Changes in the number, the immunoreactivities and the ultrastructures of sero- tonin immunoreactive mucosal mast cells[MMCs] in rat gastrointestinal tracts after vagus nerve stimulation were investigated by using light and electron microscopic immunocytochemical methods. The vagus nerves were electrically stimulated with a square wave pulse generator for a duration of 5 minutes each, a total of 8 times at 2 minute intervals. Serotonin immunoreactive cells of the connective tissues of the gastrointestinal tract were mainly located in the lamina propria, and a small number of the cells were also scattered in the submucosa. By using electron microscopic immunocytochemistry and Wright stain, the serotonin immunoreactive cells of the lamina propria and the submucosa were identified to be MMCs. A few large-sized serotonin immunoreactive connective tissue mast cells [CTMCs], showing strong metachromasia with the Wright stain, were located together with the MMCs in the submucosa of the stomach. In most of the gut regions of the control group, the majority of the MMCs did not show any serotonin immunoreactivities and only a few MMCs showed weak serotonin immunoreactivities. After stimulation of the vagus nerves, the number and the immnu- noreactivities of the serotonin immunoreactive MMCs dramatically increased in all gut regions observed, especially in the small intestines. In the samples treated with the electron microscopic immnunocytochemical methods, hardly any serotonin immunoreactivities were detected in the MMCs of the control group. However, the serotonin imrnunoreactivities of the MMCs were significantly increased after vagus nerve stimulation. The serotonin immnunoreactive products were localized, following vagal stimulation, both in the peripheral matrix of the granules and in the cytoplasm. Also, it was confirmed ultrastructurally that the Golgi complexes were expanded in the MMCs of the vagal stimulation group. The above results suggest that vagus nerve stimulation may activate serotonin biosynthesis in MMCs.
Animals ; Connective Tissue ; Cytoplasm ; Gastrointestinal Tract* ; Golgi Apparatus ; Immunohistochemistry ; Intestine, Small ; Mast Cells* ; Mucous Membrane ; Rats* ; Serotonin* ; Stomach ; Vagus Nerve Stimulation* ; Vagus Nerve*

This study was undertaken to investigate the ultrastructure of the neurons, neuroglial cells and capillaries in the area postrema[AP] of the Oriental discolured bat, Vespertilio superans. The AP of the bat was a single midline structure at the most caudal portion of the fourth ventricle. Most neurons in the AP were small cells, but their ultrastructure were similar to the typical neurons located elsewhere in the central nervous system. Astroglial cells and oligodendrocytes were also observed and showed their typical ultrastructure. Ultrastructural features of neurons, astroglial cells and oligodendrocytes were not changed during hibernating cycles. However, microglial cells were only found in the hibernating AP ; these cells were located in the parenchyma and near the blood vessels of the AP. Since the microglial cytoplasm was filled with phagocytotic inclusions, the nuclei of the these cells were eccentrically located. Phagocytotic cytoplasmic inclusions were shown to be composed of a dense irregular peripheral region and the pale round central region. A Large vacant space was often found in the electron lucent central region. Continuous and fenestrated capillaries surrounded by pericytes were found in the bat`s AP. Especially, Phagocytotic inclusions were found in the pericyte cytoplasm of the hibernating AP, and this result supports suggestion that pericytes might be phagocytotic cells. On the basis of the distributions of phagocytotic tells[pericytes and microglial cell], ultrastructure of these cells, morphology of their cytoplasmic inclusions, and the appearance of phagocytotic activity of the pericytes during the hibernating stage when microglial cells were observed, it can be concluded that pericytes may also participates in the formation of rrlicroglial cells. Tanycytes were also found in the bat AP.
Area Postrema* ; Blood Vessels ; Capillaries ; Central Nervous System ; Cytoplasm ; Ependymoglial Cells ; Fourth Ventricle ; Inclusion Bodies ; Microglia ; Neuroglia ; Neurons ; Oligodendroglia ; Pericytes

