Peritoneal permeability of CAPD patients generally affects the ultrafiltration volume, dialytic protein loss, plasma protein level and eventual prognosis of individual patients. However, the precise mechanisms to govern the peritoneal transport rate are poorly understood. Intraperitoneal prostaglandin(PG), synthesized by peritoneal mesothelial cell(MC), appears to play a significant role in control of peritoneal permeability. We investigated MC synthesis of PGEz and active metabolite of prostacyclin, 6-keto-PGF< by radio-immunoassay following exposure to different concentrations of D-glucose(30, 60 & 90mM/L), commercial unused dialysate(1.5% glucose Dianeal(R), Baxter) & overnight dwell dialysate for 1 to 48 hours in the absence or presence of IL-1 8 (1ng/ml) & TNF-a (1ng/rnl). We also assessed the effect of cyclooxy-genase inhibitor(1 pg/ml of indomethacin) on PG synthesis of MC. Cultured human peritoneal MC was seeded at a density of 5xl(P/well in 12-well plate. After growth arrest for 48 hours following confluency, MCs were exposed to control media(serum restricted Hams F12) or various experimental conditions. At specific time points, MC supernatants were removed, centrifuged at 12,000Xg and then stored at -70C until PG assay. Exposure of MC to serum-free Hams F12 media (5mM/L of glucose) resulted in a constitutive synthesis of PGEz and 6-keto-PGF> . Concentrations of PGEz and 6-keto- PGFr in supernatant of MC culture were not changed with time after exposure to high glucose(30, 60, 90mM/L of D-glucose) compared to control media. Exposure of MC with unused commercial peritoneal dialysate or drained dialysate for 2 hours stimulated significant releases of PGEz & 6-keto-PGF>. Stimulation with IL-l and TNF-a induced a significant increase in PGEz from 2 hours after exposure and showed a time-dependent increase up to 48 hours. Combined stimulation of drained dialysate with IL-1P and TNF-a to mimic the intraperitoneal condition of peritonitis was associated with a greater increase in PGEp and 6-keto-PGF, compared to each stimulation alone. Treatment of MC with indomethacin(1 pg/ml) inhibited cytokine-stimulated PGEz increase. In conclusion, stimulation of MC with commercial peritoneal dialysate or cytokine induced PG synthesis, indicating the possible mechanism of intraperitoneal PG to participate in an increased peritoneal perme-ability by peritoneal dialysis process itself and es- pecially during the peritonitis.
Epoprostenol ; Glucose ; Humans* ; Interleukin-1 ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Permeability ; Plasma ; Prognosis ; Prostaglandin-Endoperoxide Synthases* ; Ultrafiltration

Bacterial peritonitis remains one of the major problem in patients undegoing CAPD, resulting in massive mesothelial cell (MC) death, remesothelialization failure, fibrosis and sclerosis. Since the preservation of the functional integrity of peritoneal membrane as a dialyzing organ is essential, complete resolution and adequate remesothelialization are necessary. This study was performed to investigate the effects of peritonitis on the number, secretory and regulatory function of MC. Subjects were nine episodes of peritonitis in 7 CAPD patients (M:F 5:2, mean age 48 years, mean CAPD duration 46 months). Dialysate CA125 and phospholipid were measured as markers of MC mass, and we also check the level of IL-6 and TNF-alpha, specific cytokines which can be detected in dialysate effluent. The concentrations of above mentioned substances were measured from the first cloudy bag, and thereafter overnight effluent were collected daily during the course of peritonitis and 4 weeks after discontinuation of antibiotics. Dialysate CA125 reached a peak in 2nd day of peritonitis and showed a second peak in 7th day. Other substances also showed a sharp increase on 1st day of peritonitis, returned to the baseline value rapidly. No differences in changes in the dialysate CA125, phospholipid and cytokine levels were noted according to the causative organism. There was no significant correlation between the values of MC marker and cytokines. In one patients who experienced 3 consecutive peritonitis with one-month interval, there was no second peak in dialyste CA125 level, and phospholipid remained the lowest level. He finally died due to sclerosing peritonitis and sepsis. In conclusion, MC markers and cytokines in peritoneal effluent can be used to follow the effects of inflammation in the peritoneal cavity. CA125 can be regarded both as a marker of MC damage and regeneration. Therefore, regular follow-up of CA125 during peritonitis can be an indicator to adequate treatment and remesothelialization.
Anti-Bacterial Agents ; Cytokines ; Dialysis* ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Interleukin-6* ; Membranes ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Regeneration ; Sclerosis ; Sepsis ; Tumor Necrosis Factor-alpha*

