No abstract available.

No abstract available.
Renal Insufficiency*

PURPOSE: Polypoid lesions of the gall bladder (PLG) have a variety of pathologies. Problems exist in the selection of patients for operation and in the operative approach used. We studied the accuracy of the preoperative radiologic diagnosis and suspected risk factors. METHODS: 121 polypoid lesions of gallbladder were sugically treated during 10 years. Preoperative radiologic diagnosis, age, gender, related symptoms, concurrent gallstone, size, shape, number and histologic diagnosis of the ployps were retrospectively reviewed. RESULTS: The average size of malignancy was 23.0 mm, and that of benign tumors was 7.1 mm (P=0.000). The mean age of patients with a malignancy was significant higher than that of those with benign tumor (P=0.000). The preoperative sensitivity of computed tomography for a malignancy was 67.7%. The patients with malignancy more frequently had related symptoms. CONCLUSION: A CT must be considered, for patients with risk factors, even if the ultrasonographic diagnosis was benign. An Age greater than 60 years, a tumor size greater than 10 mm, a solitary polyp, sessile shape, and related symptoms are predictive factors of a malignancy.
Diagnosis ; Gallbladder* ; Gallstones ; Humans ; Pathology ; Polyps ; Retrospective Studies ; Risk Factors ; Urinary Bladder

PURPOSE: Proangiogenic and antiangiogenic growth factors are related to control of cancer progression and metastasis. The expression of Factor VIII-Related antigen in liver, that is marker of the vascular endothelial cell antigen, may be an indicator of neovascularization. This study aimed to monitor the change of plasma and tissue levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and endostatin in rat liver carcinogenesis and to determine the possibility of the future predictive indicator and antiangiogenic therapy application. METHODS: Sprague-Dawley Rats received 120 ppm concentration diethylnitrosamine (DEN) in drinking water as a carcinogen and in control and experimental groups, sequentially sacrificed by three and seven rats at 3, 6, 9, 12, 15 and 18 weeks, respectively. The liver tissue was examined with light microscopy, immunohistochemistry and enzyme immunoassay method. RESULTS: In hepatocarcinogenesis, the preneoplastic nodules appeared at 6 weeks after oral 120 ppm concentration DEN administration. The hepatocellular carcinomas and their pulmonary metastatic foci developed at 15 weeks and 18 weeks, respectively. The immunohistochemical staining of Factor VIII-Related antigen was negative in all sinusoids in normal control livers, but focal or scattered expression in preneoplastic nodules and diffuse expression were found in hepatocellular carcinomas. The tissue levels of VEGF and bFGF were found to have a direct correlation with the plasma levels, but not endostatin. The levels of VEGF and bFGF increased slightly in preneoplastic nodules and markedly elevated in hepatocellular carcinoma. However, there was no significant difference between the levels of VEGF and bFGF and the state of metastasis. There was no significant relation between the levels of endostatin and carcinogenesis and progression of the rat liver. CONCLUSION: From the above results, it could be suggested that VEGF and bFGF may play an important role in initiation and progression of hepatocellular carcinomas in rat liver, but not endostatin. Also, there was no correlation between the levels of VEGF and bFGF and the state of metastasis. Therefore, further study to determine the relationship between the angiogenic regulators and its receptors will serve as a promising research in the predictive indicator and antiangiogenic therapy.
Animals ; Carcinogenesis ; Carcinoma, Hepatocellular ; Diethylnitrosamine ; Drinking Water ; Endostatins* ; Endothelial Cells ; Fibroblast Growth Factor 2 ; Immunoenzyme Techniques ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Liver* ; Microscopy ; Neoplasm Metastasis ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A* ; von Willebrand Factor

PURPOSE: The wild-type p53 protein participates in suppressing cell transformations while its mutant forms has tumorigenic potential. Alterations in the structure of the p53 protein are one of the most common changes associated with human cancers. CREB-binding protein (CBP) and its homologue, p300, are transcriptional co-activators of various sequence-specific DNA-binding transcription factors and are involved in a wide range of cellular activities, such as DNA repair, cell growth, differentiation, and apoptosis. Several studies suggested that an association between p53 and p300 might account for the p53-responsible negative regulation. This study examined the relationship between p53 and CBP expression in terms of the clinicopathological factors and significance. METHODS: The level of p53 protein and CBP expression was measured in 150 gastric adenocarcinoma patients, who had undergone a gastrectomy, and the relationship between p53 and CBP was examined. Immunohistochemical stain was performed on formalin-fixed paraffin-embedded sections using monoclonal anti-p53 and anti-CBP antibody. RESULTS: 1. p53 protein was expressed in 46.3% (31/67) of early gastric cancers (EGC), 69.9% (58/83) of advanced gastric cancers (AGC)(P<0.05), 69.1% (65/94) of the intestinal type, 42.9% (24/56) of the diffuse type (P<0.05), 78.5% (55/70) of patients with a lymph node metastasis and 42.5% (34/80) of patients without a lymph node metastasis (P<0.01). 2. CBP expression was observed in 65% (61/94) of intestinal type, 51% (29/56) of the diffuse type (P>0.05), 47.8% (32/67) of EGC, 69.8% (58/83) of AGC (P<0.05), 68.6% (48/70) of patients with a lymph node metastasis and 52.5% (42/80) of patients without a lymph node metastasis (P>0.05). 3. p53 protein and CBP expression was coincidentally observed in 66.7% of gastric adenocarcinomas, and there was a significant correlation between the expression of both (P<0.05). CONCLUSION: That the expression of the p53 protein and CBP indirectly indicate the malignant potential of a cell, and may play an indirect role in the CBP and p53-mediated tumorigenic potential.
Adenocarcinoma* ; Apoptosis ; CREB-Binding Protein* ; DNA Repair ; Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Transcription Factors

