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BACKGROUND: Despite recent advances in multimodality therapy, the prognosis for invasive esophageal cancer is poor, with five years survival rate generally below 10%. Therefore, immunotherapy is considered as one of the new therapeutic modality in esophageal cancer. However, expression of tumor specific antigen in tumor tissue should be necessary for immunotherapy of tumor. This study is to clarify that mutant p53 protein and MAGE-3 gene product is expressed in esophageal cancer specifically and they can be played a role of prognostic factors in esophageal cancer. MATERIAL AND METHOD: Expression of mutant p53 protein and MAGE-3 gene products in formalin fixed, paraffin embedded samples of 79 patients with primary squamous cell carcinoma of the esophagus, who undewent esophageal resection, were analyzed immunohistochemically with DO-7 monoclonal antibody and anti- MAGE-3 antibody. Twenty cases of esophageal normal mucosa and 20 cases of leiomyoma which is a benign tumor of esophagus, were used as control groups. Immunoreactivities of mutant p53 and MAGE-3 gene product in esophageal cancer tissues were analyzed and the relationships between immunoreactivity of mutant p53 protein, MAGE-3 gene product and AJCC stage of esophageal cancer were determined by the Chi-square test. RESULT: Positive immunoreactivity of mutant p53 and MAGE-3 gene product were each of 41/79(51.9%), 48/79(60.8%) in esophageal cancer tissue, but 0% in normal mucosa and leiomyoma of esophagus(p<0.001). Both immunoreactivity of mutant p53 and MAGE-3 gene products were not related to AJCC stage of esophageal cancer(p=0.193, p=0.452). There was not correlation between expression of mutant p53 protein and MAGE-3 gene product in esophageal cancer(p=0.697). CONCLUSION: Mutant p53 and MAGE-gene product cannot be a prognostic factor in squamous cell carcinoma of esophagus, but mutant p53 and MAGE-3 gene product is expressed in squamous cell carcinoma of the esophagus specifically, so esophageal cancer can be target for cytotoxic T lymphocyte in anticancer immunotherapy.
Carcinoma, Squamous Cell* ; Esophageal Neoplasms ; Esophagus ; Formaldehyde ; Humans ; Immunotherapy ; Leiomyoma ; Lymphocytes ; Mucous Membrane ; Paraffin ; Prognosis ; Survival Rate

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Influence of Prosthesis Size on Change in Left Ventricular Hypertrophy Following Aortic Valve Replacement.

Hee Sung LEE ; Hyun Keun CHEE ; Kun Il KIM ; Ki Woo HONG ; Yun Chul SIN ; Won Yong LEE ; Eung Joong KIM ; Won Jin LEE ; Kwang Min CHOI ; Ho Seng SIN ; Hee Chul PARK

The Korean Journal of Thoracic and Cardiovascular Surgery.2001;34(1):57-63.

BACKGROUND: Aortic valve stenosis induces left ventricular hypertrophy as an adaptive response to the chronic overload caused by the valve disease. Despite the fact that aortic valve replacement may lead to regression of the left ventricular hypertrophy, there is a controversy on the change of the left ventricular muscle after use of small prostheses. MATERIAL AND METHOD: We reviewed 20 patients who had undergone aortic valve replacement for aortic stenosis. There were 13 males and 7 females with a mean age of 61+/-13.8 years. A retrospective analysis of Doppler echocardiography was undertaken in preoperatively, early postoperatively(mean 10.4days), and late postoperatively(mean 29.9 months). They were divided into two groups according to the size of prosthesis used(group 1; 21 mm or smaller, group 2; 23 mm or larger). RESULT: Significant improvement of NYHA Functional class was detected in all groups. Ejection fraction was not significantly different in the group 1 between preoperative and postoperative period, however it increased significantly in the group 2 over time. But preoperative ejection fraction of the group 2 was significantly lower than that in the group 1(p=0.044). Left ventricular muscle mass index(g/m2) was not reduced significantly in the group 1 at the early postoperative period, but it was reduced significantly at the late postoperative period. In the group 2 it was reduced significantly over time. CONCLUSION: Both groups showed clinical improvement. However, the number of patients in whom 19 mm size prosthesis was used was only two. Thus, we suggest that more attention to age, BSA, and exercise should be paid in patients who will undergo aortic valve.
Aortic Valve Stenosis ; Aortic Valve* ; Echocardiography, Doppler ; Female ; Humans ; Hypertrophy, Left Ventricular* ; Male ; Postoperative Period ; Prostheses and Implants* ; Retrospective Studies

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Cardiac Function Changes According to the Type of Operation for Mitral Regurgitation.

Jin Hee KIM ; Jong Won KIM ; Sung Woon CHUNG

The Korean Journal of Thoracic and Cardiovascular Surgery.2001;34(1):51-56.

