No abstract available.

BACKGROUND: To date, a laparoscopic gastrectomy has been performed by a small number of surgeons around the world, but the laparoscopic approach has been extended to Billroth I and a total gastrectomy. To evaluate the validity of the procedure, we present the results of six patients who underwent a gastrectomy using a laparoscopic technique. METHODS: First, two patients had a totally intra-abdominal laparoscopic B-II gastrectomy, and one of two also had a bilateral truncal vagotomy. The rest had a laparoscopic-assisted gastrectomy. One patient had concurrently an open reduction and an internal fixation with a K-wire for a patellar fracture. Indications were (a) gastric outlet obstruction due to peptic ulcer disease in five patients and (b) duodenal ulcer bleeding in one patient. RESULTS: Except for one patient who had stump leakage, which was solved by conservative therapy, there were no complications or operative mortality. The operating time and the cost were less for the patients who had their operations later in the series and who had laparoscopic-assisted operation. CONCLUSIONS: These forms of laparoscopic gastric surgery for patients with complications of peptic ulcer disease may be useful from the standpoint of minimal access, rapid recovery, less pain, and good cosmesis.
Duodenal Ulcer ; Gastrectomy* ; Gastric Outlet Obstruction ; Gastroenterostomy ; Hemorrhage ; Humans ; Mortality ; Peptic Ulcer ; Stomach Diseases* ; Vagotomy, Truncal

No abstract available.
Ulcer*

PURPOSE: Various prognostic indicators have been identified for mammary carcinomas, but the issue of their significance remains unsettled. The prognostic impact of c-erb B2, Ki-67 and topoisomerase II alpha expression was investigated in relation to prognostic factors for carcinomas of the breast and to the tumor cell growth fraction. METHODS: One hundred eighteen cases of invasive mammary carcinoma were investigated by immunohistochemical staining for c-erb B2, topoisomerase II alpha, and Ki-67. Clinicopathologic parameters were compared with the expression pattern and incidence of c-erb B2, topoisomerase II alpha and Ki- 67 in invasive mammary carcinoma. RESULTS: C-erb B2 showed significant correlation with topoisomerase II alpha (P<0.05), but others were not significant. Topoisomerase II alpha and Ki-67 index closely paralleled each other, indicating that both reflect the proliferate activity of tumor cells and were associated with high nuclear and histological grade, ER and PR expression (P<0.05). CONCLUSION: These results indicate that ki-67 and topoisomerase II alpha proteins might play a role in tumor progression of breast carcinoma. The Ki-67 and topoisomerase II alpha index may be proliferate factors of breast cancer. In addition, the increase expression of Ki-67 and topoisomerase II alpha and hormone receptor were closely correlated each other, and could be used as factors suggesting poor prognosis in breast carcinoma.
Breast ; Breast Neoplasms ; DNA Topoisomerases, Type II* ; Incidence ; Prognosis

PURPOSE: Galectin 3 is a beta-galactoside binding protein that is involved in various biological processes such as cell adhesion, migration, cell growth, tumor progression and metastasis. Although the precise acting mechanisms of Galectin 3 are unclear, it have been reported that the expression of Galectin 3 may related to tumor progression and metastasis. We investigated the immunohistochemical expression of Galectin 3 in 57 cases of benign and malignant breast neoplasm to evaluate the relation of a Galectin 3 expression to malignancy of breast neoplasm and the acting mechanism of Galectin 3. METHODS: Twenty fibroadenomas, 7 intraductal papillomas, 10 intraductal carcinomas and 20 invasive ductal carcinomas were studied. Immunostaining of Galectin 3 was evaluated in comparison with that of the internal controls, and the intensity of immunostaining was semiquantitatively graded on an intensity scale of 0 to 3. RESULTS: The normal ductal epithelium of the breast showed strong immunoreactivity with an intensity 2 to 3. The staining gradually and significantly decreased in accordance with the histopathological type and tumor progression from a fibroadenoma, intraductal papilloma, ductal carcinoma in situ and invasive ductal carcinoma (P<0.001). In particular, the expression of galection-3 was prominently decreased in invasive ductal carcinoma. CONCLUSION: The galectin-3 expression pattern suggests that progression from benign breast tumor to malignant breast tumor leads to a reduced expression of galectin-3.
Biological Processes ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carrier Proteins ; Cell Adhesion ; Cell Movement ; Epithelium ; Fibroadenoma ; Galectin 3* ; Galectins* ; Neoplasm Metastasis ; Papilloma ; Papilloma, Intraductal

While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.
Adult* ; Child ; Humans ; Intestine, Small* ; Intussusception* ; Lymphoma* ; Male ; Meckel Diverticulum ; Middle Aged ; Sarcoma

BACKGROUND: Cathepsin D is an acid optimal protease present in a variety of normal and neoplastic tissues. Cathepsin D is an aspartylendopeptidase which is thought to be important in intracellular processes, such as protein degradation, and cathepsin D may be implicated in intracellular protein turnover. Recent evidence shows that in rabbit alveolar marcrophages, cathepsin D is synthesized as an inactive, membrane associated precursor which is then processed, via an active membrane-associated intermediate form, to an active soluble form of cathepsin D found in lysosomes and endosomes. Antibodies to cathepsin D which are suitable for immunohistochemistry have been available for approximately 20 years although the first immunohistochemical study of cathepsin D as a prognostic factor in breast cancer appeared in 1990. METHOD: The sample in this study consisted of 121 breast cancer's that had been surgically resected. Using the mouse monoclonal antibody (NCL-CDm, Novocastra Laboratories Ltd, UK) specific for the cathepsin D, we performed immunohistochemical staining by ABC methods. We examined the correlations between the expression of cathepsin D and the patient's age, the estrogen receptor status, the tumor size, the lymph node involvement, the staging, the menopausal state, the pathologic grade, the DNA ploidy, and the S-phase fraction. RESULTS: Overall, 53.7% of the patients were positive for cathepsin D. Positive staining did not correlate with age, estrogen receptor status, tumor size, axillary node status, tumor stage, monopausal status, pathologic grade, DNA ploidy, or S-phase fraction. CONCLUSIONS: The expression of cathepsin D by tumor cells was not the only significant prognostic factor of the breast cancer. We need more follow-up studies, and we need exact calculations of the survival rate.
Animals ; Antibodies ; Breast Neoplasms* ; Breast* ; Cathepsin D ; DNA ; Endosomes ; Estrogens ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lysosomes ; Membranes ; Mice ; Ploidies ; Proteolysis ; Survival Rate

The mouse is one of the most popular experimental animal which has wide variation of strains, diet, environment, breeding technique, and diurnal cycle. Total 731 mice (male 372, female 359) were used for the standard data of our laboratory. Proper age for experiment were 30 +/- days, body weight were 25 +/- gm(male), 23 +/- gm. (female), minimal diurnal variation showed from 9 A.M. to 12 P.M.
Aging* ; Animals ; Body Weight* ; Breeding ; Diet ; Female ; Humans ; Mice*

BACKGROUND/AIMS: The authors compared laparoscopic changes of the diseased liver surface according to Shimadas classification with laparoscopic needle biopsy in order to clarify whether the two diagnostic criteria have consistency or discrepancy in each other. By serologicai tests the patients with chronic hepatitis B were 179 cases, chronic hepatitis C 22 cases and NBNC hepatitis 54 cases. Histologically the patients with non-specific reactive hepatitis were 35 cases, chronic lobular hepatitis 20 cases, chronic persistent hepatitis 18 cases, chronic active hepatitis 8~5 cases, subacute hepatic necrosis 32 cases, circumscribed hepatic necrosis 9 cases and liver cirrhosis 56 cases. METHODS: We performed laparoscopy on 255 patients with chronic hepatitis and laparoscopic guided liver needle biopsy was done in all cases. RESULTS: 1) Age incidence of chronic viral hepatitis was peak in chronic hepatitis C, and then that in chronic hepatitis B and NBNC heatitis in decreasing order. 2) Code numbers of liver surfaces were mainly numbers between 200 and 300 in chronic hepatitis B and NBNC hepatitis, but those of chronic hepatitis C were numbers between 300 and 400 which meant advanced patterns. 3) Comparing macroscopic fmdings of liver surfaces with histologic diagnosis by guided liver biopsy, the consistency of two criteria was 83.9% in all cases and the discrepancy was 16.1%. 4) Among the cases with diagnostic discrepancy, the patients showing macroscopically chronic hepatitis but histologically liver cirrhosis were predominant in chronic hepatitis B under the age of 40. In contrast to this, the cases showing surface changes of liver cirrhosis but histologically chronic hepatitis was mainly in chronic hepatitis C over the age of 40. CONCLUSIONS: The above results suggest that laparoscopy and guided liver biopsy may be very useful diagnostic tools to determine correct diagnosis, adequate treatment and prognosis.
Biopsy ; Biopsy, Needle ; Classification ; Diagnosis ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Incidence ; Laparoscopy ; Liver Cirrhosis ; Liver* ; Necrosis ; Prognosis

BACKGROUND: Even though several oral anti-diabetic drugs (OAD) with various modes of action are replacing sulfonylurea (SU), some patients seem to be dependent on SU for adequate glycemic control. Therefore, we evaluated the clinical characteristics of such patients. METHODS: We selected the patients with type 2 diabetes who met following criteria from 2009 to 2014 at Seoul National University Hospital: glycated hemoglobin (HbA1c) was maintained below 7.5% for at least 6 months under small dose of SU (glimepiride < or =2 mg/day or equivalent dose); after discontinuation of SU, HbA1c increased > or =1.2% within 3 months or > or =1.5% within 6 months; and after resuming SU, HbA1c reduction was > or =0.8% or reduction of fasting plasma glucose was > or =40 mg/dL within 3 months. Patients with impaired hepatic or renal function, and steroid users were excluded. RESULTS: Nineteen subjects were enrolled: after averaged 4.8+/-1.5 months of SU-free period, HbA1c increased from 6.7%+/-0.4% to 8.8%+/-0.8% even though adding other OAD such as gliptins. However, HbA1c decreased to 7.4%+/-0.7% after resuming SU within 2.4+/-0.8 months. There was no sexual predominance. Despite their old age (67+/-11 years) and long duration of diabetes (18+/-10 years), fasting C-peptide was relatively well-reserved (3.9+/-2.6 ng/mL), and nephropathy was not observed (albumin-creatinine ratio 21.2+/-16.6 mg/g and estimated glomerular filtration rate 75.8+/-18.0 mL/min/1.73 m2). Strong family history was also noted (73.7%). CONCLUSION: Despite hypoglycemia risk of SU, it seemed indispensable for a subset of patients with regard to insulin secretion. Genetic influences would be evaluated.
Blood Glucose ; C-Peptide ; Diabetes Mellitus ; Dipeptidyl-Peptidase IV Inhibitors ; Fasting ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Seoul