BACKGROUND: Mutations eliminating or altering the p53 protein function are the single most common genetic alteration in nearly all types of human cancers. The project of the p53 gene is hypothesized to maintain genomic stability by blocking cell replication or by initiating apoptosis after DNA damage. Many p53 mutations alter the conformation of the protein, which results in abnormal overexpression. METHODS: This study investigated the correlation between p53 mutations detected at the DNA level and the p53 protein expression determined by immunohistochemical staining. Abnormalities of the p53 gene and protein in 30 primary paraffin embedded breast cancer tissues were examined. RESULTS: Mutations in p53 exons 5-8 were identified in 9 of the 30 cases (30%) by using a polymerase chain-reaction single stranded conformational polymorphism (PCR-SSCP) analysis. Overexpression of the p53 protein was detected in 11 of the 30 cases (37%) by using mouse monoclonal p53 antibody (Zymed Essence Co.) Positive immunohistochemical staining without mutations was detected by PCR-SSCP analysis in 4 cases, but a mutation with negative immunohistochemical staining was detected by PCR-SSCP analysis in only one case. p53 abnormality was not associated with TNM stages. The sensitivity between these methods was 73%. CONCLUSIONS: Positive immunohistochemical staining using p53 monoclonal antibody could detect p53 protein expression, but this result did not correlate completely with p53 mutation in exon 5-8.
Animals ; Apoptosis ; Breast Neoplasms* ; Breast* ; DNA ; DNA Damage ; Exons ; Genes, p53 ; Genomic Instability ; Humans ; Immunohistochemistry ; Mice ; Paraffin ; Polymorphism, Single-Stranded Conformational

PURPOSE: It was reported that 25% to 75% patients with a periampullary cancer were found to be unresectable after exploratory surgery. The aim of this study was to evaluate the role of a prophylactic gastrojejunostomy in patients with an unresectable periampullary cancer. METHODS: During January 1999 to April 2004, a prophylactic gastrojejunostomy (GJ group) or no gastrojejunostomy (non-GJ group) was carried out for an unresectable periampullary cancer without a gastric outlet obstruction in 42 patients. The clinicopathological characteristics, postoperative complications and time survival were evaluated retrospectively. RESULTS: Of the 42 patients, a prophylactic gastrojejunostomy was performed in 24 cases. There were no immediate postoperative deaths in both groups, and the postoperative morbidity rate was similar in both groups (GJ group 10% vs non-GJ group 7%). There were no differences in the mean postoperative hospital stay (GJ group 29.5 days vs non-GJ group 26.8 days) and mean survival (GJ group 7.5 months vs non-GJ group 8.1 months) between the two groups. In the 5 of the non-GJ group (27%), a postoperative gastric outlet obstruction had developed. The median interval time between the initial exploration and the postoperative gastrojejunostomy was 4.1 months. CONCLUSION: Although a small number of patients developed a postoperative gastric outlet obstruction in the non-GJ group, the prophylactic gastrojejunostomy did not increase the number of postoperative complications or the length of hospitalstay. However, several patients who did not received the prophylactic gastrojejunostomy developed a duodenal obstruction. Furthermore they needed a prophylactic gastrojejunostomy. These results suggest that a prophylactic gastrojejunostomy is a necessary and feasible procedure for patients with an unresectable periampullary cancer without duodenal obstructive symptoms.
Bile Ducts ; Duodenal Obstruction ; Gastric Bypass* ; Gastric Outlet Obstruction ; Humans ; Length of Stay ; Pancreas ; Postoperative Complications ; Retrospective Studies

PURPOSE: As a common and dangerous disease, an abdominal aortic aneurysm (AAA) occurs in approximately 2-4% of the general population and recently the incidence of AAA has been gradually increasing in Korea. Since rupture of an AAA is recognized as a lethal event, a more aggressive policy of early diagnosis and of an elective repair of the AAA are that can be performed with a mortality rate of less than 5 percent is the approach of choice for treating an AAA nowadays. METHODS: This retrospective study reports our experience managing forty-two patients with an AAA who had been operated on between January 1993 and December 1999 at Korea University hospitals. RESULTS: Thirty- seven of the patients were male, and five were female. The mean age was 67.1 years. The most common clinical manifestation was abdominal pain in 26 cases (61.9%), followed by abdominal pulsatile mass in 20 cases (47.6%), and back pain in 12 cases (28.5%). The most common associated disease was hypertension in 24 cases (57.1%). An abdominal CT scan was performed in 26 cases (61.9%) and was the most commonly used method for diagnosis. Emergency repair of the AAA was performed in 10 cases; the repair was performed electively in the other cases. Among the 42 aortic grafts implanted for AAA repair, 37 were bifurcated Y grafts and 4 were straight tube grafts. Axillobifemoral bypass surgery was performed in the case of one infected aneurysm. Among the 42 cases, 10 cases (23.8%) experienced ruptures, requiring 4 urgent operation and 6 emergency procedures. Among the 42 cases, 6 patients (14.2%) expired. In the elective cases, one (3.1%) expired. In the urgent cases, one (25.0%) expired, and in the emergency cases, four (66.6%) expired. CONCLUSION: This study showed that an AAA should be considered as a possible cause of unexplained abdominal pain in aged patients. In such patients, various diagnostic tools must be used to eliminate the possibility of an abdominal aortic aneurysm. Early diagnosis and elective surgery are crucial for a better outcome in the management of patients with an abdominal aortic aneurysm.
Abdominal Pain ; Aneurysm, Infected ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Rupture ; Back Pain ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Hospitals, University ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Mortality ; Retrospective Studies ; Rupture ; Tomography, X-Ray Computed ; Transplants