Clinical Correlation of iNOS and p53 Expression in Colorectal Cancer

PURPOSE: Nitric oxide (NO) is synthesized from the amino acid L-arginine by nitric oxide synthase (NOS) which exists as three isoforms, the calcium-dependent endothelial NOS and neuronal NOS, and a calcium-independent inducible NOS. NO has been studied in a variety of human cancers and is implicated in both tumor promotion and inhibition. NO cause p53 mutation in human cells and mutations of p53 are the most common genetic abnormality yet found in human cancers. Aims of this study is to investigate the correlation of iNOS and p53 expression in colorectal cancer, and to evaluate its clinicopathological siginificance with the expression of these proteins. METHODS: 125 patients, who received curative resection of colorectal cancer from 1992 to 1996, were analyzed retrospectively. The monoclonal antibody to the iNOS (Transduction Laboratories.), the monoclonal antibody to the mutant p53 (Dako Co.) were used for the immunohistochemical analysis. Normal colorectal tissue were assayed in 45 cases. The relationship between mutant p53 and iNOS was investigated. RESULTS: When iNOS expression were detected in specimens, positive rate of mutant p53 were 72.4%. When mutant p53 expression were detected in specimens, positive rate of iNOS expression were 65.8%(P<0.05). Positive rate of iNOS, mutant p53 in tumor size were 51%, 56% below 4 cm and 60%, 63% in 4~8 cm and 47%, 67% above 8 cm. Positive rate of iNOS, mutant p53 in Dukes' stage were55%, 55% in stage B and 56%, 67% in stage C. Positive rate of iNOS, mutant p53 in histologic differentiation were 55%, 55% in well-differentiation and 61%, 66% in moderate differentiation and 35%, 48% in poor-differentiation. There was no difference in each Dukes stage between iNOS expression or p53 mutation and postop five year survival rate. Positive rate of iNOS, mutant p53 in normal tissue were 22%, 32%. CONCLUSION: The prevalence of iNOS expression and p53 mutation has been found in exceeding 50% of cases. There was a significant correlation between iNOS expression and p53 mutation in colorectal cancer. No correlation was found between iNOS expression or p53 mutation and clinicopathologic parameters.

Chronic Arterial Occlusion by Hypercoagulable State 2 cases report (Antiphospholipid syndrome and Polycythemia vera)

Hypercoagulable states (HS) are well recognized as a cause of arterial and venous thromboembolism. These coditions are usually associated with abnormalities in natural anticoagulants, the fibrolytic system, or platelet aggregation. Primary arterial thrombosis is unusual in the young population. Hypercoagulable states are usually acquired, but they may be congenital. The congenital states occur in response to deficiency of protein C, protein S, AT-III. And the acquired states occur in response to disease, in response to tissue injury, or in response to therapy. But in this country, we have no any data of prevalence ratio of HS, which developed symptome of arterial occlusion, cases of bypass and theapeutic modality. We experienced two cases of acquired HS that is antiphospholipid syndrome and polycythemia. Based on our experience with this patients and a review of the literature on the previously reported. And we suggest that there will be made for the purpose of studying non-atherosclerotic lower extremity occlusion registry which developed in our country through the small study group.