PURPOSE: The purpose of this study was to identify the retention effects of an individualized dietary education program for hemodialysis patients on diet knowledge, diet self-care compliance, and physiological indices, thus to find the most effective time period for re-education. Method: This study utilized one-group repeated pretest-posttest design. The participants were 52 hemodialysis patients in C hospital, Gyeonggi-Do. Data were collected at 4 and 12 weeks after the education from January through April 2016. RESULTS: There was significant increases in diet knowledge even 12 weeks after the education (p=.007). Diet self-care compliance showed a significant increase at 4 weeks (p=.001), but a decrease at 12 weeks after the education. The level of blood natrium was significantly decreased between 4 and 12 weeks after the education (p=.006). The weight was significantly decreased at 12 weeks after the education. CONCLUSION: It has been identified that re-education for hemodialysis patients should be implemented between 4 and 12 weeks after education in order to maintain patients' diet self-care compliance, an ultimate aim of diet education. By helping them with their self-care compliance, the patients would maintain their physical and psychological function optimally, thus contributing to a better quality of life among hemodialysis patients.
Compliance* ; Diet* ; Education* ; Gyeonggi-do ; Humans ; Methods ; Quality of Life ; Renal Dialysis* ; Self Care*

A case of the brain death confirmed by isotope angiogrphy is described. Isotope angiography is a simple and noninvasive technic compared to carotid angiography, and is recommended as a reliable test for the diagnosis of brain death.
Angiography* ; Brain Death* ; Brain* ; Diagnosis

A case of the brain death confirmed by isotope angiogrphy is described. Isotope angiography is a simple and noninvasive technic compared to carotid angiography, and is recommended as a reliable test for the diagnosis of brain death.
Angiography* ; Brain Death* ; Brain* ; Diagnosis

PURPOSE: This study compared the radiological and clinical results of minimally invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) of distal tibial fractures, which were classified as the simple intra-articular group and extra-articular group. MATERIALS AND METHODS: Fifty patients with distal tibial fractures, who could be followed-up more than 12 months, were evaluated. Group A consisted of 19 patients treated with MIPO and group B consisted of 31 patients treated with IMN. The results of each group were analyzed by radiological and clinical assessments. RESULTS: The mean operation times in groups A and B were 72.4 minutes and 65.7 minutes, respectively. The mean bone union times in groups A and B were 16.4 weeks and 15.7 weeks, respectively. The bone union rate in groups A and B were 100% and 93%, respectively. The ranges of ankle motion were similar in the two groups at the last follow-up. The mean American Orthopaedic Foot and Ankle Society score was similar: 90.1 in group A and 90.5 in group B. The radiological and clinical results were similar in the intra and extra-articular groups. In groups A and B, two cases of posterior angulation and five cases of valgus deformity of more than 5° were encountered. CONCLUSION: Both MIPO and IMN achieved satisfactory results in extra-articular AO type A and simple articular extension type C1 and C2 distal tibia fractures.
Ankle ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Fracture Fixation, Intramedullary ; Humans ; Tibia ; Tibial Fractures

PURPOSE: The application rate for surgical residents in Korea has continuously decreased over the past few years. The demanding workload and the occupational stress of surgical training are likely causes of this problem. The aim of this study was to investigate occupational stress and its related factors in Korean surgical residents. METHODS: With the support of the Korean Surgical Society, we conducted an electronic survey of Korean surgical residents related to occupational stress. We used the Korean Occupational Stress Scale (KOSS) to measure occupational stress. We analyzed the data focused on the stress level and the factors associated with occupational stress. RESULTS: The mean KOSS score of the surgical residents was 55.39, which was significantly higher than that of practicing surgeons (48.16, P < 0.001) and the average score of specialized professionals (46.03, P < 0.001). Exercise was the only factor found to be significantly associated with KOSS score (P = 0.001) in univariate analysis. However, in multiple linear regression analysis, the mean number of assigned patients, resident occupation rate and exercise were all significantly associated with KOSS score. CONCLUSION: Surgical residents have high occupational stress compared to practicing surgeons and other professionals. Their mean number of assigned patients, resident recruitment rate and exercise were all significantly associated with occupational stress for surgical residents.
Burnout, Professional ; Humans ; Korea* ; Linear Models ; Occupations

