Both fibronectin and vitronectin bind to Pneumocystis carinii (P. carinii) and mediate the attachment of the organisms to respiratory epithelial cells. Surfactant A and D play a role in the interaction between P. carinii and host cells. In this study we examined the expression of fibronectin, vitronectin, surfactant-A and D in the interaction between P. carinii and alveolar epithelial cells by immunohistochemistry and pre-embedding immunoelectron microscopy. The experimental rat model of P. carinii pneumonia was induced by administration of low protein diet (8%) and drinking water containing dexamethasone (2 mg/liter) for 6 to 8 weeks. The primary antibodies for light and electron microscopic immunohistochemistries were monoclonal antibodies including fibronectin (1:100) and vitronectin (1:100), and polyclonal antibodies including surfactant A (1:50) and D (1:50), respectively. Light microscopic immunohistochemistry for the fibronectin, vitronectin, surfactant-A and D showed strong expressions on the P. carinii and surface linings of type I alveolar epithelial cells. The electron microscopic immunohistochemistry of the fibronectin and vitronectin showed a strong immunoexpression along the surface pellicles and tubular extensions of P. carinii trophozoites, and surface membranes of the type I epithelial cells. The surfactant-A and D proteins showed a strong expression on the pellicles of P. carinii and surface membranes of the type I epithelial cells, but a weak expression on the free-floating surfactant materials. In conclusions, the trophozoites of P. carinii were mostly attached to type I epithelial cells. The fibronectin, vitronectin, surfactant-A and D were strongly expressed, and played an enhancing role in the binding between the P. carinii organisms and the type I alveolar epithelial cells.
Antibodies ; Antibodies, Monoclonal ; Dexamethasone ; Diet, Protein-Restricted ; Drinking Water ; Epithelial Cells* ; Fibronectins* ; Immunohistochemistry ; Membranes ; Microscopy, Immunoelectron ; Models, Animal ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Trophozoites ; Vitronectin*

No abstract available in English.
Congenital Abnormalities

Lung cancer is one of the most common types of malignancy in western nations with serious health problem, and it has become the leading cause of cancer death of males, second only to stomach cancer, in Korea. A review of the histopathology of 1363 cases (1231 patients) of lung carcinoma, diagnosed at the Keimyung University Medical center from 1987 to 1996, was performed to reclassify the type of carcinomas and to investigate the change in the distribution of histologic types of lung carcinoma according to age, sex and year. Among the 1363 cases, 132 patients underwent a surgical operation after biopsy. The diagnosis of each case was proven by histopathologic analysis of surgical specimens (13.2%) and biopsy materials (86.8%). The histologic types in our study were basically based on modified WHO classification (1982) and on new WHO classification (1999). The classification of small cell carcinoma was based on International Association for the Small Cell Lung Cancer (IASLC, 1988). Of the 1231 patients with lung carcinoma, 1012 were male and 219 were female (male to female ratio was 3.6:1). According to the analysis of age distribution, the most prevalent age group was 60~69 years in both sex as (n=516, 42.0%). Changing trends in sex distribution of lung carcinoma patients showed that the proportion of men had decreased throughout the years, whereas the proportion of women had significantly increased. Histologically, squamous cell carcinoma was the most common (n=624, 50.7%), followed by small cell carcinoma (21.1%), adenocarcinoma (18.1%), large cell undifferentiated carcinoma (2.1%), adenosquamous carcinoma (0.4%), and large cell neuroendocrine carcinoma (0.4%), in order of frequency. In men, squamous cell carcinoma was the most frequent type (55.1%). In women, adenocarcinoma was the most frequent type (39.7%). In both sexes, adenocarcinoma was the most common type in patients under the age of 40 (n=12, 41.4%), while squamous cell carcinoma proved the most frequent type in patients over the age of 40 (n=617, 51.3%). Changing trends of histologic types of lung cancer showed that the incidences of squamous cell carcinoma had significantly decreased throughout the years, whereas those of adenocarcinoma and small cell carcinoma had increased. In conclusion, the results showing increases in the percentage of female patients and in the number of cases of adenocarcinoma were noteworthy, and well correlated with other related reports.
Academic Medical Centers ; Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Lung* ; Male ; Sex Distribution ; Small Cell Lung Carcinoma ; Stomach Neoplasms

Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

Fatigue is a very distressing symptom experienced by many individuals with cancer, especially those who are receiving active chemotherapy. The effects of fatigue are multiple. If not managed, impaired functional status with a decreased quality of life may result. Therefore, this study was designed to identify the relation between fatigue and quality of life in cancer patients undergoing chemotherapy. The subjects for this study were 180 cancer patients receiving chemotherapy who were hospitalized or who visited the outpatient clinics of two university hospitals in Seoul. The following instruments were used in the study: Piper's fatigue scale, Symptom checklist, Mood state scale, Disruption of usual activity scale. The result of this study can be summarized as follows: 1. The relationship between fatigue and quality of life revealed a significantly negative correlation(r=-.513, p<.001). Therefore, the hypothesis "the lower the level of fatigue, the higher the quality of life" was accepted. The relationship between fatigue and physical well-being revealed a significantly negative correlation(r=-.319, p<.001). The relationship between fatigue and emotional well-being revealed a significantly negative correlation(r=-.417, p<.001). The relationship between fatigue and social well-being revealed a significantly negative correlation(r=-.409, p<.001).
Ambulatory Care Facilities ; Checklist ; Drug Therapy* ; Fatigue* ; Hospitals, University ; Humans ; Quality of Life* ; Seoul

In an attempt ultrastructural study of alcohol-induced gastric mucosal change, we selected sixty Sprague-Dawley rats. The rats were administrated with 4 ml of 10% and 40% ethanol enterically and examined by light and electron microscopy. Light microscopically, the thickness of the mucus layer of both 10% and 40% ethanol groups was decreased. The antral mucosa revealed focal inflammatory infiltrates, disturbed glandular arrangements, and significant decrease of mucosal thichness and proper glands. On scanning electron microscopy, flattened or swollen mucosal epithelium and irregularly distributed gastric pits were seen in both experimental groups, and these changes were more severe in the groups of higher concentration and longer duration. On transmission electron microscopy, mitochondrial abnormalities with myelin-like materials and dilatation of endoplasmic reticulum and cytoplasmic blebs were observed. Also the mucus cells show significantly decreased mucus globules, increased fat vacuoles, and large autophagic vacuoles. These alterations were similar to those produced by ethanol in the liver and small intestine. This study indicates that, prolonged administration of ethanol induced chronic gastritis, especially chronic atrophic gastritis.
Rats ; Animals

PURPOSE: The purpose of the study is to investigate the degree of fatigue and its related factors in patients with breast cancer. METHOD: The subjects of this study consisted of 62 breast cancer patients receiving chemotherapy. The Revised Piper Fatigue Scale, Disruption of Usual Activity Scale, Linear Analogue Self Assessment Scale and Self-Care Diary Scale were employed to measure fatigue, disruption of usual activity, mood state and physical symptom respectively. Collected data were analyzed using SPSS-PC to obtain summary statistics for the descriptive analysis, Pearson Correlation, and Stepwise Multiple Regression. RESULT: The results are as follows. 1. The mean score of the degree of fatigue was 4.82 points indicating moderate level. 2. The mean score of the degree of disruption of usual activity, mood state and physical symptom were 2.66, 5.00, and 4.69 points. 3. Fatigue of the subjects was significantly correlated with disruption of usual activity(r=.517, p<.01), mood state(r=.420, p<.01) and physical symptom(r=.463, p<.01). 4. With the result of stepwise multiple regression, disruption of usual activity, mood state and physical symptom being the three variables which could explain fatigue by 39.1%. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following chemotherapy considering these factors.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Fatigue* ; Humans ; Piper ; Quality of Life ; Self Care ; Self-Assessment

PURPOSE: The purpose of the study is to investigate the degree of fatigue and its related factors in patients with breast cancer. METHOD: The subjects of this study consisted of 62 breast cancer patients receiving chemotherapy. The Revised Piper Fatigue Scale, Disruption of Usual Activity Scale, Linear Analogue Self Assessment Scale and Self-Care Diary Scale were employed to measure fatigue, disruption of usual activity, mood state and physical symptom respectively. Collected data were analyzed using SPSS-PC to obtain summary statistics for the descriptive analysis, Pearson Correlation, and Stepwise Multiple Regression. RESULT: The results are as follows. 1. The mean score of the degree of fatigue was 4.82 points indicating moderate level. 2. The mean score of the degree of disruption of usual activity, mood state and physical symptom were 2.66, 5.00, and 4.69 points. 3. Fatigue of the subjects was significantly correlated with disruption of usual activity(r=.517, p<.01), mood state(r=.420, p<.01) and physical symptom(r=.463, p<.01). 4. With the result of stepwise multiple regression, disruption of usual activity, mood state and physical symptom being the three variables which could explain fatigue by 39.1%. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following chemotherapy considering these factors.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Fatigue* ; Humans ; Piper ; Quality of Life ; Self Care ; Self-Assessment