Ambulatory Hemorrhoidectomy under Local Anesthesia

PURPOSE: Hemorrhoidectomy can be associated with severe pain in the immediate postoperative period. The aim of this study was to evaluate the advantages and feasibility of hemorrhoidectomy under local anesthesia (pudendal nerve block). METHODS: From september 1998 to August 2000 we performed 77 hemorrhoidectomy with local anesthesia in our Colorectal unit under the ambulatory surgery regimen. 0.5% lidocaine and 0.25% bupivacaine mixed by 1:1 ratio were used for pudendal nerve block and local anesthesia. RESULTS: Using pudendal nerve block, ambulatory hemorrhoidectomy with or without band ligation were done in 77 patients. Male to female ratio was 46:31, mean age was 35.2 years. 3 major piles plus 1 minor pile were present in 40 patients (51.9%). We injected mixed lidocaine and bupivacaine solution through external sphincter and puborectalis muscle. All patients were successfully operated without conversion to general anesthesia or even intravenous anesthetic injection. Postoperative pain of them were compared the patients who were operated hemorrhoidectomy under general (spinal or caudal) anesthesia during the same time. The pain were assessed using verbal rating pain scale at 24 hours, 48 hours and 72 hours (1-10, where 1 presented no pain and 10 represented the worst pain imaginable) by phone call examination. Mean pain scores for pudendal anesthesia group at 24, 48, 72 hours were 5.32, 3.07 and 2.21, respectively, compared with other anesthesia group with 6.47, 4.52 and 3.24. These differences were statistically significant (P value<0.05). Post operative pain was successfully controlled with home care and oral medications. CONCLUSIONS: Under local anesthesia with pudendal nerve block, ambulatory hemorrhoidectomy were able to decrease pain and urinary retension in comparison to spinal or caudal anesthesia group. Ambulatory hemorrhoidectomy is useful, low cost and feasible.

Surgical Treatment of the Patient with Non- specific Colon Ulcer

PURPOSE: Non-specific ulceration of colon is a rare disease of unknown etiology. To establish correctly the diagnosis of nonspecific colon ulcer preoperatively is difficult, but with more wide spread use of colonoscopy and complementary diagnostic aids, this lesion may be accurately diagnosed more often. The presentating symptoms were mainly lower abdominal pain, which mimic such conditions as acute appendicitis, diverticulitis, intestinal obstruction, and colon cancer. If its serious complications (perforation, abscess formation, or uncontrolled bleeding) were developed, resection of ulcerated segment or more extensive colectomy was recommended. The purpose of this study was to establish correctly the diagnosis of nonspecific colon ulcer preoperatively and to identify definitive treatment of complicated colon ulcer. METHODS: 6 cases, surgically treated as non-specific colon ulcer at Chosun University hospital from January 1995 to December 1999 were studied retrospectively. RESULTS: The ages of the patient ranged from 35 to 70 years; the ratio of male to female is 2: 1. The main clinical symptoms were abdominal pain (6 cases), nausea and vomiting (4 cases), hematochezia (3 cases), constipation (2 cases) and palpable mass (1 case). The preoperative diagnosis was generalized peritonitis (2 cases), colon cancer (2 cases), acute appendicitis (1 case), mechanical obstruction (1 case). 3 cases had past medication history, one was anti-hypertensive drug and the two were nonsteroidal anti-inflammatory drug. The preoperative diagnostic study were simple abdomen (6 cases), abdominal CT (6 cases), colon study (3 cases), abdominal sonograph (4 cases) and selective angiogram (1 cases), The location of ulcer were cecum (2 cases), sigmoid colon (2 cases), transversecolon (1 case) and descending colon (1 case). The methods of operation were hemicolectomy (3 cases), segmental resection (1 case) and anterior resection (2 case). There was one death, but 5 cases were completely recovered. CONCLUSIONS: Non-specific ulcer of the colon is not detected until complicated by bleeding, perforation, or obstruction. The patient who has chronic abdominal pain and rectal bleeding can be diagnosed preoperatevely by colonoscopy and colon study. The recommended therapy of complicated cases is resection of the ulcerated segment or more extensive colectomy. Non-specific colonic ulcer should be suspected as one of colonic disease in the patients with complications.

The Comparison between Transanal and Transvaginal Ultrasonography of Anal Sphincter in Normal Women

PURPOSE: The purpose of this study was to evaluate the normal value of the anal canal structures by transvaginal sonography in normal woman and compare this technique with the more commonly used transanal technique. METHODS: Transvaginal ultrasonography was performed in 25 parous patients between 4th and 8th decade of age, using a Bruel and Kajer type-1890. This procedure was followed by transanal sonography using the same system. The thickness of mucosa and submucosa, internal and external anal sphincter and puborectalis muscle were measured by both methods. RESULTS: The thickness of mucosa- submucosa, internal anal sphincter, external anal sphincter and puborectalis muscle by transvaginal sonography were 2.84 0.2 (2.6~3.0) mm, 2.98 0.4 (2.6~3.3) mm, 7.4 0.3 (7.1~7.7) mm, 7.5 0.5 (7.4~7.6) mm respectively(mean value standard deviation and range). The detection rate of external anal sphincter and puborectalis muscle by transvaginal sonography were between 55.5% (5/9) and 71.4% (5/7). CONCLUSIONS: The thickness of internal anal sphincter was increased with age(p<0.05). The thickness of mucosa-submucosa, internal anal sphincter measured.

Changes of Nitric Oxide Synthase (NOS) Isozymes in Cultured Human Colon Carcinoma Cell

Nitric oxide (NO), the production of which is dependent on Nitric oxide synthase (NOS), has been shown to contribute to pathogeneses in various diseases. Recent investigations of NOS expression in tumor tissues indicate that NO may mediate one or more roles during the growth of human cancers. The aim of this study was to determine whether iNOS is expressed in human colon carcinoma cell lines and to determine the types of NOS isozymes in colon carcinoma cell lines with high and low metastatic potentials. METHODS: We measured the expressions of iNOS and eNOS and the formation of nitrotyrosine which indicates peroxinitrate production in highly metastatic colon cancer cell (KM1214) and lowly metastatic colon cancer cell (KM12C) by Western blots. RESULTS: The iNOS were detected in both KM1214 and KM12C by Western blot analysis. The expression of iNOS in KM1214 cells was significantly higher than in KM12C cells. The expression of iNOS was increased with lipopolysaccharide (LPS) in colon cancer cells but the rate of increase was higher in KM1214 cells than in KM12C cells. CONCLUSIONS: In human colon carcinoma cells, iNOS is expressed in cancer cells and expression of iNOS is higher in highly metastatic colon cancer cells than in lowly metastatic colon cancer cells and iNOS expression may have some role in colon cancer metastasis.

Clinical Significance of CEA Level of Peripheral Vein, Inferior Mesenteric Vein, Bile, and Peritoneal Fluid in Sigmoid Colon and Rectal Cancer

Carcinoembriogenic antigen (CEA) was widely used as a marker for staging and detection of recurrence and metastases, and evaluation of response of radical opertion or chemotherapy in colorectal cancer patients. METHODS: We examined 50 patients with sigmoid colon and rectal cancer patients who had a radical operation between 1994 May and 1995 April. We checked the level of CEA of peripheral blood preoperatively and postoperatively, and inferior mesenteric vein, bile of gall bladder and peritoneal fluid during surgery. We review clinical characters of the patients, and analyzed the importance of CEA level. RESULTS: The mean CEA levels of peripheral blood (postoperation), inferior mesenteric vein, bile, peritoneal fluid were 5.35+/-2.65, 13.23+/-2.13, 9.23+/-1.65, 7.42+/-2.34 ng/ml respectlively. The mean CEA level of inferior mesentiric vein (13.23+/-2.13 ng/ml) was significantly higher than that of preoperative peripheral blood (8.13+/-2.34 ng/ml) (p<0.05). Falling of postoperative peripheral blood CEA level was also significantly lower than that of preoperative level (p<0.05). CONCLUSIONS: Level of postoperative peripheral blood was related to recurrence rate and survival rate, but tumor size, tumor location, tumor differentiation, Dukes' stage were not related to the CEA level. Bile and peritoneal fluid CEA levels were related with the liver metastasis or local recurrence respectively. We suggest that CEA was useful indicator for evaluation, management, and prognosis of colorectal cancer not only preoperatively but also postoperatively.

A Clinical Significancy of Evoked Thrill Test in the Arteriovenous Fistula

PURPOSE: Arteriovenous fistula at the wrist has remained the procedure of choice for long-term chronic hemod ialysis since its development by Brecia and Cimino in 1966. Thrombosis is the most common cause of early failure after arteriovenous fistula procedure, should be reconized preoperatively or intraoperatively, but no consensus exits regarding the ideal preoperative or intraoperative screening method for access surgery. We describe a simple intraoperative maneuver that can be used to detect proximal stenotic vein segments. METHODS: From September 1998 to September 1999, a total of 117 arteriovenous fistulas were performed for permanent hemodialysis in patients with chronic renal failure. Of them, a intraoperative evoked thrill test was performed in 61 patients (A group), in 56 patients (B group or control group) was not. RESULTS: Early failure rate (<30 days) was 12.5% in A group, 9.8% in B group or control group. In this study, the specificity and positive predictive value of the evoked thrill test was 100%, indicating that this maneuver is highly accurate in predicting early failure. CONCLUSION: Evoked thrill test is a simple and useful intraoperative method for improving the patency rate of autologous arteroiovenous fistula.

Clinical Analysis of Fournier's Gangrene Caused by a Perianal Abscess

PURPOSE: Fournier's gangrene is a rapidly progressive fulminant infection of the perineum and abdominal wall along with the scrotum in men and the vulva in women. If the effective surgical treatment is delayed, the patients result in fatal. Modern surgical series report a mortality of 8-67%. Objective: The aims of this study were to examine the outcomes of 20 consecutive patients with Fournier's gangrene caused by a perianal abscess and to identify the factors leading to improved survival in these patients. METHODS: The medical records of all patients who had been treated at Chosun University Hospital between January 1991 and December 1999 for Fournier's gangrene caused by a perianal abscess were retrospectively reviewed. RESULTS: Twenty patients were identified (mean age 47 years, range 20-66). The sexual ratio was 2.3:1 (male:female). The etiologies included perianal fistula (35%), unknown (35%), hemorrhoidectomy (10%), rectal cancer perforation (10%), and injection therapy (10%). Associated conditions included diabetes mellitus (50%), liver cirrhosis (10%), pulmonary tuberculosis (5%), intestinal tuberculosis (5%), ulcerative colitis (5%), Crohn's disease (5%) and iron deficiency anemia (5%). Escherichia coli and bacteroid fragilis were most commonly identified. All 20 patients initially received multiple incisions and debridement. At the time of first surgery, a diverting colostomy was required in 35% of the cases and a ileostomy in 5%. Over the past 10 years, the survival rate of patients with Fournier's gangrene caused from perianal abscess has been high (100%). CONCLUSION: The keys to a successful outcome included early diagnosis, prompt surgical intervention with radical debridement, prompt fluid resuscitation, rapid initiation of broad-spectrum antibiotics, and hemodynamic support in an intensive care setting.

The Conservative Treatment of Rectal Perforation after Insertion of A Stent and Chemo-Radiotherephy in the Patient with Obstructive Rectal Cancer

The use of self-expanding metal stent has been widely reported that its utility can make a palliative decompression treatment and one stage operation without doing colostomy in the patient with unresectable and resectable obstructive colorectal cancer, respectively. It, however, can sometimes cause complications such as intestinal perforation. We report that the conservative treantment could be possible without removing stent or performing laparotomy in case of intestinal perforation during chemoradiotheraphy after insert of stent for relieving colonic obstruction in the 53 years old female patient with stage IV rectal cancer.

