One hundred and ten rats weighing 100 gm. or more were used. These animals were divided into two study groups. The first consisted of 80 rats and this groupwas used to follow up the process of bladder regeneration. The second consisted of 30 rats and in this group polyethylene tube (I.D. .023" X O.D. .038") was placed in the space after subtotal cystectomy through the urethra, and the tube was sutured to the urethra with 4-0 silk to investigate whether the urinary retention is necessary for the bladder regeneration. Anesthesia was accomplished by intraperitoneal and through a subumbilical median incision the bladder was exposed transperitoneally and subtotal cystectomy was done saving the trigone andureteral orifices. To prevent the urinary leakage the edge of remnant bladder wasclosed with 4-0 chromic catgut. In the first group, 10 rats each were sacrificed at intervals of one week after initial operation for 8 weeks. There was complete restoration of what appeared to be normal bladder capacity at the end of 8 weeks. The regenerated bladder was a definite thick-walled pouch lined with normal epithelium and many capillaries. In the second group, 30 rats were sacrificed after the initial operation: 6 each at the 4th, 5th, 6th, 7th and 8th week. At the end of 8 weeks regeneration of the bladder was markedly inhibited as compared with the first group. It is felt that the mechanical stretch of the bladder is the main factor by which the bladder grows. The urine pooling in the pouch serves not only to preserve and enlarge the pouch but also to develop the elements of new bladder wall by intermittent filling and emptying. The most inhibitory factorin bladder regeneration is the wound infection.
Anesthesia ; Animals ; Capillaries ; Catgut ; Cystectomy ; Epithelium ; Follow-Up Studies ; Polyethylene ; Rats ; Regeneration* ; Silk ; Urethra ; Urinary Bladder* ; Urinary Retention ; Wound Infection

No abstract available.
Female ; Humans ; Immunoglobulin G* ; Immunoglobulins* ; Immunotherapy* ; Infertility* ; Pregnancy*

Blood utilization review has recently been used to minimize inappropriate transfusion, reduce post transfusion infections and improve the quality of transfusion practices. Ajou University Hospital is a 906 bed tertiary care teaching institution. Since March, 1995, the concurrent review of blood transfusion requests using institutional blood transfusion criteria has been initiated. To evaluate the effectiveness of the transfusion review, the units of blood components transfused per patient(total number of units of blood components transfused/total number of patients discharged) and inappropriate transfusion ratio of blood components(total number of units of blood components inappropriately transfused/total number of units of blood components transfused) were compared during the concurrent review for 9 months and pre-concurrent review for 9 months, respectively. The possible savings of blood components realized by the review were also extrapolated. The results were as follows : 1. The unit transfused per patient for pre-review and during review were 0.675 (9,080/ 13,422) and 0.654(12,123/18,546) for packed RBC(PRBC); 0.417 (5,602/ 13,422) and 0.296 (5,444/18,546) for fresh frozen plasma(FFP); 0.372(5,007/13,422) and 0.424(7,868/18,546) for platelet con-centrates(PC), respectively. 2. The inappropriate transfusion ratio of blood components for pre-review and during review were 0.039 and 0.009 for PRBC; 0.321 and 0.064 for FFP; 0.143 and 0.008 for PC, respectively. These differences were statistically significant(p=0.000). 3. The PRBC and FFP anticipated to have been saved by this review was 519 units and 2,992 units annually, respectively. 4. However, 2,621 units of PC were used additionaly during this review due to increased number of oncology patients and better hemostatic therapy practiced during the same period. In conclusion, the concurrent review of transfusion requests was very effective tool to educate residents in clinical departments the transfusion medicine and improve utilization of blood and its components.
Blood Platelets ; Blood Transfusion* ; Concurrent Review* ; Humans ; Income ; Tertiary Healthcare ; Transfusion Medicine ; Utilization Review

