Pulmonary paragonimiasis is one of the most important endemic parasitic disease in Korea. Although it is well known that Paragonimus westermani invades into the lung tissue eventually resulting respiratory failure, the pathogenesis of inducing lung lesions is not fully elucidated. It is still debatable on the nature of morphological component of 'cyst' which is known to be the most consistent change in lung paragonimiasis. For the purpose of clarification of morphological changes associated with pulmonary paragonimiasis, an experimental study was carried out by giving metacercariae of P. westermani to 10 dogs. These dogs were sacrificed 2 months and 6 months after infection respectively, and light microscopic and electron microscopic observations were made. Following conclusions were obtained. Paragonimus lung lesions could basically be classified into two categories, i.e., direct mechanical effects by the worms and eggs, and the changes secondary to the worm infection. The relative importance of these two appeared almost same. Adult worms of P. westermani reside inside the lumina of the dilated bronchi in great majority of the cases. Only exceptions were secondary abscess formation and subsequent scar where no epithelial lining was detected around the worms. In 6 months group almost all P. westermani worms were found inside the bronchial lumina. Obliterative endobronchiolitis was another prominent feature among changes that were not directly associated with worms or eggs. This finding was more prominent in the distal segments of the bronchial trees that harbor the Paragonimus worms. P. westermani eggs were found as isolated and aggregated fashions, provoking characteristic granulomatous inflammation. Some of the egg granulomas were seen in the areas apart from the locations where the worms were physically located. Ultrastructural observations of the cyst wall showed fair numbers of plasma cells and mast cells. Some of the cystlining epithelial cells showed increased deposit of glycogen granules, suggestive of early metabolic alteration of the respiratory epithelium.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; dog ; lung ; histology ; pathology ; egg granuloma ; plasma cell ; glycogen

This study was conducted to evaluate the effect of prolonged treatment in children with chronic hepatitis B with combination of alpha-interferon and acyclovir. The study population consisted of 7 patients with chronic hepatitis B who showed histological findings compatible with chronic active hepatitis (4 cases) or chronic persistent hepatitis (3 cases) on liver biopsy and had elevated AST and ALT with positive HBsAg, HBeAg and HBV-DNA for more than 6 months. Recombinant interferon-alpha-2 was given in a dose of 3 million IU/m2 daily for 3 months with acyclovir in a dose of 15mg/Kg of body weight every 12 hours for 7 days of each month for 3 months. Then, the same dose of interferon was given thrice a week for 9 more months. One patient who had vertically transmitted hepatitis B from her mother had received only 6 months of treatment in total as she did not show any effect after 6 months of treatment. Among 6 patients who had positive HBV-DNA on entry to the study, 4 patients (66.7%) showed conversion of HBV-DNA to negative. HBeAg was converted to negative in 3 patients (42.9%). AST and ALT became normal in 6 cases but HBsAg remained positive in all cases. prolonged treatment in children with chronic hepatitis B with combination of alpha interferon and acyclovir seems to be beneficial but the proper dosage and duration of therapy need to be determined with further and controlled study.
Acyclovir* ; Biopsy ; Body Weight ; Child* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver ; Mothers

In an attempt to investigate the antigen-antibody relations and the value of immunodiagnosis for several helminths, Ouchterlony tests and immunoelectrophoreses were carried out. Taenia saginata, Cysticercus sp. of cestodes, Clonorchis sinensis, Fasciola hepatica and Paramphistomum sp. of trematodes,and Ascaris suum of nematodes were used as antigens. On the other hand, antisera were obtained by injecting 0.5 ml each of the above antigens and the same amount of complete Freund's adjuvant into rabbits ten times at an interval of one week. The result obtained in this study are as follows: A larger number of precipitin arcs were demonstrated in homologous antigen-antibody reactions than in heterologous antigen-antibody reactions both in Ouchterlony tests and immunoelectrophoreses. Gross reactions were observed between the different species of the same class, but no cross reactions were noticed when the classes were different with one or two exceptions, such as between T. saginata, F. hepatica and A. suum. In A. suum, the difference between the male and female was more distinct in Ouchterlony test and immunoelectrophoresis than in the examination of organs such as genital organ and coeliac fluid. Immunoelectrophoresis revealed specific arcs and higher sensitive reaction than Ouchterlony test, and was considered to be a more valuable method for identifing species and immunological diagnosis.
parasitology-helminth-trematoda ; cestoda ; nematoda ; immunoelectrophoresis ; Taenia saginata ; Cysticercus ; Clonorchis sinensis ; Fasciola hepatica ; Paramphistomum sp. ; Ascaris suum ; antigen ; immunology

