No abstract available.
Depression*

No abstract available.
Family Practice* ; Humans ; Primary Health Care*

No abstract available.
Hepatitis B Surface Antigens* ; Humans ; Prevalence*

BACKGROUND: It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-beta1(TGF-beta1), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-alpha(TNF-alpha) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. METHOD: Wistar rats were divided into three groups(control group, BML treated group, BML and vitamine E treated group). Animals were sacrifices periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six defferent mediators(TGF-beta1, PDGF, bFGF, IL-1, IL-6 and TNF-alpha) and mRNA in situ hybridization for TGF-beta1. RESULTS: IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-alpha is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-alpha causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-beta1 are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-beta1 and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-beta1 and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). CONCLUSION: After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-alpha which induce infiltration of many neutrophils. It is thought that variable enzymes and O2 radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-beta1, PDGF, bFGF, TNF-alpha secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-alpha compares quite important with TGF-beta1 to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.
Animals ; Bites and Stings ; Bleomycin* ; Blood Platelets ; Bronchoalveolar Lavage Fluid ; Coloring Agents ; Cytokines* ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Fibroblasts ; Fibrosis ; Idiopathic Pulmonary Fibrosis ; In Situ Hybridization ; Intercellular Signaling Peptides and Proteins* ; Interleukin-1 ; Interleukin-6 ; Interleukins ; Lung ; Lung Injury ; Macrophages, Alveolar ; Necrosis ; Neutrophils ; Pneumonia ; Pulmonary Fibrosis* ; Rats ; Rats, Wistar ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha ; Vitamins

No abstract available.
Lung* ; Tracheoesophageal Fistula*

As the oral cavity plays a vital role in swallowing, speech articulation and intelligibility, a variety of surgical techniques have been devised to reconstruct the intraoral defect which remains after ablative surgery. The ideal method of intraoral reconstruction has not yet been established, but microvascular free flaps have rapidly become the "gold standard" compared to other techniques, and nowadays interest is focused on the improvement of detailed function following reconstruction. The purposes of this study are to understand the main goal of reconstruction and to suggest the appropriate donor sites of free flap depending on the location and size of defects. From July 1988 to December 1999, 42 patients underwent intraoral reconstruction with various kinds of free flaps in accordance with the location nd size of defects. We divided the location of intraoral defects into tongue, mouth floor, buccal mucosa, and palate, retromolar trigone, pharyngeal wall according to the anatomical structures. We tried to select the most appropriate donor tissue for the requisites of defect area. After partial glossectomy, we used free jejunal patch flap as a first choice. Free lateral arm flap has been used to reconstruct the defect of hemi-glossectomy, and free rectus abdominis flap for the defect of total glossectomy. For the reconstructions of mouth floor and buccal mucosa, transversely designed and two skin paddles free radial forearm flaps have been used as a first choice. For the defects of palate, retromolar trigone or pharyngeal wall, free jejunal patch flap has been a first choice. The postoperative courses of these cases are uneventful. There was no orocutaneous fistula during follow up periods. The patients could recover their intelligible speech, deglutition and mastication. We conclude that appropriate selection of free flap donor site for intraoral reconstruction depending on the location and size of defects can improve detailed function and aesthetics, and enhance the rehabilitation and remaining quality of life.
Arm ; Deglutition ; Esthetics ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps* ; Glossectomy ; Humans ; Mastication ; Mouth ; Mouth Floor ; Mouth Mucosa ; Palate ; Quality of Life ; Rectus Abdominis ; Rehabilitation ; Skin ; Tissue Donors* ; Tongue

Adenomatoid tumor of the uterus is a rare benign neoplasm which has been known as mesothelial origin. Characteristically, it appears as a small nodular lesion less than 2.0cm in the myometrium of subserosal region. We describe a case of giant adenomatoid tumor of the uterus having multicystic gross appearance. A 49-year-old woman complained of vaginal bleeding. The tumor was an intramural mass with maximum diameter of 10 cm and located at posterior wall of the uterus. Histologically, the tumor was composed of multiple cystic cavities of variable size lined by flattened cells, lying among thin septa of connective tissue. Immunohistochemically, the cells are positive for low molecular weight cytokeratin(CAM 5.2) and are negative for factor VIII.
Female ; Humans

No abstract available.
Polyarteritis Nodosa*

Pigmented contact dermiatitis is a disease resulting from recirrent contact dermatitis due to hypersensitivity to cosmetic components, which produces secondery bizarre dark brown hyperpigmentation. Histological examinaition of this condition reveals liquefaction degeneration of the basal cells of the epidermis and melanopbages in the upper dermis. We report a case of pigmented contact dermatitis from musk tibeten, which was diagnosed by the histological examination, the patch and photopatch tests. Residul hisperpigmentation was seen on the region of the patch testing.
Dermatitis, Contact* ; Dermis ; Epidermis ; Hyperpigmentation ; Hypersensitivity ; Patch Tests

A clinical study was made on 85 cases of prematurity under 37 weeks of gestational age who had history of blood transfusion during their admission at the National Medical Center from January 1989 to June 1992. The results were as follows: 1) Among 339 prematurity patients, 85 patients(25.1%) received blood transfusion once at least. 2) Male to female ratio was 1.13:1 and mean gestational age was 32.5 2.7weeks (range:25~36 weeks). 3) Most of blood transfusion(66/85 cases) were performed within first week of life. 4) 67 patients(78.8%) received blood transfusion 3 times or less. 5) Combined diseases were hyaline membrane disease(69.4%), jaundice(51.8%), sepsis(30.6%), PDA (14.1%), DIC (8.2%), pulmonary hemorrhage(7.1%), intraventricular hemorrhage (7.1%), pneumonia(7.1%) and hepatitis(4.7%). 6) Clinical manifestations at the time of blood transfusion were pallor (47.1%), decreased activity (44.7%), bradycardia (23.5%),apnea (21.2%), tachypnea (20.0%), lethargy (4.7%), poor weight gain (3.5%) and tachycardia (3.5%). 7) The values of hematocrit were significantly increased after transfusion(42.4 +/-7.2 vs 34.6 +/- 6.8vol%). 8) The episodes of bradycardia were significantly decreased after blood transfusion(0.09 +/- 0.39 vs 0.23+/- 0.78)while the episodes of apnea were not (0.15 +/-0.71 vs 0.27+/- 0.84).
Apnea ; Blood Transfusion* ; Bradycardia ; Dacarbazine ; Female ; Gestational Age ; Hematocrit ; Hemorrhage ; Humans ; Hyalin ; Lethargy ; Male ; Membranes ; Pallor ; Tachycardia ; Tachypnea ; Weight Gain