No abstract available.

No abstract available.
Hand*

PURPOSE: To investigate the effect of combined inhibition of protein kinase B (AKT) and SRC on the growth and metastatic potential of human pancreatic cancer cells. MATERIALS AND METHODS: AKT and SRC were inhibited using 10-DEBC and PP2, respectively. The expression of their messenger RNAs were down-regulated by specific small interfering RNA (siRNA). Changes in pancreatic cancer cell growth and metastatic potential were determined using a cell viability assay and a xenotransplant model of pancreatic cancer, as well as cell migration and invasion assays. Signal proteins were analyzed by Western blot. RESULTS: The inhibitors 10-DEBC and PP2 suppressed cell proliferation in a dose-dependent fashion in pancreatic cancer cell lines MIA PaCa-2 and PANC-1. The simultaneous inhibition of AKT and SRC at low concentrations resulted in a significant suppression of cell proliferation. Knockdown of AKT2 and SRC using siRNAs also significantly decreased cell proliferation. In a pancreatic cancer model, combined treatment with 10-DEBC and PP2 also significantly suppressed the growth of pancreatic cancer. Application of 10-DEBC with PP2 significantly reduced the metastatic potential of pancreatic cancer cells by inhibiting migration and invasion. The combined inhibition suppressed the phosphorylation of mTOR and ERK in pancreatic cancer cells. CONCLUSION: Combined targeting of AKT and SRC resulted in a synergistic efficacy against human pancreatic cancer growth and metastasis.
Blotting, Western ; Cell Line ; Cell Movement ; Cell Proliferation ; Cell Survival ; Humans* ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; RNA, Messenger ; RNA, Small Interfering

PURPOSE: Pancretojejunostomy leakage is the most dreaded complication after a pancratoduodenectomy. However, little is known about what causes the leakage and how to prevent it. The aim of this study was to dentify the risk factors for pancreatic leakage. This paper describes our experience of its management. METHODS: Between Aug. 1996 and Aug. 2003, 75 consecutive patients with periampullary cancer or benign disease received a pancreatoduodenectomy. The patients' clinical characterisitcs, pathological features and surgical findings were retrospectively evaluated. The patients were classified into those with major complication and rhose with no complications and the risk factors were analyzed. Pancreatic leakage, intraabdomnial fluid collection and abscess, intraabdomnial bleeding were categorized as major complications related to a pancreatic fistula. RESULTS: The postoperative mortality and morbidity rate was 2.6% and 36%, respectively. Univariate analysis showed that the pancreatic texture, pathologic diagnoses and comorbidity were significant risk factors for major complications (P= 0.003, 0.045, 0.02). Multivariate analyses revealed that the, pancreatic texture was the only significant risk factor (P=0.003). The preoperative serum albumin level and pancreatic texture were significant risk factors for pancreatic leakage (p=0.03, 0.025) and multivariate analysis showed that the pancreatic texture was also the most significant risk factor. CONCLUSION: Considering that the pancreatic texture is the most significant risk factor for a pancreatic fistula, the technical skill and experience of the surgeon appears to be important for its prevention.
Abscess ; Comorbidity ; Diagnosis ; Hemorrhage ; Humans ; Mortality ; Multivariate Analysis ; Pancreatic Fistula* ; Pancreaticoduodenectomy ; Retrospective Studies ; Risk Factors* ; Serum Albumin

Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was performed to evaluate the effect of telescoping anastomotic technique upon the healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. METHOD: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n=15). RESULT: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< 5days) and remarkable band-like fibrous union compared to the simple interrupted group.
Anastomosis, Surgical ; Animals ; Bronchi ; Fibrosis ; Humans ; Ischemia ; Lung Transplantation ; Mortality ; Tissue Donors ; Trachea

The purpose of this study is to evaluate the tissue response in applying of various bone substitutes included toothash-plaster mixture, resorbable hydroxylapatite (HA) and demineralized freeze-dried bone and to show the clinical usefulness of toothash-plaster mixture for the repair of craniomaxillofacial bone defect. For this experiment, 100 Sprague-Dawley rats weighing 200gm or more were used. There were four experimental groups: group I, toothash-plaster mixture; group II, demineralized freeze-dried bone; group III, resorbable HA; and group IV, control group. A full thickness, round bone defect measuring 10mm in diameter was created in the midcranium, and the substitutes cited above were embedded in the experimental rats based on their group assignment. Blood clot was filled in the rats assigned to the control group. Experimental rats were sacrificed on the 1st, 3rd, 5th, 8th, 12th and 24th week after implantation and stained with the hematoxylin-eosin, Masson's Trichrome, using Van Gieson's stain method, and were examined under light microscope. The results were as follows: 1. In all the groups, prominent inflammatory reaction and the infiltration of multinucleated giant cells were noted during the early stage. Gradual healing decreased this reaction. 2. Among the rats in the experimental group II, which were given demineralized freeze-dried bone implants, active formation of new bone traveculae manifested. Chondroid tissues appeared, and it was suggested that the defect was filled with newly formed bone by virtue of osteoinductive activity. On the 12th week after the experiments, most of the defect was filled with newly formed bone trabeculae. 3. In experimental groups I and III, it was noted that HA manifested a healing process similar to that characterized by the toothash-plaster mixture, but inflammatory reaction was more prominent in experimental group I. Active osteoblasts were observed along the periphery of osteoid tissues, while newly formed bone trabeculae appeared adjacent to the implanted materials three weeks later. Formation increased to the extent that newly formed bone trabeculae fused directly with the host bone. Increase in new bone ingrowth into the filling materials was revealed by both experimental groups. 4. In the control group, new bone formation adjacent to the host bone was observed, but most of the defect was filled with mature connective tissue 24 weeks after the experiments.
Animals ; Bone Substitutes* ; Connective Tissue ; Durapatite ; Giant Cells ; Osteoblasts ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Virtues

