2.Expression of Cellular Oncogenes in Colorectal Cancer : c-myc, c-Ha-ras and c-erbB-2.
Hae Hyeon SUH ; Keun Nam SHIN ; Young Jin KIM
Journal of the Korean Surgical Society 1998;54(Suppl):983-990
Although causative factors are not completely defined, carcinogenesis of colorectal cancer is attributed to multiple genetic alterations. The abnormal expressions of oncogenes are regarded to be responsible for the production of malignant phenotype, subsequent invasion and metastasis. From 63 surgically resectable colorectal adenocarcinoma patients, expression of oncogenes in colorectal cancer tissue was evaluated with immunohistochemical staining methods using monoclonal antibodies to products of the oncogenes. To evaluate the possibility of oncogenes as a prognostic factor, we studied the relationship between the expression of oncogenes and the clinicopathologic findings which are well known prognostic factors. Rates of expression in colorectal cancer tissue were 27% for c-myc, 74.6% for c-Ha-ras and 77.8% for c-erbB-2 oncogenes. The positive rate of c-erbB-2 oncogene was higher in the well differentiated group than in the poorly differentiated group. The rates of expression of c-myc and c-Ha-ras oncogenes were significantly correlated each other. Expression of these oncogenes in colorectal cancer were not correlated with the pathologic stage, location of cancer, DNA ploidy pattern and histologic differentiation except between c-erbB-2 and histologic differentiation. In conclusion, there seems to be a possibility that c-erbB-2 could be used as a prognostic factor of colorectal cancer. However, further and more intensive study seems to be required.
Adenocarcinoma
;
Antibodies, Monoclonal
;
Carcinogenesis
;
Colorectal Neoplasms*
;
DNA
;
Humans
;
Neoplasm Metastasis
;
Oncogenes*
;
Phenotype
;
Ploidies
3.Surgical Treatment of Esophageal Perforation Caused by Balloon Catheter and Expandible Metal Stent in a Benign Distal Esophageal Stricture.
Keun Nam SHIN ; Jong Hoon YOON ; Hae Hyeon SUH
Journal of the Korean Surgical Society 1998;55(2):282-289
An esophageal perforation is a condition requiring emergency treatment. Although previously spontaneous ruptures were the most common etiology, as endoscopic and radiologic diagnosis and treatment have developed recently, iatrogenic ruptures due to instrumentation have increased to become the most common cause of esophageal perforations. Generally, the treatment of esophageal stenosis is composed of esophageal dilatation using a Maloney or a Mercury dilator and medical treatment for reflux esophagitis. Recently, balloon-catheter dilatation of the esophagus has produced safe and excellent results, and self-expansible metallic stents has been very useful in controlling malignant strictures of the esophagus with low mortality and morbidity. We experienced an esophageal perforation after balloon dilatation and the insertion of a self-expanding silicone-covered Gianturco stent to the site of the esophageal stenosis which was due to reflux esophagitis. The abdomen was opened through an upper midline incision. There was a 3-cm-long longitudinal laceration on the distal esophagus which was closed transversely as with a Heinecke-Mikulicz pyloroplasty after a debridement. To reinforce the site of esophageal laceration and to prevent esophageal reflux, the gastric fundus was pulled and sutured over the esophageal sutures, and the second-layer mattress suture was made 1 cm proximal to the first sutures, including central ligaments of the diaphragm. To prevent bile reflux, we converted from a Billroth-II to a Roux- en-Y gastrojejunostomy. We followed up for 30 months and found no signs of any esophageal stenosis or gastroesophageal reflux.
Abdomen
;
Bile Reflux
;
Catheters*
;
Constriction, Pathologic
;
Debridement
;
Diagnosis
;
Diaphragm
;
Dilatation
;
Emergency Treatment
;
Esophageal Perforation*
;
Esophageal Stenosis*
;
Esophagitis, Peptic
;
Esophagus
;
Gastric Bypass
;
Gastric Fundus
;
Gastroesophageal Reflux
;
Lacerations
;
Ligaments
;
Mortality
;
Rupture
;
Rupture, Spontaneous
;
Stents*
;
Sutures
4.Enzyme Histochemical Study for the Estimation of the Lapse of Time in Brain Injury.
Chung Hyeon KIM ; Ho SHIN ; Kyu Hyeok CHO ; Hyeong Keun KIM
Journal of Korean Neurosurgical Society 1984;13(1):61-69
This experiment was designed for the evaluation of the usefulness of enzyme histochemistry in the determination of the lapse of time in brain wound, and also for the establishment of medicolegal 'biological time table' on brain wound. Brain injury was made by contusion and laceration of meninges and brain itself in rats. The results were as follows; 1) By routine histological technique, estimation of the lapse of time in brain wound could be possible 4 hours after the infliction of wound. 2) The earliest change of enzyme activities was recognizable by the decreased activities of ATPase and succinic dehydrogenase 30 minutes after the injury. These decreased enzyme activities were not recovered up to the 4th day after the brain injury. 3) Increased acid phosphatase activity was noticed 1 hour, and beta-glucuronidase, 2 hours after the injury in a mild degree. Both increased activities were pronounced following the lapse of time in brain wound. 4) No significant change was seen in alkaline phosphatase, monoamine oxidase, non-specific esterase and leucine aminopeptidase activities throughout the experimental period up to the 4th day. So the enzyme histochemistry of these enzymes seemed to be little valuable for the study on the timing of wound in brain injury. In the light of these results it appeared that the enzyme histochemistry, in particular of ATPase, succinic dehydrogenase, and acid phosphatase, for the estimation of timing of brain wound not only shortened the histological "lag period" up to 30 minutes after the injury, but also provided a useful information in determining the biological time table following the brain injury.
