No abstract available.
Adenocarcinoma*

In an attempt to elucidate the pathological changes following common bile duct ligation, the present study was undertaken in male Sprague-Dawley rats. Morphologic studies of the livers were performed at 1, 2, 3, 5, 7, 9, 11, 13 and 15 weeks after common bile duct ligation. In an attempt to clarify the relationship between the process of bile duct formation and the nature of primitive cells observable around the primitive biliary structure, light microscopic, immunohistochemical and electron microscopic studies were performed. The results were noted as follows: 1) Light microscopically, proliferation of biliary cells began in the periphery of portal areas and expanded toward hepatic lobules. In severe cases of biliary structure proliferation, hepatocytic cords and classic hepatic lobules were inconspicuous. 2) Immunohistochemically, CK-19 expression was limited to biliary structures in protal areas and proliferated biliary epithelial cells. In the serial sections of paraffin block, proliferated intrahepatic biliary structures were associated with those of portal areas. Some oval cells in the ductular hepatocytes were stained for both CK-19 and MNF 116. 3) Ultrastructurally, the proliferated biliary epithelial cells divided into three patterns: absence of lumen, formation of incomplete lumen, and formation of complete lumen. Furthermore these patterns had spectral continuity of maturation in their structures. 4) In some biliary structures, individual biliary cells pushed the basement membrane toward neighboring tissue with accompanying destruction of basement membranes, patterns of budding. Sometimes these cells and hepatocytes comprised the same lumen. In summary, the results obtained by the present study indicate that proliferated biliary structures may be derived from the preexisting intralobular or portal biliary system.
Male ; Humans

No abstract available.
Colon* ; Fibromatosis, Aggressive*

The purposes of this study are to describe some of the basic and practical services available on the internet, and to evaluate the efficacy of a lecture using the internet together with a traditional classroom lecture. Growing demands for better education and increasing amount of knowledge have brought up the need to use new methods in learning. Information and communication technology has given new opportunities and challenges in the field of education. Especially, the internet is creating information and communication spaces that are removing the traditional boundaries of time and location. It offers new ways to learn and communicate in the field of medical education. Medicine is a very suitable area to use WWW-based teaching, because a great part of it is based on visually learned topics. The internet carries vast quantities of information in all different formats and modalities such as text, figures, video and audio. Teaching and learning are complex processes, and a wide variety of techniques and facilities are needed for each student and subject, which may vary at different times. The internet will not, and should not, replace traditional classroom lectures or tutorials, but it dose have the ability to add value to these traditional teaching techniques and to make the life of the student and teacher a little easier, more varied and possibly more interesting. Preliminary results show that this kind of lecture is useful in teaching medicine, especially in self-oriented learning, but cannot replace totally a clinical teacher's share in the learning process. Feedback from the users shows that this education is widely used and needed. The internet is likely to play more important roles in many aspects of medicine in the future.
Education ; Education, Medical* ; Humans ; Internet ; Learning ; Lectures

Changes in education and technology have influenced medical education and have altered many traditional concepts of teaching & learning skills. We are familiar with the traditional lecture in the classroom, but there are a lot of limitations to this method. In order to overcome geographical and time constraints of the limitations, I have tried implementing a cyber class using the internet lectures, homework, discussions, and even examination for the graduate medical course. The purpose of this study was to find alternatives for improvement of teaching and learning methods in medical education, especially in graduate courses. The cyber class was conducted on the internet with 69 medical graduate students in a course on the pre- & postoperative management of the surgical patient. Each student used his/her personal computer, and he/she entered the cyber classroom of the server computer of Chungnam National University (http://cyber.chungnam.ac.kr), connected to the auther's homepage. The computer program consisted of several menus and the system was also able to automatically check the student's contact number and duration, submission of homework, examination and discussion. I believe that the cyber class using internet is a useful tool for graduate medical course.
Chungcheongnam-do ; Education ; Education, Medical ; Humans ; Internet ; Learning ; Lectures ; Microcomputers ; Schools, Medical*

