No abstract available.
Hernia, Hiatal*

PURPOSE: This project is designed to investigate the immune response of a rat transplantation model to donor specific allogeneic blood transfusion (DST) prior to kidney transplantation. It has been hypothesized that partial activation of the immune system due to allogeneic antigen presentation, followed by immune unresponsiveness. In addition, previous models have shown prolonged donor cell microchimerism can be established following organ transplantation. Mixed chimerism has been demonstrated in organ transplant recipients surviving over a long period. Attempts were made to assess the fate and movements of donor cells following organ transplantation. METHODS: Rat male-to-female renal transplantation and microchimerism was assessed by semiquantitative PCR. A PCR specific for the Y-chromosome (sex-determining region Y[Sry]) allowed the distinction of small amounts of male cells in a large excess of female cells. The study group was divided into four according to the donor specific transfusion (DST) and cyclosporin (CsA) Group 1 are recipients without DST or CsA administration, Group 2 are recipient with CsA, Group 3 with DSILT and Group 4 with full immunosuppresive agent (CsA & DSILT). The samples were obtained at thymus, lymph node, spleen and sternum following transplantation day 1, 7, 21. Donor cell microchimerism were detected by donor Y chromosome in female recipients using PCR RESULTS: The Y-chromosome was detected at high levels in group 4, 21 days after transplantation. The detection ratio in the lymph node was higher than in the other organs. CONCLUSION: The fate of donor cell were closely related to he additional supporting immunosuppressive agent.
Animals ; Antigen Presentation ; Blood Transfusion ; Chimerism ; Cyclosporine ; Female ; Humans ; Immune System ; Kidney Transplantation* ; Kidney* ; Leukocytes* ; Lymph Nodes ; Male ; Organ Transplantation ; Polymerase Chain Reaction ; Rats* ; Spleen ; Sternum ; Thymus Gland ; Tissue Donors ; Transplants ; Y Chromosome

Abdominoscrotal hydrocele is a collection of fluid in the tunica vaginalis, which extends from the scrotum to the abdominal cavity. The pathogenesis is unclear but the extension may be properitoneal or retroperitoneal, and the processus vaginalis is patent or not. Pressure alone cannot explain this phenomenon, but may coexist with a preformed abnormality of the tuica vasinalis. A case is presented of an unususlly large retroperitoneal mass which was extending from the right scrotal hydrocele discovered at operation. A complete surgical excision is made through both an inguinal and a transabdominal apprach.
Abdominal Cavity ; Scrotum ; Testicular Hydrocele

PURPOSE: Cholestasis is a common manifestation of biliary obstructive diseases. This study was designed to verify histopathologic manifestations of cholestatic liver injury after bile duct ligation in a murine model. METHODS: Eight-week-old female CB6 F1 mice underwent common bile duct ligation and sacrificed at various intervals after surgery. Serum samples were used for the levels of ALT, gamma-GT, total bilirubin. Liver tissues were used for H&E stain for histopathologic examination, Masson's trichrome to assess fibrosis, and reticulin for evaluation of hepatic lobular framework and cell loss. Data were analyzed using the Students' t-test. RESULTS: In mid-duct ligated animals, marked microvesicular fatty change was noted between 1 to 2 days, which completely subsided after 3 days. Scattered variable-sized foci of hepatic cell loss were noted also, beginning at 12 hours, but becoming more prominent at 1 to 3 days. Fibrosis in larger portal tracts near the hilum was first noted through day 3, and remained at days 7 and 28. This was accompanied by marked branching and/or epithelial proliferation in the large bile ducts. Peripheral hepatic fibrosis was evident at day 5 and continued postoperatively. Liver function tests on serums showed an obstructive jaundice pattern during the first week. These values normalized by week 4. Choledochoduodenal fistulae were formed in mice surviving 4 weeks after ligation. CONCLUSION: This study provides a temporally reproducible pattern of biochemical and histopathological changes in the liver, providing a useful model for studying the pathobiology of cholestatic liver diseases secondary to extrahepatic bile duct obstruction.
Animals ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bilirubin ; Cholestasis ; Common Bile Duct* ; Female ; Fibrosis ; Fistula ; Hepatocytes ; Humans ; Jaundice, Obstructive ; Ligation* ; Liver Diseases ; Liver Function Tests ; Liver* ; Mice* ; Reticulin

Kimura's disease is a rare benign disease characterized by subcutaneous or dermal tumors occurring predominantly on the head and the neck. It usually occurs in young adults without constitutional symptoms, except for peripheral blood eosinophilia. The histopathologic features of the tumor are characterized by dense lymphoid aggregates containing a prominent germinal center and by the proliferation of endothelial cells associated with varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. We report a case of Kimura's disease without peripheral blood eosinophilia in a 24-year-old male who had had a painless and slowly growing tumor-like swelling on his right groin for one year. The mass was excised, and the specimen was confirmed as Kimura's disease. After surgical excision, the lesion recurred, so 30 mg of oral prednisone was given daily for one month and then decreased gradually for another one month. Now, the lesion is completely healed.
Endothelial Cells ; Eosinophilia ; Eosinophils ; Germinal Center ; Groin* ; Head ; Humans ; Male ; Neck ; Prednisone ; Young Adult

