No abstract available.

BACKGROUND: To date, a laparoscopic gastrectomy has been performed by a small number of surgeons around the world, but the laparoscopic approach has been extended to Billroth I and a total gastrectomy. To evaluate the validity of the procedure, we present the results of six patients who underwent a gastrectomy using a laparoscopic technique. METHODS: First, two patients had a totally intra-abdominal laparoscopic B-II gastrectomy, and one of two also had a bilateral truncal vagotomy. The rest had a laparoscopic-assisted gastrectomy. One patient had concurrently an open reduction and an internal fixation with a K-wire for a patellar fracture. Indications were (a) gastric outlet obstruction due to peptic ulcer disease in five patients and (b) duodenal ulcer bleeding in one patient. RESULTS: Except for one patient who had stump leakage, which was solved by conservative therapy, there were no complications or operative mortality. The operating time and the cost were less for the patients who had their operations later in the series and who had laparoscopic-assisted operation. CONCLUSIONS: These forms of laparoscopic gastric surgery for patients with complications of peptic ulcer disease may be useful from the standpoint of minimal access, rapid recovery, less pain, and good cosmesis.
Duodenal Ulcer ; Gastrectomy* ; Gastric Outlet Obstruction ; Gastroenterostomy ; Hemorrhage ; Humans ; Mortality ; Peptic Ulcer ; Stomach Diseases* ; Vagotomy, Truncal

No abstract available.
Ulcer*

PURPOSE: Various prognostic indicators have been identified for mammary carcinomas, but the issue of their significance remains unsettled. The prognostic impact of c-erb B2, Ki-67 and topoisomerase II alpha expression was investigated in relation to prognostic factors for carcinomas of the breast and to the tumor cell growth fraction. METHODS: One hundred eighteen cases of invasive mammary carcinoma were investigated by immunohistochemical staining for c-erb B2, topoisomerase II alpha, and Ki-67. Clinicopathologic parameters were compared with the expression pattern and incidence of c-erb B2, topoisomerase II alpha and Ki- 67 in invasive mammary carcinoma. RESULTS: C-erb B2 showed significant correlation with topoisomerase II alpha (P<0.05), but others were not significant. Topoisomerase II alpha and Ki-67 index closely paralleled each other, indicating that both reflect the proliferate activity of tumor cells and were associated with high nuclear and histological grade, ER and PR expression (P<0.05). CONCLUSION: These results indicate that ki-67 and topoisomerase II alpha proteins might play a role in tumor progression of breast carcinoma. The Ki-67 and topoisomerase II alpha index may be proliferate factors of breast cancer. In addition, the increase expression of Ki-67 and topoisomerase II alpha and hormone receptor were closely correlated each other, and could be used as factors suggesting poor prognosis in breast carcinoma.
Breast ; Breast Neoplasms ; DNA Topoisomerases, Type II* ; Incidence ; Prognosis

PURPOSE: Galectin 3 is a beta-galactoside binding protein that is involved in various biological processes such as cell adhesion, migration, cell growth, tumor progression and metastasis. Although the precise acting mechanisms of Galectin 3 are unclear, it have been reported that the expression of Galectin 3 may related to tumor progression and metastasis. We investigated the immunohistochemical expression of Galectin 3 in 57 cases of benign and malignant breast neoplasm to evaluate the relation of a Galectin 3 expression to malignancy of breast neoplasm and the acting mechanism of Galectin 3. METHODS: Twenty fibroadenomas, 7 intraductal papillomas, 10 intraductal carcinomas and 20 invasive ductal carcinomas were studied. Immunostaining of Galectin 3 was evaluated in comparison with that of the internal controls, and the intensity of immunostaining was semiquantitatively graded on an intensity scale of 0 to 3. RESULTS: The normal ductal epithelium of the breast showed strong immunoreactivity with an intensity 2 to 3. The staining gradually and significantly decreased in accordance with the histopathological type and tumor progression from a fibroadenoma, intraductal papilloma, ductal carcinoma in situ and invasive ductal carcinoma (P<0.001). In particular, the expression of galection-3 was prominently decreased in invasive ductal carcinoma. CONCLUSION: The galectin-3 expression pattern suggests that progression from benign breast tumor to malignant breast tumor leads to a reduced expression of galectin-3.
Biological Processes ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carrier Proteins ; Cell Adhesion ; Cell Movement ; Epithelium ; Fibroadenoma ; Galectin 3* ; Galectins* ; Neoplasm Metastasis ; Papilloma ; Papilloma, Intraductal

