Gallbladder (GB) polyp is a mucosal projection into the GB lumen. With increasing health awareness, GB polyps are frequently found using ultrasonography during health screening. The prevalence of GB polyps ranges between 1.3% and 9.5%. Most patients are asymptomatic and have benign characteristics. Of the nonneoplastic polyps, cholesterol polyps are most common, accounting for 60%-70% of lesions. However, a few polyps have malignant potential. Currently, the guidelines recommend laparoscopic cholecystectomy for polyps larger than 1 cm in diameter due to their malignant potential. The treatment algorithm can be influenced by the size, shape, and numbers of polyps, old age (>50 years), the presence of primary sclerosing cholangitis, and gallstones. This review summarizes the commonly recognized concepts on GB polyps from diagnosis to an algorithm of treatment.
Alginate microspheres, containing fluorescein isothiocyanate-bovine serum albumin (FITC-BSA) or green fluorescent protein (GFP) were prepared and used as a model drug to develop the oral vaccine delivery system. The alginate microspheres were coated with poly-L-lysine or chitosan. Two methods, w/o-emulsion and spray, were used to prepare alginate microspheres. To optimize preparation conditions, effects of several factors on the particle size and particle morphology of microsphere, and loading efficiency of model antigen were investigated. In both preparation methods, the particle size and the loading efficiency were enhanced when the concentration of sodium alginate increased. In the w/o-emulsion preparation method, as the concentration of Span 80 was increased from 0.5% to 2%, the particle size was decreased, but the loading efficiency was increased. The higher the emulsification speed was, the smaller the particle size and loading efficiency were. The concentration of calcium chloride did not show any effect on the particle size and loading efficiency. In the spray preparation method, the particle size was increased as the nozzle pressure $(from\;1\;kgf/m^2\;to\;3\;kgf/m^2)$ and spray rate was raised. Increasing calcium chloride concentration (<7%) decreased the particle size, in contrast to no effect of calcium chloride concentration on the w/o-emulsion preparation method. Alginate microspheres prepared by two methods were different in the particle size and loading efficiency, the particle size of microspheres prepared by the spray method was about $2-6\;{\mu}m$, larger than that prepared by the w/o emulsion method $(about\;2{\mu}m)$, and the loading efficiency was also higher with spray method. Furthermore, drying process for the microspheres prepared by the spray was simpler and easier, compared with the w/o emulsion preparation. Therefore, the spray method was chosen to prepare alginate microspheres for further experiments. Release pattern of FITC-BSA in alginate microspheres was evaluated in simulated intestinal fluid and PBS (phosphate buffered saline). Dissolution rate of FITC-BSA from alginate/chitosan microsphere was lower than that from alginate microsphere and alginate/poly-L-lysine microsphere. By confocal laser scanning microscope, it was revealed that alginate/FITC-poly-L-lysine microspheres were present in close apposition epithelium of the Peyer's patches of rabbits following inoculation into lumen of intestine, which proved that microspheres could be taken up by Peyer's patch. In conclusion, it is suggested that alginate microsphere prepared by spray method, showing a particle size of & $10\;{\mu}m$ and a high loading efficiency, can be used as a model drug for the development of oral vaccine delivery system.
In this work, oil-in-water emulsions (O/W) were prepared successfully by membrane emulsification with $0.5{\mu}m$ pore size membrane. Sunflower oil was emulsified in aqueous Tween80 solution with a simple crossflow apparatus equipped with ceramic tube membrane. In order to increase the shear-stress near the membrane wall, a helical-shaped reducer was installed within the lumen side of the tube membrane. This method allows the reduction of continuous phase flow and the increase of dispersed phase flux, for cost effective production. Results were compared with the conventional cross-flow membrane emulsification method. Monodisperse O/W emulsions were obtained using tubular membrane with droplet size in the range $3.3-4.6{\mu}m$ corresponded to the membrane pore diameter of $0.5{\mu}m$. The final aim of this study is to obtain O/W emulsions by simple membrane emulsification method without reducer and compare the results obtained by membrane equipped with helix shaped reducer. To indicate the results statistical methods, $3^p$ type full factorial experimental designs were evaluated, using software called STATISTICA. For prediction of the flux, droplet size and PDI a mathematical model was set up which can describe well the dependent variables in the studied range, namely the run of the flux and the mean droplet diameter and the effects of operating parameters. The results suggested that polynomial model is adequate for representation of selected responses.
