PURPOSE: p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas. MATERIALS AND METHODS: Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases. RESULTS: Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.
Carcinogenesis ; Exons ; Genes, p53 ; Humans ; Immunohistochemistry ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis, DNA ; Silver Staining

No abstract available.
Humans

Sixty one cases of gastric adenocarcinoma were studied immunohistochemically for expression of HLA-DR and secretory component(SC) in order to analyze the relationship between expression of these in gastric cancer cells and the adjacent mucosa. Immunostaining was detected within the cytoplasm and on the cell memgrane. The rate of HLA-DR and SC expressions in cancer cells were 59.0% and 49.2%, respectively, and 52.5%/52.5% and 31.2%/50.8% the mucosa in adjacent/remote from the site of to cancer. The SC expression in the adjacent mucosa was lower than that of the remote mucosa(p=0.027). The HLA-DR expression in the cancer cells in the intestinal type of gastric adenocarcinoma(73.9%) was higher than that of the diffuse type(14.3%) and it was statistically significant(p=0.02). The presence of an increased amount of lymphoid infiltration in the gastric mucosa was closely related to the expression of HLA-DR and SC. Decreased or absent expression of SC at the transitional mucosal cells was possibly a result of exposure to genotoxic agents due to the lack of protective function of SC-IgA. From these results, one can postulate that the expression of HLA-DR and SC may play an important role in atleration in microenvironment with lymphoid infiltration.
Adenocarcinoma ; Stomach Neoplasms

No abstract available.
Interleukin-2*

For the management of adult dysplastic hips with early degenerative arthritis, we can prevent further progress of secondary degenerative changes of the hip by a Rotational Acetabular Osteotomy, which effectively corrects the preoperatively inadequate acetabular coverage of the femoral head. Biomechanical advantages of this procedure are, l. An adequate coverage of tl; femoral head then enlarges the actual weight-bearing surface area, and so diminishes the resultant force per unit area of the acetabular weight-bearing surface and femoral head. 2. The resultant forces are also diminished by a medial shift of the femoral head. 3. The shearing force is decreased by the reduction of roof obliquity. 4. Because of the rotation of the original articular surface, remodeling the post-operative acetabular articular surface as Chiari operation is not necessary, and so can be performed even on elderly patients.
Acetabulum ; Adult ; Aged ; Head ; Hip ; Humans ; Osteoarthritis ; Osteotomy ; Weight-Bearing

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas. There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.
Antibodies, Monoclonal ; Apoptosis ; B-Lymphocytes ; Cell Survival ; Cytoplasm ; Genes, bcl-2 ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Proto-Oncogenes

This study is verifying the hypothesis that distraction followed by recompression may promote fracture healing of the osteoporotic bone on the assumption that distraction induces increased callus formation at the distracted gap and recompression results in fusiform callus, having biomechanically stronger fracture stiffness. Sixty-six Sprague-Dawley rats, in which osteoporosis were induced 6-8 weeks after oophorectomy, were separated into two groups. Group I was control group that had fracture healing by simple external fixation. Group II was experimental group that had fracture healing by monofocal distraction-compression. Radiomorphometric study revealed that there was significantly increased amount of callus and ensuing bone formation, which becehe obvious from 20 days after osteotomy in group II compared with group I. Biomechanical study also showed that tensile break strength was significantly higher in group II compared with group I with time. It is concluded that monofocal distraction-compression method may be one of the useful method to promote fracture healing of the estrogen deficient osteoporotic bone.
Animals ; Bony Callus ; Estrogens ; Female ; Fracture Healing* ; Osteogenesis ; Osteoporosis* ; Osteotomy ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Truncus Arteriosus*

PURPOSE: Laparoscopy-assisted distal gastrectomy (LADG) has become a viable alternative treatment for patients suffering with early gastric cancer. Surgeons have long thought that obesity might increase the rate of intraoperative or postoperative complications. This study was performed to evaluate the impact of obesity, according to the learning curve, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. METHODS: We retrospectively reviewed 100 patients who had undergone LADG for gastric cancer between September 2004 and May 2007 at Keimyung University Dongsan Medical Center. We measured the degree of obesity by using the body mass index (BMI: kg/m(2)), and we compared the surgical outcomes between the low BMI group (BMI < 25 kg/m(2), n=72) and the high BMI group (BMI >25 kg/m(2), n=28). We further subdivided the patients into the surgeons' number of cumulative LADG cases, the early learning curve group (from the first patient to the 50th patient) and the late learning curve group (from the 51th patient to the 100th patient). We analyzed them in terms of the operation time, the amount of intraoperative bleeding, the number of retrieved lymph nodes, the rate of operative morbidity and the length of the postoperative hospital stay. RESULTS: There no significant differences between the high and low BMI groups in terms of the patients' clinicopathologic characteristics and surgical outcomes, but there was a statistically significant difference in the operation times between the high BMI (303.3 min) and low BMI groups (269.3 min, P=0.029). The postoperative morbidity was not different between the high BMI (25%) and low BMI groups (12.5%, P=0.12). However, when we subdivided the patients by the learning curve, there was a statistically significant difference for the operation time (360 vs 297 minutes, respectively), postoperative morbidity (41.7 vs 10.5%, respectively) and the postoperative hospital stay (15.5 vs 8.6 day, respectively) between the high BMI and low BMI groups at the early learning curve period. Especially for male patients, the early learning curve period showed significant differences in the operation time, the postoperative morbidity and the postoperative hospital stay between the high BMI and low BMI groups, but in case of the female patients, there was no difference in postoperative morbidity and the length of the postoperative hospital stay. At the late learning curve period, there was no difference according to gender and obesity. CONCLUSION: Obesity itself does not increase operative morbidity when performing LADG in patients with gastric cancer. However, at a surgeon's initial period of performing LADG, a careful approach seems to be required for male obese patients.
Body Mass Index ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Lymph Nodes ; Male ; Obesity ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; Stress, Psychological