The author carried out an experimentation to clarify a possible pathogenesis of renal papillary necrosis induced by an univisceral Shwartzman reaction. The experimental animals were healthy white rabbits in weighing between 1.7 kg and 3.0 kg. Under the condition of ureterostomy, animals were pretreated with 0.5 cc of 50% ethyl alcohol and followed by administration of 0.2 ~ 1.5 mg endotoxin (E. coli 026 : B6, bacto lipopolysaccharide B. Difco, U.S.A.) as preparation in the renal pelvis. And then sacrificed at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours and 24 hours after intravenous injection of 0.2 mg or 0.6 mg endotoxin through the ear veins, subjection to examine light and electron microscopically. The obtained results were summarized as follows: Papillary necrosis was developed in 88% among 18 cases excluding 6 cases died before sacrification. There were two types of necrosis, namely papillary and medullary type, but the former and combined forms of both types were the most common findings. Initial main target site of injury in renal papilla induced by endotoxiin was the endothelium of vasa recta and then followed by the Henle's loop, interstitial cell and collecting tubule respectively. Vascular injuries such as swelling and detachment of endothelium were observed since 10 minutes after endotoxin injection. Henle's loop showed stratification of basement membrane without consistent features with time lapses and initially observed fatty vaculoes at 1 hour after endotoxin injection were more eminent in 24 hours group. Main changes of interstitial cells were decrease of lipid droplets while increase of fatty vacuoles; the latter were initially observed in 1 hour group and more eminent in 24 hours group. Collecting tubule showed many fatty vacuoles especially in 24 hours group. It is thought that emergence of fatty vacuoles seems to be a kind of immature lipid droplets to compensate the increased demand of PC release due to continuous ischemic condition. In conclusion, it is thought that ischemic injury due to the vascular changes is pathogenic mechanism producing renal papillary necrosis. Endotoxin induced univisceral Shwartzman reaction in the kidney may be a good experimental model in studying renal papillary necrosis.
Rabbits ; Animals

The authors studied the ultrastructural changes of liver cell mitochondria in autolysis. The male Sprague-Dawley rats, weighting 140~160 gm were sacrificed for extract liver tissue. The slices of the liver tissue were incubated in 37 degrees C aseptic normal saline, and those were examined by following intervals; 10, 20 and 30 minutes and 1, 2, 6, 12 and 24 hours with light and electron microscope. The results obtained by light microscopy were summerized as follow. Several fine intracytoplasmic vacuoles were observed 1 hour after incubation. After 3 hours, focal destruction of cytoplasmic membrane with pyknosis of nuclei were observed. More delicate intracytoplasmic architectural changes could not be detected at light microscopic studies. The cord arrangement and cellular boundaries were relatively well preserved until 24 hours after incubation. Electronmicroscopically, mild intramitochondrial swelling with diminution of intramatrical granules were observed at 20 minutes. These were the earliest findings. Both high amplitude swelling and destruction of mitochondrial membrane were observed concurrently at 1 hour after incubation. The earlier membrane changes were observed at inner membrane with cristae and followed by degeneration of the outer membrane. The intramatrical amorphous dense deposits were observed at 30 minutes when the membranes were not destroyed. These deposits were noted in the other experimental groups which were incubated longer than 30 minutes. More electron dense deposits were observed after 1 hour at that time the membrane changes appeared. Vhe results suggest in this experiment that the earliest autolytic changes of liver cell mitochondria is loss of intramitochondrial granules and the membraneous changes led to the irreversible mitochondiral injury. The appearance of two types of intramitochondrial dense deposits would be an interesting finding needed to require further investigation for the chemical stucture and mechanism of dense deposit formation.
Male ; Humans

The author studied 11-cases of adenocarcinoma of the stomach confirmed by gastrofiberscopic biopsy before in order to differentiate between differentiated and undifferentiated adenocarcinoma by scanning electron microscope. Light and transmission electron microscopie examination were done, too. Seven of them are differentiated accompanied by severe intestinal metaplasia and four of them are undifferentiated with rearly focal intestinal metaplasia. Two of the undifferentiated cases shows focal tubular differentiation on the superficial region of the mucosa. Microvilli on the free border are long, regular on the differentiated type but in state of variable loss of microvilli under the transmission electron microscope. Number and density of the mucous granules are variable. Scanning electron microscopic examination shows prominent disorganization of the folds, cellular pleomorphism and pleomorphic microvilli are suggestive of early marker of neoplastic transformation. The size of them are 0.6 micrometer and 1.2 micrometer on the differentiated type respectively. Disorganization of the folds is an important differential point between differentiated and undifferentiated type on the lower power examination. Development of folds, furrow, and hemispheric colliculi are more porminent on the differentiated adenocarcinoma. Presence of striated border, partial or complete loss of microvilli and intestinal metaplasia on the undifferentiated and differentiated adenocarcinomas are consisent with origin from common precursor cells.
Adenocarcinoma ; Biopsy

BACKGROUND: Chlamydia pneumoniae, a new species of the obligate intracellular Chlamydia, has been recognized as a significant pathogen that causes infection of the human respiratory tract and has recently been associated with coronary atherosclerosis. Diagnosis of infections with C. pneumoniae is problematic, because the syndrome usually presents few distinguishing features and culture of the organism is far more difficult than other Chlamydia species. To further improve the cell culture isolation and passage of C. pneumoniae organisms. we have studied several chemical and physical factors that might affect their viability and growth. METHODS: C. pneumoniae strain (TW-183) was obtained from the Centers for Disease Control, Atlanta. Ga. First we compared McCoy HeLa-229, and HEp-2 cells in the search for a more efficient and practical cell culture system. The growth rate of C. pneumoniae was assessed by the effects of diethylaminoethyl-dextrin, by the adequate centrifugation force and time, by the growth promoting effect of cycloheximide, and by the optimal incubation time. All of the results were evaluated by the indirect immunofluorescent stain using the genus-specific monoclonal antibody(HYMo 1-1) to Chlamydia. RESULTS: The HEp-2 cell was the most efficient for culturing C. pneumoniae and the inclusion bodies in monolayer were increased with DEAE-dextran pretreatment at 30microgram/ml. Also application of a centrifugal force of 1.500 xg for at least 15 minute during inoculation enhanced the growth of C. pneumoniae. The best concentration of cycloheximide in the culture medium for host cell cytostasis was 1microgram/ml. The yields of organisms were greater when the cultures were harvested at 48 hours. CONCLUSIONS: We suggest that this system may make it more practical for laboratories to culture for C. pneumoniae.
Cell Culture Techniques ; Centers for Disease Control and Prevention (U.S.) ; Centrifugation ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Artery Disease ; Cycloheximide ; DEAE-Dextran ; Diagnosis ; Humans ; Inclusion Bodies ; Pneumonia ; Respiratory System

Amiodarone, an antiarrhythmic drug, may exert pulmonary toxicity in some patients but the pathogenesis is not clear. This study was carried out to investigate the pathogenetic mechanism of pulmonary injury induced by amiodarone at dose of 100 mg/kg/day given to rats by intraperitoneal injection for 3 weeks. And the preventive effects of concomitantly injected steroid (10 mg/kg/day) on amiodarone induced pulmonary injury was also studied using bronchoalveolar lavage, light microscopy and transmission electron microscopy. The results obtained were summarized as follows: Mild lymphocytosis of bronchoalveolar lavage fluid was found in all experimental groups. Intracytoplasmic lamellar body formation was found in all types of pulmonary cells and type II pneumocytes revealed the earliest abnormal lamellar body formation. The capillary endothelial cells showed cellular swelling and detachment from underlying basement membrane at early phase of experiment and the edema of alveolar wall and interstitium were noted. Interstitial fibrosis and proliferation of type II pneumocytes were noted at late phase. The lungs of steroid injected groups revealed accumulation of lamellar bodies in all types of pulmonary cells but interstitial fibrosis was not occurred. These findings support the concept that amiodarone is responsible for a drug-induced phospholipidosis and directly toxic to pulmonary endothelial and epithelial cells. And steroid may regress the progression of amiodarone induced pulmonary injury.
Rats ; Animals

