The effect of implant surface treated by anodizing on proliferation of the rat osteoblast / 대한치주과학회지

The surface characteristics of titanium have been shown to have an important role in contact ossseointegration around the implant. Anodizing at high voltage produces microporous structure and increases thickness of surface titanium dioxide layer. The aim of present study was to analyse the response of rat calvarial osteoblast cell to commercially pure titanium and Ti-6Al-4V anodized in 0.06 mol/l beta-glycerophosphate and 0.03 mol/l sodium acetate. In this study, rat calvarial osteoblasts were used to assay for cell viability and cell proliferation on the implant surface at 1, 2, 4, 7 days. 1. Surface roughness was 1.256micrometer at 200V, and 1.745micrometer at 300V. 2. The thickness of titanium oxide layer was increased 1micrometer with the increase of 50V. 3. The proliferation rate of osteoblastic cells was increased with the increase of the surface roughness and the thickness of titanium oxide layer. 4. There was no difference in cell viability and cell proliferation between commercially pure titanium and Ti- 6Al-4V anodized at the same condition. In conclusion, the titanium surface modified by anodizing was biocompatible, produced enhanced osteoblastic response. The reasons of enhanced osteoblast response might be due to reduced metal ion release by thickened and stabilized titanium dioxide layer and microporous rough structures.

Chest Well Muscle Changes after A Mestectomy Findings of Chest CT / 한국유방암학회지

BACKGROUND: Chest CT after a mastectomy in breast cancer patients is usually performed to detect recurrence or metastasis. It is essential for surgeons an radiologists to know the appearance of the chest wall in a postmastectomy state. Especially, muscle atrophies of the chest wall, such as that of the pectoralis major muscle, indicate whether the modified radical mastectomy (MRM) was properly performed or not. MATERIALS AND METHODS: We performed a retrospective analysis of chest wall changes in mastectomy patients with follow-up chest CT finding to evaluate the results of MRMs. The medical records and CT findings of chest wall atrophy for a total of 38 patients who were treated at Kangnam St. Mary's Hospital, the Catholic University of Korea, were reviewed. The mean age was 58.3 years, and the interval between operation and follow-up CT was 6.6 years. The operations performed were a radical mastectomy (RM) in 3 patients and a MRM in 35 patients: Petey in 28 patients, Auchincloss in 6 patients, and Scanlon in 1 patient. RESULTS: In the RM, muscle atrophies were noted at the m, subscapularis in 3 patients (100%), the m. serratus anterior in 2 patients (66.7%), and the m. lattisimus dorsi in 1 patient (33.3%). In MRM, the Patey and Auchincloss operations showed m. pectoralis major atrophies in 22 patients (78.8%) and 5 patients (83.3%) respectively. Additionally m. pectoralis minor atrophy was noted in all 6 patients (100%) who underwent the Auchincloss operation. However. there was no muscle atrophy in patients who received Scanlon operation. CONCLUSIONS: These results suggest that lateral pectoral nerve injury is the main cause of m. pectoralis major atrophy in a MRM. The Scanlon operation which preserves the serve by dividing the pectoralis minor m. at its origin is a suitable operation for chest-wall muscle preservation. We hope that by the future study, we can confirm the best way of preventing chest-wall muscle atrophy in MRMs.

Chest Wall Muscle Changes after a Mastectomy: Findings of Chest CT

BACKGROUND: Chest CT after a mastectomy in breast cancer patients is usually performed to detect recurrence or metastasis. It is essential for surgeons and radiologists to know the appearance of the chest wall in a postmastectomy state. Especially, muscle atrophies of the chest wall, such as that of the pectoralis major muscle, indicate whether modified radical mastectomy (MRM) was properly performed or not. METHODS: We performed a retrospective analysis of chest wall changes in mastectomy patients with follow-up chest CT findings to evaluate the results of MRMs. The medical records and CT findings of chest wall atrophy for a total 38 patients who were treated at Kangnam St. Mary's Hospital, the Catholic University of Korea, were reviewed. The mean age was 58.3 yeras, and the interval between operation and follow-up CT was 6.6 years. The operations performed were a radical mastectomy (RM) in 3 patients and a MRM in 35 patients: Patey in 28 patients, Auchincloss in 6 patients, and Scanlon in 1 patient. RESULTS: In the RM, muslce atrophies were noted at the m. subscapularis in 3 patients (100 %), the m. serratus anterior in 2 patients (66.7%) and the m. lattisimus dorsi in 1 patient (33.3%). In MRM, the Patey and Auchincloss operations showed m. pectoralis major atrophies in 22 patients (78.8%) and 5 patients (83.3%) respectively. Additionally m. pectoralis minor atrophy was noted in all 6 patients (100%) who underwent the Auchincloss operation. However, there was no muscle atrophy in patients who received scanlon operation. CONCLUSIONS: These results suggests that lateral pectoral nerve injury is the main cause of m. pectoralis major atrophy in MRM. The scanlon operation which preserves the nerve by dividing of pectoralis minor m. at its origin is a suitable operation for chest-wall muscle preservation. We hope that by the future study, we can confirm the best way of preventing chest-wall muscle atrophy in MRMs.