Acid Phosphatase
;
Adenosine Triphosphatases
;
Alkaline Phosphatase
;
Animals
;
Brain Injuries*
;
Brain*
;
Carboxylesterase
;
Contusions
;
Glucuronidase
;
Histological Techniques
;
Lacerations
;
Leucyl Aminopeptidase
;
Meninges
;
Monoamine Oxidase
;
Rats
;
Succinate Dehydrogenase
;
Wounds and Injuries
5.Hemorrhoidectomy Under Local Anesthesia after Pentothal Induction versus Spinal Anesthesia: a Concurrent Nonrandomized Prospective Study.
Choong Hoon KANG ; Sang Woo LEE ; Hyeon Keun SHIN ; Seung Kyu JEONG ; Jai Pyo CHOI ; Hyung Kyu YANG
Journal of the Korean Society of Coloproctology 2006;22(1):1-7
PURPOSE: The aim of this study was to evaluate the effectiveness of local anesthesia compared to spinal anesthesia and the usefulness of pentothal induction before infiltration of a local anesthetic agent. METHODS: A concurrent non-randomized prospective study was conducted on 52 patients who underwent a hemorrhoidectomy. For the spinal anesthesia (SA) group (n=29), 0.5% heavy bupivacaine (Marcaine(R)), 5 mg (1 ml), was used, and for the local anesthesia (LA) group (n=23), pentothal, 3.3 mg/kg, was administrated intravenously prior to infiltration of a mixture of local anesthetics (2% lidocaine, 14 ml, with 0.5% bupivacaine, 7 ml). RESULTS: There were no differences between the two groups in terms of operating time, postoperative pain, headache, urinary difficulty, nausea or vomiting, pain-free interval after operation, analgesic requirements, and patient's or surgeon's satisfaction. Postoperative ambulation was earlier in the LA group than in the SA group. CONCLUSIONS: Local anesthesia after pentothal induction can be used effectively for a hemorrhoidectomy and may be a safe alternative to spinal anesthesia.
Anesthesia, Local*
;
Anesthesia, Spinal*
;
Anesthetics, Local
;
Bupivacaine
;
Headache
;
Hemorrhoidectomy*
;
Humans
;
Lidocaine
;
Nausea
;
Pain, Postoperative
;
Prospective Studies*
;
Thiopental*
;
Vomiting
;
Walking
6.Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?.
Cheong Ho LIM ; Hyeon Keun SHIN ; Wook Ho KANG ; Seung Kyu JEONG ; Hyung Kyu YANG
Journal of the Korean Society of Coloproctology 2011;27(5):237-240
PURPOSE: Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity. METHODS: The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject's serum and to compare the results with those for the control groups. RESULTS: Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 +/- 0.78 pg/mL for male subjects and 1.16 +/- 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 +/- 0.44 pg/mL in group 1, 1.46 +/- 0.83 pg/mL in group 2, and 1.20 +/- 0.56 pg/mL in group 3 (P = 0.14). CONCLUSION: Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.
Endothelin-1
;
Endothelium
;
Female
;
Fissure in Ano
;
Hemorrhoids
;
Humans
;
Ischemia
;
Male
7.Two cases of listeria meningitis in patients with SLE.
Sung Kyeong WOO ; Hyeon Ok LIM ; Sang Goon SHIM ; Won Ho SHIN ; Keun Ho KIM ; Jong Yeul HAM ; Jong Seok LEE ; Jin Hak CHOI
Korean Journal of Infectious Diseases 1991;23(3):195-199
No abstract available.
Humans
;
Listeria*
;
Meningitis, Listeria*
8.Tuberculous Brain Abscess: A Case Report.
Chang Sub LEE ; Hyung Shik SHIN ; Jae Hyeon PARK ; Sang Jin KIM ; Sang Keun PARK
Journal of Korean Neurosurgical Society 1998;27(10):1408-1411
Tuberculous brain abscess is a rare form of the central nervous system tuberculosis. Clinical characteristics of the tuberculous brain abscess are symptoms and signs of intracranial hypertension rather than meningeal irritation. A 23-year-old man presented with headache and vomiting for 4 months. Neurological examination revealed mild left hemiparesis. Chest X-rays showed a large tuberculous cavity in the right upper lobe. Brain computed tomography scan revealed multiple ring enhancing cystic masses with marked edema and midline shift in the deep right temporo-occipital lobe. Without symptomatic relief with several months of antituberculous medication, the patient was subjected to stereotactic aspiration of the mass. Persistence of the abscess on postoperative CT scan rendered him to undergo right temporo-occipital craniotomy with removal of the remaining nodular mass. Follow up brain CT showed no residual abscess. He was discharged with no neurologic deficit. Having experienced this rare case with review on relevant literaturs, the authors suggest excision of the abscess cavity plays an important role to eradicate intracranial tuberculous abscess.