PURPOSE: We examined the expressions of claudin-4 and E-cadherin, which are known as cell adhesion-associated proteins, in stomach cancer. The relationship of their expression with the clinicopathologic factors was examined to investigate the roles of these proteins in the invasion or metastasis of stomach adenocarcinoma. METHODS: The expressions of claudin-4 and E-cadherin were examined in 73 cases of adenocarcinoma of the stomach by performing immunohistochemical staining. RESULTS: The expressions of claudin-4 and E-cadherin in the stomach adenocarcinoma were both correlated with the histologic grade, the T-stage and nodal metastasis, respectively (P<0.05). The expression of claudin-4 was significantly associated with the expression of E-cadherin. CONCLUSION: Our data suggests that claudin-4 and E-cadherin are involved in the processes of histologic differentiation, invasion and metastasis of stomach adenocarcinoma.
Adenocarcinoma ; Cadherins* ; Claudin-4* ; Neoplasm Metastasis ; Stomach Neoplasms* ; Stomach*

Most anesthesiologists, at one point or another, are faced with a difficult airway. We came upon an unexpected difficult airway and a failed intubation using a direct laryngoscope and lightwand. At this point, we decided to insert an i-gel which is quick and simple. This allowed us to maintain oxygenation and ventilation. After checking for the location of the laryngeal inlet with a flexible fiber optic bronchoscope, a 5.5 mm internal diameter endotracheal tube was inserted into the trachea over the flexible fiber optic bronchoscope. Finally, a suitable a 7.0 mm internal diameter endotracheal tube was inserted using an exchange catheter technique. With respect to this case, we conclused that the i-gel is a very helpful device for endotracheal intubation in patients with difficult airways.
Bays ; Bronchoscopes ; Catheters ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopes ; Oxygen ; Porphyrins ; Trachea ; Ventilation

PURPOSE: Laparoscopic cholecystectomy has replaced open cholecystectomy as the standard treatment and it has widely gained rapid acceptance. However, laparoscopic cholecystectomy has many complications and it can require conversion to open cholecystectomy or further management. We reviewed our cases for determining the complications and clinical results in order to improve the efficacy and safety of laparoscopic cholecystectomy in our hospital. METHODS: The data from 3,224 laparoscopic cholecystectomies that were performed at our hospital from January 1995 to December 2004 were reviewed retrospectively. The pre-operative laboratory data, operative findings, post-operative pathologic findings, complications and proper treatment were evaluated. RESULTS: 52 of all the patients developed complications. The median patient age was 51.8+/-11.6 years, and the median admission time was 29.9+/-10.6 days. The most common complications were post operative bleeding (20 case), and bile duct injury (15 cases). A collection of bile was noted in 12 cases. The treatment of complications were operations (16 case) radiologic interventions (14 case), and observation with conservative management (22 case). CONCLUSION: There were various complications of laparoscopic cholecystectomy, and these patients needed a longer hospital stay and operative treatment. So, improvement of surgeons' skill with a carefully approach and better understanding of the anatomical variations of the biliary tree and vascular system, recognition of pre-operative patients' general condition and the severity of inflammation, and prompt and proper management for complications should be done to prevent serious problems.
Bile ; Bile Ducts ; Biliary Tract ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Hemorrhage ; Humans ; Inflammation ; Length of Stay ; Retrospective Studies

BACKGROUND/OBJECTIVES: Rubus Coreanus Miquel (RCM), used as a traditional Korean medicine, reduces chronic inflammatory diseases such as cancer and rheumatoid arthritis. However, its mechanism has not been elucidated. In this study, we examine the anti-inflammatory effects of RCM and their possible mechanisms using RAW 264.7 cells. MATERIALS/METHODS: Unripe RCM ethanol extract (UE), unripe RCM water extract (UH), ripe RCM ethanol extract (RE), and ripe RCM water extract (RH) were prepared. Inflammatory response was induced with LPS treatment, and expression of pro-inflammatory mediators (iNOS, COX-2, TNF-alpha, IL-1beta, and IL-6) and NO and PGE2 productions were assessed. To determine the anti-inflammatory mechanism of RCM, we measured NF-kappaB and MAPK activities. RESULTS: UE and UH treatment significantly reduced NF-kappaB activation and JNK and p38 phosphorylation and reduced transcriptional activities decreased iNOS, COX-2, and pro-inflammatory cytokines expressions, and NO and PGE2 productions. RE and RH treatments reduced IL-1beta and IL-6 expressions through suppressions of JNK and p38 phosphorylation. CONCLUSIONS: In this study, we showed that RCM had anti-inflammatory effects by suppression of pro-inflammatory mediator expressions. Especially, unripe RCM showed strong anti-inflammatory effects through suppression of NF-kappaB and MAPK activation. These findings suggest that unripe RCM might be used as a potential functional material to reduce chronic inflammatory responses.
Arthritis, Rheumatoid ; Cytokines ; Dinoprostone ; Ethanol ; Inflammation ; Interleukin-6 ; NF-kappa B* ; Phosphorylation ; Phosphotransferases* ; Tumor Necrosis Factor-alpha ; Water

BACKGROUND: Inflammatory response on LPS and IFN-gamma induced Macrophage Raw 264.7 cells was secreted NO (nitric oxide) and PGE2 (prostaglandin E2) though expression of iNOS and COX-2. And many pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6 etc.) was secreted on LPS and IFN-gamma induced Macrophage Raw 264.7 cells, too. Atopy dermatitis was inflammatory skin disease with pruritus, xeroderma and specific eczema. OBJECTIVE: We sought to effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. METHODS: The immune response of Raw 264.7 cells were induced by LPS and IFN-gamma. Then LPS and IFN-gamma induced Raw 264.7 cells was measured NO, PGE2 production after treatment of different concentrations for AF-343. The related genes (iNOS, COX-2) for NO, PGE2 production were detected using Western blot in LPS and IFN-gamma induced Raw 264.7 cells after treatment of different concentrations for AF-343. Pro-inflammatory cytokines were detected, too. NC/Nga mice as Atopy dermatitis model was induced atopy dermatitis. Then NC/Nga mice with atopy dermatitis were performed oral administration of AF-343 for 1weeks. After oral administration of AF-343, TEWL was measured on skin tissues of NC/Nga mice with atopy dermatitis according to whether were performed oral administration of AF-343 or not. And pro-inflammatory cytokines and IgE was measured in serum, protein of skin tissues of NC/Nga mice. Skin tissues of NC/Nga mice were performed H&E staining, immunohistochemical staining for PCNA, Involucrin and filaggrin. RESULTS: LPS and IFN-gamma induced Raw 264.7 cells was decreased NO, PGE2 production in dose-dependent after treatment of different concentrations for AF-343. The expression level of iNOS, COX-2 protein was decreased in dose-dependent, too. The related pro-inflammatory cytokines in media with LPS and IFN-gamma induced Raw 264.7 cells were decreased after treatment of different concentrations for AF-343. TEWL level of NC/Nga mice skin (back, ear) with atopy dermatitis according to whether were performed oral administration of AF-343 or not was decreased in NC/Nga mice with atopy dermatitis group was performed oral administration by AF-343. When NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343, induced pro-inflammatory cytokines and IgE expression in serum, protein of back, ear skin tissues of each NC/Nga mice group was decreased. H&E stained Skin tissues of NC/Nga mice was confirmed that thickness of epidermis, dermis were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis. The expression of PCNA, involucrin and filaggrin were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis as results of immunihistochemical staining using specific antibodies such as PCNA as cell proliferation marker, involucrin and filaggrin as keratinocytes differentiation markers for skin tissues (back, ear) of NC/Nga mice. CONCLUSION: We confirmed effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. In conclusion, AF-343 is expecting as therapeutics for atopic dermatitis.
Administration, Oral ; Animals ; Antibodies ; Antigens, Differentiation ; Blotting, Western ; Cell Proliferation ; Cytokines ; Dermatitis ; Dermatitis, Atopic ; Dermis ; Dinoprostone ; Ear ; Eczema ; Epidermis ; Ichthyosis ; Immunoglobulin E ; Inflammation ; Interleukin-6 ; Intermediate Filament Proteins ; Keratinocytes ; Macrophages ; Mice ; Proliferating Cell Nuclear Antigen ; Protein Precursors ; Pruritus ; Skin ; Skin Diseases ; Taraxacum