Immunohistochemical staining for the C-erbB-2 oncoprotein was performed on sections from paraffin- embedded tissue blocks of 96 primary breast-cancer patients who were operated on our hospital, in order to evaluate its significance as a prognostic factor in human breast cancer. We investigated the correlation between the traditional prognostic factors - patient age, primary tumor size, axillary lymph-node metastasis, pathological grade, and hormonal receptors(ER & PR) - and C-erbB-2 oncoprotein overexpression. The overall rate of positive staining of the C-erbB-2 oncoprotein was 37.5% (36/96). Statistically, the C-erbB-2 positive staining was not correlated with patient age, primary tumor size, axillary lymph node involvement, or hormonal receptors. However a high pathologic grade appeared to be statistically correlated with C-erbB-2 oncoprotein overexpression(p=0.010). In conclusion, the C-erbB-2 oncoprotein appears to have prognostic significance in human breast cancer.
Breast Neoplasms* ; Breast* ; Humans* ; Lymph Nodes ; Neoplasm Metastasis

BACKGROUND/AIMS: The authors compared laparoscopic changes of the diseased liver surface according to Shimadas classification with laparoscopic needle biopsy in order to clarify whether the two diagnostic criteria have consistency or discrepancy in each other. By serologicai tests the patients with chronic hepatitis B were 179 cases, chronic hepatitis C 22 cases and NBNC hepatitis 54 cases. Histologically the patients with non-specific reactive hepatitis were 35 cases, chronic lobular hepatitis 20 cases, chronic persistent hepatitis 18 cases, chronic active hepatitis 8~5 cases, subacute hepatic necrosis 32 cases, circumscribed hepatic necrosis 9 cases and liver cirrhosis 56 cases. METHODS: We performed laparoscopy on 255 patients with chronic hepatitis and laparoscopic guided liver needle biopsy was done in all cases. RESULTS: 1) Age incidence of chronic viral hepatitis was peak in chronic hepatitis C, and then that in chronic hepatitis B and NBNC heatitis in decreasing order. 2) Code numbers of liver surfaces were mainly numbers between 200 and 300 in chronic hepatitis B and NBNC hepatitis, but those of chronic hepatitis C were numbers between 300 and 400 which meant advanced patterns. 3) Comparing macroscopic fmdings of liver surfaces with histologic diagnosis by guided liver biopsy, the consistency of two criteria was 83.9% in all cases and the discrepancy was 16.1%. 4) Among the cases with diagnostic discrepancy, the patients showing macroscopically chronic hepatitis but histologically liver cirrhosis were predominant in chronic hepatitis B under the age of 40. In contrast to this, the cases showing surface changes of liver cirrhosis but histologically chronic hepatitis was mainly in chronic hepatitis C over the age of 40. CONCLUSIONS: The above results suggest that laparoscopy and guided liver biopsy may be very useful diagnostic tools to determine correct diagnosis, adequate treatment and prognosis.
Biopsy ; Biopsy, Needle ; Classification ; Diagnosis ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Incidence ; Laparoscopy ; Liver Cirrhosis ; Liver* ; Necrosis ; Prognosis

