Prognostic Significance of Cyclin B1 and p53 Expression in Patient with Esophageal Squamous Cell Carcinoma / 대한흉부외과학회지

BACKGROUND: It has been reported that p53 regulates the G2-M checkpoint transition through cyclin B1, and it has been suggested that p53 plays an important role in the development and progression of various malignancies. The aim of this study is to clarify the role of the cell cycle regulators, cyclin B1 and p53 in patients with esophageal squamous cell carcinoma (ESCC). MATERIAL AND METHOD: Tissue samples from 46 patients with ESCC were included in this study. Expression levels of cyclin B1 and p53 in samples of normal squamous epithelium, dysplasia, and tumor cells from patients with ESCC were analyzed by immunohistochemical study. RESULT: Several cells in the basement layer of normal epithelium expressed cyclin B1. The number of cyclin B1 positive cells tended to increase as the degree of dysplasia increased from low grade to high grade. More than 10% of tumor cells were cyclin B1 positive in 19 patients (41.3%). Several clinicopathologic parameters, including tumor stage (p<0.05), pathologic lymph node status (p<0.05) and invasion of lymphatic vessels (p<0.05), were correlated with the overexpression of cyclin B1. Elevated expression levels of cyclin B1 also correlated with a poor prognosis in patient with ESCC in univariate analysis (p<0.05) and multivariate analysis (p<0.05). In contrast, p53 expression exhibited significant correlation with the level of cyclin B1 expression, but was not associated with prognostic parameters in patients with ESCC. CONCLUSION: These findings suggest that cyclin B1 is involved in the pathogenesis of carcinoma of the esophagus and that elevated levels of cyclin B1 expression, but not p53 expression, may indicate a poor prognosis for patients with ESCC.

Nonrenal Indications for Continuous Arteriovenous Hemofiltration / 대한신장학회잡지

Continuous arteriovenous hemofiltration(CAVH) is used to treat hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients. Patients received CAVH during a 3-year-period from March 1994 to February 1997. Their clinical findings were analyzed retrospectively, and the results were as follows; They were 6 men and 3 women from 28 to 62 years. 3 patients had ARDS, 2 patients had CHF. The remainder had SLE, liver cirrhosis, septic shock with cholangitis, diabetic ketoacidosis with pulmonary edema. The duration of treatment ranged from 30 to 50 hours, with a mean of 41.6+/-6.9 hours. The total fluid repalcement was 22.4+/-1.7L and the mean fluid loss was 3.9+/-2.6L. Changes in serum BUN, creatinine, sodium, potasium before and after treatment were not significantly diffrent. The complication of CAVH is clotting of hemofilter, hypotension, bleeding, and mild thrombocytopenia. 2 of 3 ARDS patients expired during CAVH, liver cirrhosis patient expired later due to hepatic encephalopathy, and, finally 6 patients discharged with improved conditions. In conclusion, CAVH, a safe and effective therapy in hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients.

Relation of Serum Eosinophilic Cationic Protein, Eosinophil and Neutrophil Count to Pulmonary Function and Smoking History / 대한내과학회지

OBJECTIVES: A prospective study was performed to find out the correlation between neutrophil, eosinophil and eosinophilic cationic protein (ECP)-the granular protein in eosinophil- and smoking history and pulmonary function change, METHODS: In this study there were seventy smokers and seventy lifetime nonsmokers. None of them had the history of atopy, or the evidence of parasitic infestation. Smoking history, spirometric pulmonary function test and blood samples for CBC, serum ECP were analyzed. RESULTS: 1) Eosinophil and neutophil count was elevated in the smokers compared with the nonsmokers. 2) Serum ECP was elevated in smokers and the magnitude of this increase was greater than that of eosinophil count. 3) In the smokers, there was a direct proportional correlation between serum ECP and FEV1, but inverse proportional correlation between neutophil count and FEV. 4) In the smokers, neutrophil count was elevated regardless of FEV value. 5) The level of serum ECP well correlated with the daily tobacco consumption but not with the duration of smoking or pack-year consumption. CONCLUSION: Incresed neutrophil count, decreased eosinophil count and decreased serum ECP level could be useful in the understanding of pathophysiology of lung parenchymal destruction in smokers.

Biliary Tract & Pancreas; A Case of Biliary Mucinous Cystadenoma: Improved Jaundice after EST / 대한소화기내시경학회지

Biliary cystadenoma is a rare biliary ductal neoplasm that usually arises in the liver and less frequently in the extrahepatic bile ducts. Clinical manifestations are non-specific; hence preoperative diagnosis depends heavily on imaging. Computed tomography, ultrasonography, angiography and cholangiogram are useful diagnostic procedures in biliary cystic tumor, but definite diagnosis depends on histologic diagnosis. Surgical resection often yields excellent results. Surgical procedures used to treat cystadenomas include: aspiration, drainage, marsupialization, and excision. If there is no evidence of metastasis, complete resection of these tumors is necessary for a complete cure. We experienced an 80-year-old man who complained of jaundice and RUQ pain. He was diagnosed as biliary mucinous cystadenoma, We confirmed our diagnosis by cholangioscopic biopsy, and performed endoscopic sphincterotomy(EST). So, we report this case and have reviewed the relevant literature as a part of our report for the subject case.