• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.388-393
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• 2023

Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

• Journal of Chest Surgery
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• v.5 no.2
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• pp.87-96
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• 1972

Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.

• Korean Journal of Veterinary Research
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• v.36 no.4
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• pp.973-990
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• 1996

To investigate diagnostic imaging of cystitis and to apply it to the small animal practice, ultrasonogram of urinary bladder with moderate distension(4ml/kg) and with complete distension(9ml/kg) to evaluate the irregularity and thickness of bladder, radiography and histopathological examination were performed after experimental cystitis induction. On double contrast cystography, mucosal membrane of the urinary bladder was smooth and thickening urinary bladder wall was not found before cystitis induction. At 3rd day post induction(PI), mucosal irregularity was noted at the cranioventral region of the urinary bladder. Thickening of the urinary bladder wall and filling defect was observed as well. Cystographic findings of 7, 10, 15, 21 day PI were similar to that of 3rd day PI. On ultrasonographic findings of the mural thickness in induction group, it was ascertain that the mural thickness with moderate distention was more thickened than with complete distention at transverse scan. Ultrasonographic findings at longitudinal scan were similar to those of transverse scan. On ultrasonographic findings of mucosal irregularity in induction group, from PI to 7 day PI, mucosal irregularity with moderate distention was more irregular than mucosal irregularity with complete distention. At 10 day PI, there was similarity between moderate distention and complete distention. On histopathologic examination of a section of urinary bladder taken 3 day PI, the mucosal and submucosa were infiltrated by a mixture of thick inflammatory exudate which was composed of neutrophil, plasma protein, bacterial colony and necrotic cells. Congestion, hemorrhage and edema were also observed in the submucosa. At 7th day PI, the mucosal change was similar to that of 3rd day PI, but neovascularization and fibroplasia were observed in the submucosa. At 15th and 21th day PI, mild hyperplasia of mucosal epithelium was observed in the mucosa. Deposition of collagen, neovascularization and severe diffuse infiltration of lymphocyte were observed. These results suggest that ultrasonographic examination with moderate distention is considered to be a more simple, rapid, noninvasive, sensitive and useful diagnostic method than other diagnostic methods for the diagnosis of the cystitis and the differential diagnosis of urinary tract infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.181-190
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• 2001

Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

• Applied Microscopy
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• v.33 no.1
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• pp.79-92
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• 2003

Ultrastructural changes of the pericarp in Citrus reticulata has been investigated during hesperidium abscission. The pericarp was composed of compactly arranged parenchyma cell layers during early stages of fruit development. The outermost exocarp was green and active in photosynthesis. However, cells in the exocarp soon changed into collenchyma cells by developing unevenly thickened walls within a short time frame. As the fruit approached maturation, the chlorophyll gradually disappeared and chloroplasts were transformed into carotenoid-rich chromoplasts. In the mature fruit the exocarp consisted of large, lobed collenchyma cells with primary pit fields and numerous plasmodesmata. The immature mesocarp was a relatively hard and thick layer, located directly under the exocarp. With development, the deeper layers of the exocarp merged into the white, spongy mesocarp. Before separation of the hesperidium from the plant, some unusual features were detected in the plasma membrane of the exocarp cells. The number of small vacuoles and dark, irregular osmiophilic lipid bodies also increased enormously in the exocarp collenchyma after the abscission. They occurred between the plasma membrane and the wall, and invaginated pockets of the plasma membrane containing double-membraned vesicles were also frequently noticed. The lipid bodies in the cytoplasm were often associated with other organelles, especially with plastids and mitochondria. The plastids, which were irregular or amoeboid in shape, contained numerous large lipid droplets, and occasional clusters of phytoferritin, as well as few loosely -oriented peripheral lamellae. Myelin-like configurations of membrane were frequently observed in the vacuoles, as was the association of lipid bodies with the vacuolar membrane. Most vacuoles had an irregular outline, and lipid bodies were often connected to the tonoplast of the vacuoles. The structural changes underlying developmental, particularly to senescence, processes in various hesperidium will be reported in the separate paper.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.5-17
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• 2000

To evaluate the possible therapeutic effects of growth hormone and vitamin C on multiorgan failure, a rat model was developed for LPS-induced sepsis. Using this model, the effects of growth hormone and vitamin C on tissue damages, catalase and i-NOS activities, and MDA levels were examined in the lung and liver. The level of TNF- in plasm was also examined. Male, Sprague-Dawley rats were injected with LPS intraperitoneally then divided into 3 groups : positive controls injected with LPS only, the ones injected with growth hormone or vitamin C immediately after the LPS injections. The lung and the liver were then isolated, blood samples were collected at 24 or 48 hours after the LPS injection, then examined for histopathological and biochemical changes. The results obtained were as follows. 1. LPS induced sinusoid vasodilation and mild destruction of lobular structure in the liver. In the lung, alveolar structure appeared to be thickened and interstitial edema was observed. The levels of MDA in the liver and the lung was increased by LPS, while the activity of catalase was decreased. The activity of i-NOS of those tissues was also increased, which was more pronounced at 24 hr. The level of TNF- in plasm was increased by LPS 2. In the lung, vitamin C suppressed lymphocyte and neutrophil infiltration, alveolar wall thickening and interstitial edema. In the liver, vitamin C protected against the destruction of the lobular structure. The activity of catalase reduced by LPS was reversed partly by vitamin C. The activity of i-NOS enhanced by LPS was also reversed by vitamin C. The level of TNF- in plasm reduced in some animals by vitamin C, which however was not significant statistically(p<0.05). 3. Growth hormone showed similar protective effects against inflammation and damages in the liver and lung tissues. Growth hormone reversed partly the LPS effects on the level of MDA, the activity of catalase and i-NOS induction in the liver and the lung. Growth hormone reduced plasma level of TNF-${\alpha}$ substantially, which contrasted from vitamin C. Besides this, overall protective effects of growth hormone against LPS-induced experimental sepsis were similar to those of vitamin C. From this results, the mechanism of growth hormone on suppression of LPS-induced tissue damage might be associated with production of antioxidative enzyme and suppression of plasma TNF- level.

• Korean Journal of Weed Science
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• v.12 no.1
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• pp.31-38
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• 1992

This study was conducted to investigate the effect of plant growth retardants on the growth and characters related with lodging in rice. The results are summarized as follows. Plant height which is closely related to lodging was significantly inhibited by the application of inabenfide, paclobutrazol, and uniconazole. Among the tested application times, inabenfide, paclobutrazol, and uniconazole were the most effective in inhibiting plant height at 30, 20, 20 days before heading respectively. Inabenfide was markedly effective in reducing the lower (4th) internode length, whereas paclobutrazol and uniconazole were more effective in reducing the upper (3rd and 2nd) internode length. Internode wall of rice plant treated with chemicals was tended to be thickened as compared with control. Heading date was not influenced by inabenfide, but paclobutrazol and uniconazole were inhibited 1 or 2 days in heading date as compared with control. Lodging index was the most reduced when inabenfide was applied 30 days before heading with 160g ai whereas paclobutrazol and uniconazole were applied 15 days before heading with 12, 1.2g ai per 10a, respectively. All the treatments inhibited the lodging of rice but control was completely lodged. Yield treated with these chemicals was prevented by 10-12% of yield decrease occurred by lodging. As a conclusion, inabenfide with 120 or 160g ai at 40 or 30 days before heading, paclobutrazol with 12g ai at 15 days before heading, arid uniconazole with 1.2g ai at 15 days before heading appear to be the most practical application time and rate for preventing lodging in paddy rice.

• Korean Journal of Animal Reproduction
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• v.21 no.3
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• pp.255-264
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• 1997

The purpose of this study was attempted to investigate the number changes of the growing and mature follicles in ovary following repeats of pregnant mare serum gonadotropin(PMSG) treatments for superovulation in nulliparous rats. Thirty two rats(Sprague-Dawely, about 200~250 gm) were randomized into 4 groups. Control group rats were sacrified at estrus phase confirmed by vaginal smear. PMSG-treated group 1 rats, PMSG-treated group 2 rats and PMSG-treated group 3 rats were sacrified at 48 hrs after injection once with PMSG 25 IU, after 2 repeated injection by a week interval, and 3 repeated injection, respectively. The uteri and ovaries of rats were removed and weighed and then were observed grossly and serial sections of all ovaries and some sections of uteri by paraffin embedding were stained with H-E. Number of ovarian follicles about 3 grades of small, middle and large follicles from seondary and follicles were investigated by LM photographies of ovary preparations. The criteria of the small, middle, and large follicles were based as small follicle with preantral follicles with 2~4 layers of granulosa cells surrounding the oocyte, as secondary follicles with more than 5 layers of granulosa cells and early signs of antral cavity or with small clefts on either side of the oocytes, and as tirtiary follicles with a single medium sized antral cavity or large well-formed antral cavity, respectively. In gross findings, the wall of the uteri in control group were thin, and those in 3 PMS-treated group were markedly thickened and some uterine lumen of those filled with fluid. In histological findings, the walls of the uteri from 3 PMSG-treated groups were hypertrophied and their blood and lymph vessels were dilated than those of control group. The ovaries fo 3 PMSG-treated groups were more increased in size and the cortexes were more developed and increased in width but there are no difference of development and changes in 3 PMSG-treated groups. The weight of the uteri and ovaries per rat in PMSG -treated group 1, 2 and 3 were a, pp.ared to be significantly increased 171.4$\pm$47.6%, 162.3$\pm$43.9%, 206.9$\pm$30.4%, respectively than those of control groups. The mean number of follicle per ovary in control group were a, pp.ared to be 17.1$\pm$3.5, 46.2$\pm$14.5, and 74.3$\pm$22.7 at large, middle and small follicles, respectively and total number of these 3 grade follicles per ovary were a, pp.ared to be 137.7$\pm$31.7. The mean number of follicle per ovary in PMSG-treated group 1 were a, pp.ared to be 25.6$\pm$7.3, 78.1$\pm$29.9, and 83.2$\pm$34.0, at large, middle and small follicles, respectively and total number of these 3 grade follicles were a, pp.ared to be 187.5$\pm$58.8. The mean number of follicle per ovary in PMS-treated group 2 were a, pp.ared to be 21.9$\pm$5.2, 67.8$\pm$16.8, and 68.0$\pm$14.9 at large, middle and small follicles, respectively and total number of these 3 grade follicles were a, pp.ared to be 157.7$\pm$26.2. The mean number of follicle per ovary in PMS-treated group 3 were a, pp.ared to be 21.7$\pm$4.8, 61.5$\pm$17.0, and 59.7$\pm$16.2 at large, middle and small follicles, respectively and total number of these 3 grade follicles were a, pp.ared to be 143.5$\pm$29.6. The number of follicles in PMSG-treated group 1 a, pp.ared to be more number than other 2 PMSG-treated gruops and tended to be decreased by frequency of PMSG-treatment.

