Recently attention has been focused on the biology of transforming growth factor-beta1 (TGF-beta1). TGF-beta1, a potent regulator of cell proliferation, stimulates the proliferation of many cell types of mesenchymal origin and inhibits the growth of many epithelial cells. But its cellular distribution and temporal expression remain unknown. The aim of this study was to investigate immunohistochemically the cellular distribution and temporal expression of TGF-beta1 during rat hepatic fibrosis induced by dimethylnitrosamine (DMN). At an early stage of liver fibrosis, there was evidence of multiple centrilobular hemorrhagic necrosis with parenchymal lobular collapse, and at a late stage, there was septal fibrosis with micronodule formation of the parenchyme. TGF-beta1 peptide was first expressed in centrilobular clusters of macrophage which were surrounded by many TGF-beta1 negative fat-storing cells (FSCs). Along with the progression of fibrosis, the TGF-beta1 peptide was expressed in the alpha-smooth muscle actin positive FSCs and also in some peripherally located hepatocytes of micronodules. Serum IFN-gamma was detected in the serum 2 weeks after an initial administration of DMN had reached the peak level at the 4th week and then markedly decreased at the 5th week. We think that TGF-beta1 peptide is produced by macrophages influenced by soluble IFN-gamma, and is expressed in the -smooth muscle actin positive mesenchymal cells and regenerating hepatocytes, and that this cytokine may have an important role in the synthesis of the extracellular matrix and in the regulation of hepatocytic regeneration.
Actins ; Animals ; Biology ; Cell Proliferation ; Dimethylnitrosamine* ; Epithelial Cells ; Extracellular Matrix ; Fibrosis* ; Hepatocytes ; Liver Cirrhosis ; Liver* ; Macrophages ; Necrosis ; Rats* ; Regeneration ; Transforming Growth Factor beta1*

PURPOSE: This study is to assess the quality of life(QOL) of hematic cancer survivors after hematopoietic stem cell transplantation(HSCT) and received chemotherapy(RC) to prepare basic information for nursing interventions in order to improve the patients' QOL. METHOD: The data were collected by self-reporting questionnaire from January to March, 2003 intended for outpatients at the Cancer center of D university hospital in Busan. All 44 of them were diagnosed as hematic cancer and had spent 100 days after getting HSCT and complete remission(CR) throughout RC. The collected data were analyzed with descriptive statistics, t-test. ANOVA using SPSS/WIN 10.0 program. RESULTS: The total mean score of the QOL was moderate. In case of survivors in HSCT, the total mean score of the QOL was 5.81+/-.08, and that of survivors in RC was 5.94+/-.13. The facts above has not been considered statistically as the result of analysis of differences in each domain of the QOL depending on the general characteristics of the objects of this study. CONCLUSION: The total mean score of the QOL was at moderate levels, indicating that the survivors after HSCT and RC were perceiving their QOL as moderate. In the nursing business aspect, the most important thing is to understand the QOL which the 2 groups of the survivors perceive, and the plans of nursing intervention that can be helpful to more qualitative life should be studied constantly.
Busan ; Commerce ; Drug Therapy* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Nursing ; Outpatients ; Quality of Life* ; Surveys and Questionnaires ; Survivors*

A case of Tuberous Sclerosis, 4 year-old-Korean boy was observed. He had some symptoms about Tuberous Sclerosis which were abenoma sebaceum, seizure, shagreen patch and hypopigmented macule. Diagnosis was confirmed by facial skin biopsy and adenoma sebaceum was noticed.
Biopsy ; Diagnosis ; Humans ; Male ; Seizures ; Skin ; Tuberous Sclerosis*

No abstract available.