The authors studied the formation of giant mitochondria in liver cell. The Sprague Dawley rats were sacrificed following intervals; 5, 10, 20, 30, and 60 minutes after intraperitoneal injection of hydrazine in the amount of 200 microliter/kg. And the extracted liver tissues were examined with light and electron microscopes. The results obtained were summarized as follow; Light microscopically, there is little difference between control and experimental groups. Electron microscopically, elongated, bizzare shaped mitochondria are appears 5 minutes after hydrazine injection. Those show attenuated portion, Y, U, or C shaped feature suggesting fusion or budding mitochondria. The number of giant mitochondria is decreased after 10 minutes group and rarely present in 60 minutes group. The results suggest in this experiment that the formation of giant mitochondria is kind of reversible change and it is different from the mitochondrial swelling of cellular injury. Intermitochondrial fusion and mitochondrial budding may be related with the formation of giant mitochondria.
Rats ; Animals

The authors studied the lung injury induced by endotoxemia and the effects of proteolytic agent on the lung changed by endotoxemia. Sprague-Dawley rats were intraperitoneally administrated with a single dose of endotoxin (4 mg/kg, E. coli 025 : B6 lipopolysaccharide) or with endotoxin and gabexate mesilate (200 mg/kg), a proteolytic agent, concomitantly. Rats of each group were scarificed at 9, 18, and 27 hours after injection. Light and electron microscopic examination were done. The results obtained were summarized as follows: Light microscopic exmination revealed congested capillaries and neutrophilic infiltration in both groups. Electron microscopic findings were interstitial and alveolar neutrophilic infiltration, endothelial swelling with increased pinocytotic vesicles and cytoplasmic process formation, and interstitial edema. Decrease of osmiophilic bodies in the type II pneumocytes had appeared at 9 hours after endotoxin injection. These changes were increased in severity at 18 hours and 27 hours after endotoxin injection. In the group of concomitant treatment of gabexate mesilated and endotoxin, there was no edema at 9 hours after injection. After 18 hours welling of endothelial cell and interstitial edema had appeared. However, the severity of the edema was markedly decreased. Type II pneumocytes showed well preserved osmiophilic bodies. According to these results, it is considered that administration of gabexate mesilate can significantly redeced the lung injury induced by endotoxemia.
Rats ; Animals

This study was performed to investigate the effect of endotoxin to the CCl4-induced liver injury. Twelve Sprague-Dawley rats were intraperitoneally injected 1.6 g/kg CCl4 as control group. Another 24 rats were orally administrated 300 mg/kg of neomycin at 16 and 3 hours prior to CCl4 injection as experimental group. Twelve among them were intraperitoneally infected 1.0 mg/kg of endotoxin(E-Coli, 0111:B4, No L-2630, lipopolysaccharide, Sigma, USA) and CCl4 simultaneously for offsetting neomycin effect. The rats were sacrificed at 1, 4, 10, and 24 hours after CCl4 injection. The liver tissues from all experimental groups were observed by light and electron microscopy. The results obtained were summarized as follows: In the CCl4 only group, the hepatocytes revealed sweling of ER and mitochondria with many lipid droplet in the cytoplasm. Focal cellular necrosis was seen at the later phase. The Kupffer cells were activated and showed many cytoplasmic processes, secondary lysosomes, and vaculoles. The endothelial cells were edematous. Several neutrophils, platelets, and microthrombi were scattered in the sinusoid. In the neomycin-CCl4-endotoxin administrated group, both hepatocytic destruction and intrasinusoidal microthrombi formation were more pronounced. In the neomycin pretreated group, the hepatocytes revealed mild cellular destruction without necrosis. There is no intrasinusoidal microthrombi. According to these results, it would be concluded that the small dosage of gastrointestinal tract-derived endotoxin affects to the liver injury caused by CCl4. The synergistic effects of CCl4 and gastrointestinal tract-derived endotoxin which can not be detoxified by damaged Kupffer cells, may be more important in the pathogenesis of CCl4-induced liver injury.
Rats ; Animals

This study was made to identify compliance in self-medication, and factors influencing the self-medication of pulmonary TB patients. Self-medication of pulmonary TB patients is a very important factor for the cure of the patients. In this study, variables were used from three theories of health behavior. These were the Health Belief Model, Health Locus of Control, Theory of Planned Behavior. These were included to examine their effect on self-medication. Data were collected during the period from July 1 to August 20, 1994 using a structured questionnaire. And they were analyzed by mean, standard deviation, ANOVA, Pearson Correlation Coefficient, and Multiple Regression analysis using the SAS program. The result were as follows : 1. The mean on the self-medication scores ranging from 6.0 to 12.0 was 10.93. The mean for the self-evaluation scores of the self-medication ranging from 50.0 to 100.0 was 86.51. 2. There were significant associations between the scores on self-medication and age(F=2.34, p=0.033), and method of treatment(F=4.65, P=0.018). And there were significant associations between the self-evaluation scores of self-medication and age (F=3.79, P=0.000), and presence of TB patients among family(F=4.92, P=0.000). 3. (a) The relationship between the scores on self-medication and perceived barrier in health belief revealed a significant correlation(r=-.2046, p=0.0082). (b) The relationship between the scores on self-medication and other-dependency in LOC revealed a significant correlation(r=0.2322, p=0.0018). (c) The relationship between the self-evaluation score of self-medication and other-dependency in LOC revealed a significant correlation(r=0.1946, p=0.0122). (d) The relationship between the attitude in self-medication of the subjects and the self-evaluation score of self-medication revealed a significant correlation(r=0.2102, p=0.0066). 4. (a) 14.8% of the score of compliance in self-medication of the subjects was explained by five variables : Behavioral Intention, Duration of Treatment, Age, Perceived Sensitivity and Perceived Sensitivity and Perceived Barrier. (b) 8.7% of the score of self-evaluation of self-medication was explained by three variables : Perceived Control, Perceived Sensitivity, and Age. In conclusion : This study provides insights and information which may be valuable for motivation and instruction to improve compliance in self-medication among pulmonary TB patients.
Compliance* ; Diagnostic Self Evaluation ; Health Behavior ; Humans ; Intention ; Internal-External Control ; Motivation ; Tuberculosis, Pulmonary* ; Surveys and Questionnaires

Reconstruction of the anophthalmic contracted socket was performed in 28 eyes (34 cases) from October 1981 to February 1985. The follow-up period after surgery ranged from 6 months to 12 months. The age range of the patients was from 5 years to 60 years, and there were 25 males and 3 females. Degree of the contraction and method of the operation were as follows: 1. Mildly contracted socket. Among 12 eyes, 7 eyes were operated with acrylic conformer(AC) after buccal mucous membrane graft(BMMG) and 5 eyes with dental conformer(DC) after buccal mucous membrane graft. 2. Moderately contracted socket. Among 9 eyes, 6 eyes were operated with AC after BMMG and 3 eyes with DC after BMMG. 3. Severely contracted socket. Among 7 eyes, 5 eyes were operated with AC after BMMG and 2 eyes with DC after BMMG. The results were as follows: 1. Etiology of the contracted socket was inflammation(12 eyes: 43%), trauma(7 eyes: 25%), burn(5 eyes: 18%) and irradiation(4 eyes: 14%). 2. In reconstruction of the contracted socket, buccal mucosa was a good substitute for conjunctiva. 3. Better result was obtained in the cases with lesser contraction preoperatively, and in the cases of reconstruction after preoperative repair of lid defect. 4. The optimal interval for further surgery was at least about 6 months due to resolution of the fibroblastic activity. 5. Postoperative complications were noted in 8 cases(24%), which were recontraction in 4 cases(12%), shrinkage of the graft in 2 cases(6%), necrosis of the graft in 1 case(3%), and infection in 1 case(3%). 6. Most patients now wear artificial eyes with or without lightly tinted glasses, giving them good appearance, even though their sight was gone.
Conjunctiva ; Eye, Artificial ; Eyeglasses ; Female ; Fibroblasts ; Follow-Up Studies ; Glass ; Humans ; Male ; Mouth Mucosa ; Mucous Membrane ; Necrosis ; Postoperative Complications ; Transplants