• Journal of Sericultural and Entomological Science
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• v.25 no.2
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• pp.1-31
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• 1984

Flacherie, as one of the most prevalent silkworm diseases, causes severe economic damage to sericultural industry and its pathogens have been proved to be flacherie virus (FV) and densonucleosis virus (DNV). Multiplications of the viruses in the larvae of the silkworm, Bombyx mori, were studied by the sucrose density gradient centrifugation and electron microscopy. The quantitative and qualitative changes of nucleic acids and proteins were investigated from the midgut and hemolymph in the silkworm larvae infected separately with FV and DNV. The histopathological changes of epithelial cells of infected midgut also were examined by an electron microscope. 1. Purified fractions of FV or DNV in a sucrose density gradient centrifugation yielded one homogenous and sharp peak without a shoulder, suggesting no heterogenous materials in the preparation. Electron microscopy also revealed that FV and DNV were spherical particles, 27nm and 21nm in diameter, respectively. 2. Silkworm larvae showed a decrease in body weight on the 6th day and in midgut weight on the 3rd day after inoculation with FV or DNV. 3. DNA content was higher in the midgut when infected with FV or DNV, but the hemolymph of the infected larvae showed no difference during first 6 days after inoculation, after which DNA concentration declined rapidly. 4. RNA synthesis of silkworm larvae infected separately with FV and DNV was stimulated in the midgut, but RNA content was reduced in the hemolymph at the early stage of virus multiplication. At the late stage of virus multiplication, however, it was extremely reduced in both midgut and hemolymph. 5. The concentration of protein in the midgut and hemolymph of silkworm larvae infected separately with FV and DNV showed no difference from that of the healthy larvae at the early stage of virus multiplication, but it was significantly reduced at the late stage of virus multiplication. 6. There was no difference in the electrophoretic patterns of RNAs extracted from the midgut of healthy or virus-infected larvae. 7. The electrophoresis of proteins extracted from the midgut infected with FV or DNV, when carried out on the 1st and 5th day after virus inoculation, showed no difference from that of the healthy larvae. But, there was an additional band with medium motility in the proteins on the 8th day after virus inoculation, while a band with low mobility shown in the proteins of healthy larvae disappeared in the infected larvae. However, a band with high mobility in the healthy larvae was separated into two fractions in the infected larvae. 8. The electrophoretic pattern of hemolymph proteins of the silkworm larvae infected separately with FV and DNV was similar to that of the healthy larvae, but the concentration of hemolymph proteins in the infected larvae was lower than that of the healthy larvae at the late stage. 9. Two types of inclusion bodies were shown by the double staining of pyronin-methyl green in the columnar cell of the midgut on the 8th day after FV inoculation. 10. Electron microscopy of the infected midgut revealed that the 'cytoplasmic wall' of the goblet cell thickened on the 5th day after FV inoculation and several types of the cytopathogenic structures, such as virus$.$specific vesicles, virus particles, linear structures, tubular structures, and high electron-dense matrices were observed in the cytoplasm of the goblet cell. The virus particles were also observed in the microvilli and the structures similar to spherical virus particles were observed around the virus-specific vesicles, suggesting the virus assembly in the cytoplasm. 11. Fluorescence micrograph of the infected midgut stained with acridine orange showed that the nucleus, the site of DNV multiplication in the columnar cell, enlarged on the 5th day after virus inoculation. 12. Electron microscopic examination of DNV infected midgut revealed that the nucleolus of the columnar cell was broken into granules and those granules dispersed into apical region of the nucleus on the 5th day after virus inoculation. On the 8th day after inoculation, it was also observed that the nucleus of the columnar cell was full with the high electron-dense virogenic stroma which were similar to virus particles. These facts suggest that the virogenic stroma were the sites of virus assembly in the process of DNV multiplication.