BACKGROUND: Peritoneal recurrence is one of the most common relapse forms after curative surgery for a gastric adenocarcinoma, and this recurrence pattern is a big problem in the treatment of advanced gastric adenocarcinoma. The mitomycin C (MMC) adsorbed by activated charcoal particles (CH) is slowly released when the mitomycin C concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. This type of intraperitoneal chemotherapy may be a logical method to prevent or treat the peritoneal dissemination of the gastric cancer after a gastric cancer resection. METHODS: One handred (100) mg of mitomycin C, 1,000 mg of activated carbon particles, and 100 ml of water were mixed and stirred for more than 7 minutes. For intraperitoneal chemotherapy for advanced gastric adenocarcinomas, The mitomycin C adsorbed on the activated carbon particles (MMC-CH) was spread on the peritoneal surface just before abdominal wall closure. Closed drainage tubes were inserted in the peritoneal cavity, one placed in the subhepatic space and another placed in the pelvic cavity, and clamped for two hours after MMC-CH application. The mitomycin C concentrations were serially measured in the peritoneal fluid from drainage, plasma, and urine at 2 hours, 24 hours, 48 hours, 72 hours, and 168 hours following its administration in order to study the efficacy of the MMC-CH as a slowly releasing drug-delivery system. RESULTS: The mitomycin C concentrations in the peritoneal fluid were 3.62 microgram/ml at 2 hours after administration of the MMC-CH and 0.38 microgram/ml at 24 hours, the concentrations in plasma at 2 and 24 hours after MMC-CH administration were 1.10 microgram/ml and 0.21 microgram/ml, respectively, and those in urine were 3.94 microgram/ml and 17.6 microgram/ml. CONCLUSIONS: The mitomycin C concentration of the peritoneal fluid was higher than that of the plasma, but the effective duration of maintenance was less than 24 hours in the peritoneal fluid.
Abdominal Wall ; Adenocarcinoma ; Ascitic Fluid ; Carbon ; Charcoal ; Drainage ; Drug Therapy ; Humans ; Logic ; Mitomycin* ; Peritoneal Cavity ; Peritoneum ; Plasma ; Recurrence ; Stomach Neoplasms* ; Water

BACKGROUND: There is a great need for a new drug delivery system that provides higher sustained exposure of the anticancer drug to the peritoneal surface or lymphatics with a lower systemic toxicity. Intraperitoneal chemotherapy will be an effective therapeutic strategy for disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface after surgery. The auther has made a fluorouracil-polyglycolic acid composite disk (Fu-PGA disk) for a more effective intraperitoneal chemotherapeutic agent. METHODS: The Fu-PGA disk(s) was (were) inserted in the peritoneal cavity of a rat, and a pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at day 1, day 3, day 7, and day 14 after administration of the agent. The myelosuppressive action of this composite was also determined following its administration. RESULTS: After administration of the Fu-PGA disks, the 5-Fu concentration of the peritoneal fluid of the rat was much higher than that of the plasma. Also, the 5-Fu concentrations of the liver, kidney and heart tissue were very low. The numbers of white cells and platelets decreased after administration of the Fu-PGA disks, but they were almost recovered to normal range at day 14th. Only focal necrosis around the central veins of the liver and minimal vacuolar degeneration in the proximal tubules of the kidney were observed microscopically. CONCLUSION: This animal study suggests that the Fu-PGA composite can be used as a new biodegradable drug delivery system for releasing the drug in a controlled manner with the peritoneum as its target. This Fu-PGA device may overcome some of the disadvantages of conventional anticancer chemotherapy and improve the efficacy of intraperitoneal chemotherapy.
Animals ; Ascitic Fluid ; Drug Delivery Systems ; Drug Therapy ; Fluorouracil ; Heart ; Kidney ; Liver ; Necrosis ; Peritoneal Cavity ; Peritoneum ; Plasma ; Polyglycolic Acid ; Rats ; Reference Values ; Veins

No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. MATERIALS AND METHODS: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. RESULTS: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). CONCLUSION: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
Chemoradiotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Intestinal Obstruction ; Leucovorin ; Leukopenia ; Lymph Node Excision ; Multivariate Analysis ; Nausea ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia ; Vomiting

PURPOSE: Peritoneal irrigation and drain insertion were traditionally performed following major abdominal surgery, as routine procedures The aim of this retrospective study was to evaluate the usefulness of peritoneal irrigation and drain insertion following elective gastric cancer surgery. METHODS: Between December 2000 and Feburary 2002, 184 patients having undergone surgery for gastric cancer were divided into two groups, a comparative group (86 patients with peritoneal irrigation and drainage) and an experimental group (98 patient without peritoneal irrigation and drainage). The demographics, histopathological classification, range of dissection, comorbid disease, first passage of flatus, start of soft diet, operation time, anesthesia time and operative complication were analyzed retrospectively in consecutive patients. The data were analyzed by student's t-tests with the level of significance set at P<0.05. RESULTS: No significance differences were found between the two groups in regard to demographics, range of dissection, comorbid disease or complications. However the mean length of hospitalization, operation time and anesthesia time and the first passage of flatus, and start of soft diet in the experimental group were significantly shorter than those in the comparative group. CONCLUSION: The result shows that routine peritoneal irrigation and drain insertion following elective gastric cancer surgery are ineffective in reducing postoperative complications. We think these procedures are unnecessary and offer no considerable advantages.
Anesthesia ; Classification ; Demography ; Diet ; Drainage* ; Flatulence ; Hospitalization ; Humans ; Peritoneal Lavage* ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms*