice variant v6) in infiltrating ductal carcinoma of the breast by immunohistochemical and RT-PCR method. Paraffin embedded blocks from seventy-five cases of mastectomized samples were analyzed immunohistochemically using monoclonoal antibody against CD44v6. CD44v6 was detected in fifty-seven cases (76%) of the tumor samples. Adjacent normal myoepithelial cells and ductal epithelial cells revealed focal positive reaction to CD44v6. Thirtytwo cases (80.0%) with lymph nodal metastasis revealed overexpression of CD44v6 monoclonal antibody, but twenty-five cases (71.4%) without nodal metastasis also showed positive reaction to CD44v6 monoclonal antibody, and there is no statistically significant value. Other prognostic factors of infiltrating ductal carcinoma, such as tumor size, histologic grade and hormonal receptors did not show any significant correlation with CD44v6 expression. The RT-PCR studies for 9 cases of infiltrating ductal carcinoma showed the same band patterns both in the normal and tumor tissues. From the above results, it is concluded that the expression of CD44v6 is not a valuable prognostic marker of infiltrating ductal carcinoma of breast.

Ultrastructure of surgically excised subfoveal neovascular membranes

We studied the ultrastructural features of four consecutive subfoveal neovascularmembranes (SFNM) associated with age-related macular degeneration. Cellular components of the membranes included retinal pigment epithelial (RPE) cells, endothelium-lined vascular channels, macrophages, myofibroblasts, fibrocytes, glial cells, erythrocytes, and lymphocytes. Extracellular interstitial constituents included collagen fibrils, basal laminar deposits, fibrin and young elastic fibrils. These findings show that SFNMs consist of various cells originating from surrounding tissues and vessels. Among these RPE cells and macrophages are the main cellular components and in conjunction with various extracellular matrix, especially collagen, may play an important role in the formation and maintenance of the membranes.

Degradation of phagosomes and diurnal changes of lysosomes in rabbit retinal pigment epithelium

Diurnal changes of lysosomes including ultrastructural changes of phagosomes and acid phosphatase reactions in phagosomes, as well as diurnal biochemical changes in cathepsin D activity, were studied in the retinal pigment epithelium (RPE) of the rabbit. The rabbit was maintained on a natural light-dark cycle over seven days in fall and was sacrificed at various times during the day and night. The number of lysosomes or phagosomes in the RPE was the highest at 1.5 hours after exposure to sunlight (8:00 AM), and thereafter decreased with time. Three types of phagosomes were observed and acid phosphatase reactions were different in each type of phagosome; the fresh phagosomes were negative or positive, lamellar bodies positive, and dense bodies partially positive. The biochemical activity of cathepsin D was the highest at 8:00 AM, and this was consistent with the time of peak in phagocytic activity in the RPE. This report shows that phagocytic activity in the RPE occurred in the early stage after exposure to sunlight, and that fresh phagosomes were sequentially degraded to lamellar or dense bodies. Cathepsin D activity also increased, and this was consistent with the phagocytic activity in the RPE.

Lipoma of the Heart: An Autopsy case report

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.