PURPOSE: The purpose of this study is to analyze the mode of recurrence and it's relating factors in gastric adenocarcinoma. MATERIALS AND METHODS: 1,446 patients who had been undergone gastrectomy for gastric adeno carcinoma from September 1983 to December 1996 (Department of Surgery, Korea University) were studied (median follow-up was 2.9 years). Of them, 243 patients who had been proven recurrence were studied on recurrence mode and clinicopathological factors. RESULTS: The mean duration to recurrence was 22 months. The modes of recurrence were locore gional (30.0%), peritoneal (23.0%), hematogenous (19.3%) and distant lymph node metastasis (4.1%) in order. In 23.5%, more than 2 recurrent pattern were combined. Age, gross type, tumor size and stage were statistically significant to the mode of recurrence. The disease free survival was calculated: regional lymph node, number of lymph node, stage, and tumor emboli had statistical significance in all types of recurrence and in locoregional recurrence, tumor size was significant. Multivariate analysis showed that regional lymph node influenced the disease free survival period in all cases and tumor size in locoregional recurrence. CONCLUSION: The number of positive regional lymph node and tumor size are important factors predicting the timing of recurrence after curative resection for gastric adenocarcinoma.
Adenocarcinoma* ; Disease-Free Survival ; Follow-Up Studies ; Gastrectomy ; Humans ; Korea ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Stomach Neoplasms

BACKGROUNDS/AIMS: Growth of tumors and their metastases is dependent on factors that stimulate vessel formation (angiogenesis). Vascular endothelial growth factor (VEGF) is closely related to angiogenesis in various human cancers. The aim of this study was to determine the value of serum VEGF levels in hepatocellular carcinomas as a tumor marker. METHODS: We measured serum VEGF levels, by enzyme immunoassay, and platelet counts in healthy controls (n=22), liver cirrhosis (LC; n=4) and hepatocellular carcinomas (HCC; n=14). RESULTS: The mean serum VEGF levels in controls and the patients with LC and HCC were 251.8+/-121.5 (mean+/-SD), 163.4+/-82.1 and 557.8+/-520.3pg/ml, respectively. The levels were significantly elevated in the HCC group, compared with the control group (p<0.05). Serum VEGF levels in the HCC group were highly correlated with platelet counts (r=0.915, p<0.05). Conclusions : We consider that serum VEGF is a possible tumor marker for HCC. Serum VEGF may be partly derived from platelets.
Carcinoma, Hepatocellular* ; Humans ; Immunoenzyme Techniques ; Liver Cirrhosis ; Neoplasm Metastasis ; Platelet Count ; Vascular Endothelial Growth Factor A*

Both diabetic retinopathy (DR) and coronary heart disease (CHD) are clinically significant in diabetic patients. We investigated the correlation between the severity of DR and the presence and severity of CHD among type 2 diabetic patients. A total of 175 patients who were examined at the DR clinic and underwent dual-source computed tomography (DSCT) angiography within 6 months were included. The degree of DR was graded as no DR, nonproliferative DR (NPDR), and proliferative DR (PDR). The severity of CHD and the numbers of significant stenotic coronary artery on DSCT angiography according to DR grade were assessed. The mean Agatston Calcium Score (ACS) in patients with PDR was significantly higher than other groups (P < 0.001). The overall odds of an ACS increase were about 4.7-fold higher in PDR group than in no DR group (P < 0.001). In PDR group, in comparison with in no DR, the odds of having 1 or 2 arterial involvement were 3-fold higher (P = 0.044), and those of having 3 were 17-fold higher (P = 0.011). The c-index, one of the predictability values in regression analysis model, was not significantly increased when PDR was added to classical CHD risk factors (0.671 to 0.706, P = 0.111). Conclusively, patients with PDR develop a greater likelihood of not only having CHD, but being more severe nature. PDR has no additional effect to classical CHD risk factors for predicting CHD.
Aged ; Angiography ; Coronary Artery Disease/complications/*pathology ; Coronary Vessels/diagnostic imaging ; Diabetes Mellitus, Type 2/*complications ; Diabetic Retinopathy/complications/*diagnosis/diagnostic imaging ; Female ; Glomerular Filtration Rate ; Humans ; Linear Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Severity of Illness Index ; Tomography, X-Ray Computed

Both diabetic retinopathy (DR) and coronary heart disease (CHD) are clinically significant in diabetic patients. We investigated the correlation between the severity of DR and the presence and severity of CHD among type 2 diabetic patients. A total of 175 patients who were examined at the DR clinic and underwent dual-source computed tomography (DSCT) angiography within 6 months were included. The degree of DR was graded as no DR, nonproliferative DR (NPDR), and proliferative DR (PDR). The severity of CHD and the numbers of significant stenotic coronary artery on DSCT angiography according to DR grade were assessed. The mean Agatston Calcium Score (ACS) in patients with PDR was significantly higher than other groups (P < 0.001). The overall odds of an ACS increase were about 4.7-fold higher in PDR group than in no DR group (P < 0.001). In PDR group, in comparison with in no DR, the odds of having 1 or 2 arterial involvement were 3-fold higher (P = 0.044), and those of having 3 were 17-fold higher (P = 0.011). The c-index, one of the predictability values in regression analysis model, was not significantly increased when PDR was added to classical CHD risk factors (0.671 to 0.706, P = 0.111). Conclusively, patients with PDR develop a greater likelihood of not only having CHD, but being more severe nature. PDR has no additional effect to classical CHD risk factors for predicting CHD.
Aged ; Angiography ; Coronary Artery Disease/complications/*pathology ; Coronary Vessels/diagnostic imaging ; Diabetes Mellitus, Type 2/*complications ; Diabetic Retinopathy/complications/*diagnosis/diagnostic imaging ; Female ; Glomerular Filtration Rate ; Humans ; Linear Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Severity of Illness Index ; Tomography, X-Ray Computed

Mycobacterium abscessus (M. abscessus) is the second most common nontuberculous mycobacteria (NTM) in South Korea. Nevertheless, the diagnosis and treatment of M. abscessus lung disease can be problematic. Surgical resection has been tried for patients with localized M. abscessus lung disease refractory to medical treatment. Here, we report on a 25-year-old woman with M. abscessus lung disease who had been diagnosed and treated three times for pulmonary tuberculosis. She was initially diagnosed as having M. intracellulare lung disease; however, M. abscessus was isolated after several months of medication. She had multiple bronchiectatic and cavitary lesions bilaterally, and M. abscessus was repeatedly isolated from her sputa despite prolonged treatment with clarithromycin, ethambutol, moxifloxacin, and amikacin. She improved only after sequential bilateral lung resection. Based on the experience with this patient, we suggest that, if medical treatment fails, surgical resection of a diseased lung should be considered even in patients with bilateral lesions.
Adult ; Anti-Bacterial Agents/pharmacology/*therapeutic use ; Female ; Humans ; Lung Diseases/*drug therapy/*microbiology/surgery ; Mycobacteria, Atypical/drug effects/*physiology

No abstract available.
Actinobacillus* ; Aggregatibacter actinomycetemcomitans* ; Inflammation* ; Interleukin-6* ; Periodontal Pocket* ; Prevotella intermedia* ; Prevotella*

