PURPOSE: Tumor invasion and metastasis are multistep phenomina, involving proteolytic degradation of extracellular matrix (ECM) and alteration of cell adhesion. It is another oncologic therapeutic strategy to block tumor invasion and metastasis through analyzing the molecules which are involved in these processes. We examined the expressions of some of matrix metalloproteinases (MMPs) in colorectal cancer and analyze the correlation with clinical factors and survival. METHODS: Fifty-five patients with colorectal cancer who underwent surgical resection were included. The expressions of the MMP-2, -7, -9, and -12 in tumor tissue and normal mucosa using RT-PCR technique was carried out. We evaluated and analyzed the correlation among these molecules, clinical characteristics, and survival. RESULTS: Expressions of MMP-7, -9, and -12 were significantly higher in tumor tissue than in normal mucosa (P=0.00). The expressions of MMP-2 between cancer and normal mucosa had no significant difference but it had a significant difference according to the lymph node (LN) invasion (P=0.03) in tumor tissues. Three-year overall survival was worse in patient with high expression of MMP-2 compared to low expression. CONCLUSION: The expressions of MMP-7, -9, -12 in tumor tissue were higher than in normal mucosa and MMP-2 expression of tumor tissues had a significant difference according to LN invasion. MMP-2 overexpression seems to be a prognostic factor for 3-yr overall survival. But, large scale study with long term survival analysis will be needed for the prognostic significance of MMPs.
Cell Adhesion ; Colorectal Neoplasms ; Extracellular Matrix ; Humans ; Lymph Nodes ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Mucous Membrane ; Neoplasm Metastasis

No abstract available.

Eleven cases of juvenile diabetes mellitus who were admitted Seoul National University Hospital from Jan., 1969 to Aug., 1978 were aha1yzed. The mean age of onset was 7 and female to male ratio was 8 to 3 with female preponderance. Four had family history of diabetes, although none had diabetic sibling. Polyuria and polydipsia were noted in all cases as initial symptoms, and symptoms of weight loss (6 cases), disturbances in consciousness (5), generalized weakness (5), anorexia (4) and enuresis (3) were noted in the order of frequency. Leucocytosis was noted in 5 cases, but only 2 among the 4 who had infection revealed leucocytosis, The mean blood glucose level was 320 mg% and serum osmolality was 293 mOsm/L. There was no significant difference in the level of blood sugar and serum osmolality according to the consciousness status. Eight episodes of ketoacidosis occured in 5 cases. Three episodes developed due to discontinuance of insulin and three episodes accompanied infection. The mean blood glucose level was 495 mg% and serum osmolality was 300 mOsm/L in ketoacidosis. The consciousness cleared in average 20 hours and ketonuria disappeared in average 26 hours after the administration of insulin (average 5 units/kg of body weight). At discharge, the average dose of insulin needed was 1.2 U/kg/d. Six patients were followed from 6 months to 6 years. Two developed pulmomary tuberculosis during the period of follow up.
Age of Onset ; Anorexia ; Blood Glucose ; Consciousness ; Diabetes Mellitus* ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Insulin ; Ketosis ; Male ; Osmolar Concentration ; Polydipsia ; Polyuria ; Seoul ; Siblings ; Tuberculosis ; Weight Loss

Although attachments have been utilized for a retainer of removable prostheses during several decades, there is little information on the force distribution by the attachments. This study was undertaken to evaluate the stress patterns developed by partial dentures employing rigid attachments on the supporting structures. Four types of the mandibular removable partial dentures were designed depending upon the position of the rigid attachment and the existency of lingual bracing. Under 100N of vertical and 25N of lateral loads on the 1st and 2nd lower molar of partial denture, stress distribution patterns and displacement were analysed with three dimensional finite element method by ANSYS version 5.3. 1. The highest stresses were concentrated on the distal alveolar crest of posterior abutment and the second stresses on the apical region of posterior abutment in the models. 2. The greatest displacement were shown on the distal alveolar crest of posterior abutment and the second displacement on the distal alveolar crest of anterior abutment in the models. 3. There was little difference between the models with intraoral attachment and those with extracoronal attachment. 4. There was little difference between the models with and without the lingual bracing.
Braces ; Denture, Partial* ; Denture, Partial, Removable ; Molar ; Prostheses and Implants