Fatigue is regarded as a universal and unavoidable side effects of chemotherapy. Most of patients in chemotherapy prefer resting and reducing their level of activity, but reduced physical activity can actually decrease physical strength and functional status to produce secondary fatigue. The purpose of this study was to determine the effects of rhythmic walking exercise on physical strength, fatigue, and functional status of breast cancer patients in adjutant chemotherapy. A matched control group pretest-pottiest design was used. Seventeen subjects of the experimental group were taught the rhythmic walking exercise(Winningham etal, 1990) on their first visiting day and encouraged to practice it at home throughout that treatment cycle(four weeks). Participants kept an everyday exercise diary that included pulse rates, exercise time and subjective data. The rhythmic walking exercise consists of approximately 30-minute walking, everyday if possible for 4 weeks. Outcomes were measured by each instrument :1) physical strength by the treadmill test estimated the walking ability. The subject is instructed to walk as long as possible to the level of their tolerance ;2)functional status by the Inventory of Functional Status-Cancer(Tollman et al, 1991) ; and 3)fatigue was measured by the Piper Fatigue Scale in both groups at five different times-before beginning chemotherapy(pretest) and one time per week for 4 weeks. Data were analyzed with mean, standard deviation, X2-test, t-test, repeated measure MANOVA using SPSSWIN program. Results were obtained as follows :1)The physical strength of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise(t=3.92, p<.001). 2)The fatigue scores of the experimental group measured at the end of each week were significantly lower than those of the control group following the rhythmic walking exercise (1st week ; F=6.51, p<.016, after 1st week ; 863, p<.0001, after 2nd week ; F=46.754, p<.0001, after 3rd week ; F=60. 183, p<.0001, after 4th week). 3)The functional status of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise (t=13.20, p<.0001). The results suggest that the appropriate rhythmic walking exercise for the breast cancer patients in adjutant chemotherapy can improve physical strength and functional status, and ultimately decrease the secondary fatigue.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Exercise Test ; Fatigue* ; Heart Rate ; Humans ; Motor Activity ; Piper ; Walking*

In an attempt to investigate the sensitivity of immunodiagnosis in cats experimentally infected with Paragonimus westermani, agar-gel precipitin reaction were studied. Metacercariae of P. westermani were administered to cats in various doses(2-100 metacercariae per cat) and antisera were obtained at an interval of a week. Precipitin bands appeared in homologous antigen-antibody in experimental paragonimiasis between 3 and 5 weeks after infection in all the cats. Almost all the cases in which a large number of worms were detected, showed strong reactions as revealed by deeply stained bands. Precipitin reactions did not necessarily parallel with the number of worms detected. This may be attributable to the individual difference of a cat's conditions. Very weak precipitin reactions were noticed between Clonorchis antigen and Paragonimus antisera of cats, but no reactions were noticed between Paragonimus antigen and Clonorchis antisera of cats or rabbits.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus westermani ; immunology ; Clonorchis sinensis ; cat ; rabbit