Postoperative muscle pain is well known to occur in man following intravenous administration of succinylcholine. The mechanism of muscle pain is yet unknown. A number of methods for preventing muscle pains or decreasing their severity have been suggested, including nondepolarizing relaxants prior to succinylcholine (Churchill-Davidson, 1954: Cullen, 1971: Wig and Bali, 1979) or lidocaine(Usubiaga et al., 1967: Haldia et al., 1973: Fry, 1975), use of vitamin C (Gupte & Savant, 1971), procaine chloride(Morris & Dunn, 1957), thiopental sodium (Craign, 1964) or diazepam (Verma et al., 1978) and the use of a "self-taming" method of succinylcholine by prior injection of a small dose(Baraka, 1977). To investigate methods of preventing muscle pains or decreasing their severity after intravenous injection of succinylcholine, we studied four groups, a control group and three experimental groups (a lidocaine group, a d- Tubocurarine group and a succinylcholine self-taming group). The following results were obtained: 1) In the lidocaine group, the incidence of muscle pain was lower than in the control group, but there was no significant difference between the two groups. However the incidence of muscle pain in the d-Tubocurarine group or the succinylcholine self-taming group were lower than in the control group and there were statistically significant differences(p<0.0005). 2) In most of the patients of each group, the degree of postoperative muscle pain was mild and a difference of degree of muscle pain was not found in each group (p>0.05).3) The muscle pain usually appeared in the first day after operation and disappeared usually within three days. 4) The degree of muscle fasciculation showed a significant decrease with lidocaine, d-Tubocurarine or the succinylcholine self-taming group over the control group(p<0.0005), but there was no significant relationship between the degree of muscle fasciculation and the incidence of postoperative muscle pain(p>0.05). 5) The degree of muscle relaxation during intubation in the d-Tubocurarine group was less complete than in the other 3 groups and it was statistically significant(Zi>1.96). It is suggested from the above results that d-Tubocurarine(0.05~0.06mg/kg) prior to succinylcholine or the method of self-taming of succinylcholine(prior use of succinylcholine 0.15mg/kg) can be used as methods to prevent muscle pain after intravenous administration of succinylcholine, but lidocaine(2mg/kg) prior to succinylcholine is not effective in preventing muscle pain following succinylcholine administration.
Administration, Intravenous ; Ascorbic Acid ; Diazepam ; Fasciculation ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Methods ; Muscle Relaxation ; Myalgia* ; Procaine ; Succinylcholine ; Thiopental ; Tubocurarine

The purpose of this study is to determine the effect of diabetes education program on Glucose Metabolism(blood sugar. HbAlc) and Lipid Metabolism(total cholesterol. triglyceride. low density lipoprotein. high density lipoprotein). Self-efficacy in non-insulin independent diabetes mellitus. The study design was a non equivalent control group pre-test post-test design. Data for the study were collected from March 12 to June 19, 2001. Sixty-two research subjects were assigned to experimental (36) and control (26) groups. The collected data was analyzed using the Chi-Square test. t-test by spsswin program The results are as follows: 1. Experimental group had higher level of glucose metabolism than control group(FBS: t=-3.317. p=.002. HbAlc: t=-4.956. p=.000). 2. Level of lipid metabolism were partly a significant different between experimental group and control group(Triglyceride: t=-2.108. p=.039). 3. Experimental group had higher efficacy score than control group(t=4.651. p=.000). In conclusion. the study supported the effects of diabetes education program to increase metabolism and self-efficacy. Further study with a longitudinal design is suggested to verify the effect of diabetes education program in NIDDM and standardized diabetes education program.
Cholesterol ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Education* ; Glucose* ; Humans ; Lipid Metabolism* ; Lipoproteins ; Metabolism* ; Research Subjects ; Triglycerides

The purpose of this study is to clarify success factors for desirable relationship between buyer and supplier in elementary school. Therefore, the survey questionnaire consisted of general background, past success, success difference, buyer-supplier relationship characteristics(trust, supporting status, communication behavior, conflict resolution techniques, supplier selection process). The subjects were 66 dieticians of elementary school in Inchon. The statistical analysis of data was completed using SPSS program. The results were summarized as follows : Average total cost/day per one person 1,156Won. The number of suppliers per one school were 6. 92.3% of the subjects were in favor of private contract, regarding contract methods of purchasing food materials. For the past success, degree of satisfaction about past their supplier showed 3.49 score. The present success difference was shown higher than the past success. There was significant correlation between the past success and the present success difference. Trust about suppliers showed 3.40score. Supplying companies hardly support for buying school. Among information quality(timely, accurate, adequate, complete, credible), timely and complete showed lower score than the other kind of elements. Among the buyer-supplier relationship characteristic elements, only trust correlated with satisfaction about suppliers significantly. Among the conflict resolution techniques, joint problem solving and persuasive attempts were often made use of by subjects. The supplier selection criteria were shown quality(7.47), supplier's capabilities(6.46), management plan(6.00), price(5.73), scale(5.48), assets(5.27), considers delivery(4.76) and technology(2.39). As results, trust was needed for the desirable relationship between buyers and suppliers. This study has some limitations. The data in this study were collected from only buyer. It is more desired to acquire data from suppliers also.
Humans ; Incheon ; Joints ; Lunch* ; Negotiating ; Nutritionists ; Patient Selection ; Problem Solving ; Surveys and Questionnaires

