No abstract available.
Colorectal Neoplasms*

Infantile hypertrophic pyloric stenosis (IHPS) a common childhood disorders characterized by nonbilious projectile vomiting, an olive shaped mass in the right upper quadrant of the abdomen and visible gastric peristaltic wave in the upper abdomen. Its etiology and pathogenesis are not clear but abnormal nerve distribution of the pylorus has been postulated2-6. We performed immunocytochemical staning to the pyloric muscle from 10 IHPS and 3 controls patients, utilizing specific monoclonal antibody to NCAM(neural cell adhesion molecule). In IHPS patients, the number of NCAM protein immunoreactive nerve fibers were less than that in normal subjects. Auerbach myenteric plexuse was well developed and interbundle nerve plexuse was present but nerve fibers supplying individual muscle cells in smooth muscle bundles were poorly developed. These results indicate reduction of innervation in smooth muscles in IHPS patients that possibly contributes to the pathogenesis of IHPS.
Abdomen ; Cell Adhesion ; Humans ; Muscle Cells ; Muscle, Smooth ; Myenteric Plexus ; Nerve Fibers ; Neural Cell Adhesion Molecules ; Olea ; Pyloric Stenosis, Hypertrophic* ; Pylorus* ; Vomiting

Microcystic adenoma, also known a glycogen rich or serous cystadenoma is very rare and usually presents grossly a large multiloculated mass, and the individual cystic cavities being small and filled with a clear(serous) fluid. The cut surface is spongy in appearance. Microscopically, cysts are composed of multiple small cysts lined by small, flat or cuboidal cells containing abundant glycogen but only an insignificant amount of mucin. The microcystic cystadenoma is benign, but mucinous cystadenoma is potentially malignant,so the two cysts should be differentiated, and should never be treated by-pass sugery in the case of mucinous cystadenoma. A 43-year-old female was admitted to this hospital with the palpable epigastric mass, postprandial nausea and weight loss for the preceeding 2 years, and increase in size in the past recent 8 months. Upper G.I series and ultrasonographic studies revealed a huge mass in the pancreatic head portion. Exploratory laparotomy was performed, which disclosed a round adult fist sized multicystic mass in the pancreatic head. Pancreaticoduodenectomy was performed. In gross specimen examination, the mass was 9x7.5x7 cm in size, the outer surface was smooth and grayish white, the cut surface was sponge- like with multiple small cysts. The content of cysts was serous fluid. Microscopically, the cystic mass was composed of small cysts, in which the lining of the cell shows flat and mild secretory activity. There was no malignant evidence. The patient was discharged uneventfully on the 22nd postoperative days.
Adenoma* ; Adult ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Female ; Glycogen ; Head ; Humans ; Laparotomy ; Mucins ; Nausea ; Pancreas* ; Pancreaticoduodenectomy ; Weight Loss

PURPOSE: The purpose of this study is to measure the diameter of saphenofemoral junction (SFJ) by using duplex scan and to assess the different anatomic characteristics of SFJ according to the clinical manifestation. METHODS: 100 Limbs of 77 patients with varicose veins due to greater saphenous vein (GSV) were assessed prospectively about sex, symptom, disease duration, morphology of varicose vein. The diameter of GSV (GSVD), SFJ, femoral vein (FVD) and the ratio of each value-GSV/FV (GFDR) and SFJ/FV (JFDR)-were measured by color-flow duplex scanning. Findings were compared with clinically normal 20 control limbs. RESULTS: The mean value of GSVD, FVD, SFJ, GFDR, JFDR in patients group were different from that of control group with statistical significance except FVD. There were statistically significant differences in the mean value of GSVD, FVD, GFDR, JFDR between men and women. The mean value of GSVD, FVD, SFJ, GFDR, JFDR between symptomatic and asymptomatic group were not different statistically. The result of comparison according to the disease duration showed statistically significant difference, which the more duration of disease were longer, the more the mean value of SFJ were increased. In comparison of the findings according to the morphologic classification, there were no statistically significant differences in the mean value of GSVD, FVD, SFJ, GFDR, JFDR. CONCLUSION: Dilatation of SFJ may be related to the cause of varicose veins from the result that the mean value of SFJ was more increased in patients group than control group.
Classification ; Dilatation ; Extremities ; Female ; Femoral Vein ; Humans ; Male ; Prospective Studies ; Saphenous Vein ; Varicose Veins*