BACKGROUND: Before the development of an ideal artificial valve, repairing of native valves was considered the best choice and clinicians have been reported that valvuloplasty was much better than valve replacement, when possible with the respect to clinical outcomes. This study was conducted under the hypothesis that in some cases, the surgical and clinical outcomes could be better in patients with valve replacement and it may be influenced by left ventricular function. MATERIAL AND METHOD: This study included 40 patients who received pure mitral valve regurgitation. We divided the patients into three groups(Group I: classical valve replacement in 12 patients, Group II: preserving posterior leaflet in 18 patients, Group III: valvuloplasty in 10 patients) and compared the patient`s clinical findings, echocardiographical indexes obtained at admission and 4 weeks after operation. RESULT: After operation, Group II and III showed the better clinical condition changes than Group I but there was no statistical significance. According to NYHA classification, favorable results were achieved but there are no statistical significances in these three patient groups. The left ventricular function was worsened in Group I and in the Groups II and III, the left ventricular function showed no changes postoperatively. In Groups II and III, there were improvements in the postoperative clinical findings but the left ventricular ejection fraction revealed no statistical differences in these two groups. CONCLUSION: Due to different left ventricular functions, repair is considered a better method for the mitral regurgitation. If there the deformity is impossible to repair, preserving a portion of the leaflet is the preferred surgical method.
Classification ; Congenital Abnormalities ; Humans ; Mitral Valve Insufficiency* ; Stroke Volume ; Ventricular Function, Left

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Early Results of Coronary Artery Bypass Grafting Using Multiple Arterial Grafts.

Jae Won LEE ; Sang Wan RYU ; Kun Il KIM ; Suck Jung CHOO ; Hyun SONG ; Jong Ook KIM ; Myeong Gun SONG

The Korean Journal of Thoracic and Cardiovascular Surgery.2001;34(1):45-50.

BACKGROUND: Coronary artery bypass grafting(CABG) has been established as an effective treatment modality in improving the symptoms of ischemic heart disease as well as in preventing sudden death. Since the relatively wide use of arterial grafting in the 80's, an improvement in long term patency rates compared with saphenous vein grafting has been suggested. We have been using multiple arterial grafts since 1998, and we attempted to compare our early results with those of saphenous vein grafting. MATERIAL AND METHOD: Out of the 355 patients that received CABG at our center between June,1998 and May,1999, 153 patients that used cardioplegia were reviewed. 76 had received single arterial graft(Group I) and 77 had received more than 2 arterial grafts(Group II). Preoperative clinical data, ecohocardiography, and angiographic studies were analyzed retrospectively. RESULT: Preoperatively, there were statistically significant differences between Group I and Group II with respect to age and smoking history. There was one early postoperative mortality in each group. The number of anastomoses constructed per patient showed a statistical difference. There were no other differences in operative and postoperative results. CONCLUSION: Even in our learning period, there was no difference in our early results between arterial grafting and saphenous vein grafting. These early results suggest that arterial grafting may afford patients as improving in late survival. Futhermore, these results suggest that complete arterial revasularization may serve to prolong life expectancy.
Coronary Artery Bypass* ; Coronary Vessels* ; Death, Sudden ; Heart Arrest, Induced ; Humans ; Learning ; Life Expectancy ; Mortality ; Myocardial Ischemia ; Retrospective Studies ; Saphenous Vein ; Smoke ; Smoking ; Transplants*

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Congenital Heart Surgery with Fast Track Hospital Discharge.

Jeong Ryul LEE ; Dong Seop JEONG

The Korean Journal of Thoracic and Cardiovascular Surgery.2001;34(1):41-44.

BACKGROUND: Recently, reports show that minimally invasive cardiac surgery is effective in shortening the hospital stay. We reviewed the patients who underwent repair of their congenital heart anomalies under ministernotomy approach and were discharged within 5 days. MATERIAL AND METHOD: In this study, we included two groups : Group I were 29 patients who underwent minimally invasive cardiac surgery from November 1998 to July 1999(FT group), and Group II were 29 patients who underwent cardiac surgery via median sternotomy from January 1997 to May 1997(conventional group). We compared these two groups. All patients had similar disease categories and underwent the operation by the same surgeon. RESULT: The mean hospital stay in FT group was significantly shorter than conventional group(4.5 vs. 9.1 days, p<0.05, n=29). No complications were found. However, the total mean hospital cost did not reach statistical difference(7,333,184 vs. 7,486,136 won, p>0.05, n=29). CONCLUSION: Our protocol of fast track hospital discharge could shorten the hospital stay without complications. However, the economic benefit remains to be determined.
Heart* ; Hospital Costs ; Humans ; Length of Stay ; Sternotomy ; Thoracic Surgery*

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