PURPOSE: Recent studies have indicated that the p53 tumor suppressor gene and vascular endothelial growth factor (VEGF) play an important role in the angiogenic process of tumors. In this study, the correlation of the expressions of p53 and VEGF and the clinical features in gastric cancer were investigated. METHODS: The expressions of p53 and VEGF in gastric cancer were determined using immunohistochemistry on 98 randomly selected gastric cancer patients that had received curative resection. RESULTS: The expression of p53 and VEGF were observed in 51% and 50% of tumors, respectively. A significant correlation was found between p53 expression and the tumor histological type (P=0.045). The higher the TNM stage, the higher the observed level of p53 expression. The p53 and VEGF expression stati coincided in 70.4% of tumors, with a significant correlation found between the p53 and VEGF stati. Significantly worse survival rates were found in p53-positive and VEGF-positive patients than in those that were p53-negative and VEGF-negative. CONCLUSION: The present results indicated that p53 and VEGF expressions are useful in predicting the prognosis of patients with gastric cancer.
Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Prognosis ; Stomach Neoplasms* ; Survival Rate ; Vascular Endothelial Growth Factor A*

PURPOSE: The cold ischemia augments the inflammatory cell infiltration in the rat kidney allograft by increasing expression of ICAM-1. The ICAM-1 proteins and ICAM-1 mRNA were overexpressed and upregulated on the tubular epithelium and endothelium of renal allografts that were preserved in the cold preservation solution such as University of Wisconsin (UW) solution. The aims of this study was to examine whether perfusion of kidney with anti ICAM-1 antibody (1A29) prevent inflammations and injuries of graft even in long ischemic time. METHODS: Rat kidneys were perfused in situ with 60 mL of cold UW solution without or with anti-rat ICAM-1 antibody and nephrectomized. The kidneys were exposed to 48 hour cold (4 degrees C storage time) ischemia and examined for the counts of necrotic tubules and apoptotic cells on the high power fields by terminal deoxynucleotidyltransferase mediated nick-end labeling (TUNEL) assay. RESULTS: The number of necrotic tubules per high power field of the allograft treated by anti ICAM-1antibody (6.97+/-4.25) was significantly less than that of the other control allograft (12.71+/-6.42) (P<0.001). The number of apoptotic cells per high power field of antibody treated graft (4.27+/-4.11) was significantly less than that of the other control graft (8.43+/-5.56) (P<0.001). CONCLUSION: Rat anti ICAM-1 antibody (1A29) inhibits ICAM-1 mediated allograft tubular necrosis as well as apoptosis. These results are expected to contribute to prevent allograft rejection and delayed graft function when used for pretreatment of allografts with anti ICAM-1 antibody mixtures of the perfusion and preserving solution clinically.
Allografts ; Animals ; Apoptosis ; Cold Ischemia ; Delayed Graft Function ; DNA Nucleotidylexotransferase ; Endothelium ; Epithelium ; Inflammation ; Intercellular Adhesion Molecule-1* ; Ischemia ; Kidney* ; Necrosis ; Perfusion ; Rats* ; RNA, Messenger ; Transplantation ; Transplants ; Wisconsin*

PURPOSE: By virtue of advances in scientific methods and technical systems, there has been a rapid growth in the number of end stage renal disease (ESRD) patients treated using continuous ambulatory peritoneal dialysis (CAPD) as their primary renal replacement therapy. However, there are various catheter related complications that are limiting factors in patient and catheter maintenance. This study was aimed at introducing of the techniques of CAPD catheter implantation designed for reducing the complication rate, as well as conducting an investigation of the incidence of CAPD catheter related complications and patient survival and catheter survival rates. METHODS: We performed 234 cases of CAPD catheter implantation using a conventional surgical method (n=162, between January 1993 and December 1997) or a modified surgical method (n=72, between January 1998 and December 1999), and retrospectively reviewed the patient's medical records to elucidate the incidence of early catheter related complications and the catheter removal rate in relation to the surgical methods. RESULTS: There were 21 cases (23.8%) of peritonitis in the modified group, which was less than that in the conventional group (79 cases, 48.8%) (P=0.036). There were 9 cases (12.5%) of exit site and tunnel infection in the modified group, which was less than that in the conventional group (36 cases, 22.2%) (P=0.019). We were able to reduce the peritonitis as well as exit site and tunnel infection by a long segment of tunneling and immobilization of the catheter to the skin. Nine cases of leakage (5.5%) have occurred in the conventional group and one case (1.3%) in the modified group; the difference was statistically significant (P=0.046). CONCLUSION: These results indicate that our modified surgical methods can reduce the rate of early catheter related complications.
Catheters* ; Humans ; Immobilization ; Incidence ; Kidney Failure, Chronic ; Medical Records ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Replacement Therapy ; Retrospective Studies ; Skin ; Survival Rate ; Virtues