Laparoscopic cholecystectomy is now the treatment of choice for the surgical treatment of uncomplicated cholelithiasis. Application of this rule in acute cholecystitis is still controversal, in spite of the eagerness of the experts in the field of laparoscopic surgery.The role of a laparoscopic cholecystectomy in patients with acute cholecystitis was evaluated by comparing clinical data from a laparoscopic cholecystectomy group with those from an open cholecystectomy group.Clinical data for 24 patients with acute cholecystitis who underwent a laparoscopic cholecystectomy in the mid 1990, were compared with data for 31 patients with acute cholecystitis who went through an open cholecystectomy in the early 1990s. Preoperative clinical data showed no statistical difference between the laparoscopic cholecystectomy group and the open cholecystectomy group. The operating time, the postoperative hospitalization, the duration of drainage, and the returning time of intestinal motility were shorter in laparoscopic cholecystectomy group, and the incidence of wound infection was lower. However, the incidence of bile duct or bowel injury was larger in the laparoscopic cholecystectomy group. Laparoscopic cholecystectomy can be performed safely in most patients with acute cholecystitis, in spite of the difficulties in observation, traction and dissection, which can be overcome with complete understanding, confirmation of the biliary anatomy, and sufficient experience.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute* ; Cholelithiasis ; Drainage ; Gastrointestinal Motility ; Hospitalization ; Humans ; Incidence ; Traction ; Wound Infection

PURPOSE: The severe combined immunodeficient (SCID) mice which lack the functional T and B lymphocytes have been widely used for the research of various human diseases including AIDS, transplantation, autoimmune disease and cancer. The purpose of this study was to evaluate the huPBMC-SCID mouse as an animal model for human breast cancer research. METHODS: 5x10(7) human PBMC (peripheral blood mononuclear cell) were injected intraperitoneally in 18 SCID mice. After 24 hours, 2.5x10(6), 5x10(6) and 10x10(6) MCF-7 human breast cancer cells were innoculated subcutaneously in the right flank of each of the 3 groups of 6 huPBMC-SCID mice. RESULTS: 4 subcutaneous ecchymosis (2 perioral area, 2 scalp), 1 splenomegaly and 1 hepatic embolism were found during the 20 weeks after the injections. The growth of tumor xenograft was identified in 14 of the total 18 huPBMC-SCID mice, and the growth rate of the tumor was proportional to the number of the innoculated cancer cells. Distant metastases were found in the retroperitoneum, kidney, pelvic cavity, omentum, perisplenic area and regional lymph node in 50 % of mice, but not in the lung and liver at 20 weeks. CONCLUSION: In summary, the huPBMC-SCID mouse was expected to play an important roles as an animal model of human cancers including breast cancer.
Animals ; Autoimmune Diseases ; B-Lymphocytes ; Breast Neoplasms* ; Breast* ; Ecchymosis ; Embolism ; Heterografts ; Humans ; Kidney ; Liver ; Lung ; Lymph Nodes ; Mice* ; Mice, SCID ; Models, Animal ; Neoplasm Metastasis* ; Omentum ; Splenomegaly ; Transplants*