Angioimmunoblastic lymphadenopathy (AILD) is a systemic disease clinically characterized by fever, generalized lymphadenopathy, hepatosplenomegaly, polyclonal gamma-globulinemia and Cooms' positive hemolytic anemia. The lymph node in AILD reveals a polymorphic feature consisting of a proliferation of small vessels, immunoblasts and plasma cells and acidophilic interstitial material. Progression into immunoblastic sarcoma is reported as high 35% of the patient with AILD. Nathwani et al have observed not only malignant transformation of AILD in sequential tissue examination, but also the coexistence of AILD and immunoblastic lymphoma in the same lymph node or at different sites in the same patient. Multiple clusters or islands of compactly arranged large lymphoid cells constitute the initial histologic evidence of immunoblastic sarcoma. Immunoblastic sarcoma is a large cell lymphoma conceptually related to transformed T-and B-lymphocytes of the extrafollicular compartment of the immune system, which proignosis is poor. We have recently experienced a case of immuno blastic sarcoma arising in angioimmunoblastic lymphadenopathy in a 24-year-old woman. She had history of multiple enlarged lymph nodes in the inguinal, axilla and supraclavicular areas. Previous lymph node biopsies revealed reactive change. Six month later, right axillary lymph node biopsy reveled AILD with focal clusters of immunoblasts. Subsequent lymph node biopsy at the same site revealed diffuse immunoblasic sarcoma, B-cell type. A case presentation with histologic findings and a brief review of literature were done.
Female ; Humans ; Biopsy

Aspiration and resultant chemical pneumonitis remain a serious hazard associated with the administration of anesthesia. Anticholinergic drugs are commonly used to reduce the volume and acidity of gastric secretion. We studied the effectiveness of atropine, glycopyrrolate and cimetidine in increasing gastric pH, free acidity and total acidity in the pre-and the 1hr post-anesthesia. Fifty patients scheduled for elective surgery in Dept. of Ansthesiology in EWUH, were randomly allocated into five groups with ten patients in each group. Patients in the control group were given neither anticholinergics nor cimetidine; patients in group I received 0.5 mg of atropine intramuscularly 1 hr. before induction of anesthesia, patients in group II received 0.2 mg of glycopyrrolate intramuscularly 1 hr. before induction of anesthesia, patients in group III received 200 mg of cimetidine intravenously and atropine as in group I, patients in group IV received 200 mg of cimentidine intravenously and glycopyrrolate as in group II. The results were as follows; 1) There were not any significant changes in the gastric pH, free acidity or total acidity in any of the patient groups in pre-and post-anesthesia. 2) In the control group, the mean gastric pH was 1.86+/-0.07, free acidity was 33.48+/-8.73 and total acidity was 49.31+/-9.10. 3) In the group I, the mean gastric pH was 2.62+/-0.24, free acidity was 5.65+/-1.89 and total acidity was 19. 76+/-3.27. Compared with the control group, the gastric pH in group I increased but free acidity and total acidity both decreased significantly(p<0.05). 4) In the group II, the mean gastric pH was 3.46+/-0.52, free acidity was 4.18+/-l.75 and total acidity was 19.76+/-3.27. 5) In the group III, the mean gastric pH was 6.17+/-0.66, free acidity was 10.96+/-4.42. Compared with the control group, the mean gastric pH in group III increased but free acidity and total acidity both decreased significantly(p<0.001).6) In the group IV, the mean gastric pH was 2.70+/-0.39, free acidity 11.01+/-4.73 and total acidity was 33.41+/-5.81. Compared with the control group, the gastric pH in group IV increased but free acidity and total acidity both decreased significantly(p<0.05). So, compared with the control group, the mean gastric pH above 2.5 increased significantly in the all groups. In conclusion, it would seem that the incidence of severe aspiration pneumonitis can be decreased by anticholinergic drugs and cimetidine pretreatment in surgical patients.
Anesthesia ; Atropine ; Cholinergic Antagonists* ; Cimetidine ; Glycopyrrolate ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Pneumonia

BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage