PURPOSE: Recent studies have indicated that the p53 tumor suppressor gene and vascular endothelial growth factor (VEGF) play an important role in the angiogenic process of tumors. In this study, the correlation of the expressions of p53 and VEGF and the clinical features in gastric cancer were investigated. METHODS: The expressions of p53 and VEGF in gastric cancer were determined using immunohistochemistry on 98 randomly selected gastric cancer patients that had received curative resection. RESULTS: The expression of p53 and VEGF were observed in 51% and 50% of tumors, respectively. A significant correlation was found between p53 expression and the tumor histological type (P=0.045). The higher the TNM stage, the higher the observed level of p53 expression. The p53 and VEGF expression stati coincided in 70.4% of tumors, with a significant correlation found between the p53 and VEGF stati. Significantly worse survival rates were found in p53-positive and VEGF-positive patients than in those that were p53-negative and VEGF-negative. CONCLUSION: The present results indicated that p53 and VEGF expressions are useful in predicting the prognosis of patients with gastric cancer.
Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Prognosis ; Stomach Neoplasms* ; Survival Rate ; Vascular Endothelial Growth Factor A*

PURPOSE: Transilluminated powered phlebectomy (TIPP) offers a minimally invasive operation alternative to stab avulsion for varicose veins. The purpose of this study is to compare the safety and efficacy of TIPP with conventional phlebectomy (CP) for removal of varicose veins. METHOD: A retrospective review was performed on the clinical records from March 2001 to March 2002. We divided the patients into 2 groups. The first group consisted of 87 patients (107 limbs) who had undergone TIPP. The second group of 27 patients (29 limbs) had undergone CP by the stab avulsion. We compared operation time, number of skin incisions, duration of hospital stay, patient's satisfaction scores, and complications. RESULT: Mean operation time was significantly shorter in the TIPP group than in the CP group (47.3 min vs. 64.0 min). The number of skin incision was also significantly less in the TIPP group (3.4 vs. 4.9). Length of hospital stay was significantly shorter in the TIPP group (2.5 days vs. 4.0 days). However, postoperative patient's satisfaction score was similar in both groups. 81 patients (93%) in the TIPP group developed ecchymosis postoperatively, resolved spontaneously within approximately 8 weeks. CONCLUSION: TIPP can make the better cosmetic result, shorter duration of hospitalization and operation time. These results suggest that TIPP is a feasible surgical treatment modality for varicose veins of the lower extremity. However, we should minimize postoperative ecchymosis and improve the surgical technique.
Ecchymosis ; Hospitalization ; Humans ; Length of Stay ; Lower Extremity* ; Retrospective Studies ; Skin ; Varicose Veins*

Gastric inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion with mimicking malignant features and accompanied with various clinical manifestations. Here we present a 2-yr-old boy who had a gastric IMT with a huge extragastric mass, which closely resembled a neuroblastoma on imaging studies. He experienced intermittent fever and poor appetite for 6 weeks. Fever remained up to 38degrees C even on the operation day. He underwent partial gastrectomy and distal pancreatectomy with splenectomy including the tumor. The preoperative fever disappeared and did not recur in the postoperative course.
Child, Preschool ; Fever of Unknown Origin/*etiology ; Granuloma, Plasma Cell/*complications/*diagnosis/surgery ; Humans ; Male ; Stomach Diseases/*complications/*diagnosis/surgery

PURPOSE: Pancreatic cancer is a devastating disease and the complete resection is difficult due to its the aggressive histologic behavior. Among the possible treatments for the unresectable pancreatic cancer, intraoperative radiation therapy (IORT) has the several advantages. But the impacts of the IORT on survival and local control are not clear. We analyzed the effects of the IORT on pain control, survival duration and local control in patients with unresectable pancreatic cancer. METHODS: We reviewed 6 years of the medical records of 94 patients who had undergone operations involving the pancreatic adenocarcinoma (33 patient IORTs, 39 palliative surgerys only and 22 curative resections involving a curative resection). The clinicopathologic factors and outcomes of the 33 patients treated with the IORT were compared with those of the palliative surgery groups. RESULTS: The age and sex distribution and tumor stage were same for the two groups. The average tumor size in the IORT group was larger than those of the palliative surgery group. The preoperative serum CA19-9 level in the IORT group was higher than the other group. The most common reason for unresectability in the IORT group was local invasion to the adjacent organs including of the great vessels. On the contrary, distant metastasis was a more common cause unresectability in the palliative surgery group. The postoperative complications and operative times were similar in both groups. Pain relief after treatment was observed in 12 cases of the 26 patients in the IORT group, and 5 of 29 patients in the palliative surgery group (P<0.05). The cases of minor and partial remission were more common in the IORT group than the palliative surgery group. However, the survival rate of the IORT group was no better than the palliative surgery group. CONCLUSION: This study suggests that IORT may have an important palliative role especially in ameliorating visceral pain in patients with unresectable pancreatic cancer. However, IORT appears to have no significant effect on overall survival.
Adenocarcinoma ; Humans ; Medical Records ; Neoplasm Metastasis ; Operative Time ; Palliative Care ; Pancreatic Neoplasms* ; Postoperative Complications ; Sex Distribution ; Survival Rate ; Visceral Pain

