No abstract available.
Pancreaticojejunostomy*

In order to study the histogenesis of gastric carcinoma, and to find the correlationship between the gastric carcinoma and endocrine tumor of digestive tract, we performed immunoperoxidase staining for serotonin, somatostatin and gastrin respectively in the 34 cases of surgically resected gastric carcinoma. The results were as follows; 1) Endocrine cells were found in 26.5% (9/34) of the gastric adenocarcinoma, but in 58.6% (17/29) in the normal gastric mucosa near the cancer area. The occurrence of endocrine cells was less frequent in cancer than in the normal gastric mucosa. 2) Among the 15 cases of intestinal type adenocarcinoma, serotonin-positive cells were found in 2 cases, somatostatin-positive cells in 1 case and gastrin-positive cells in 1 case. Among 16 cases of diffuse type adenocarcinoma, gastrin-positive cells were found in 2 cases, and somatostatin-positive cells were found in 2 cases. 3) We concluded that, the endocrine cells are more frequently observed in the well differentiated gastric carcinoma than poorly differentiated carcinoma tissue. In summary, gastric carcinomas are supposed to arise from the totipotent stem cells of endoderm origin, and they have multidirectional property of differentiation into both endocrine and nonendocrine cells. Most of them differentiate into nonendocrine cells and only a few of them differentiate into endocrine cells.

It is generally accepted that tbe lepromin test is of great value in the type classification and the evaluation of the prognosis of leprosy. But the nature of the antigenicity in lepromin reaction stiIl remains uncertain. The present study was carried out to investigate the antigenic characteriatics of the early(Fernandez) and the late (Mitsuda) reactions to Mitsuda lepromin antigen. Mycobacterium leprae was purified by trypsin digestion from human lepromas, and was broken down by passing 5 times through a French Pressor at 16, 000 p.s.i.. From the broken cell suspension, cell wall, cytoplasm, very low density lipoprotein (VLDL) and lipopolysaccharide (LPS) were prepared. IntradermaI skin tests were perforrned on 30 leprosy patients classified according to the Ridley-Jopling scale (4 TT, 6 BT, 2 BB, 7 BL and 11 LL), with 0. 1ml of the Mitsuda lepromin(intact cells) broken cells, cell wall, cytoplasm, VLDL and LPS antigens. Readings for the early and the late reactions were done 72 hours and 28 days, respectively, after itradermal injections of the above antigens. The results are summerized as follows: 1, Early reactions were elicited by broken cells, cell wall and cytoplasm in all of the patients who could react to Mitsuda lepromin antigen. VLDL and LPS antigens could also elicit early reactions in 9(56)% and in 14(88%), respectively, of the 10 patients who showed positive reaction to Mitsuda lepromin antigen. These results mean that the early reaction may be due to multiple antigena, originated either from M. leprae or from contaminated human tissues. 2. Late reactions were elicited by broken cells and cell wall antigens, but not by cytoplasm antigen, in all of the patients who showed late reactions to Mitsuda lepromin antigen. These results mean that broken cells also produce a late reaction and the specific antigen(s) of the late reaction may reside in the cell wall fraction of the M. leprae.
Cell Wall ; Classification ; Cytoplasm ; Digestion ; Humans ; Lepromin* ; Leprosy ; Lipoproteins ; Mycobacterium leprae ; Prognosis ; Reading ; Skin Tests ; Trypsin

The increased susceptibility in patients of chronic renal failure to infection has been reported to be attributed to defects in granulocyte and lymphocyte function and proliferative activity of hematopoietic cells. The definite cause of the frequent infection in uremic patients, however, is still controversial. The effect of uremic plasma on the aspect of the hematopoietic cells has been scarcely been studied. In the present study, mouse bone marrow was cultured with uremic plasma, to evaluate the effect of uremic plasma on the proliferative activity and morphological features of CFU-GM. The results obtained were as follows. 1) The number of colonies in group co-cultured with uremic plasma was more reduced than that of normal plasma group. 2) There was no difference between the group cultured with predialytic uremic plasma and that of postdialytic plasma in number of colonies, macroclusters and microclusters. 3) The forms of colony were granulocytic and monocytic forms at 5 day of culture. Electron microscopically, granulocytes disclosed electron dense azurophilic granules and electrolucent specific granules in the cytoplasm, and monocyte showed numerous vesicles and vacuoles in the cytoplasm which had finger-like projections. 4) The molecular weight of inhibitory factor in the uremic plasma was supposed to be less than 50,000 daltons.
Mice ; Animals

We have investigated an immunohistochemical expression of the Human-Ha-ras oncogene product p21 in tumor cells of the primary mass and metastatic lymph nodes with different histological features of gastric cancer by using avidinbiotin complex immunoperoxidase method in formalin-fixed tissue sections from 73 cases of primary tumor mass and 23 cases of metastatic lymph node. Histologic type of the gastric cancer was classification. The results obtained were as follows: 1) Expression of Ha-ras p21 was consistantly increased in the well differentiated tubular adenocarcinoma as compared with poorly differentiated tubular adenocarcinoma (p<0.01), and was substantially decreased in mucinous carcinoma and signet ring cell carcinoma. 2) Signet ring cell carcinoma showed that positive immunoperoxidase reaction for Ha-ras p21 exhibited in the majority of immature signet ring cell with scant cytoplasm rather than in the mature signet ring cells which have abundant cytoplasm filled with mucin. This findings indicate that mucin production from the tumor cell was not correlated with activation of ras gene in the tumor tissue of gastric carcinoma. 3) In general Ha-ras p21 expression was enhanced in the metastatic tumor cells of the regional lymph node compared with primary tumor, especially it was consistantly increase in the well differentiated tubular adenocarcinoma.
Humans ; Adenocarcinoma ; Neoplasm Metastasis ; Stomach Neoplasms