PURPOSE: A pancreatic leak is a major source of morbidity associated with pancreatic surgery. A review of the indication for distal pancreatectomy and the disease and technique dependent factors associated with morbidity and mortality after this procedure were sought. METHODS: A retrospective analysis of the hospital records of all patients having undergone a distal pancreatectomy between January 1998 and December 2002 was prformed. The clinical, technical and pathological data were correlated with the operative morbidity or mortality. RESULTS: 95 patients had undergone a distal pancreatectomy. The male to female ratio of our series was 2.3 to 1, with a mean age of 54.2 years. 38 patients underwent the distal pancreatectomy for an intrapancreatic disease and 57 for an extrapancreatic disease, with a curative resection for stomach cancer the most common indication (47.4%). The clinicopathological and technical factors included the urgency of the operation, presence or absence of malignancy in the resected pancreas, method of pancreatic stump closure (suture vs. stapled) and the presence of a concomitant splenectomy. The morbidity and mortality rates were 27.3 and 2%, respectively. The postoperative complications included pancreatic fistula, intraabdominal abscess and wound infection among others. There were no factors significantly associated with the development of postoperative complications, especially pancreatic leakage. CONCLUSION: A distal pancreatectomy can be performed for a variety of benign and malignant conditions, with a low rate of mortality, although a pancreatic leak can be a serious cause of morbidity. The morbidity and pancreatic leakage rates in our study were 27.3 and 9.4%, respectively, but as there were no clinical or technical factors associated with pancreatic leakage in this retrospective analysis, it is propose that a prospective trial should be performed.
Abscess ; Female ; Hospital Records ; Humans ; Male ; Mortality* ; Pancreas ; Pancreatectomy* ; Pancreatic Fistula ; Postoperative Complications ; Retrospective Studies ; Splenectomy ; Stomach Neoplasms ; Wound Infection

PURPOSE : Human uteroglobin (hUG) is a cytokine-like multifunctional protein that possesses potent immunomodulatory and anti-tumor activity. And, the G38A polymorphism of uteroglobin exon 1 has been associated with the development of immunoglobulin A nephropathy, systemic lupus erythematosus and bronchial asthma. In addition, the 38AA genotype has been related to lower serum levels of uteroglobin than the GG or GA genotypes. Although the hUG gene is one of the candidate tumor suppressors in lung cancer, the uteroglobin gene polymorphism has not been reported upon in lung cancer. Therefore, we studied the frequencies of the G38A polymorphism of the hUG gene in patients with lung cancer and control subjects to investigate its relation with lung cancer. MATERIALS AND METHODS : A matched case control design study was adopted to investigate the possibility of an association between primary lung cancer and the G38A polymorphism. To exclude the possible influence of tobacco smoke exposure, or of age or gender on the development of lung cancer, these factors were matched between the 60 patients and the 60 controls. Genotypes were determined by polymerase chain reaction followed by restriction fragments length polymorphism analysis for the hUG gene. RESULTS : The frequency of the 38A allele in patients was 0.55, which was significantly different from its frequency of 0.37 in controls (p=0.007). Moreover, the frequency of the 38AA genotype was significantly higher in patients (35%) than in controls (15%) (p=0.01). Furthermore, two patients previously diagnosed as having prostate cancer were all genotyped as 38AA. CONCLUSION : The G38A polymorphism of the hUG gene is associated with the development of primary lung cancer in Koreans
Alleles ; Asthma ; Case-Control Studies ; Exons ; Genotype ; Glomerulonephritis, IGA ; Humans* ; Lung Neoplasms* ; Lung* ; Lupus Erythematosus, Systemic ; Polymerase Chain Reaction ; Prostatic Neoplasms ; Smoke ; Tobacco ; Uteroglobin*

BACKGROUND: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. METHODS: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. RESULTS: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). CONCLUSION: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.
Adenocarcinoma ; Brain* ; Consensus ; Electrons* ; Humans ; Lung ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Neoplasm Staging ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Solitary Pulmonary Nodule ; Tomography, X-Ray Computed

A 17-year old female presented with a chief complaint of melena and epigastric pain. She had a family history of colon cancer, her mother having been diagnosed with hereditary nonpolyposis colorectal carcinoma (HNPCC). After close examination including double-balloon enteroscopy, the patient was diagnosed with small bowel carcinoma, in spite of her young age. Here we report this rare case of small bowel carcinoma in a young patient with a family history of HNPCC.
Adenocarcinoma/*diagnosis/pathology/surgery ; Adolescent ; Double-Balloon Enteroscopy ; Female ; Humans ; Jejunal Neoplasms/*diagnosis/pathology/surgery ; Positron-Emission Tomography ; Tomography, X-Ray Computed