No abstract available.
Animals ; Cholesterol ; Corn Oil ; Guinea Pigs* ; Guinea* ; Heart* ; Ischemia* ; Reperfusion*

No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Heart* ; Histamine Release* ; Histamine*

Stroke patients have increased with the overall aging of our population, 60 years and older. Recently the number of stroke patients has been on the increase even among younger people in their thirties. The family support is frequently mentioned as a major variable which plays an important role in helping the patients adapt themselves to their hemiplegic situations. The purpose of the study was to examine between family support and activities of daily living(ADLs)abilities for the hemiplegic patients. and to provide the basic data to help the patients carry out their ADLs on their own. The sample for the study included 106 hemiplegic patients and their family members. The data were collected using a focused, structured interviews. The major findings of the study were as follows: 1. The hemiplegic patients perceived that their family supports were very high(Mean, 49.00). 2. The degree of family support was significantly higher in female, high economic status. and non-use of brace patients than in male, poor economic status, use of brace patients. 3. The ADL abilities of the hemiplegic patients were significantly higher in ambulatory. younger. and longer-period-of-illness patients and patients who used a cane as a assistive device. 4. The family support for the hemiplegic patients showed a statistically significant Cor relationship with their performance of ADL(r =.30809. p=0.0013). 5. The performance of ADL for the ambulatory patients were mainly affected by the degree of family support. the period of the hemiplegic illness, the use of brace, informal care giving, and the age. These variables explained 50% of variance. 6. The length of illness was a statistically significant affecting variable for ADL performance in OPD and assistive device in IPD. In conclusion. the higher the hemiplegic patients perceived the degree of family support. the better they performed ADL. We should develop nursing methods which enhance the family support for the hemiplegic patients in order to increase their performance of ADL.
Activities of Daily Living* ; Aging ; Braces ; Canes ; Female ; Humans ; Male ; Nursing ; Patient Care ; Self-Help Devices ; Stroke

The use of human chorionic gonadotropin(hCG), human placental lactogen(hPL) as markers for trophoblastic tissue has been well documented in the literature. However, it is not widely recognized that cytokeratin is a very sensitive and reliable marker for various types of trophoblastic tissue. The authors have studied 15 cases of human placental tissue ranging in age from first to third trimesters. Unlike hCG and hPL, which stain only the syncytiotrophoblast and intermediate trophoblast, cytokeratin(low molecular weight) stains all three types trophoblastic tissue. The staining of placental tissue for cytokeratin is marked and very consistent throughout pregnancy. Because of its high sensitivity and ability to stain cytotrophoblast, it is believed that it could be very useful in detecting trophoblasts of early pregnancy and in the study of the pathologic process of trophoblastic diseases.
Pregnancy ; Female ; Humans

No abstract available.
Anesthesia* ; Liver Transplantation*

No abstract available.
Humans ; Siblings* ; Vesico-Ureteral Reflux*

No abstract available.
Aged* ; Humans ; Hypertension* ; Motor Activity*

PURPOSE: Recently, it has been reported that Epstein-Barr virus (EBV) is associated with some gastric cancers. But EBVs role in EBV-associated gastric carcinomas (EBVaGCs) has not been fully elucidated. This study was undertaken to evaluate the characteristics of EBVaGCs and to compare those with non-EBVaGCs. MATERIALS AND METHODS: EBV infection was studied using paraffin-embedded tissue blocks of 119 cases of gastric adenocarcinomas by in situ hybridization for EBV-encoded small RNAs (EBERs). In EBVaGCs and non-EBVaGCs, molecular characteristics were evaluated by immunohistochemical staining for latent membrane protein (LMP)-1, p53 protein, and proliferating cell nuclear antigen (PCNA). RESULTS: EBERs were detected in 12 cases (10.1%) of 119 gastric adenocarcinomas. LMP-1 was negative in all carcinomas tested, p53 protein was positive in 7 cases (58.3%) of 12 EBVaGCs and in 51 (47.7%) of 107 non-EBVaGCs, the difference between two groups being not significant. Mean PCNA index was 38.2+-26.1% in EBVaGCs and 22.8 +- 20.0% in non-EBVaGCs. The index was significantly higher in the former than in the latter. CONCLUSION: These results suggested that neoplastic progression in EBVaGCs was implicated with high expression of PCNA, but not consistently with overexpression of p53 protein or LMP-1.
Adenocarcinoma* ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; In Situ Hybridization ; Membrane Proteins ; Proliferating Cell Nuclear Antigen* ; RNA ; Stomach Neoplasms