Experimental and clinical observation on the effects of severing the mesentery in sigmoidocystoplasty was presented with the following results. Preceded by experimental study on 8 dogs,3 clinical cases of severe hyperchloremic acidosis after bladder reconstruction following sigmoidocystoplasty and undergone severing of the mesentery of the graft at 10.11 and 34 months respectively. As far as can be assessed after such short of post-operative observations, certain common features can be ascertained and the following conclusion drawn: 1)Severing of the mesentery to the intestinal segment 60 days after sigmoidocystoplasty yields no ill effect and no mortality. The post-operative course was uneventful and no sign of necrosis or peritonitis has been demonstrated. 2)Hyperchloremic acidosis and hypopotassemia after the bladder reconstruction were promptly corrected after this procedure, and clearly demonstrated in 3 clinical cases of severe hyperchloremic acidosis with hypopotassemia. 3)Mucus secretion in the reconstructed bladder disappeared almost completely 3 months after severing the mesentery. 4)Reabsorption of the radioisotope Na 24 from the artificial bladder was considerably reduced by the procedure.
Acidosis ; Hypokalemia ; Mesentery* ; Mortality ; Necrosis ; Peritonitis ; Transplants ; Urinary Bladder

No abstract available.
Animals ; Carcinoma, Hepatocellular* ; Epidermal Growth Factor* ; Rats*

Two hundreds and forty six preoperative endoseopic gastric biopsies from 236 conaecutive cases were subjected to the retrospective analyais of diagnostic accuracy among 597 tumor- bearing gastrectomy specimens confirmed by extended histotopographic investigations during a period of 1980 to 1981 at Seoul National University Hospital. The overall diagnostic accuracy of endoscopic gastric biopsy was 93.1% with 0.8% false positivity and 3.5% of false negative caaes; of those, the concordance rate of preoperative biopsy diagnosis based on the histotopographic investigation of the gastrectomy remained in 85.5%, whereas 75% of diagnostic discrepancy wae reaulted from inappropriate biopsy sampling or failure of neoplastic tissue obtainability; and the rest of 25% was mostly false negative cases. (continue...)
Biopsy* ; Diagnosis ; Gastrectomy ; Retrospective Studies ; Seoul

No abstract available.
Acne Vulgaris* ; Cytosol* ; Humans ; Propionibacterium acnes* ; Propionibacterium*

No abstract available.
Animals ; Mucous Membrane* ; Nucleolus Organizer Region* ; Rats*

For sequential phenotypic changes including enzyme altered hepatocytic foci, hyperplastic nodules, hepatocellular adenomas and carcinomas were produced in Sprague-Dawley rats by Solt-Farber method (administration of diethylnitrosamine and acetylaminofluorene (AAF), and partial hepatectomy). The immunohistochemical expressions of glutathione S transferase P (GST-P) and bromodeoxyuridine (BrdU) were assessed for selective proliferative activity in the enzyme altered foci and the subsequently developed lesions by double immunohistochemical staining technique. Immunoreactive areas against GSTP gradually increase from early period of carciogenesis. BrdU labeling in such areas remained high during the first week. but decreased thereafter. BrdU labeling index remained low in the GSTP negative area throughout the experimental period. This suggests that cells in the enzyme altered foci keep away from the suppressor effect of AAF in contrast to the normal cells in which their growth are inhibited by AAF. BrdU labeling index remained very low in both hyperplastic nodule and adenoma which were prevalent during the mid-experimental period, but increase markedly in carcinoma. The long period of low BrdU labeling index seems to correspond to the "slowly growing step of persistent nodule" during hepatocarcinogenesis. The differentiation index, a ratio of S phase fraction between GSTP positive and negative areas, was low in adenoma-developing period and high in carcinoma-developing period. C-Ha-ras p21 was not expressed in foci of enzyme altered hepatocyte and hyperplasia, but highly positive in carcinoma. This indicates that the c-Ha-ras may involve the late step of hepatocarcinogenesis.
Rats ; Animals ; Adenoma ; Carcinoma, Hepatocellular

