Necrosis of the papilla and chronic interstitial nephritis of the renal cortex are the two renal 1esions most commonly. described in cases of analgesic nephropathy. Some authors believed that the necrosis of the papilla was secondary to the cortical changes by which fibrosis of the cortex produced ischemia of papilla and necrosis. However, other authors have suggested that the pathogenesis is, in fact, the reverse and that the cortical changes in analgesic nephropathy are caused by the medullary necrosis. An experimental study was therefore undertaken to clarify this problem and also to determine the influence of increased intrapelvic pressure on the postpapillectomy renal alterations. Followings are the results: 1. In 'the group having renal papillectomy, marked tubular dilatation and interstitial edema of the medulla are prominent changes upto two weeks after removal of the papilla. Tubules are usu. ally filled with various casts. After three weeks, there starts the tubular atrophy and interstitial fibrosis with mil infiltration of inflammatory cells. The tubular atrophy and renal scarring become much severe and diffuse six weeks after papillectomy. but glomeruli remain relatively intact. 2. The degree of tubular changes and parenchymal scarring are assumed influential to the size of removed papilla. The tubular atrophy is prominent in distal convoluted tubules and collecting tubules, and the interstitial changes extend from the medulla to the cortex in the late stage. 3. Focal or scattered depositions of amorphous calcium or calcium oxalate are found in about one fourth of cases. 4. In the group having partial ureteral ligation a week after renal papillectomy, the tubular and interstitial changes appear earlier and are more remarkable than those of papillectomy alone. The inflammatory reaction is also more prominent, and conglomeration of glomerulus is noted in some instances of the later stage. The form of the renal scarring found in this experimental study closely resembles that seen in analgesic nephropathy in man. This findings support the view that the cortical lesions in analgesic nephropathy develop as a direct consequence of papillary necrosis and additional ureteral ligation enhances interstitial nephritic process. It is possible that the tubular atrophy and interstitial edema that develop shortly after removal of the papilla may produce cortical changes.
Atrophy ; Calcium ; Calcium Oxalate ; Cicatrix ; Dilatation ; Edema ; Fibrosis ; Ischemia ; Kidney* ; Ligation* ; Necrosis ; Nephritis, Interstitial ; Ureter*

Toxic epidermal necrolysis is a reactive erythema of nonstaphylococcal origin characterized by a scalded appearance of the skin. The TEN is widely regarded as a variant of severe erythema multiforme because of its acute course, its freguent common cause, its freguent overlap with Stevens-Johnson disease, and its histologic identity. I present a case of TEN with severe mucosal involvement resembled Stevens-Johnson disease.
Erythema ; Erythema Multiforme ; Skin ; Stevens-Johnson Syndrome*

PURPOSE: The purpose of this study was to identify the degree of perceived powerlessness in hospitalized elderly patients of the medical and surgical unit. METHOD: The instrument for this study was the Powerlessness Behavioral Assessment Tool(Miller, 1983). The reliability of the instruments was .85. The data was analyzed by descriptive statistics, t-test, and ANOVA. RESULTS: The results were as follows; 1. The mean score of powerlessness was 35.02(SD=+/-9.24) in a range of 19 to 64, and the mean of powerlessness was total 1.84. Among 4 subscales, the highest score was in the area of verbal response (M=1.98), and the lowest score for powerlessness was in the area of daily activities(M=1.74). In all items, 'verbal expression of fatalism' showed the highest score(M=2.78), and 'verbal expressions of giving up' showed the lowest score(M=1.38). 2. There were significant differences in the level of powerlessness according to hospitalization experience(t=-3.03, p=0.006), medical treatment experience(t=.291, p=.004). Especially, there was significant difference according to the hospitalization experience of the hospital in all sub-scales. CONCLUSION: Based on these conclusions, nursing education for patient's diseases and treatment can be used for proper nursing intervention in reducing the level of powerlessness of hospitalized elderly.
Aged* ; Education, Nursing ; Hospitalization ; Humans ; Nursing

