In spite of the great measure of recent success in tuberculosis withchemotherapy, it is still one of the most fundamental questions in what state ofrenal tuberculosis should be treated surgically. So as to set up a criterion onthe chemotherapy, forty-nine extirpated tuberculous kidneys were observed withmy own classification of tuberculous renal lesions. 1. The lesions were classified macroscopically and pyelographically according to the development of renal tuberculosis (1) Those with neither change of calyceo-pelvic system nor pyelographical abnormality were named Class O. representing parenchymal tubercles. (2) Those with only infiltration in the tip of papilla were named Class I, showing caliectasis or clubbing pyelographically. (3) Those with initial minor ulceration in calyceal system were named Class II, showing fuzzy irregular or moth-eaten outline pyelographically (4) Those with progressed distorted ulceration were named Class III, showing definite irregular deformity but still keeping some semblance to the original calyceal form pyelographically. (5) Those with cavitation, open or closed were named Class IV, showing irregularly outlined shadow without original anatomic form pyelographically. (6) Those with tuberculous pyonephrotic ectasis were named Class E, showing less irregularly out lined cavity shadow pyelographically. 2. Tuberculous kidneys might also be graded clinically and pyelographically with the classification of the lesions. (1) The tuberculous kidneys with early lesions,i.e. Class O, Class I and/or Class II were called minimal renal tuberculosis.(2)Those with intermediate lesions. i.e. Class III were called moderate. (3) Those with a progressed lesion, i.e. Class IV or Class E were called advanced. (4) Those with two or more lesions of Class IV and/or Class E were called far advanced. 3. The lesions belong to each Class were divided again into untreated control group and three treated groups with triple drug therapy of different durations and the macroscopical and histopathological appearances in each treated group were compared with in untreated one. 4. Macroscopically the lesions in treated kidney with remaining excretory function and without obstruction showed tendency toward clearing of caseous material in each class.5. The specific reactions in tuberculous tissue were improved histopathologically in proportion to duration of the therapy. (1) Caseous material was cleared up. (2) Epithelioid cells revealed sufficient degeneration and diminution, occasionally complete disappearing. (3) Giant cells also revealed degeneration, vacuolation and diminution, frequently complete disappearing. 6. The severity of non-specific tissue reactions in the lesions. i.e. connectivetissue reaction, parenchymal degeneration and defect, interstitial inflammation and lymphocytic infiltration was not influenced by duration of the therapy, but depended on Class of lesions at the time of therapy began. 7. The repairing reactions in the lesions were increased according as prolongation of the therapy, but there might be some variety between the different reactions. (1) Vascularization: according as the duration, but not remarkable. (2) Regeneration of epithelium: according as the duration, but only partial covering. (3) Vacuolation: significant, however, also noticed in untreated group. (4) Reducing of perifocal reaction: according as the duration, but not sufficient in the progressed lesions.8. In the more progressed tuberculous lesions, specific and non-specific tissuereactions predominsted over repairing, therefore histological healing was more delayed. 9. There were noticeable evidences of histological improving in the specimens from patients with triple drug therapy for more than three months. 10. As a result of these observations, I should like to recommend that: (1) for minimal renal tuberculosis, chemotherapy is continued; (2) for moderate, chemotherapy is tried firstly, and if the lesions are persistent or worsened surgery will be considered; (3) for advanced and far advanced, surgery including partial nephrectomy is preferable after at least three month chemotherapy.
Classification ; Congenital Abnormalities ; Drug Therapy* ; Epithelioid Cells ; Epithelium ; Giant Cells ; Humans ; Inflammation ; Kidney* ; Nephrectomy ; Regeneration ; Tuberculosis ; Tuberculosis, Renal ; Ulcer

No abstract available.
Catheters*

No abstract available.
Cell Line* ; Humans*

The positive binding activity of lectin, peanut agglutinin (PNA), against the mucinous malignancies of the ovary was studied in order to clarify biologic differences among those lesions using immunoperoxidase method (ABC). A total of 23 cases were included in this study and they were classified as 10 cases of mucinous cystadenocarcinoma, 9 mucinous tumors of borderline malignancy and 4 pseudomyxoma peritonei, histologically. Nine of 10 cystadenocarcinomas and all cases of pseuomyxoma peritonei showed more than moderate degree of positive binding activity (>2+) with PNA in the neoplastic epithelial cells. In the cases of borderline malignancy, only 3 of 9 revealed as much similar binding pattern with PNA as cystadenocarcinoma group, in contrast, minimal degree of positivity (1+) was noted in the remainder. These findings may suggest heterogeneity in the biochemical characteristics among the cases of borderline lesion. And it is proposed that the higher PNA binding cases in ovarian mucinous borderline malignancy require extensive sampling by multiple sections and further careful follow-up study.
Follow-Up Studies