No abstract available.
DNA* ; Nucleic Acid Hybridization*

Reconstruction of contracted bladder with a segment of small or large bowel has got a wide acceptance in the urological field today The use of a sigmoid colon segment isolated from the fecal stream appears to be most feasible for replacing or enlarging the bladder because the sigmoid colon with its proximity to the bladder would be the most logical donor organ. It might even be assumed so from a functional point of view. From January. 1961 to December 1962. in the Department of General Surgery. National Medical Center there has been performed 30 sigmoidocystoplasties for contracted bladder. The purpose of this paper is to present comparative clinical features of the reconstructed bladder and post-operative complications following closed loop and cup form sigmoidocystoplasty. Material: Of 30 cases of contracted bladder, 28 were contracted T. B bladder and 2 were non-specific cystitis. All 30 cases had previously undergone nephrectomy due either to non-functioning kidney, or extensive destruction. Seventeen cases were males and 13 cases were females. Agewas ranging from 12 to 67 years Two different techniques of sigmoidocystoplasty have been employed, namely closed loop (13 cases) and cup-form (17) sigmoiducyetoplasty, therefore, it has been possible to make a comparative study between two techniques. Clinical result and Conclusion: 1) Bladder reconstruction by means of an isolated sigmoid segment resulted in producing an efficaciously functioning artificial bladder as a urinary reservoir. No mortality 2) One case which was a complete failure was a case of contracted T. B. bladder with urinary incontinence, therefore, it should be emphasized that urinary incontinence is an absolute contraindication for sigmoidocystoplasty. 3)Bladder reconstructi with cup-form sigmoidocystoplasty was superior to closed loop sigmoidocystoplasty because of; A) Shape, position and Prevention of residual urine formation of the reconstructed bladder. B) Tidal volume as closed as total bladder volume. C) Very similar cystometry curve to the normal. D) Reduction of post-operative complication. 4) Production of mucus urine causes troublesome discomfort to the patient after bladder reconstruction, therefore, it would be ideal if we can prevent mucous urine. 5) Although the serum chloride has some tendency to increase after sigmoidocyetoplagty, however, no hyperchloremic acidosis was produced if the kidney function was normal. 6) All hyperchloremic acidosis cases in this series had irreversible hydronephrosis of the remaining kidney. This might give the impression that severe hydronephrosis is a contra-indication to sigmoidocystoplasty. However, as a contracted bladder gives not only miserable urinary symptoms but also shortens the life by progressive destruction of be kidney, the indication for reconstruction of a contracted bladder, even in the presence of severe hydronephrosis, should be discussed. A non-absorbable reconstructed bladder should be most ideal artificial bladder.
Acidosis ; Colon, Sigmoid ; Cystitis ; Female ; Humans ; Hydronephrosis ; Kidney ; Logic ; Male ; Mortality ; Mucus ; Nephrectomy ; Rivers ; Tidal Volume ; Tissue Donors ; Urinary Bladder* ; Urinary Incontinence

Filiform polyposis(FP), an unusual form of inflammatory polyposis, has been recently designated to a lesion characterized by multiple, long slender, finger-like projections of mucosa and submucosa of the gastrointestinal tract. We present 5 cases of FP, of which two were associated with irritable bowel syndrome, two with advanced colon carcinoma, and one with active ileotyphlitis(Behcet's disease). The polyps ranged from 1.0 cm to 3 cm; they were either isolated or aggregated, and their numbers were up to 100. The common microscopic feature was filiform polyps which consisted of central submucosal core covered by intact or minimally inflamed intestinal mucosa, comparable with that in reparative processes and formation of inflammatory(redundant) pseudopolyps. We conclude that awareness of FP in non-inflammatory bowel disease may promote the endoscopists to search its underlying disease and prevent unnecessary surgical procedure. Behcets enterocolitis in the ileocecal junction seems an additional preceding disorder of a localized form of FP.
Colon ; Enterocolitis ; Gastrointestinal Tract ; Intestinal Mucosa ; Irritable Bowel Syndrome ; Mucous Membrane ; Polyps

Pathological proliferation of Brgnners gland is rare, and its wide range of morphologieal variations have led to confusing the terminology with considerable lack of agreement. Six cases of duodenal nodular lesions which consisted of pathological proliferation of Brunners glands were examined by light microscopy. Polypectomy was made in two cases, and the remaining 4 cases were examined with endoscopic biopsy materials. Two polypectomy specimens, 2 cm and 3 cm each in great diameters, consisted of protruded ovoid mass with broad and short stalks. Microacopically, all of 6 cases revealed thin strands of fibrous connective tissue which separated the normal-looking Brunners glands in lobules. Individual lobules were composed of groups of acini formed by cuboidal cells admixed with occasional endocrine cells. Presence of glandular and ductal configuration of the Brunners gland aside from thick, randomly arranged bundles of smooth muscle were featured without distinct relation to interlobular septa. Also, one polypectomy case disclosed the nests of fat cells interspersed with the glandular acini. One mucosal biopsy case contained not only the smooth muscle bands but also the intimate mixture of both acini and ducts. We conclude that some of heterogeneous composition of duodenal nodular proliferation of Brunners gland is indicative of a hamartomatous growth.
Adipocytes ; Biopsy ; Brunner Glands ; Connective Tissue ; Duodenum ; Endocrine Cells ; Hamartoma* ; Microscopy ; Muscle, Smooth ; Pathology