Experimental studies suggest that captopril plays an important preventive role in radiation induced renal injury (RRI). To elucidate the pathogenesis of RRI and effect of captopril, one subgroup was irradiated with a single dose of 9 gray (Gy) total body irradiation and another subgroup with 17 Gy local irradiation in the right kidney. Twenty-four healthy looking Sprague-Dawley rats, weighing 200~250 g, were divided into one control and three experimental group (EG)s for this study. The control group, composed of 2 rats, was maintained on stock diet and drinking tap water. EG was divided into three. EG 1 composed of two subgroups, the first subgroup, 3 rats each, was sacrificed within 12 hours after 9 Gy and 17 Gy single dose irradiation only and the second subgroup, 2 and 1 rats each, was sacrificed 8 weeks after the same doses irradiation. EG 2 composed of subgroups of 2 and 3 rats was given 500 mg/L of captopril in the drinking water after irradiating them with 9 Gy and 17 Gy and sacrificed in the 8th week. EG 3 was subdivided into four subgroups by captopril doses given, 62.5 mg/L, 125 mg/L and 250 mg/L and sacrificed 20 weeks after 9 Gy and 17 Gy irradiation. On light microscopy proximal convoluted tubules showed cytoplasmic vacuolization and focal necrosis in the subcapsular region in EG 1 sacrificed within 12 hours after 9 Gy and 17 Gy irradiation only (sham) and very mild fibrosis in juxtamedullary regions in rats sacrificed 8 weeks after irradiation. In EG 3 these changes were severely increased with additional increased fibrosis in the juxtamedullary region in the group given captopril 62.5 mg/L. On transmission electron microscopy, there were various degenerative changes of organelle. Among the captopril administered EG 2 and EG 3, rats given a high dosage revealed milder degree of damage compared to that of rats given a low dosage, and thickening of basement membrane was remarkable in rats given a low dosage. There was a reduction in tubular damage related to the captopril dosage. According to the above findings, administration of a high dose of captopril might preserve the ultrastructure in RRI and the possible mechanism of captopril was discussed.
Animals ; Basement Membrane ; Captopril ; Cytoplasm ; Diet ; Drinking ; Drinking Water ; Fibrosis ; Kidney ; Microscopy ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rats* ; Rats, Sprague-Dawley ; Water ; Whole-Body Irradiation

Anaphylaxis during anesthesia is rare, but often fatal. Rocuronium is a neuromuscular relaxant used for induction of anesthesia. We experienced a case of anaphylaxis after rocuronium administration during induction of anesthesia. A 64-year-old female patient was scheduled for bilateral radius fracture fixation. The history of patient showed no specific findings other than hypersensitivity to mackerel. She had no previous experience of anesthesia. Anesthesia was induced by intravenous injection of propofol 100 mg and continuous infusion was begun with remifentanil 0.25 µg/kg/min, followed by rocuronium 40 mg. Immediately after intravenous administration of rocuronium, the manual ventilation became difficult, and the patient developed erythema and severe hypotension. The patient was diagnosed with anaphylaxis based on clinical features and started treatment. First, we performed endotracheal intubation promptly. Then, immediate intravenous administration of epinephrine and fluid followed. Despite adequate treatment, hypotension was not corrected and intravenous epinephrine was administered. However, ventricular tachycardia occurred which was successfully treated with a defibrillator. Later, the patient uneventfully recovered in the intensive care unit. The patient was not tested for skin prick test, but rocuronium was the most likely cause of anaphylaxis at that time. The authors unexpectedly experienced drug-induced anaphylaxis, which is life-threatening to the patient. Clinicians should be aware of the diagnosis, treatment, and prevention as anaphylaxis can be hazardous to the patient.
Administration, Intravenous ; Anaphylaxis* ; Anesthesia* ; Defibrillators ; Diagnosis ; Epinephrine ; Erythema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Injections, Intravenous ; Intensive Care Units ; Intubation, Intratracheal ; Middle Aged ; Perciformes ; Propofol ; Radius Fractures ; Skin ; Tachycardia, Ventricular ; Ventilation