Ultrastructure of the secretory portion of the small ampullate gland in the orb web spider, Nephila clavata, has been investigated using the electron microscope. The secretory portion of this gland comprise two different regions which are a S-shaped storage sac and a long, convoluted tail. By the internal textures of the secretory granules, the sac is subdivided into two regions ; the proximal region near the tail and the distal region near the duct. Commonly single layered connectives cover the basal portion of the sac epithelium, and apical portion of the epithelial cells is occupied by the thick cuticles. Within the epithelial cells of both the proximal and distal region, several types of the secretory granules surrounded by a limiting membrane and had characteristic crystalloid are scattered throughout the cytoplasm. The granular size and its electron densities are not coincide with each other according to the maturation level of the granules. The wall of the tail is composed of single layer of columnar epithelial cells, and their nuclei are found at the basal portion of the cells. Dissimilar to the epithelial cells of the sac, apical cuticles are not found at this portion. In the cytoplasm of these cells, numerous secretory granules, synthesized from the rough endoplasmic reticula commonly and had fine fibrous materials, are found. At the cell surface bordering the lumen, microvilli are seen, arid along the cellular boundaries specialized septate junctions and desmosomes appeared.
The role of vascular NAD(P)H oxidase in subarachnoid hemorrhage (SAH)-induced vasospasm in the basilar artery was examined in a rat model. Arterial vasospasm characterized by increased wall thickness and decreased lumen size was observed at 5 to 7 days after $2^{nd}$ injection of blood into cisterna magna, and these changes were significantly ameliorated by pretreatment of diphenyleneiodonium $(DPI,\;25\;{\mu}l\;of\;100\;{\mu}M),$ an inhibitor of NAD(P)H oxidase. To determine the time course of changes in the vascular NAD(P)H oxidase activity, cerebral vasculature was isolated at different time intervals from 12 hrs to 14 days after injection of autologous blood. At 24 hrs after the second injection of blood, the NAD(P)H oxidase activity was markedly increased with an enhanced membrane translocation of p47phox, but by 48 hours both the enzyme activity and p47phox translocation regained normal values, and were remained unchanged up to 14 days after SAH. However, no significant changes in the expression of p22phox mRNA was observed throughout the experiments. These findings suggest that the activation of NAD(P)H oxidase by which assembly of the oxidase components enhanced and subsequent production of superoxide in the early stages of SAH might contribute to the delayed cerebral vasospasm in SAH rats.
We have studied the possible mechanism of anti-asthmatic action of ethanolic extracts of dried seeds of Lepidium sativum (EXLS, 400 mg/kg) using various experimental models. EXLS produced an increase in the Pre-Convulsion Dyspnoea time induced by histamine and acetylcholine aerosol, a significant reduction in the elevated leucocyte counts in the Broncho-Alveolar Lavage fluid of sensitized guinea-pigs and reduction in the paw edema volume as compared to the control rats. Treatment with EXLS also produced decrease in the elevated histamine release from the sensitized guinea-pig lungs. The anti-asthmatic anti-inflammatory responses of EXLS was supported by improvement in microscopic changes like infiltration of inflammatory cells, submucosal edema, epithelial desquamation and reduced lumen size of the bronchi. The $pD_2$ values of histamine in tracheal chain and taenia-coli were significantly greater and that in lung strip was lower in the sensitized animals as compared to control. Treatment of sensitized guinea pigs with EXLS significantly decreased $pD_2$ values of histamine in all three preparations. Our data suggest the prevention of hyper-responsiveness in bronchial smooth muscles and inhibition of the immediate hypersensitive reaction, histamine release in the lungs and the infiltration of various inflammatory cells as the possible mechanisms of anti-asthmatic activity of EXLS.