No Abstract Available.
Retinal Detachment* ; Retinaldehyde*

The cell cycle is composed of G1, S, G2 and M phase. The transitions between different phases are regulated at checkpoint such as Start(restriction), S phase and mitotic checkpoint. These checkpoints are regulated by specific cyclins and Cdks(cyclin-dependent kinases). Especially, Start checkpoint in late G1 is though to be very important in control of cell cycle. In this study, it was shown various CDKN2(p16ink4A) alteration, including deletions, mutations, down regulations, and performed differential expression of p53, Cdk4, PCNA and pRb in stomach cancer tissues. 1. The frequency of CDKN2 mutations was not observed in the 19 primary stomach cancer tissues. In contrast to the mutations of CDKN2, mRNA levels was showed by Northern blot analysis that expression of CDKN2 was absent or decreased in 10 of the 19(53%) primary stomach adenocarcinoma. Western blot analysis was performed to determine the differential expression of p53, Cdk4, PCNA related to Start checkpoint. Overexpression of p53 was shown 38%, Cdk4 was expressed in all each specimens, and expression of PCNA was not shown. 2. As the other method to determine the differential expression of p53, Cdk4, PCNA and pRb, immunohistochemical analyses were performed on each 14 formalin-fixed and paraffin embedded tumor tissues of stomach adenocarcinoma. p53 overexpression was showed to clear nuclear staining only in tumor cells not in nonneoplastic cells. In staining for cdk4, the tumor was considered to be cdk4 positive if there was nuclear staining in tumor cells, regardless of cytoplasmic staining. PCNA staining for carcinoma tissues showed more intense nuclear staining in tumor cells than in nonneoplastic cells. pRb overexpression was show in tumor cells. Significant differences were observed in the expression of the proteins among the cancers from different anatomic site. Overexpression of adenocarcinomas had high rate of p53(57.1%) and pRb(71.4% ), and low late of cdk4(7.1% ) and PCNA(14.3% ), As these results, deletion of CDKN2 gene in human stomach cancer was not observed but mRNA expression was down regulated in restriction checkpoint, G1 phase. Inactivation of the CDKN2 gene due to hypermethylation may play an important role in development of cancer. And one of the abnormalities in p53, Cdk4, PCNA or pRb function occurs very common in various cancers, especially oral adenocarcinoma, osteosarcoma and squemous cell carcinoma, suggest that components in restriction checkpoint also play an critical role in the carcinogenesis and progression of cancers.
Adenocarcinoma ; Blotting, Northern ; Blotting, Western ; Carcinogenesis* ; Cell Cycle ; Cell Division ; Cyclins ; Cytoplasm ; G1 Phase Cell Cycle Checkpoints ; Genes, p16 ; Humans ; M Phase Cell Cycle Checkpoints ; Osteosarcoma ; Paraffin ; Proliferating Cell Nuclear Antigen ; RNA, Messenger ; S Phase ; Social Control, Formal ; Stomach ; Stomach Neoplasms

The introduction of the strong clover-leafed nail combined with the principle of reaming out the medullary canal and the development of image intensifiers has been extended the indications of the in tramedullary nailing. In this report, an attempt was made to introduce the method and to verify the indications and advantage of retrograde intramedullary nailing of humeral shaft fractures, as compared with the conventionally accepted methods.
Fracture Fixation, Intramedullary ; Humerus ; Methods

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

The pathogenesis of IgA nephropathy is unknown, but the systemic character of the IgA deposits (skin and glomerular capillaries), the presence of circulating IgG and IgA complexes and its similarity to Henoch-Schonlein purpura suggest that it is an immune-complex mediated disease. The nature and source of the antigen are unknown. Anatomically, the extremely vascular uvea offers a favorable site for the interplay of various components of immune reaction. We have experienced a 21-year old male who had a choroiditis and IgA nephropathy and had suffered the Henoch-Schonlein purpura when he was 16-years old. We performed the choroidal aspiration and scleral buckling, but steroid and other specific therapy were not given. In the course of follow-up check, the choroidal lesion and hematuria were progressively subsided. In conclusion, we report that the choroiditis is manifested as a part of immunecomplex mediated disease associated with IgA nephropathy.
Adolescent ; Choroid* ; Choroiditis* ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Male ; Purpura, Schoenlein-Henoch ; Scleral Buckling ; Uvea ; Young Adult

PURPOSE: The globe luxation is a rare phenomenon in which there is a forward displacement of the eye ball so that the eye lids spasmodically close behind it. In Korea, no case has been reported. The authors experienced a case of globe luxation by laceration of the conjunctiva with trauma. METHODS: The authors experienced a case of globe luxation in 64-year-old male who had crushed with infantile marry-go-round handle and complained proptosis and ocular pain. Ocular examination revealed best corrected visual acuity of right eye 0.1, IOP 44mmHg, conjunctival hyperemia and laceration, extraocular muscle limitation in all direction. Exophthalmometer shows right eye 23mm, left eye 19mm. Orbital CT yielded proptosis and globe luxation without avulsion of internal and external rectus muscle and optic nerve. RESULTS: After the lateral canthotomy, we successfully treated with the corticosteroid therapy without visual impairment or eyeball movement disorder. we report a case of globe luxation with the review of literature.
Conjunctiva ; Exophthalmos ; Humans ; Hyperemia ; Korea ; Lacerations ; Male ; Middle Aged ; Movement Disorders ; Optic Nerve ; Orbit ; Vision Disorders ; Visual Acuity

OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.
Classification ; Hospital Information Systems* ; Humans ; Information Centers