PURPOSE: The cold ischemia augments the inflammatory cell infiltration in the rat kidney allograft by increasing expression of ICAM-1. The ICAM-1 proteins and ICAM-1 mRNA were overexpressed and upregulated on the tubular epithelium and endothelium of renal allografts that were preserved in the cold preservation solution such as University of Wisconsin (UW) solution. The aims of this study was to examine whether perfusion of kidney with anti ICAM-1 antibody (1A29) prevent inflammations and injuries of graft even in long ischemic time. METHODS: Rat kidneys were perfused in situ with 60 mL of cold UW solution without or with anti-rat ICAM-1 antibody and nephrectomized. The kidneys were exposed to 48 hour cold (4 degrees C storage time) ischemia and examined for the counts of necrotic tubules and apoptotic cells on the high power fields by terminal deoxynucleotidyltransferase mediated nick-end labeling (TUNEL) assay. RESULTS: The number of necrotic tubules per high power field of the allograft treated by anti ICAM-1antibody (6.97+/-4.25) was significantly less than that of the other control allograft (12.71+/-6.42) (P<0.001). The number of apoptotic cells per high power field of antibody treated graft (4.27+/-4.11) was significantly less than that of the other control graft (8.43+/-5.56) (P<0.001). CONCLUSION: Rat anti ICAM-1 antibody (1A29) inhibits ICAM-1 mediated allograft tubular necrosis as well as apoptosis. These results are expected to contribute to prevent allograft rejection and delayed graft function when used for pretreatment of allografts with anti ICAM-1 antibody mixtures of the perfusion and preserving solution clinically.
Allografts ; Animals ; Apoptosis ; Cold Ischemia ; Delayed Graft Function ; DNA Nucleotidylexotransferase ; Endothelium ; Epithelium ; Inflammation ; Intercellular Adhesion Molecule-1* ; Ischemia ; Kidney* ; Necrosis ; Perfusion ; Rats* ; RNA, Messenger ; Transplantation ; Transplants ; Wisconsin*

PURPOSE: By virtue of advances in scientific methods and technical systems, there has been a rapid growth in the number of end stage renal disease (ESRD) patients treated using continuous ambulatory peritoneal dialysis (CAPD) as their primary renal replacement therapy. However, there are various catheter related complications that are limiting factors in patient and catheter maintenance. This study was aimed at introducing of the techniques of CAPD catheter implantation designed for reducing the complication rate, as well as conducting an investigation of the incidence of CAPD catheter related complications and patient survival and catheter survival rates. METHODS: We performed 234 cases of CAPD catheter implantation using a conventional surgical method (n=162, between January 1993 and December 1997) or a modified surgical method (n=72, between January 1998 and December 1999), and retrospectively reviewed the patient's medical records to elucidate the incidence of early catheter related complications and the catheter removal rate in relation to the surgical methods. RESULTS: There were 21 cases (23.8%) of peritonitis in the modified group, which was less than that in the conventional group (79 cases, 48.8%) (P=0.036). There were 9 cases (12.5%) of exit site and tunnel infection in the modified group, which was less than that in the conventional group (36 cases, 22.2%) (P=0.019). We were able to reduce the peritonitis as well as exit site and tunnel infection by a long segment of tunneling and immobilization of the catheter to the skin. Nine cases of leakage (5.5%) have occurred in the conventional group and one case (1.3%) in the modified group; the difference was statistically significant (P=0.046). CONCLUSION: These results indicate that our modified surgical methods can reduce the rate of early catheter related complications.
Catheters* ; Humans ; Immobilization ; Incidence ; Kidney Failure, Chronic ; Medical Records ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Replacement Therapy ; Retrospective Studies ; Skin ; Survival Rate ; Virtues