Clinical Impact of Postoperative Tamoxifen Therapy in Patients with Breast Cancer

BACKGROUND: Tamoxifen is one of the most widely prescribed drug in patients with breast cancer and has been proven to have a favorable effect on disease-free survival (DFS) and overall survival (OS) when given as an adjuvant therapy. However, there is little known about the effects of tamoxifen in Korean patients with breast cancer. The purpose of this report was to obtain the informations about tamoxifen as an adjuvant therapy for the prospective study hereafter. METHODS: The medical records of 349 patients with breast cancer from Jan. 1 1988 to Dec. 31 1995, who have no distant metastasis and have had adjuvant therapies after surgery with appropriate follow up, were reviewed retrospectively. The univariate analysis of various prognostic factors, such as age, menopausal status, stage, steroid receptor status, operation method, chemotherapy, and the relationship of tamoxifen therapy with them were analyzed using SAS program. RESULTS: 1) The benefit of Tamoxifen administration in DFS was observed in women 40-49 and over 60 years of age, premenopausal women, tumors with the size of 2-5 cm, Stage IIb, progesterone receptor positive tumors, and for patients treated with chemotherapy and CAF (Cyclophopamide Adriamycin 5-Fluorouracil) regimen of it. Tamoxifen also improved OS in women over 60 years of age, Stage I or IIb, and for the patients treated with chemotherapy and CAF regimen (P<0.05, log rank or Wilcoxon test). 2) The relapse or death rate decreased linearly as the duration of tamoxifen administration was extended (P=0.001, Cochran-Armitage test). The Kaplan-Meier disease free and overall survival rates of the four groups of duration were significantly different (P=0.0001, logrank test). CONCLUSIONS: There is a benefit of tamoxifen therapy in the patients aged 60 or older, tumors with the size of 5 cm or less, Stage IIb or less, and for the patients treated with chemotherapy and CAF regimen of it. This benefit is increasing as the duration of tamoxifen administration is extended. Thebenefit of tamoxifen is unreliable in the patients aged 40-49, premenopausal women and progesterone receptor positive tumors, possibly because of bias in those subsets.

Telomerase Activity in Breast Cancer and Benign Breast Disease of Korea / 한국유방암학회지

BACKGROUND: Telomerase is an RNA-dependent DNA polymerase that compensates for the telomere shortening that occurs in its absence. Reactivation of telomerase is thought to be an important step in cellular immortalization, and recent studies have indicated that telomerase activity is often detected in primary human malignancies. The purpose of this study is to identify telomerase activity in breast cancer. MATERIALS & METHODS: Telomerase activities were analyzed in the samples of 12 breast cancer tissues and 11 benign breast disease tissues by TRAPeze ELISA detection kit (Oncor, Gaithersburg, USA). All samples were obtained from the excised mass at the time of specimen removal in the operating room and stored in liquid-nitrogen tank. RESULTS: Telomerase activity was detected in 10 of 12 (83.3%) breast cancer samples and 4 of 11 (36.4%) benign breast disease samples. The detection of telomerase activity in diagnosis of breast cancer has validity: 83.3% sensitivity rate, 63.6% specificity rate, 71.4% (+) predictability rate, 77.8% (-) predictability rate. The telomerase activity correlates with the estrogen receptor status (p=0.009). CONCLUSION: The telomerase activity can be detected in breast cancer sensitively. Further study with sufficient samples is needed to establish detection of telomerase activity as diagnostic tool in breast cancer.

Clinical Experience in Liver Transplantation

We have performed 10 primary liver transplantations between August 1993 and September 1995 in patients with end stage liver disease at Department of Surgery, Catholic University, Medical College. Donor and recipient operations were performed using modified techniques described by Starzl et al. Cyclosporine and prednisone were used as the principal immunosuppressive regimen and cyclosporine levels were monitored daily with dosage adjustment. when acute rejection was suspected based on clinical parameters, methylprednisolone was given for 2 days and if there was no response, we treated with the OKT3 monoclonal antibody. Our clinical results were as follows : 1. Mean age of donors was 32 years, ranging from 17 to 50 years, eight males, 2 females. The causes of brain death were traffic accident in 5 cases, falling down in 3 cases, and others (CVA, brain tumor). 2. Mean age of recipient was 41 years, ranging from 18 to 57 years and all were male. The indications of liver transplantation were liver circhosis related to viral hepatitis in 9 cases and alcoholic cirrhosis in one. 3. In arterial reconstruction, aortic carrel patch of common hepatic artery was sewn to hepatic-gastroduodenal bifurcation (5 transplants), to supraceliac aorta (3 transplants), and to infrarenal aorta (2 transplants). The biliary anastomosis was a choledochocholedochostomy with T-tube stent in nine and Roux-en-Y choledochojejunostomy in one transplant. 4. Average length of operation was 9 hours 28 minutes (range 7. 6-12 hours), and liver ischemia 6 hours 14 minute. An average requirements of packed red cell were 21.2 unit (range 12-31 units) 5. The surgical complication occurred in 3 patients (postoperative bleeding, hepatic arterial thrombosis and bile peritonitis), acute rejection in 5 patients, bacterial infection in 5 patients and coma in 2 patients. 6. Of the 10 patients, 6 are alive ranging from 15 days to 27 month and four patients died in the early postoperative period : one of postoperative bleeding, one of hepatic arterial thrombosis, one of acute rejection and one of neurologic complication. 7. In the consideration of prognostic factors from donor, the dosage of vasopressor and liver enzyme but not donor age were significant in early postoperative mortality. As perioperative parameters of recipients, preoperative general status, serum BUN, bilirubin, and reversibility of respiratory, renal and graft function within the first week following transplant were important.