PURPOSE: When pneumothorax occurs during a percutaneous needle biopsy, the radiologist usually stops the biopsy. We evaluated the usefulness of computed tomographic (CT) fluoroscopy-guided percutaneous needle biopsy in the presence of pneumothorax during biopsy. MATERIALS AND METHODS: We performed 288 CT fluoroscopy guided percutaneous needle biopsies to diagnose the pulmonary nodules. Twenty two of these patients had pneumothorax that occurred during the biopsy without obtaining an adequate specimen. After pneumothoax occurred, we performed immediate CT fluoroscopy guided percutaneous needle biopsies using an 18-gauge cutting needle. We evaluated the success rate of the biopsies and also whether or not the pneumothorax progressed. We classified these patients into two groups according to whether the pneumothorax progressed (Group 2) or not (Group 1) by measuring the longest distance between the parietal pleura and the visceral pleura both in the early and late pneumothorax. Additionally, we analyzed the relationship between the progression of pneumothorax after biopsy and 1) the depth of the pulmonary nodule; 2) the number of biopsies; 3) the presence or absence of emphysema at the biopsy site; and 4) the size of the pulmonary nodule. RESULTS: Biopsy was successful in 19 of 22 nodules (86.3%). Of the 19 nodules, 12 (63.2%) were malignant and 7 (36.8%) were benign. Twelve patients (54.5%) were classified as group 1 and 10 patients (45.4%) as group 2. The distance between the lung lesion and pleura showed a statistically significant difference between these two groups: < or = 1 cm in distance for group 1 (81.8%) and group 2 (18.2%), and > 1 cm in distance for group 1 (30%) and group 2 (70%), p < 0.03. Yet the number of biopsies, the presence or absence of emphysema at the biopsy site and the size of the pulmonary nodules were not related to the progression of pneumothorax (p > 0.05). CONCLUSION: When early pneumothorax occurs during a biopsy, CT fluoroscopy guided percutaneous needle biopsy is an effective and safe procedure. Aggravation of pneumothorax after biopsy is affected by the depth of the pulmonary nodule.
Biopsy* ; Biopsy, Needle* ; Emphysema ; Fluoroscopy ; Humans ; Lung ; Needles* ; Pleura ; Pneumothorax*

No abstract available.
Arteriovenous Fistula* ; Renal Dialysis*

PURPOSE: To evaluate the correlation between the conventional method and the clinical history method those determine intraocular lens (IOL) power for cataract surgery in eyes with prior laser in situ keratomileusis (LASIK) in the absence of pre-LASIK data. METHODS: The medical records of 200 eyes in 100 patients who had been treated with LASIK for myopia and were followed up for more than 6 months were reviewed. The IOL powers by conventional method using post-LASIK keratometric value and by clinical history method were compared. RESULTS: The mean values of IOL powers by conventional method, and by clinical history method were +20.00+/-1.48D (+13.74~+23.23D) and +20.79+/-1.28D (+17.27~+24.32D), respectively. The following equation describes the regular relationship between the two METHODS: IOL(CHM) (clinical history method)=0.708*IOL(CM) (conventional method) +6.624 (r=0.816, p<.01). CONCLUSIONS: This equation may offer more accurate IOL power for cataract surgery in eyes with prior LASIK surgery in the absence of pre-LASIK data.
Cataract* ; Humans ; Keratomileusis, Laser In Situ* ; Lenses, Intraocular* ; Medical Records ; Myopia

BACKGROUND: The lower levels of cardiotoxicity and motor block make ropivacaine well suited as an epidural infusion for postoperative analgesia. This study examined the analgesic efficacy of an epidural infusion of ropivacaine alone and in combination with alfentanil after major abdominal surgery. METHODS: Thirty patients undergoing major abdominal surgery under general anesthesia were divided into two groups receiving patient-controlled thoracic epidural analgesia with 0.2% ropivacaine (Group I) and 0.15% ropivacaine +150 microgram/ml alfentanil (Group II). The motor block, side effects, VAS (visual analog pain scale) score on coughing and resting, additional analgesics use, and patient's satisfaction were checked for 24 hours after a loading dose injection. RESULTS: The VAS score in group II was significantly lower than in group I, and the patients in group II were more satisfied than those in group I (P < 0.05). However, there were more side effects in group II. CONCLUSIONS: Postoperative epidural infusion of 0.15% ropivacaine with 150 microgram/ml alfentanil is more effective than 0.2% ropivacaine only.
Alfentanil* ; Analgesia* ; Analgesia, Epidural ; Analgesics ; Anesthesia, General ; Cough ; Humans