This study was designed for the evaluation of the mean proportions and range of individual difference of muscle fiber types in human Gastrocneminus, Soleus, Peroneus longus and Tibialis anterior muscles, respectively. Flash-frozen muscle sections obtained from 15 cadavers were stained for H&E, trichrome, PAS, regular & reversed myosin ATPase, succinic dehydrogenase (SDH), acid phosphatase (Ac-Pase) and alkaline phosphatase (Alk-Pase). The results obtained were as follows. 1) Differentiation of muscle fiber types was not evident in H&E and trichrome stained specimen. Three types of muscle fibers were, however, evident in PAS-stained sections according to the degree of positivity in observed skeletal muscles. 2) Two fiber types (Types I and II) were only differentiated and the predominant muscle fiber type was type I by regular myosin ATPase reaction in Gastrocnemius, Soleus, Peroneus longus and Tibialis anterior muscles. 3) Three muscle fiber types (Type I, IIa and IIb) were, however, differentiated and the predominant muscle fiber type was type IIa, contrary to patterns of regular myosin ATPase in skeletal muscles except for Soleus muscle by reversed myosin ATPase stains. Only two muscle fiber types (Type I and II) and predominant type I fibers were shown in Soleus muscle. 4) SDH stains showed three types of muscle fiber except Soleus muscle. The mean proportions(%) of type 1 fibers were 48.0% in Gastrocnemius, 62.3% in Soleus, 40.8% in Peroneus longus, and 39.8% in Tibialis anterior muscles, respectively. 5) The mean proportions (%) of muscle fiber types in human skeletal muscles were markedly different, according to individuals and various enzyme histochemical stains. 6) The size of muscle fibers was relatevely small in type I fibers compared with type IIb. 7) Evaluation for the combination patterns of various enzyme histochemical activities showed that the common muscle fiber types (Type I, IIa and IIb) were markedly reduced in the mean proportions and unusual rare muscle fibers predominant. This predominance of unusual muscle fiber types and marked discrepancy in muscle fiber types between regular and reversed myosin ATPase seemed to be ascribed to decreased muscle enzyme activities following postmortem period.
Humans

Tracheal stenosis can be caused by various etiologies, such as infectious disease, trauma from previous prolonged incubation, airway surgery, or external blunt trauma, and neoplasm. Recently, the development of emergency and intensive care units leads to the primary cause of airway stenosis using airway devices. The stenotic lesions can be produced at any level between the vocal cord and the site of the tip of the tube. Laryngotracheal stenosis may be due to prolonged endotrachel intubation, especially with large tube, large tracheostomy stoma, too highly placed oacheostomy, erosion by local infection, the prying action of heavyweight equipment that connects the tracheostomy to the ventilator, excessive cuff pressure, or erosion by the tip of the tube. Prevention of tracheal stenosis is of key importance by understanding and attending to these causes. We experienced three cases of tracheal stenosis occurred after use of airway devices. In first and second cases, We performed end-to-end anastomosis artier resection of stenotic segment of the trachea in a 22-year-ol4 female and a 25-year-old male. They ha6 been treated with prolonged endotracheal incubation and emergency tracheostomy, respectively, for a ventilatory support for the respiratory failure after falling down from a height. The stenotic lesions occurred at the cuff site in the first case and at the stomal level in the second case. In third case, We performed one-stage laryngotracheoplastic procedure for subglottic stenosis in a 23-year-old male. He had been treated with emergence tracheostomy which had been placed too high for a ventilators support for the respiratory failure after traffic accident. The stenotic lesion occurred at the stomal level. The postoperative courses were uneventful.
Accidents, Traffic ; Adult ; Communicable Diseases ; Constriction, Pathologic ; Emergencies ; Female ; Humans ; Intensive Care Units ; Intubation ; Male ; Respiratory Insufficiency ; Trachea ; Tracheal Stenosis* ; Tracheostomy ; Ventilators, Mechanical ; Vocal Cords ; Young Adult

The experiment was designed to investigate type-selectivity of the involved muscle fibers and changes in the component ratios of the fiber types following the progression of disuse atrophy in the skeletal muscle. After inducing disuse atrophy of the skeletal muscle by applying cast on the hind limb, we used histological and histochemical stains in the sections of the rat Tibialia anterior muscles. The results were as follows. 1. Even 8 weeks after immobilization of the hind limb, differentiation of muscle fiber types by histolo gical and histochemical staining methods in the Tibialis anterior muscle could be possible. 2. Atrophy of muscle fibers was more pronounced in type IIB and type I fibers than in type IIA fibers. 3. Central migration of sarcolemmal nuclei and ring fiber appeared after 6th and 8th weeks of immobilization respectively, in the H&E and trichrome preparations. Ac-pase or Alk-pase positive fibem were not noted throughout the experimental periods.
Animals ; Atrophy ; Coloring Agents ; Extremities ; Immobilization ; Muscle, Skeletal ; Muscles ; Muscular Disorders, Atrophic ; Rats

No abstract available.

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.
Classification ; Delivery of Health Care* ; Diagnosis ; Home Care Services ; Home Health Nursing ; Hospitals, Teaching ; Lung Diseases ; Mass Screening ; Nursing* ; Perfusion ; Risk Management ; Seoul ; Vital Signs