Proton magnetic rcsonance spectroscopy (1H MRS) has demontrated its abilities to detect an increase of choline containing compounds (Cho) in various brain tumors and prostatic cancer tissues. Based on preclinical works done by other authors using multinuclei MRS, it is reasonable to assume malignant breast tumors will have elevated level of Cho compared to that of normal tissues and benign breast lesions. Several challenges must be met to obtain clinically useful 1H breast spectrum. Good water and fat suppression, Bo homogeneity are required to detect low level metabolic signals like choline if any. In this study, we investigated the clinical utility of 1H MRS with simultaneous suppression of water and fat signals, using breast imaging surface coil for evaluating breast cancer with small lesions. All studies were performed using a GE signa MRI unit (1.5 T, Ver 5.5) and 2-channel breast coil (GE). Water suppression was achieved by chemical selective saturation, and fat signal was attenuated using inversion recovery sequence. Spectroscopic data were acquired with PRESS sequence. Twenty-three patients, age 14-75, were examined. Eleven of these patients presented with invasive ductal carcinoma. The remaining patients presented with benign processes including fibroadenoma, fibrocystic change, galactocele, adenosis, ductal ectasia and dystrophic calcification. The size of lesions were variable (8-90 mm in diameter). Choline at 3.25 ppm was visible in the spectra of all cancer patients, while invisible in the spectra of all benign lesions except a lesion of dystrophic calcification. We concluded that in vivo detection of choline containing compounds in breast carcinomas using proton magnetic resonance spectroscopy demonstrated its potential as a noninvasive tool for differential diagnosis of malignant and benign breast lesions larger than 7 mm in diameter.
Brain Neoplasms ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Choline ; Diagnosis, Differential* ; Dilatation, Pathologic ; Fibroadenoma ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Prostatic Neoplasms ; Protons* ; Spectrum Analysis ; Water

BACKGROUND: Almost all cholecystectomies these days are performed using laparoscopic equipment. Recently, this has been applied in all possible pathologies of the gallbladder by many surgeons. However, we occasionally have had bitter experiences, difficult operations and long operative times, when doing laparoscopic cholecystectomies. The aim of this study was to detect the factors causing long operative times, conversions to open surgery, and higher postoperative complication rates, when difficult laparoscopic cholecystectomies are encountered. METHODS: From among the 250 patients who had undergone laparoscopic cholecystectomies during the recent 5 years (from November 1992 to January 1998), the clinical data of the 58 patients who had undergone laparoscopic cholecystectomies with operative times over 120 minutes (a long operative time) were compared with those of 45 patients with operative times of 60 minutes or less (short operative time). RESULTS: Clinical data for the patients with long operative times showed a higher incidence of steady pain (29.3 versus 0%), fever (36.2 versus 4.4%), previous history of upper abdominal surgery (6.9 versus 4.4%), tenderness (48.3 versus 4.4%), rebound tenderness (20.0 versus 0%), palpable tender mass (12.1 versus 0%), thick abdominal wall (13.8 versus 4.4%), leukocytosis (36.2 versus 8.9%), elevated bilirubin level (10.3 versus 0%), wall thickening of the gallbladder (34.5 versus 6.7%), fibrous adhesion after gastric surgery (5.1 versus 0%), inflammatory adhesion (39.7 versus 2.2%), and contracted gallbladder (1.2 versus 0%), as well as a higher required level of surgical experience (5.2 versus 2.2%). The surgical complication rate was 13.8% in the long-operation group and 0% in the short-operation group. Laparoscopic cholecystectomy was completed successfully in 250 of the 258 patients and the overall conversion rate to open surgery was 3.1%; that of the long-operation group was 7.9%. CONCLUSIONS: A laparoscopic cholecystectomy with a long operative time is inevitable in patients with acute severe inflammation of the gallbladder, previous history of gastric surgery, and a contracted gall-bladder. Also, the surgeon needs a learning period to be able to overcome the long operation. In spite of the higher rates complications and conversions to open surgery in the long-operation group, a difficult laparoscopic cholecystectomy with a long operative time is a clinically acceptable procedure in patients who need a cholecystectomy.
Abdominal Wall ; Bilirubin ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Fever ; Gallbladder ; Humans ; Incidence ; Inflammation ; Learning ; Leukocytosis ; Operative Time* ; Pathology ; Postoperative Complications

