We present a case of localized mucosal hyperplasia of the stomach. The resected stomach contained four large, short stalked polyps, three of which were located in the anterior wall of body and the other in the posterior wall. In addition, numerous small sessile polyps were also scattered in the anterior and posterior fundic walls. Microscopically, the abnormally thick mucosa, carrying with it the muscularis mucosae and a thin core of loose fibrous tissue comprised the polyps by intraluminal infolding of widening of mucosal area. Abundant vasculature of the rugal pattern was prominent in the submucosa. The above findings suggest that the histogenesis of the polyps is related to both hyperplastic thickening and widening of mucosal areas in rugal pattern in the background of inverted distribution pattern of intestinal metaplasia.

Obstructive colitis is an ulceroinflammatory lesion of the large intestine at a distance proximal to the obstructing or potentially obstructing lesion of any etiology. It has been suggested that a rise in the intraluminal pressure related to the obstruction results in a fall in the intramural blood flow with subsequent ischemic necrosis. We examined 7 cases of surgically resected obstructive colitis associated with distal constrictive adenocarcinoma of the large intestine. Two cases of the obstructive colitis were radiologically suspected prior to surgery either as a separate tumor mass or diverticulosis, and another case was suggested to be a tumor seeding by colonoscopy. Grossly, five cases presented with single or multiple, shallow, well-demarcated ulcerative lesions, and the remaining two were featured with a segmental ulcerative lesion the with pseudopolypoid area. The ulceroinflammatory lesions were separated from the distal obstructive carcinoma by a skipped zone of relatively normal mucosa measuring 4-43 cm. The proximal colon to the obstructive lesions were obviously dilated except in one case. Microscopically, mucosa and submucosa were replaced by granulation tissue, and showed inflammatory cell infiltration and fibrin exudates. Muscle coat often accompanied ischemic contraction. Fissuring was noted in one case. The recognition of these lesions prior to or during surgery is stressed based on the morphological features corresponding to an ischemic change in the proximal mucosa to the primary obstructive lesion.
Adenocarcinoma

In rat kidney, the changes in concentrations of nucleotides and their derivatives during ischemia induced by renal artery ligation was measured quantitatively with high performance liquid chromatography (HPLC). After the ligation of renal artery for 60minutes, the concentrations of the nucleotides and derivatives to 80.7±18.39 µg (p<0.01); ATP, 307.2±56.68 µg to 47.6±5.95µg (p<0.01); ADP+AMP, 227.1±7.98 µg to 61.4±3.92 µg (P<0.01); NAD+, 217.9±4.49 µg to 126.6±10.44 µg (P<0.01); GTP, 202.5±23.76 µg to 117.7±14.24 µg (P<0.05); GMP, 54.5±9.03µg to 23.7±0.46 µg (p<0.05), and inosine, 16.6±3.45 µg to 7.8±0.87 µg (P<0.05). But hypoxanthine and xanthine were significantly increased from 113.0±15.58µg to 159.7±12.97µg (P<0.05) and from 87.7±6.77µg to 173.1±12.52µg (P<0.01). In ischemic kidney, concentration of ATP was decreased to 39.9% of control at 10 minutes, 19.8% at 30 minutes, and 15.5% at 60 minutes, and ADP+AMP were decreased to 70.3% of control at 10 minutes, 67.3% at 30 minutes, and to 27.0% at 60 minutes, but hypoxanthine and xanthine were increased to 121.5% and 127.1% at 10 minutes, 126.0% and 174.4% at 30 minutes, and 141.4% and 197.3% at 60 minutes. Total adenosine nucleotides were decreased to 20.3% of control during 60 minutes of ischemia, but hypoxanthine and xanthine were increased to 157.5% of control. These results suggest that the changes in the concentration of nucleotides and their metabolic derivatives are useful indices of the extents of tissue ischemia in rat kidney.
Adenosine ; Adenosine Triphosphate ; Animals ; Chromatography, High Pressure Liquid* ; Chromatography, Liquid ; Guanosine Triphosphate ; Hypoxanthine ; Inosine ; Ischemia* ; Kidney ; Ligation ; Nucleotides* ; Rats* ; Renal Artery ; Xanthine