PURPOSE: We evaluated the validity of laparoscopy-assisted distal gastrectomy (LADG) with systemic lymphadenectomy for early gastric cancer in elderly patients compared with younger patients. METHODS: Seventeen elderly patients (aged 70 years or more) and 113 younger patients who underwent LADG for early gastric cancer between May 1998 and July 2004, at the department of Surgery, Dong-A University Medical Center, were studied. Postoperative outcomes were compared. RESULTS: In elderly patients, co-morbidity was more common than in younger ones (P=0.0220) and postoperative complication rate was more common, too (P=0.0480). Operation time (P=0.7301), time to first flatus (P=0.4766), postoperative hospital stay (P=0.4860), mortality (P=0.2453), were similar in these two groups. CONCLUSION: Because LADG with systemic lymphadenectomy in elderly patients has more co-morbidity and complications than younger ones, great cares should be given to treat co-morbidity preoperatively and prevent complications during operation and postoperative period in elderly patients.
Academic Medical Centers ; Aged* ; Flatulence ; Gastrectomy* ; Humans ; Length of Stay ; Lymph Node Excision* ; Mortality ; Postoperative Complications ; Postoperative Period ; Stomach Neoplasms*

BACKGROUND: The prognosis following surgery for gastric cancer has been markedly improved as a result of early diagnosis and advancements both in operative techniques and perioperative management. However, gastrointestinal surgery in the presence of hepatic cirrhosis has shown high operative morbidity and mortality due to severe perioperative complications, such as bleeding, lymphorrhea, anastomosis leakage, hepatic failure, fluid retention, acute renal failure and multiple organ failure. Recently, the frequency of gastric cancer involving liver cirrhosis has been increasing, especially early gastric cancer cases. METHODS: From June 1995 to December 1997, a total of 410 patients with gastric cancer were treated surgically. Among them, 9 cases with liver cirrhosis underwent gastric resection. RESULTS: Three major postoperative complications occurred in 2 patient, anastomosis leakage in one, and bleeding in both. CONCLUSIONS: The purposes of this study were to assess the causes of complications and to decide the appropriate operation type for improving the prognosis for these patients with liver cirrhosis.
Acute Kidney Injury ; Early Diagnosis ; Hemorrhage ; Humans ; Liver Cirrhosis* ; Liver Failure ; Mortality ; Multiple Organ Failure ; Postoperative Complications ; Prognosis ; Stomach Neoplasms*

BACKGROUND: Cathepsin D is an acid optimal protease present in a variety of normal and neoplastic tissues. Cathepsin D is an aspartylendopeptidase which is thought to be important in intracellular processes, such as protein degradation, and cathepsin D may be implicated in intracellular protein turnover. Recent evidence shows that in rabbit alveolar marcrophages, cathepsin D is synthesized as an inactive, membrane associated precursor which is then processed, via an active membrane-associated intermediate form, to an active soluble form of cathepsin D found in lysosomes and endosomes. Antibodies to cathepsin D which are suitable for immunohistochemistry have been available for approximately 20 years although the first immunohistochemical study of cathepsin D as a prognostic factor in breast cancer appeared in 1990. METHOD: The sample in this study consisted of 121 breast cancer's that had been surgically resected. Using the mouse monoclonal antibody (NCL-CDm, Novocastra Laboratories Ltd, UK) specific for the cathepsin D, we performed immunohistochemical staining by ABC methods. We examined the correlations between the expression of cathepsin D and the patient's age, the estrogen receptor status, the tumor size, the lymph node involvement, the staging, the menopausal state, the pathologic grade, the DNA ploidy, and the S-phase fraction. RESULTS: Overall, 53.7% of the patients were positive for cathepsin D. Positive staining did not correlate with age, estrogen receptor status, tumor size, axillary node status, tumor stage, monopausal status, pathologic grade, DNA ploidy, or S-phase fraction. CONCLUSIONS: The expression of cathepsin D by tumor cells was not the only significant prognostic factor of the breast cancer. We need more follow-up studies, and we need exact calculations of the survival rate.
Animals ; Antibodies ; Breast Neoplasms* ; Breast* ; Cathepsin D ; DNA ; Endosomes ; Estrogens ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lysosomes ; Membranes ; Mice ; Ploidies ; Proteolysis ; Survival Rate