BACKGROUND : There are plenty of documented observations of gastric cancer patients having suppressed cellular immunity, and this immunity may be correlated to recurrence. We studied the changes in the peripheral T-lymphocyte subpopulations in gastric cancer patients and their predictive roles for recurrence. METHODS : Lymphocyte subpopulations in peripheral blood from thirty-eight gastric cancer patients who were operated on at Taegu Catholic Medical Center from September 1995 to February 1997 were measured by 3-color direct immunofluorescence analysis with a Coulter S-plus IV automatic counter. RESULTS : CD4 significantly increased with tumor size and depth of invasion although other immune parameters, such as CD8, CD19, the CD4/CD8 ratio, and total lymphocyte count did not changed. In the patients with lymph-node metastasis, increases in CD3 and CD4 and a decrease in CD19 were observed. CD19 and the B lymphocyte count also decreased in advanced gastric cancer patients. However, T-lymphocytes subpopulations did not significantly change with stage. There were significant decreases in CD8 and in the T- & B-lymphocyte counts, without changes in CD4 and the CD4/CD8 ratio in the postoperative immune parameters.The preoperative values of the T- & B-lymphocyte counts and CD8 and CD19 were lower in patients who had recurrences during six months to two years of follow up, compared to recurrence-free patients. CONCLUSIONS : On the basis of these results, we found changes of T-lymphocyte subpopulations with size, depth of invasion, and regional lymph node metastasis, but not with stage. Postoperatively, there were significant decreases in the T- & B-lymphocyte counts. Suppressed immunity correlated with recurrence, and preoperative evaluation of peripheral T-cell subpopulations may be helpful for predict recurrence and for postoperative prognosis.
B-Lymphocytes ; Daegu ; Fluorescent Antibody Technique, Direct ; Follow-Up Studies ; Humans ; Immunity, Cellular ; Lymph Nodes ; Lymphocyte Count ; Lymphocyte Subsets* ; Lymphocytes* ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach Neoplasms* ; T-Lymphocytes

BACKGROUND : Fibronectins (FNs) are adhesive glycoproteins that have variable primary structures owing to cell type-specific splicing of the FN precursor mRNA. FNs can be classified as plasma (p-FN) and cellular (c-FN) types, and c-FN may play a role as a marker of malignancies. CEA and CA 125 have been reported as useful tumor markers, but FNs have not studied adequately in gastric cancers. METHODS : We evaluated the clinical significance of urinary and plasma c-FN in thirty-five patients who were operated on our department due to gastric cancer from January 1997 to August 1997. The c-FN level was determined by enzyme immunoassay using a FIBRONECTIN EIA kit (Takara Shuzo Co., Kyoto, Japan). RESULTS : The levels of urine c-FN in gastric cancer patients (215.6 470.2) were higher than those in the control groups (94.1 63.0 ng/mgCr) and also showed a tendency to increase with advancing of tumor growth. A higher rate of increased urine c-FN also was identified in patients with distant metastasis than in patients without distant metastasis (6/8 vs. 10/27, p=0.05). However, p-FN didn't showed any differences according to extent of tumor invasion and/or presence of distant metastasis. Other parameters, such as age, sex, preoperative tumor size, and depth of invasion, were not correlated with urine and plasma c-FN. CONCLUSIONS : Urine c-FN may be useful as a new tumor marker in gastric cancer and can be helpful in early detection of metastasis and peritoneal seeding, but further studies and follow up are needed for complete clinical application.
Adhesives ; Biomarkers, Tumor ; Fibronectins* ; Glycoproteins ; Humans ; Immunoenzyme Techniques ; Neoplasm Metastasis ; Plasma ; RNA, Messenger ; Stomach Neoplasms*