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

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

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

The main complications associated endoscopic mucosal resection are bleeding and perforation and the rate of complication is increasing in larger size of mucosal resection. We used a new method of endoscopic clipping technique for ligation on the large mucosal defect after endoscopic mucosal resection. A 53-year-old female patient visited our hospital because of epigastric pain. Endoscopic examination revealed a type IIa EGC(early gastric cancer) below angle. The endoscopic mucosal resection was performed and the size of resected specimen was 2.7x2.5cm. The mucosal defect was ligated with 6 hemoclips(Olympus, MD-850) after approximation of both resected margins by grasping forceps(Olympus, FG-4L). Follow up endoscopic examination revealed good quality of ulcer healing. The Endoscopic clipping technique might also be useful for treatment of minor perforation.
Female ; Follow-Up Studies ; Hand Strength ; Hemorrhage ; Humans ; Ligation* ; Middle Aged ; Stomach Neoplasms ; Ulcer

The main complications associated endoscopic mucosal resection are bleeding and perforation and the rate of complication is increasing in larger size of mucosal resection. We used a new method of endoscopic clipping technique for ligation on the large mucosal defect after endoscopic mucosal resection. A 53-year-old female patient visited our hospital because of epigastric pain. Endoscopic examination revealed a type IIa EGC(early gastric cancer) below angle. The endoscopic mucosal resection was performed and the size of resected specimen was 2.7x2.5cm. The mucosal defect was ligated with 6 hemoclips(Olympus, MD-850) after approximation of both resected margins by grasping forceps(Olympus, FG-4L). Follow up endoscopic examination revealed good quality of ulcer healing. The Endoscopic clipping technique might also be useful for treatment of minor perforation.
Female ; Follow-Up Studies ; Hand Strength ; Hemorrhage ; Humans ; Ligation* ; Middle Aged ; Stomach Neoplasms ; Ulcer

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

BACKGROUND: p27 is a member of the cyclin-dependent kinase (CDK) inhibitors that arrest the progression of the cell cycle; thus, it acts as a tumor suppressor gene. The loss or decrease of p27 protein is frequently seen and this has an independent prognostic potential for many human cancers. p27 is functionally inactivated through accelerated proteolysis and cytoplasmic sequestration. Cytoplasmic mislocalization of p27 by abnormal phosphorylation in the tumor cells doesn't allow it to bind and inhibit nuclear cyclin/CDK targets. METHODS: We examined the p27 protein expression in 86 cases of invasive ductal carcinoma of the breast via immunohistochemical staining to evaluate the subcellular localization of p27 and its relationship with the clinicopathologic features and the prognostic factors. RESULTS: The nuclear expression of p27 was noted in 48.9% of the tumors, a combined nuclear and cytoplasmic expression was noted in 20.9%, a cytoplasmic expression was noted in 12.8%, and a negative expression was noted in 17.4%. The decreased nuclear expression and/or cytoplasmic mislocalization of p27 were statistically correlated with the nuclear grade (p=0.001), histologic grade (p=0.036), tumor size (p=0.033), lymph node metastasis (p=0.043), ER (p=0.001), and PR (p=0.001) status, while they were not correlated with patient age, stage, HER2, p53, and Ki67. CONCLUSIONS: The breast tumors showing both decreased nuclear expression and cytoplasmic mislocalization of p27 are associated with a deranged cell cycle via functional inactivation and also with poor prognostic factors. It is expected that p27 can be a promising anticancer target molecule for the treatment of breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p27 ; Cytoplasm ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Phosphorylation ; Phosphotransferases ; Prognosis ; Proteolysis

Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures.
Adult ; Alkaline Phosphatase ; Bacteria ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Dizziness ; Europe ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Inflammation ; Korea ; Liver ; Prevalence ; Ulcer*