BACKGROUND: To review the middle and long term results of aortic valve replacement(AVR) for 11 years, we surveyed and followed up the patients who underwent AVR. MATERIAL AND METHOD: Between Feb. 1986 and May 1997, 134 patients underwent AVR. The patients consisted of 71 men and 63 women whose mean age was 38.9 years, ranging from 17 to 70. RESULT: The concomitant operations were 62 mitral valve replacement(MVR), 14 MVR + tricuspid valve annuloplasty, 10 Cabrol operation, 16 aortic annulus widening, and so forth. We used 119 mechanical(75 St. Jude Medical, 38 CarboMedics, 6 Sorin) and 15 tissue (Carpentier-Edwards) valves. Early postoperative complications occurred in 35 cases; 9 congestive heart failure, 6 low cardiac output, 5 postoperative bleeding, 5 pleural effusion, and so forth. There were 13 early postoperative deaths(9.7%) due to low cardiac output(5), CHF (2), disseminated intravascular coagulopathy(2), and so forth. The cumulative total follow-up period was 452.7 patient-years with a mean of 3.4+/-3.1 years/patient. There were 9 cases of valve-related complications; anticoagulant-related bleeding(4), prosthetic valve endocarditis(2), thromboembolism(2) and prosthetic valve failure(1) occured at rate of 0.9, 0.4, 0.4, 0.2%/ pt-yr, respectively. Late valve-related death occurred in 3 cases(2.0%/pt-yr) associated with anticoagulant-related bleeding(2) and prosthetic valve endocarditis(1). CONCLUSION: Actuarial survival rate by Kaplan-Meier method was 91.0+/-4.3 % at 11 years.
Aortic Valve* ; Cardiac Output, Low ; Female ; Follow-Up Studies ; Heart Failure ; Hemorrhage ; Humans ; Male ; Mitral Valve ; Pleural Effusion ; Postoperative Complications ; Survival Rate ; Tricuspid Valve

PURPOSE: Transabdominal sonography has been widely used in the diagnosis of suspected urinary calculi, assisted by secondary findings from urinary tract obstruction, but this method shows low specificity and relatively high incidence of false-positives. Recently, detection of stone itself with new Doppler finding and bladder distension on sonography has demonstrated high sensitivity. METHODS: We performed prospective transabdominal ultrasonography for emergency department patients with acute urinary colic pain over a 3 month period. With adequate bladder distension by intravenous hydration and initial spontaneous voiding drive, stones itself could be tracked along the entire length of urinary tract by emergency physician who received short-term education course. RESULTS: One hundred and thirty one patients enrolled; 86 received a sonographic exam and 57 showed urinary calculi. The detection rate of urinary calculi was 71.3%. The most common sonographic feature used in the diagnosis of urinary calculi was a distinct echogenic stone appearance within the dilated urinary tract with posterior acoustic shadowing. CONCLUSION: We concluded that detection of urinary calculi by transabdominal ultrasonography could be very useful in mbination with secondary sonographic finding from urinary tract obstruction in the evaluation of suspected urinary colic.
Acoustics ; Colic ; Diagnosis ; Education ; Emergencies ; Emergency Service, Hospital ; Humans ; Incidence ; Prospective Studies ; Sensitivity and Specificity ; Shadowing (Histology) ; Ultrasonography* ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract

The cardiovascular manifestations of hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, atrioventricular block, bundle branch block, angina pectoris, heart failure, and cardiomyopathy. Though complete atrioventricular block is rare, it is important to recognize it in clinical practice because of the possibility of cardiac arrest. We experienced a 47-year-old female patient who had hyperthyroidism with complete atrioventricular block and developed cardiac arrest despite the initiation of an antithyroid drug. We could resuscitate successfully and inserted a temporary pacemaker, but eventually a permanent pacemaker was needed to prevent the recurrence of cardiac arrest. We report a rare case of complete atrioventricular block and cardiac arrest associated with hyperthyroidism with the review of references.
Angina Pectoris ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block* ; Bundle-Branch Block ; Cardiomyopathies ; Female ; Heart Arrest* ; Heart Failure ; Humans ; Hyperthyroidism* ; Middle Aged ; Recurrence ; Tachycardia, Sinus ; Tachycardia, Supraventricular