No abstract available.
Hyphema*

No abstract available in English.
Humans ; Infant ; Sarcoma, Ewing ; Scapula

To evaluate the utility of gene rearrangement analysis, eight cases of malignant lymphoma, one case of Hodgkin's disease, two cases of angioiminunoblastic lymphadenopathy (AILD) and two cases of non-specific lymphadenitis were studied by immunohistochemical and genetic analysis. Southern blot analysis was perfon-ned by a using vacuum transfer system and a biotin labelled probe. This method was faster, safer, and more convenient than conventional methods. Gene rearrangement study showed rearranged novel bands in five of six cases of B cell lymphoma, in all cases of T cell lymphoma, and in all cases of AILD. No rearrangement of the B cell receptor(BCR) or of the T cell receptor(TCR) was seen in Hodgkin's disease or in nonspecific lymphadenitis. These results suggest that gene rearrangement analysis of BCR and TCR is a recommended method for the diagnosis of clonality in lymphoproliferative disorders. It would allow pathologists to differentiate lymphoma from polyclonal lymphoid proliferation and to provide information for cell lineage.

No abstract available.
Biopsy* ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*

Lichenoid drug eruption is lichenoid skin eruptions caused by certain drugs and compounds, and can be identical or similiar to lichen planus. A 75-year-old woman who had taken antituberculosis medication(INH, ethambutol, rifampin) for 4 months developed pruritic generalized erythematous papular eruptions on the trunk and extremities, alopecia and nail dystropy. Histopathologic findings were hyperkeratosis, hypergranulosis, hyc rophic degenaration of basal layer, band like lymphohistiocytic infiltration in the upper dermis and perivascular lymphohistiocytic infiltration in the deep dermis. She was treated with systemic corticosteroid, and then skin lesion were slightly improved. After termination of antituberculosis medication, skin lesions were markedly improved with residual hyperpigmentation. Alopecia and nail dystrophy were also improved.
Aged ; Alopecia ; Dermis ; Drug Eruptions* ; Ethambutol ; Extremities ; Female ; Humans ; Hyperpigmentation ; Lichen Planus ; Skin

No abstract available.
Humans

The clinical role of tumor markers to detect the extent of tumor invasion and recurrence in cervical cancer has been debated. To evaluate the chncal significance of SCC, CEA and TPA as tumor markers in cervical, we studied 744 patients weith cervieal cancer from June 1990 to Mey 1994. The cut-off val ues of SCC, CEA and TPA were 1.5 ng/ml, 4.5 ng/mi and 110 U/I respectively. Followings were the results. 1. The serum concentration and positive rates of SCC before therapy(567 cases) were 3,0+/-7.0ng/ml(40.4%) for stage I,8.7+/-13.9 ng/ml(71.6%) for stage II, 10.8+/-14.7 ng/ml(85.7%) for stage III, 23.9+/-24.3 ng/ml(94.7%) for stage IV, and 13.4+/-19.1 ng/ml(75.0%) for recurrent cancer. It was increased with advancing clinical stage(p<0.01). 2. The seum levels and positive rate of CEA before therapy(627cases) were 3.4+/-4.3 ng/ml (18%) for stage I, 7.1+/-12.3 ng/ml(37.2%) for stage II, 8.4+/-9.6 ng/ml(57.9%) for stage III, 15.4+/-22.2 ng/ml(52.6%) for stage IV, and 10.3+/-16.2 ng/ml(46.4%) for recurrent cancer. It was increased with advancing clinical stage from stage Ito stage III(p<0.01). 3. The serum concentration and positiceive rate of TFA before therapy(301cases) were 51.7+/-53.8 U/l(9.5%) for stage I, 105.3+/-108.8 U/l(32.3%) for stage II, 186.3%+/-159.8 U/l(50%) for stage III, 191.3+/-l06.2 U/I(63.6%) for stage IV, and 135.4+/-117.0 U/l(46.4%) for recurrent cancer. It was increased with advencing clinical stage(p<0.01). 4. In 64 patients{24.2%) with lymph node invasion of 265 patients treated by operation, the mean serum levels of SCC, CEA and TPA were higher than lymph node negative group(p<0.05). 5. The serum levels of SCCand CKA after therepy were 82.8% in sensitivity. 94.3% in specificity, 67.9% in positive predictive value, 97.4% in negative predictive value.
Humans ; Lymph Nodes ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*