This study is an attempt to investigate the effect of total Ginseng saponin (GTS) on the blood pressure of the rat and to elucidate its mechanism of action. GTS, when injeced into a femoral vein of the rat, caused dose-related fall in blood pressure with secondarily elevation of the blood pressure. The depressor effect of GTS was blocked by treatment of atropine and prazosin, but not affected by pretreatment with chlorisondamine or cyproheptadine. GTS inhibited significantly the pressor response evoked by norepinephrine. The pressor effect of GTS was not affected by treatment with atropine or cyproheptadine, but was attenuated markedly by pretreatment with chlorisondamine. From the above mentioned results, it is thought that GTS produces the pressor and the depressor actions in the rat, and that its depressor response is exerted partly through the stimulation of cholinergic muscaric receptors with the blockade of adrenergic alpha-receptors, and that its pressor response is revealed by stimulation of nicotinic receptors in autonomic ganglia.
Animals ; Atropine ; Blood Pressure* ; Chlorisondamine ; Cyproheptadine ; Femoral Vein ; Ganglia, Autonomic ; Norepinephrine ; Panax* ; Prazosin ; Rats* ; Receptors, Adrenergic, alpha ; Receptors, Nicotinic ; Saponins*

PURPOSE: Many surgeons are using stapled anastomosis in Billroth I gastroduodenostomy after subtotal gastrectomy because of the shorter operation time and simpler handling. However, many patients complain delayed gastric emptying after using EEA stapler. The delayed gastric emptying was compared between manual and stapled anastomosis in Billroth I gastroduodenostomy for stomach cancer. METHODS: 92 patients who performed Billroth I gastroduodenostomy after subtotal gastrectomy due to early gastric cancer at the Hanyang University Guri Hospital between January 2001 to December 2003 were reviewed. Delayed gastric emptying was diagnosed by patients' symptoms and upper gastrointestinal roentgenogram. Manual anastomosis was using the Albert-Lambert suturing and stapled procedure with EEA stapler (auto suture(R)). RESULTS: Of the 92 patients, 22 were in the stapled anastomosis group (a mean age of 61.58 years, M:16, F:6) and 70 in the manually anastomosis group(a mean age of 61.12 years, M: 44, F: 26). The incidence of delayed Gastric emptying were significantly lower in the manual than the stapler group (P=0.035), but the operation times and the hospitas stay were significantly shorter in stapler group (P=0.001 and 0.07, respectively). CONCLUSION: The manual group had better outcomes with regard to gastric emptying despite of the many advantages of stapled anastomosis in the filedld of intraabdominal operations. Various stapled anastomosis instruments and methods have been tried, but further studies are necessary if stapled anastomosis is to be the perfect substitute for manual anastomosis.
Gastrectomy* ; Gastric Emptying* ; Gastroenterostomy* ; Humans ; Incidence ; Stomach Neoplasms*

No abstract available.
Emergencies* ; Emergency Service, Hospital*

Perforation of the appendix into the neighboring viscera is an uncommon sequel to acute appendicitis, and the persistence of the fistula between the appendix and a viscus is even rarer. Although a variety of causes such as foreign body ingestion and regional enteritis may be responsible for persistent appendiceal enteric fistula, the cause for these unusual lesions in our experience appeared to be antecedent appendicitis. Generally, the incidence of persistent appendiceal enteric fistula is very rare and the progress of disease is quite different from the so-called 'usual' acute appendicitis. The diagnosis might lean the wrong way such as towards colitis or cystitis, and so surgical intervention is delayed. Treatments of perforation are diversion (colostomy), as is shown above or conservative treatment such as drainage only.
Appendicitis ; Appendix ; Colitis ; Crohn Disease ; Cystitis ; Diagnosis ; Drainage ; Eating ; Fistula* ; Foreign Bodies ; Incidence ; Viscera

PURPOSE: The role of mutation of p53 gene on the carcinigenesis was studied since 1991. There were some relationships of p53 mutation and clinicopathologic factors. This sutudy was designed for the clinicopathologic and genetic factor relation in Korean breast cancer. MATERIALS AND METHOD: A retrospective study on the clinicopathologic findings such as age, menopausal status, TNM stage, histologic grade, estrogen receptor, DNA ploidy and S-phase fraction was camed out on 47 breast cancer tissues which had been resected at the Department of Surgery, Hanyang University Hospital. Forty-seven tissues were grouped into 3 groups. Group 1 was ductal carcinoma in situ, Group 2 was invasive ductal carcinoma without axillary lymph node metastasis and Group 3 was invasive ductal carcinoma with axillary lymph node metastasis. The numbers of tissues in each groups were 14, 15 and 18, respectively. Mutation screening on the p53 tumor suppressor gene was also performed with PCR-SSCP-direct sequencing method from the genomic DNA extracted from formalin fixed and paraffin-embedded pathologic tissue blocks. The results were as followings; RESULT: p53 mutations were detected in 12 cases(25.5%) of 47. In Group 1, 4 cases(28.6%) had mutations, and in Group 2, 5 cases(33.3%), and in Group3, 3 cases(16.7%). There was no significant differences in mutation rate between three groups. In 12 mutations detected, 6 cases were transition, 5 of which were missense mutation in coding sequences, and one of which was splicing mutation at acceptor site. One case was transversion and five cases were deletions or insertions of various lengths resulting in frameshift mutations. There was no statistically significant difference between groups and clinicopathologic factors except the strong relationship between the negative estrogen receptor and p53 mutation(p< 0.001). CONCLUSIONS: From the above findings, p53 gene could be considered to be inactivated at the all stage of multistep carcinogenesis processes. The nature of mutations and genetic background of Korean breast cancers may be somewhat different from those of Caucasians. And the p53 mutation status may be used as one of the useful prognostic factors in addition to the estrogen receptor status.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Clinical Coding ; DNA ; Estrogens ; Formaldehyde ; Frameshift Mutation ; Genes, p53 ; Genes, Tumor Suppressor ; Lymph Nodes ; Mass Screening ; Mutation Rate ; Mutation, Missense ; Neoplasm Metastasis ; Ploidies ; Retrospective Studies