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively. Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up-regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: The question of whether "young age onset" is a single prognostic factor for breast cancer has been controversial. The incidence of breast cancer according to age differs by region and races. The purpose of this study was to determine the incidence of breast cancer in women 35 year old or younger and elucidate its clinical characteristics, prognosis, and differences from older age onset breast cancer. METHODS: A retrospective study of 545 consecutive breast cancer patients who had been treated at our hospital from 1990 to 1999, was conducted. We investigated the ratio of 35 year old or younger breast cancer patients, age of menarche, TNM stage, histologic grades, hormone receptor status, survival rates. This was then compared with the counter age (>35) group's data. The significances of the differences were evaluated by variable type using the Student's t-test or chi-square test. Analysis was performed using SPSS software. RESULTS: The younger age group patients numbered 62 (11.3%) among the total group, and showed earlier menarche, worse histologic differentiation, and lower mammographic detection rate than the counter group (P<0.05). There were no differences in TNM stage distribution or hormone receptor expression status according to age group (P>0.05). The young age group's 5 year overall and disease free survival rates were 83 5% and 58 8% respectively and both were lower than the counter group's 89 2% and 74 3% (P<0.05), respectively additionally, the age adjusted overall and disease free survival rates were worse than the counter age group's. CONCLUSION: The younger age group showed worse survival rates, poorer prognostic factors and a higher late of early relapse rate than the older age group. Therefore, we may consider "young age onset" to be a poor prognostic factor in breast cancer.
Adult ; Breast Neoplasms* ; Breast* ; Continental Population Groups ; Disease-Free Survival ; Female ; Humans ; Incidence ; Menarche ; Prognosis* ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: No standardized treatment protocol yet exists for intestinal Behcet's disease. The aim of this retrospective study was to identify the factors that are related to the recurrence and mortality of intestinal Behcet's disease. METHODS: Twelve patients who had undergone surgery for intestinal Behcet's disease at Korea University Hospital from 1991 to 1999 were chosen. Nineteen patients had been diagnosed as having intestinal Behcet's disease. Of the 19 patients, 7 are still being followed up, and 12 have undergone surgery, these patients were chosen as the subjects. RESULTS: Of the 11 cases, excluding one case that expired following the initial surgery, 8 cases required subsequent surgery due to recurrence. When the data was analyzed according to the patient's age, medication, classification of Behcet's disease, location of the lesion, operative method, and extent of resection, recurrence was shown to be related with medication and extent of resection (p<0.05). Of the 12 cases, 5 cases expired. When, the data of the 5 cases that expired were analyzed according to the patient's age, medication, extent of resection, classification of Behcet's disease, location of the lesion, and operative method, mortality was shown to be related with the location of the lesion (p<0.05). CONCLUSION: Medical treatment is the primary therapy for intestinal Behcet's disease and radical extended resection extending 30 cm proximal and distal to the lesion prevents recurrence. However, when the lesion was located in the small intestine and formed a fistula with the duodenum, the prognosis appears to be extremely poor.
Mortality

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively.Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up- regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively.Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up- regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan. 1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess, intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of 31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel opment of postoperative complication was related to the length of the operation, the size of the tumor, the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05). CONCLUSION: The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
Abdominal Abscess ; Acute Kidney Injury ; Adenoma ; Adrenalectomy* ; Cations ; Cushing Syndrome* ; Ganglioneuroma ; Hemorrhage ; Humans ; Hyperaldosteronism ; Hyperplasia ; Intestinal Pseudo-Obstruction ; Korea ; Neuroblastoma ; Pathology ; Pneumonia ; Postoperative Complications* ; Psychotic Disorders ; Pulmonary Atelectasis ; Wound Infection

PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan. 1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess, intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of 31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel opment of postoperative complication was related to the length of the operation, the size of the tumor, the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05). CONCLUSION: The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
Abdominal Abscess ; Acute Kidney Injury ; Adenoma ; Adrenalectomy* ; Cations ; Cushing Syndrome* ; Ganglioneuroma ; Hemorrhage ; Humans ; Hyperaldosteronism ; Hyperplasia ; Intestinal Pseudo-Obstruction ; Korea ; Neuroblastoma ; Pathology ; Pneumonia ; Postoperative Complications* ; Psychotic Disorders ; Pulmonary Atelectasis ; Wound Infection