No abstract available.
Hernia, Hiatal*

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

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

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*

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

The pyloric length, diameter and muscle thickness were measured by ultrasonograms of 15 infants with infantile hypertrophic pyloric stenosis (IHPS) and were compared with the infants who came in for the routine vaccination randomly. This study analyzed the changes in pylorus for those who received pyloromyotomy using the ultrasonogram at 4 weeks and 8 weeks postoperatively, such as the time needed to become normalized, and compare with the size of the hypertrophic pylorus before the pyloromyotomy. According to Carver5, the pyloric muscle volume (PMV) and pyloric muscle index (PMI) were calculated in each case. The pyloric muscle volume, PMI and the thickness of pyloric muscle proved to be a more reliable guide to diagnose IHPS than length and diameter of pylorus. The pyloric muscle after pyloromyotomy was measured by ultrasound at 4 weeks and 8 weeks postoperatively. The pyloric muscle length, diameter, thickness and pyloric muscle volume were not normalized at 4 and 8 weeks postoperatively. However, pyloric muscle index was normalized at 4 weeks postoperatively which was probably due to rapid weight gain after pyloromyotomy.
Humans ; Infant ; Pyloric Stenosis, Hypertrophic* ; Pylorus* ; Ultrasonography* ; Vaccination ; Weight Gain

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

PURPOSE: HBV infection acquired later in life elicits an inflammatory response. The quality and intensity of the response determines whether virus clears or persists. Clearance is mediated through antigen-specific cytotoxic T-cells. The immune response often precipitates cholestasis while releasing a number of inflammatory cytokines, such as tumor necrosis factor-alpha and interferon-gamma, which are known to inhibit HBV replication in vivo. Transgenic mice which replicate HBV provide a useful model for studying viral pathogenesis. We try to determine whether cholestasis, apart from inflammation, modulates HBV replication. Method: HBV-expressing female 9-wk old BALD/B6 mice matched for HBeAg titer were utilized. Cholestasis was achieved by mid-length ligation and transection of the common bile duct in anesthesized animals. Sham and ligated animals were sacrificed over at 4 h, 12 h, 24 h, 48 h, and 72 h after operation (4 animals/interval). Sera were assayed for ALT, GGT, and direct bilirubin. Histopathology was obtained. Cytokine profiles for interferons, interleukins and tumor necrosis factor were monitored by RNase protection assay. HBV replication was quantitated by measurement of HBV DNA and RNA using Southern and Northern blotting. RESULTS: Sham-operated animals remained without biochemical, pathological or serological changes. Operated animals demonstrated markedly elevated total bilirubin, ALT and GGT levels. Histologic examination showed marked periductular fibrosis and ductular proliferation and area of focal hepato cellular necrosis. Ribonuclease protection assays demon strated minimal infiltration of CD3 cells, and minimal to no migration of CD4 and CD8 cells. Interferon-gamma mRNA was not detected. TNF-alpha peaked between 1 and 3 days post surgery, but to a much lesser extent than that found in naive virus-challenged animals. Both major HBV RNA species remained unchanged during the experiment. HBV DNA production demonstrated no changes in the quantity of the relaxed circular or single-stranded intermediates for the first 2 days. However, by days 5 and 7, reduction in the quantity of viral intermediates were seen. This diminution did not appear to be due to the presence of inflammatory cytokines or CTLs (cytotoxic T lymphocytes) previously implicated in viral clearance. CONCLUSION: Whereas inflammatory cytokines and cellular immunity are essential for viral attenuation and clearance, Acute cholestasis does not appear to contribute independently to biological modulation of HBV replication.
Animals ; Bilirubin ; Blotting, Northern ; Cholestasis* ; Common Bile Duct ; Cytokines ; DNA ; Female ; Fibrosis ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunity, Cellular ; Inflammation ; Interferon-gamma ; Interferons ; Interleukins ; Ligation ; Mice ; Mice, Transgenic ; Necrosis ; Ribonucleases ; RNA ; RNA, Messenger ; T-Lymphocytes ; Tumor Necrosis Factor-alpha