PURPOSE: Genetic susceptibility for colorectal cancer is explained by polymorphisms of the drug-metabolizing enzymes. CYP2E1 activate the procarcinogens and they are involved in carcinogenesis. We analyzed the polymorphisms of CYP2E1 in colorectal cancer patients and the controls, and we examined the interaction between meat intake, smoking and CYP2E1 polymorphisms in colorectal cancer. METHODS: Polymerase chain reaction was performed for 96- bp insertion polymorphisms in 113 colorectal cancer patients and 110 controls. 80 cancer patients and 75 controls were interviewed for determining their meat intake and smoking behavior. We analyzed the clinical characteristics and the combined effect of meat intake, smoking and CYP2E1 polymorphisms on the susceptibility to colorectal cancer. RESULTS: The insert 0, insert 1 and insert 2 subtypes for the 96-bp insertion polymorphism were seen in 75 (66.4%), 35 (31.0%) and 3 (2.7%) cases, respectively, and in 82 (74.5%), 26 (23.6%) and 2 (1.8%), respectively. CYP2E1 polymorphisms didn't increase the colorectal cancer risk (OR: 1.5, 95% CI 0.3~10.1) in the insert 1 group and the insert 2 group. The combined effects of CYP2E1 polymorphisms, meat intake and smoking were not significant, (OR: 1.6, 95% CI: 0.4~4.7) in the low-meat intake group, the high-meat intake group, (OR: 0.4, 95% CI: 0.1~2.5) and in the smokers and ex-smokers (OR: 0.8, 95% CI: 0.3~2.3). CONCLUSION: The CYP2E1 polymorphisms, alone or combined with meat intake or smoking, did not increase the risk of colorectal cancer. Further well designed large scaled studies will be needed to determine the effects of CYP2E1 polymorphisms on colorectal cancer.
Carcinogenesis ; Colorectal Neoplasms* ; Cytochrome P-450 CYP2E1* ; Genetic Predisposition to Disease ; Humans ; Meat* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Smoke* ; Smoking*

PURPOSE: For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer. METHODS: We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases). RESULTS: The mean age of the one-stage group was 58.5+/-16.1, and that of the staged operation group was 65.0+/-13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities. CONCLUSIONS: A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity.
Anastomotic Leak ; Colectomy ; Colon* ; Colonic Neoplasms ; Colostomy ; Female ; Humans ; Length of Stay ; Mortality ; Retrospective Studies ; Stents ; Therapeutic Irrigation ; Wound Infection

Traumatic aortic transection after blunt chest injury is highly lethal and has high operative mortality. Recently, the diagnostic and therapeutic method of this injury is advanced, especially in spinal cord protection during aortic cross-clamping. We have experienced two cases of traumatic aortic transection with left hemothorax after blunt chest injury, which was diagnosed in operative field. The transected aorta was primarily repaired with clamp and sew method and postoperative paraplegia had not occured. The patients were dischraged without any significant complications. We report these cases with a review of literature.
Aorta ; Hemothorax ; Humans ; Mortality ; Paraplegia ; Spinal Cord ; Thoracic Injuries

Acute mesenteric ischemia and infarction is emergent situation associated with high mortality, arising from sudden loss of blood supply to mesenteric vessels. Most of all, the patients has cardiovascular insufficiency such as arrhythmia, recent myocardial infarction or valvular heart diseases. Acute abdominal pain is a main symptom and abdominal distension, rigidity, nausea and/or vomiting, and diarrhea are frequently observed. Delayed diagnosis and management are usually due to the nonspecific symptom and sign and lack of accurate diagnostic modality. A patient with acute abdominal pain having a history of cardiovascular disorders should be meticulously evaluated considering to exclude mesenteric vascular emergency. This dismal disease is mostly segmental ischemia of small bowel or colon due to occlusion of one mesenteric vessel, but occasionally multiple occlusions is are possible. We report a 67 years old female patient with diffuse colonic infarction due to multiple mesenteric embolism with review of literatures.
Abdominal Pain ; Aged ; Arrhythmias, Cardiac ; Colon* ; Delayed Diagnosis ; Diarrhea ; Embolism* ; Emergencies ; Female ; Heart Valve Diseases ; Humans ; Infarction* ; Ischemia ; Mortality ; Myocardial Infarction ; Nausea ; Vomiting

In cancer therapy, immunological disorder is one of most severe problem. Since thymic cortex is the home of T-cell proliferation and "education", thymic morphology following administration of certain drugs can be used as a parameter of immunological safety of the drug. In this study, morphology of thymic cortex, following administration of 5-fluorouracil or AG60, was studied. AG60 is a newly developed anti-cancer remedy, the compound of acriflavine and guanosine (1 : 1). ICR mice were subcutaneously inoculated with Ehrlich carcinoma cells (10(7) cells/mouse) in their inguinal areas. Each mouse in 5-fluorouracil group was injected subcutaneously with a single dose of 30 mg/kg of 5-fluorouracil every other day, and the mouse in AG60 group, with 30 mg/kg of AG60 (Taerim Pharm. Co., Seoul) every other day. The control mouse was injected with saline. The mice were sacrificed on the day after 7th injection. Tissues of thymic cortices were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde solution (0.1 M Millonig's phosphate buffer, pH 7.3), and refixed in 2% osmium tetroxide solution (0.1 M Millonig's phosphate buffer, pH 7.3). Tissue blocks were dehydrated, and were embedded in araldite mixture. For the overview-comparison, semithin sections stained with toluidine blue solution were photographed. And the typical portions were cut with ultratome, stained and observed with electron microscope. In light microscopy, thymic cortical morphology of AG60-injected mouse was similar with that of control mouse. But the cortical morphology of 5-fluorouracil-injected mouse was impressively different from those of the control or AG60 group mice. Thymocytes in the thymic cortex of 5-fluorouracil-injected mice were severely depleted. In electron microscopy, thymocytes in the thymic cortices of the control or AG60 group mice were crowded, and small groups of thymocytes were surrounded by the cytoplasmic processes of epithelial reticular cells. Mitotic figures were randomly seen. Thymocytes of 5-fluorouracil-injected mouse were naked out from the epithelial reticular cells, and were completely depleted out from the cortex composed mainly of enlarged epithelial reticular cells. Numerous microvilli were protruded from the naked thymocytes. The results were interpreted as that 5-fluorouracil induce leukopenia, and homing of lymphocytes to thymic cortex is severely depressed. 5-fluorouracil also disturb the normal protective and supportive function of epithelial reticular cells for thymocytes. Whereas the complex of acriflavine-guanosine compound (AG60) is immunologically safe, as seen in thymic cortical morphology.
Acriflavine ; Animals ; Cytoplasm ; Fluorouracil* ; Guanosine ; Hydrogen-Ion Concentration ; Leukopenia ; Lymphocytes ; Mice* ; Mice, Inbred ICR ; Microscopy ; Microscopy, Electron ; Microvilli ; Osmium Tetroxide ; T-Lymphocytes ; Thymocytes ; Tolonium Chloride

PURPOSE: The aim of this sutdy was to evaluate the feasibility of 3-[131I]Iodo-O-methyl-L-a-methyltyrosine ([131I]OMINT) as an agent for tumor image. MATERIALS AND METHODS: After synthesis of 4-O-methyl-L-a-methyltyrosine (OMAMT), OMAMT was labeled with 131I using Iodogen method. In viro cellular uptake study was performed using 9 L gliosarcoma cells at various time points upto 4 hr. The biodistribution (five rats implanted with the 9 L gliosarcoma cells per group) was evaluated at 30 min, 2 hr, 24 hr after iv injection of 3.7 MBq [131I]OMIMT or L-3-[131I]iodo-a-methyltyrosine ([131I]IMT). Gamma camera images were obtained at 30min, 2 hr, and 24 hr. RESULTS: [131I]OMINT uptake was 3.3 times and 2.5 times higher than [131I]IMT uptake at 30 min and 60 min, respectively and same after 2 hr in in vitro sutdy using 9L gliosarcoma cells. Maximum accumulation in tumor occurred at 30 min for both [131IOMINT and [131I]IMT in tumor bearing rats. The tumor uptake of [131I]OMINT was significantly higher than that of [131I]IMT in tumor bearing rats. The tumor uptake of [131I]OMIMT was significantly higher than that of [131I]IMT at early time point studied (3.74 +/- 0.48 vs 0.38 +/- 0.17% ID/g at 30 min and 2.40 +/- 0.17 vs 0.24 +/- 0.03% ID/g at 2 hr, respectively, p<0.01). However, the tumor uptake of both radiolabels were not significantly different at 24 hr (0.04 +/- 0.01 vs 0.05 +/- 0.01% ID/g). Tumor was visualized as early as at 30 min in gamma camera images. CONCLUSION: These data suggested that [131I]OMIMT might be a useful tumor imaging agent and has more advantage for the tumor imaging compared to [131I]IMT.
Animals ; Gamma Cameras ; Gliosarcoma ; Rats*