We designed this study to analyze the causes of repeat surgery in the low back disorder after primary procedure, to evaluate the risk factors and to suggest the rational approachs can prevent and solve the problems related with repeat surgery. We retrospectively reviewed the medical record and radiographs of 24 patients who had sustained persistent or recurrent pain, failed to extended conservative therapy, showing abnormal myelogram and/or CT scan with nerve root compression, and with segmental instability consistent with patients symptom and sign after the primary procedures. We evaluated the functional outcome according to Kims(1986) criteria. The causes of remained or recurrent pain with neurologic symptom were persistent or aggravated lumbar spinal stenosis in 10 cases(42%), recurrent disc herniation in 4 cases(17%), infection in 3 cases(12%), instability in 2 cases(8%) and others in 5 cases(20%). Satisfactory outcome was recorded in 79%(19/24) of patients. The characteristics of the patients associated with satisfactory outcome were those who operated by recurrent disc herniation, instability, retained disc, metal malposition, and nerve root compression by bone chip. But the characteristics of the patients associated with unsatisfactory outcome were those who operated by infection, lumbar spinal stenosis aggravated by degenerative spondylosis and multiple herniated disc, inadequate decompression of lateral and/or foraminal stenosis in aged patients. The most common lesion site was on L4-5 disc, and unsatisfactory result was expected at the upper lumbar spine involvement. Favorable outcome could be expected in the presence of a pain-free interval more than 1 year from the date of the previous operation or persistent symptoms immediately after the initial operaion. We were expected the risk factors leading to repeat surgery were old aged(more than 60) patients, upper lumbar spine involvement and multiple lumbar disc herniation. Postoperative diskitis or osteomyelitis, pain free interval more than 1 month or less than 1 year, and those who had a revision on the lumbar spine previously could be considered as a poor prognostic indicators. When surgery is indicated for degenerative lumbar spinal disorders, adequate diagnostic tests and the execution of appropriate procedures based upon this information should be carried out to prevent the repeat surgery in the low back disorders. Adequate postoperative management can reduce the occurrence of failed back surgery syndrome and in cases necessitating repeat surgery, thorough analysis of causes following proper surgical stabilization can reduce the operative morbidity with early return to daily life.
Constriction, Pathologic ; Decompression ; Diagnostic Tests, Routine ; Discitis ; Failed Back Surgery Syndrome ; Humans ; Intervertebral Disc Displacement ; Medical Records ; Neurologic Manifestations ; Osteomyelitis ; Radiculopathy ; Reoperation* ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine ; Spondylosis ; Tomography, X-Ray Computed

No abstract available.
Diagnosis*

Present trial was carried out to evaluate the anthelmintic efficacy of oxantel/pyrantel tablets against intestinal nematode infections, and to determine the efficacy of oxantel tablels against Trichuris infection. A total of 34 subjects with the mixed infections were treated with oxantel/pyrantel tablets (100 mg/tablet each) in a single dose of 15 mg/kg body weight, and another group of 22 Trichuris infected cases received oxantel pamoate tablets (125 mg/tablet) in a single dose of 15 mg/kg. All stool examinations were done before the treatment and 3 weeks after the treatment. The cellophane thick smear (Kato's technique) and Stoll's dilution egg counting method were employed. The results of the trial were summarized as follows: The cure rates (egg negative conversion rates) and egg reduction rates for oxantel/pyrantel tablets were 85.3 percent and 97 percent in trichuriasis, 100 percent each in ascariasis and ancylostomiasis. The oxantel tablet treated group demonstrated a cure rate of 90.9 percent and an egg reduction rate of 96.3 percent in the treatment of Trichuris. There were no detectable objective and subjective side effects in this trial. Both oxantel/pyrantel and oxantel pamoate tablets were readily accepted and well tolerated.
parasitology-helminth-nematoda ; Enterobius vermicularis ; Ancylostoma duodenale ; Trichuris trichiura ; chemotherapy-oxantel/pyrante ; oxantel pamoate