A Clinical Review of 81 Cases of Total Thyroidectomy

Total thyroidectomy has been used to treat benign or malignant thyroid diseases. However, concern about the postoperative complications after the extensive and aggressive operation makes surgeons reluctant to do total thyroidectomy. Instead, in many cases, less invasive and less complicating subtotal thyroidectomy has replaced it. But total thyroidectomy is required to eradicate bilateral and multiple nodules, diffuse toxic goiter, and thyroid cancer that cannot be cured by subtotal thyroidectomy. To evaluate the effectiveness and complications of total thyroidectomy, we reviewed retrospectively 81 patients who received total thyroidectomy from June 1987 to August 1993 according to the age, sex, clinical symptoms, duration of symptom, diagnoses, operative modalities, pathologies, postoperative complications and thyroid function. The results are as follows: 1) Male to female ratio was 1 to 4.8 (male:14, female:67). The sixth decade included 27 % of patients, and showed the peak incidence. 2) The most common symptom was the palpable mass on the precervical area or in the thyroid (96%). Palpitation (15%) and voice change (12%) were present in descending order. 3) On the duration of symptom, patients' visiting hospital after one to two years occupied the largest portion (26%). Three to four years occupied 19 cases (23%), and cases of more than five years were 17 cases (21%). Masses of 2 to 3 cm in diameter were the most common size (27%) and of 2 to 5 cm occupied more than half(59%). Most of the patients visited the hospital after full-blown of mass or symptoms. 4) Sixty five cases were cancers, and 16 cases were benign diseases. Modified radical neck dissection was done in 7 cases, suspicious of local lymph node invasion during the operation. Radical neck dissection was done in 6 cases with palpable cervial nodes. 5) The order of accuracy of preoperative diagnostic modality was thyroid scan (86%), frozen section (83%), and fine needle aspiration biopsy(80%). These result seemed different compared with the recent diagnostic value of fine needle aspiration biopsy, but might be due to the technique. 6) Pathological classification is composed of differentiated cancer (80%), toxic goiter (16%), nodular goiter (6%), adenomatous goiter (2%), and Hashimoto's thyroiditis (1%). Papillary cancer occupied 92 percent of cancer. Lymph node metastasis showed diffuse distribution according to the mass size. 7) No deaths were reported. The most common complication was hypocalcemia (38%), most of which was transient and 61 per cent of which was symptomatic. It usually persisted less than 7 days, and only 3 cases continued more than 7 days (3.7%). The other complications were hoarseness (19%), bleeding (7%), and the recurrent laryngeal nerve injury(1%). 8) Follow up on the postoperative thyroid function was available on 66 patients (81%). Of those, forty six patients (70%) were euthyroid, 2 (18%) were hypothyroid, and 8 (12%) were hyperthyroid. The cause of the hyperthyroid status after total thyroidectomy might be due to the medication for the thyroid supplementation or to the time of serum measurement shortly after the medication. We think that total thyroidectomy could be done without additional risk compared with subtotal thyroidectomy, if it were done meticulously. We suggest that total thyroidectomy should be considered for the treatment of diffuse thyroid diseases and carcinomas.

Two Cases of Angiodysplasia in Small Bowel : Intra - operative Endoscopic Transillumination Technique / 대한소화기내시경학회지

Angiodysplasia of small bowel is uncommon and frequently undiagnosed and presents a taxing surgical problem. It is usually diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that the lesion is impalpable, and invisible to the naked eye, so it usually cannot be identified unless bleeds actively at the time of surgery. Arteriography gives a little information about wax and wane pattern of bleeding in the lesion. Endoscopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few millimeters in diameter. Transillumination of the intestinal wall from inside of the lumen to the outside in a dark room can define the precise vascular anatomy of the wall. The delicate lesion of the angiodysplasia can be identified by this transillumination method. We described a simple intraoperstive endoscopic translllumination technique used successfully to identify an angiodysplasia in the small bovwel prior to the bowel resecion. This report summarized our experience and review of literature.

Recessive allelic loss in colorectal cancer tissue / 대한암학회지

No abstract available.

Serial clinical analysis and survival rate of 900 patients treated for malignant gastric tumor

No abstract available.

DNA ploidy in gastric cancer

No abstract available.

Synchronous gastric cancer and adrenocortical carcinoma

No abstract available.

Amplification of c-myc oncogene and detection of point mutation of c-K-ras oncogene by paired polymerase chain reaction in human colorectal carcinoma / 대한암학회지

No abstract available.