The concept of comfort has been regarded as a core concept of nursing and it has been frequently used as one of main goals of nursing care. Promoting comfort has been a very important objective in clinical nursing practice. There have been some ambiguities in defining the concept of 'comfort" among nursing scholars. Therefore it was necessary to analyse the concept of comfort for clearer definition to be able to share among scholars. This study is an attempt to analyse concept of comfort and to do it according to a series of concept development processes described by Walker and Avant. Based on the results of the study, the attributes of scope, precedence and consequence of comfort were identified : 1. Attributes 1) stability 2) directionality 3) equilibrium 4) firmness 2. Scope 1) physical 2) social 3) emotional 4) spiritua~ 3. Precedence and Consequence 1) precedence (1) instability (2) unsatisfied needs 2) consequence (1) physical & psychological relaxation (2) enhancement of self-worth (3) enhancement of self-efficacy (4) satisfied needs.
Nursing ; Nursing Care ; Relaxation

In an attempt to investigate the specific antigenic substance of Fasciola hepatica, Ouchterlony tests and immunoelectrophoretic analyses were carried out. Crude Fasciola antigen was prepared and fractionated by Sephadex G-200 column to Antigen I, II and III according to protein content. Crude antigens of Paragonimus westermani, Clonorchis sinensis and Paramphistomum sp. were also prepared for control and absorption study. Antiserum was prepared by injecting 0.5 ml of crude Fasciola antigen with same amount of complete Freund's adjuvant in rabbits, 10 times at an interval of l week. The results obtained in this study were as follows: Crude Fasciola antigen reacted with antiserum with 9 precipitin bands by Ouchterlony test and with 11 bands by immunoelectrophoresis. Cross reaction was observed between Paragonimus, Clonorchis and Paramphistomum antigens and anti-Fasciola rabbit serum respectively. By Ouchterlony test, 3-4 cross reacting bands were found. Anti-Fasciola sera which were absorbed with respective Paragonimus, Clonorchis and Paramphistomum antigens, reacted with Fasciola crude antigen. Ouchterlony test gave 5-6 precipitin bands. Further reaction between Fasciola antigen and antiserum absorbed with the above 3 antigens concomitantly gave 5 precipitin bands by Ouchterlony test and 7 bands by immunoelectrophoretic analyses. Fractionated Fasciola antigens (Antigens I, II and III) reacted with anti-Fasciola rabbit serum in immunoelectrophoresis. Antigen I, II and III gave 2, 3 and 5 precipitin bands respectively. Anti-Fasciola rabbit serum which was absorbed with 3 trematodes antigens gave, by immunoelectrophoresis, 1 band with Antigen I, 2 bands with Antigen II and III of Fasciola hepatica. From the above results, it is concluded that Fasciola hepatica possessed the specific antigenic substance not cross-reacted with other trematodes.
parasitology-helminth-trematoda ; Fasciola hepatica ; Paragonimus westermani ; Clonorchis sinensis ; Paramphistomum sp. ; antigen ; immunology ; electrophoresis

To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system (Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56microgram, 7.53microgram in nuclear grade 1, 8.92+/-0.98microgram, 9.02+/-0.74microgram in nuclear grade 2, and 12.90+/-1.47prn, 12.44+/-1.41microgram in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. Ths would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.
Breast ; Carcinoma, Ductal ; Erythrocytes ; Pathology, Surgical ; Purpura*