Abscess
;
Brain Abscess*
;
Brain*
;
Craniotomy
;
Edema
;
Follow-Up Studies
;
Headache
;
Humans
;
Intracranial Hypertension
;
Neurologic Examination
;
Neurologic Manifestations
;
Paresis
;
Thorax
;
Tomography, X-Ray Computed
;
Tuberculosis, Central Nervous System
;
Vomiting
;
Young Adult
9.Lift-up Submucosal Hemorrhoidectomy.
Hyung Kyu YANG ; Cheong Ho LIM ; Hyeon Keun SHIN ; Choon Hoon KANG ; Seung Kyu JEONG ; Jai Pyo CHOI
Journal of the Korean Society of Coloproctology 2005;21(3):145-151
PURPOSE: Hemorrhoidal tissues are normal anatomic structures present in every individual, and they act as cushions and are anchored to the internal anal sphincter by a connective tissue system. When the anchoring connective tissues undergo bears degenerative changes, the hemorrhoids not only bulge but also descend into the lumen of the anal canal. The veins also become distended. The previous hemorrhoidectomy methods (excision and ligation methods) tend to remove excessive amounts of hemorrhoidal tissues, possibly causing incontinence or stenosis. This study introduces a modified hemorrhoidectomy method. METHODS: A retrospective study was done with 650 patients (358 males, 292 females) who underwent hemorroidectomies from Jan. 1997 to Jan. 2000. Under saddle-block anesthesia, the patient was placed in a prone jack-knife position. After narrow incisions on the mucosa of the selected pile, a bilateral submucosal dissection was performed. The pedicle was ligated by transfixing sutures 2 or 3 times with 2-0 chromic catgut to lift up the mucosa. RESULTS: The mean operation time per hemorrhoidal pile was 12.7 minutes, and the mean hospital-stay was 4.3 days. Acute and delayed postoperative anal bleeding occurred in 7 (1.1%) and 3 (0.5%) patients, respectively. The symptoms of both subsided spontaneously. Ninety-three (93) patients (14.3%) reguired nelaton catheterization for voiding difficulty, and one patient (0.2%) showed mild anal stenosis. The most frequent complaint was skin-tag formation (148 cases, 22.8%). In 140 cases, the skin tag was removed under local anesthesia. CONCLUSIONS: It is desirable to keep the normal structure of the anal canal by removing as little of the cushions as possible. Our 'lift-up submucosal hemorrhoidectomy' shows good results and is an easy operative method when compared with Parks' original method.
Anal Canal
;
Anesthesia
;
Anesthesia, Local
;
Catgut
;
Catheterization
;
Catheters
;
Connective Tissue
;
Constriction, Pathologic
;
Hemorrhage
;
Hemorrhoidectomy*
;
Hemorrhoids
;
Humans
;
Ligation
;
Male
;
Mucous Membrane
;
Retrospective Studies
;
Skin
;
Sutures
;
Veins
10.Seroprevalence of Hepatitis B Virus among Health Care Workers in Korea.
Bo Moon SHIN ; Hyeon Mi YOO ; Ae Sook LEE ; Sang Keun PARK
Journal of Korean Medical Science 2006;21(1):58-62
We studied the seroprevalence of HBsAg, anti-HBs and anti-HBc and the vaccination histories among health care workers (HCWs) at a large suburban referral hospital in Korea. The purpose of this study was to determine the immune status of HCWs against hepatitis B virus and we also wanted to prepare a practical guideline to protect HCWs from occupational exposure. During December, 2003, 571 HCWs (56 physicians, 289 nurses, 113 technicians and 113 aid-nurses) aged between 21 and 74 yr were included in the surveillance. The positive rates of HBsAg and anti-HBs were 2.4% (14/571) and 76.9% (439/571), respectively. The positive rate of anti-HBs was lower in the physician group, and this was associated with the male gender and older age. Of the 439 anti-HBs positive cases, 320 cases (73.1%) were anti-HBc negative and this was significantly associated with a past history of HBV vaccination. The distribution of the anti-HBs levels was not associated with age (except for HCWs in their sixties), gender or occupation. Our study revealed that the seroprevalence rates of HBsAg and anti-HBs in HCWs in Korea were not different from those of the general population. Based on this surveillance, we can make reasonable decisions in case of occupational exposure to hepatitis B virus.
Adult
;
Aged
;
Antibodies, Viral/blood
;
Female
;
*Health Personnel
;
Hepatitis B/*epidemiology/virology
;
Hepatitis B Surface Antigens/blood
;
Hepatitis B virus/immunology
;
Humans
;
Korea/epidemiology
;
Logistic Models
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Occupational Diseases/*epidemiology/virology
;
Seroepidemiologic Studies
;
Vaccination/statistics & numerical data