Continued improvements in treatments of the thoracolumber spine have occured in the last several years. The operative treatment of choice currently is short segment fusion(instrumentation one level above to one level below the injury). The development of pedicle screw systems has brought short segment fusion into clinical reality from the posterior approach. We analysed the clinical results of 20 patients with unstable fracture and fracture-dislocation of thoracolumbar spine who were treated with the posterior transpedicular screw system. The mean fol- low-up was 18 month. Ll was the most common injury level and the bursting fracture was the most common fracure type by Denis classification. The mean preoperative sagital index was 21.5。 and improved 8.1。 postoperatively. The mean preoperative anterior and posterior height of the vertebral height were 56.9% and 88.8% and improved postoperatively 94.7 and 88.8 respectively. The mean preoperative neural canal impingement in neural defici: patient was 47.2% and was improved 30.65% postoperatively. The mean prooperative ASIA motor was 34.1 and improved 41.7 postoperatively. There was no metal failure. These data suggested that the posterior transpedicular screw fixation, transpedicle bone graft, decompression and posterolateral bone graft was able to porvide sufficient stability and to achieve the neurologic improvement.
Asia ; Classification ; Decompression ; Humans ; Neural Tube ; Pedicle Screws ; Spine ; Transplants

No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*

To determine clinical features and outcomes of retinal detachments[RDs] following trans-scleral fixation of posterior chamber intraocular lens[PC-IOL], we reviewed the medical records of 249 eyes[239 patients] which had undergone trans-scleral fixation of PC-IOL and had been followed 6 months or longer. Retinal detachment occurred in 8 out of 249 eyes[3.2%]. The incidences of RDs were as follows:in 2/19 eyes[10.5%] with PC-IOL exchange for PC-IOL tilt, in 1/16 eyes[6.3%] with posterior capsule rupture during ECCE, in 1/26 eyes[3.8%] with ICCE, in 2/78 eyes[2.6%] with posterior capsule rupture during phacoemusification, in 2/106 eyes[1.9%] with aphakia, and in 0/4 eyes[0%] with anterior IOL exchange with PC-IOL. The sites of retinal break corresponded with the directions of needle during fixation in 5/8 eyes[62.5%] and all retinal breaks were located anterior to the equator. The timing of RD was between 2 weeks and 4.8 years after fixation although it occured within 2 months in most cases. Pars plana vitrectomy and scleral buckling were performed in 7 eyes and scleral buckling only in one eye. Retinal reattachment was achieved in seven eyes including three eyes which required two surgical interventions. The vitrectomy should be performed with meticulous care to reduce vitreous traction as much as possible during trans-scleral fixation of PC-IOL and a close follow-up examination for RD is required during the first two months.
Aphakia ; Follow-Up Studies ; Incidence ; Lenses, Intraocular* ; Medical Records ; Needles ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Rupture ; Scleral Buckling ; Traction ; Vitrectomy

We describe a case of polyposis coli, which was followed by development of desmoid in the rectus adbominis muscle and fibromas in the mesentery during an interval of two years. This case supports the hypothesis that, in Garder's syndrome, the traumatic injury by colectomy triggers an unusual fibrous proliferation in the peritoneal cavity and incision site under the possible genetic basis.

No abstract available.
Animals ; Kidney* ; Lactulose* ; Liver* ; Rats* ; Sepsis*

No abstract available.

Unstable Colles' fractures have an inherent capacity for loss of reduction or shortening, or both. The istability can be recognized by the presence of much comminution, severe dorsal angulation(20 degrees or more), or extensive intra-articular involvement. It is difficult to align the fracture fragments and to maintain the reduction. In twenty-nine patients with unstable Colles' fracture from Jan. 1982 to Mar. 1984, several invasive methods were used. The results were as follows: 1. Among 147 patients with Colles' fractures 29 patients(19.7%) had unstable fractures. 2. Colles' fracture was occurred more frequently in women(77%) and in 6th and 7th decades(56%). Unstable fractures showed no significant age and sex related propencity. 3. Mechanism of injury caused unstable Colles' fractures were fall on the outstretched hand(25 patients), traffic accident(3 patients) and crushing injury(1 patient). Open fractures were shown in 4 patients among the unstable fractures. 4. Most of the unstable fractures were comprised of type VII and VIII(49%) but type I and II fractures with marked comminution or displacement also showed instability. 5. Complications were such as, redisplacement of the fractures, temporary neuropathy of the median nerve, compartment syndrome, Sudeck's atrophy, and shoulder-hand syndrome. 6. Overall assessments showed excellent in 4 patients, good in 16 patients, fair in 7 patients and poor in 2 patients. 7. Overall results were mainly correlated with initial severity of the injury and anatomical restoration of the fractures.
Atrophy ; Colles' Fracture ; Compartment Syndromes ; Fractures, Open ; Humans ; Median Nerve ; Radius ; Reflex Sympathetic Dystrophy