PURPOSE: The purpose of this article is to analyze the results of combined agioplasity and femorofemoral bypass in patients with unilateral iliac arterial occlusive disease. METHOD: During the 11-year period from 1990 to 2000, 44 patients with iliac artery occlusion and a hemodynamically significant contralateral iliac artery stenosis were treated by using a combination of percutaneous transluminal angioplasity (PTA) and femorofemoral bypass (n=18) as well as aortobifemoral bypass (n=12) and iliofemoral bypass (n=14) at Korea university medical center. PTA was performed if the lesions in the donor iliac artery were less than 3 cm in length with no more than one well-localized lesion in either the common or external iliac artery, or both. Stent was deployed for suboptimal PTAs. The femorofemoral bypass was done within 3 to 5 days after PTA or stenting. RESULT: The mean age was 61.2 years. The Indications of femorofemoral bypass were hypertension, ischemic heart disease, chronic obstructive lung disease, old age (>75), cancer, and previous abdominal operation. The complication rate of the combination treatment was lower than that of the others. Primary patency rate at 1 and 3 years were 89%, 78% for aortobifemoral bypass, 83%, 66% for iliofemoral bypass, and 77%, 65% for femorofemoral bypass, respectively. CONCLUSION: The combination of PTA with or without stent deployment and femorofemoral bypass can be a useful option for treating iliac occlusion and contralateral iliac stenosis in patients with severe comorbid illness, advanced age, and intra-abdominal pathology. Angioplasity can allow more widespread use of femorofemoral bypass in these patients.
Academic Medical Centers ; Angioplasty* ; Arterial Occlusive Diseases* ; Constriction, Pathologic ; Humans ; Hypertension ; Iliac Artery ; Korea ; Myocardial Ischemia ; Pathology ; Pulmonary Disease, Chronic Obstructive ; Stents ; Tissue Donors

PURPOSE: The question of whether "young age onset" is a single prognostic factor for breast cancer has been controversial. The incidence of breast cancer according to age differs by region and races. The purpose of this study was to determine the incidence of breast cancer in women 35 year old or younger and elucidate its clinical characteristics, prognosis, and differences from older age onset breast cancer. METHODS: A retrospective study of 545 consecutive breast cancer patients who had been treated at our hospital from 1990 to 1999, was conducted. We investigated the ratio of 35 year old or younger breast cancer patients, age of menarche, TNM stage, histologic grades, hormone receptor status, survival rates. This was then compared with the counter age (>35) group's data. The significances of the differences were evaluated by variable type using the Student's t-test or chi-square test. Analysis was performed using SPSS software. RESULTS: The younger age group patients numbered 62 (11.3%) among the total group, and showed earlier menarche, worse histologic differentiation, and lower mammographic detection rate than the counter group (P<0.05). There were no differences in TNM stage distribution or hormone receptor expression status according to age group (P>0.05). The young age group's 5 year overall and disease free survival rates were 83 5% and 58 8% respectively and both were lower than the counter group's 89 2% and 74 3% (P<0.05), respectively additionally, the age adjusted overall and disease free survival rates were worse than the counter age group's. CONCLUSION: The younger age group showed worse survival rates, poorer prognostic factors and a higher late of early relapse rate than the older age group. Therefore, we may consider "young age onset" to be a poor prognostic factor in breast cancer.
Adult ; Breast Neoplasms* ; Breast* ; Continental Population Groups ; Disease-Free Survival ; Female ; Humans ; Incidence ; Menarche ; Prognosis* ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively. Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up-regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: No standardized treatment protocol yet exists for intestinal Behcet's disease. The aim of this retrospective study was to identify the factors that are related to the recurrence and mortality of intestinal Behcet's disease. METHODS: Twelve patients who had undergone surgery for intestinal Behcet's disease at Korea University Hospital from 1991 to 1999 were chosen. Nineteen patients had been diagnosed as having intestinal Behcet's disease. Of the 19 patients, 7 are still being followed up, and 12 have undergone surgery, these patients were chosen as the subjects. RESULTS: Of the 11 cases, excluding one case that expired following the initial surgery, 8 cases required subsequent surgery due to recurrence. When the data was analyzed according to the patient's age, medication, classification of Behcet's disease, location of the lesion, operative method, and extent of resection, recurrence was shown to be related with medication and extent of resection (p<0.05). Of the 12 cases, 5 cases expired. When, the data of the 5 cases that expired were analyzed according to the patient's age, medication, extent of resection, classification of Behcet's disease, location of the lesion, and operative method, mortality was shown to be related with the location of the lesion (p<0.05). CONCLUSION: Medical treatment is the primary therapy for intestinal Behcet's disease and radical extended resection extending 30 cm proximal and distal to the lesion prevents recurrence. However, when the lesion was located in the small intestine and formed a fistula with the duodenum, the prognosis appears to be extremely poor.
Mortality