The origin of hamartoma from the Greek words for "error" and "tumor" is credited to Albrecht who in 1904 described a disorganized arrangement of tissues normally present in an organ and applied also to tumors found in many organs other than the lung. The hamartoma is the most common benign tumor of the lung and revealed accidentally as asymptomatic coin lesion on routine chest X-ray, but the incidence is very low and especially endobronchial origin extremely low. We have been successful surgical experienced one case of a 36-year-old female having endobronchial hamartoma, 4x2.Sx2 cm in size and located at right main bronchial lumen near the carina, which consists of a hard, nodular surfaced mass and adhered to the cartilaginous portion of the right upper lobe bronchus by dense fibrous band and migrate to trachea on expiration or coughing. This case was not suspected by chest X-ray or bronchogram and confirmed bronchoscopy with biopsy. Right pneumonectomy was inevitable because of bronchiectatic change of right bronchus due to tumor obstruction. She was discharged with relatively good general condition on 21 days postoperatively.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.18
no.1
/
pp.137-147
/
1988
This study was designed to investigate the effects of irradiation on the salivary ductal cells, especially on the intercalated ductal cells of the rat parotid glands. For this study, 36 Sprague-Dawley strain rats were irradiated on the head and neck region with absorbed dose of 15Gy by Co-60 teletherapy unit, Picker's model 4M60. The conditions irradiated were that field size, SSD, dose rate and depth were 12×5㎝m, 50㎝, 222 Gy/min. and 1㎝. respectively. The experimental animals were sacrificed 1, 2, 3, 6, 12 hours and 1, 3, 7 days after the irradiation and the changes of the irradiated intercalated duct cells of the parotid glands were examined under the light and electron microscope. The results were as follows: 1. Under the light and electron microscope, the nucleus, mitochondria and secretory granules showed severe changes in the early stage after irradiation and the most severe cellular de- generations were observed 2 hours after irradiation, but the repair processes began from 6 hours after irradiation. 2. Under the electron microscope, loss of the nuclear membranes, derrangement of the chromosomes, swelling and destruction of the secretory granules, and widening of the intercellular spaces were observed after irradiation. 3. Under the light microscope, atrophy and irregular proliferation of the ductal cells, cuboidal metaplasia, hyperchromatism, and the construction or obstruction of the lumen were observed after irradiation.
Thoracic sympathetic ganglion block(TSGB) with alcohol is a traditional method for treating a variety of disease at pain clinics. But it is a difficult block to perform requiring both skill and experience. Therefore, we performed a thoracic endoscopic cauterization to evaluate the efficacy of this method. A patient suffering sever forearm and hand pain due to radius fracture of the right arm, one and half years earlier, was referred to several different orthopaedic department of various hospitals with continued aggravated symptoms. He was then admitted to our hospital's orthopaedic department. Our diagnosis, confirmed by thermography, revealed reflex sympathetic dystrophy. Patients was therefore referred to the pain clinic where treatment consisted of endoscopic thoracic sympathetic cauterization under general anesthesia. Patient was intubated with Robertashow 37 Fr. double lumen tube left sided. Left lateral and slight head up position was applied to make lesion side up. Incisions were made to penetrate trocas 5 mm diamether on 4 th intercostal space along mid axillary line and midclavicular line. Negative pressure suction on ipsilateral lung and CO2 insufflation under 10 mmHg was applied to reduce lung size. Cauterization on thoracic sympathetic chain at T3 level was done under endoscoic guide. 24 Fr. chest tube was inserted. Patient's symptoms cleared and he was satisfied with the results of this treatment.
Tripitaka Koreana were made during Coryo Dynasty from 1236 to 1251 A.D. Buddhist scriptures were engraved on 81.340 wooden plates. Some plates were varnished with Rhus lacquer, but most of them were uncoated. Macroscopically, most of the plates appeared intact due to the storage in a well-ventilated wooden house. Because, they were irregularly used for printings with ink, it can be assumed that they were repeatedly exposed to ink-water and drying processes. The present were made to examine the changes of wood cell structures occurred during long-term aging deterioration processes in these dry archaeological wooden plates. Light, scanning and transmission electron microscopes were employed for this study. Wedge-shaped cracks and delamilations were found from the lumen side toward the compound middle lamellae and they progressed toward primary or secondary walls. A large amount of hypae in vessels and the degradation of vessel-ray pit walls by the fungal hyphae were observed. When compared to the recent wood, the birefringence of wood fibers was considerably lower or completly disappeared, suggesting the degradation of crystalline cellulose in these wood samples. The degradation of the cell wall could be also revealed the calculation of crystallinity with X-ray diffraction and the size of crystalline region was estimated.
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