Serological studies on toxoplasmosis were conducted with rabbits sera that were immunized with RH strain or infected with Beverley strain of Toxoplasma gondii. Complement fixation tests, agar-gel double diffusion tests and agar-gel immunoelectrophoresis were performed. Toxoplasma crude antigen was prepared from the organisms in mice peritoneal fluids, which were infected with RH strain of Toxoplasma gondii. The organisms were suspended in saline volume originally exudated and counted in hemocytometer for purity of the organisms over 99 per cent. These suspended organisms were prepared by sonication, and the solution was centrifuged for 30 min. at 10,000 rpm in 4C. These supernatant fluids were used as crude antigen. On the other hand, purified antigens were fractionated on Sephadex G-200 gel filtration. A Sephadex G-200 column, 80 by 4 cm, equilibrated with Tris-HCl-(0.1 M)-NaCl (1.0 M) buffer, pH 8.0 was used. The eluate fractions were collected in 3 ml per hour and the absorbance at 280 nm was measured with a Beckman Du-2 spectrophotometer. Each tube is pooled into 6 fractions by protein density graph. For immunization of rabbits, crude antigen of RH strain was emulsified with an equal amount of incomplete Freund's adjuvant and l ml of mixture was injected subcutaneously into them once a week for 5 successive weeks. Antisera were obtained at an interval of a week, beginning the first week after the last immunization, while several rabbits were infected with Beverley strain of Toxoplasma gondii by inoculating about 200 cysts and antisera were obtained from them serially at a week interval. The results were as follows: The sera from the rabbits immunized with the RH strain or infected with Beverley strain of Toxoplasma gondii againist the crude antigen showed the first positive reactions in 2 or 3 weeks after the administration or immunization in complement fixation tests. Maximum titers appeared in 4 or 5 weeks after immunization with RH strain and in 7 or 9 weeks after infection with Beverley strain respectively. Complement fixation tests showed the positive reactions in the rabbits sera immunized with RH strain against the purified antigens II, III, IV, V and VI: moreover, antigen IV fraction showed the highest titer. On the other hand in the rabbits sera infected with Beverley strain against the purifed antigens II, III and IV fractions showed the positive reaction; especially, antigen fraction IV showed the highest titer. In immuno-diffusion tests, the sera from the rabbits immunized with RH strain and infected with Beverley strain, against the crude antigen appeared the precipitin bands 2 weeks after the immunization or infection. And the former showed the 2 or 5 precipitin bands after 5-8 weeks and the latter showed the l or 2 precipitin bands after 6 weeks. The sera from the rabbits immunized with RH strain against the purified antigens II, III, IV,V and VI showed the precipitin bands, and the sera from the rabbits infected with Beverley strain against the purified antigens II, III and IV showed the precipitin bands in the immuno-diffusion tests. Especially antigen IV was the strongest reaction against the sera from RH strain and Beverley strain. In agar-gel immunoelectrophoresis, the immunized sera against the crude antigen showed 8 arcs. But the infected sera against the crude antigen showed 4 or 5 arcs. The immunized sera against the fractionated antigens II, III, IV, V, VI showed arcs, but against the fractionated antigen IV showed 6 arcs and in the antigens II, III, V, VI showed l or 2 arcs only. On the other hand, the infected sera against the fractionated antigens IV showed 4 arcs, II and III showed the l arcs, which was the most weak of all.
parasitology-protozoa-Toxoplasma gondii ; toxoplasmosis ; rabbit ; immunology ; electrophoresis

Prophylactic treatment of varices is an appealing concept because 50% of patients who experience variceal bleeding will die within the first 6 weeks of the first bleeding. However, the majority of trials which have evaluated prophylactic therapy gave failed to demonstrate advantage, We tried prophylactic endoscopic variceal ligation(EVL) in 10 patients, to evaluate the safety and effect of prophylactic EVL for esophageal varices with high-risk of hemorrhage. The eradication rate was 100% without bleeding and mortality, the mean session for eradication of varices 1.9, the number of bands per person 16.9 and the number of bands per session 8.9. Although mild chest pain(5.3%) and chest discomfortness(31.6%) were observed, no serious complication related with EVL resulted from 19 EVL sessions. The patients were followed for a mean of 327.0 days(85-708), during which recurrent esophagea1 varices were found in a case at 260 days from last session, but no bleeding nor death was occured. No late complication of EVL was documented. In conclusion, prophylactic EVL is safe and may be effective for esophageal varices with high-risk of hemorrhage. But, the large controlled-trial should be required.
Esophageal and Gastric Varices* ; Hemorrhage* ; Humans ; Ligation* ; Mortality ; Thorax ; Varicose Veins