The present study was undertaken to observe the quality and quantity of lipids in the adult worms of Chinese liverfluke, Clonorchis sinensis. Lipid extraction was done by the methods of Folch et a1. (l957) and Kenny (1952), and then the extracted lipid fractions of the worm were separated by thin layer chromatography. Those fractions were also subjected to perform the quantitative analyses of glycerides, cholesterols and phospholipids. The results obtained were summarized as follows: Total amount of glyceride was 37.56 mg per gram of worm tissue and the amount of monoglyceride was 8.34 mg per gm; diglyceride, 15.46 mg per gm; and triglyceride, 12.86 mg per gm. Total amount of cholesterol was 3.30 mg per gm of worm tissue, and the esterified cholesterol (1.72 mg/gm) was a little more than that of free cholesterol (1.26 mg/gm). The following 8 phospholipids were detected in the worm tissue of C. sinensis, i.e., lysophosphatidylcholine, phosphatidylcholine, phophatidylinositol, sphingomyelin, phosphatidylglycerol, phosphatidylserine, phosphatidylethanolamine and an unknown phospholipid.
parasitology-helminth-trematoda ; Clonorchis sinensis ; biochemistry ; glyceride ; cholesterol ; phospholipid ; lipid ; lysophosphatidylcholine ; phosphatidylcholine ; phophatidylinositol ; sphingomyelin ; phosphatidylglycerol ; phosphatidylserine ; phosphatidylethanolamine

The present experimental study was undertaken to observe the chronological change of the worm structure of Clonorchis sinensis and the pathological findings of the liver when this fluke was inoculated to the mouse intraperitoneally. The recovery rate, survival rate, location and size of the inoculated worms as well as the pathological changes of the liver were investigated for the comparison among the groups of mice, classified by number of worms and the duration of experiment. The results obtained were summarized as follows: The recovery and survival rates of the worms decreased especially 28 days after the inoculation. Most of worms (90.l percent) were collected from the peritoneal cavity and some of worms were found tightly adherent to the capsules of the liver, spleen, stomach, intestine and diaphragm. There were no worms recovered penetrated in the parenchymes of these organs. The mean worm size after inoculation was smaller than that before inoculation. At the 10th day after the inoculation, the shrinkage of posterior portion of the worm body was observed. Remarkable atrophy in the reproductive organs of the worm, such as spermatheca, testes, vitelline glands and ovary was frequently observed at the 10th day of inoculation. Histopathologically the liver failed to show any parasitic worm inside the intrahepatic biliary system. However, multiple well formed egg-containing granulomas were present along the liver capsule. These necrotic granulomas were occasionally found under the fibrotic liver capsule. Focal necrosis and focal phlebitis together with vascular dilatation were prominent features seen in the liver. The bile duct in the liver showed mild dilation of the lumen, flattening of epithelial cells and periductal small round cell infiltration. Neither adenomatous hyperplasia nor portal fibrosis was seen in the whole experimental groups. Foci of intralobular micro-granulomas were found in some experimental animals. The worms recovered in the capsule of the liver were degenerated and necrotized. Usually, there were remarkable capsulitis and granuloma formation around the eggs.
parasitology-helminth-trematoda ; Clonorchis sinensis ; pathology ; liver ; spleen ; stomach ; intestine ; diaphragm ; granuoma ; peritoneal cavity

To understand the mode of transmission in clonorchiasis, a survey was made in Kim-hae Goon, South Kyong-sang Do (=Province). The mathematical analysis of the age prevalence was done on the egg positive rates. And another analysis for the comparison was also made to the cited data from two areas, North Kyong-sang Do and Ko-yang Goon, Kyong-gi Do. Some catalytic models of H. Muench (1959) were applied to the observed age prevalence. Because the both parameters, such as force of infection(a) and loss of positivity(b) were considered to be constant for a long period in the surveyed area, the two stage catalytic model by Muench was chosen to the analysis. In the surveyed area, Kim-hae Goon where the egg positive rates were 56.2 percent and 61.2 percent (by Kim, 1974), the constant values of 'a' were found to be 0.051 and 0.089 respectively. In other words, the force of infection was 51, 89 per 1,000 susceptibles. The values of 'b' were found to be 0.006 and 0.005. This means that the rates of disappearance from egg positive cases to negative were 6 and 5 per annum per l,000 positive cases in above area. Therefore, the two catalytic curves were expressed by the following equations, y = 1.133 {e(-0.006t) - e(-0.051t)} and y = 1.047 {e(-0.005t) - e(-0.089t)} respectively. In the cases of North Kyong-sang Do and Ko-yang Goon, Kyong-gi Do where the egg positive rates of clonorchis shown as 27.7 percent and 15.2 percent by Shin (1964) and Kim (l974), the curves were expressed by y = 1.769 {e(-0.010t) - e(-0.034t)} and y = 2.857 {e(-0.020t) - e(-0.027t)} respectively. From the above mathematical analyses by age prevalence in clonorchiasis, it was considered that the mode of transmission of clonorchiasis in the surveyed area, Kim-hae Goon presented more rapid pattern than those of North Kyong-sang Do and Ko-yang Goon, Kyong-gi Do.
parasitology-helminth-trematoda ; clonorchiasis-Clnorchis sinensis ; epidemiology ; transmission