Induction of Metallothionein and Manganese-Containing Superoxide Dismutase by Paraquat in Peripheral White Blood Cells of Patients with Gastric Cancer

PURPOSE: It is known that deficiency of metallothionein (MT) and manganese-containing superoxide dismutase (Mn-SOD), scavengers of reactive oxygen species, results in aging and carcinogenesis by inducing DNA damage. Paraquat can produce reactive oxygen species and induce antioxidants in human. In this study, an attempt was made to verify the relation between gastric carcinogensis and the induction rates of these antioxidants. METHODS: Peripheral blood of 24 randomly selected patients with gastric cancer, who were treated at Chosun University Hospital between Febuuary 1999 and December 1999, was examined. 3 male and 3 female patients in each decade from 40 to 70 years were selected. Twenty-four (24) volunteers with no laboratory, chemical, radiologic and endoscopic abnormalities during the same period were used for the normal control group. White blood cells were isolated from peripheral blood and incubated in culture media, including paraquat, for 18 hours at 37oC. MT and Mn-SOD mRNA expressions were examined using the reverse transcription-polymerase chain reaction (RT-PCR) method. RESULTS: The induction rates of MT and Mn-SOD mRNA in the cancer group due to paraquat were lower than those in the control group. Also, the rates decreased in both groups with age. CONCLUSION: The inducibilities of MT and Mn-SOD mRNA by paraquat may play a role in the carcinogenesis of gastric cancer and in the aging process. Based on this result, patients with a high risk of gastric cancer should be screened actively for early detection.

Clinical Significance of Loss of Heterozygosity on Chromosome 14q in Sporadic Colorectal Carcinomas

PURPOSE AND METHODS: Colorectal carcinogenesis is a process with multiple steps involving proto- oncogenes, tumor suppressive genes, and mutator genes. Losses of heterozygosity (LOH) on APC, DCC, and TP53 loci are well known chromosomal changes for the inactivation of tumor suppressive genes. Additionally, LOH in colorectal carcinomas (CRC) are frequently found at other loci, including 1p, 8p, 11q, 14q, and 22q. LOH on 14q are quite frequent in bladder, ovarian, renal-cell carcinomas, as well as other types of carcinomas. Previous studies on CRC showed overall rate of LOH on chromosome 14q to be high, the smallest region of overlap of deletion was located at the distal portion of 14q, and a higher rate of LOH was found in more advanced tumors. To investigate whether LOH on chromosome 14q is confined to the distal part or whether it is related with prognosis, we performed an LOH study with 6 microsatellite markers covering the entire arm of 14q in 77 sporadic colorectal cancers and compared it with clinical parameters. RESULTS: Thirty-six (36) tumors (46.7%) showed LOH at one or more markers, and the highest rate was observed in D14S48 (43.5%) and the lowest in D14S297 (30.6%). No statistical differences were seen at different loci of 14q. We observed LOH in 17 less- advanced tumors (Dukes' A & B) and in 19 advanced tumors (Dukes' C & D). There is little evidence that LOH of 14q is related to tumor recurrence, the disease-free survival rate, or the overall survival. CONCLUSION: These results indicate that the entire long arm of chromosome 14 may delete in sporadic colorectal cancers but this loss may not be related to tumor stage and prognosis. We provide evidence that one or more tumor suppressive loci on chromosome 14q may contribute to colorectal carcinogenesis.

Clinical Significance of Loss of Heterozygosity on Chromosome 14q in Sporadic Colorectal Carcinomas

PURPOSE AND METHODS: Colorectal carcinogenesis is a process with multiple steps involving proto- oncogenes, tumor suppressive genes, and mutator genes. Losses of heterozygosity (LOH) on APC, DCC, and TP53 loci are well known chromosomal changes for the inactivation of tumor suppressive genes. Additionally, LOH in colorectal carcinomas (CRC) are frequently found at other loci, including 1p, 8p, 11q, 14q, and 22q. LOH on 14q are quite frequent in bladder, ovarian, renal-cell carcinomas, as well as other types of carcinomas. Previous studies on CRC showed overall rate of LOH on chromosome 14q to be high, the smallest region of overlap of deletion was located at the distal portion of 14q, and a higher rate of LOH was found in more advanced tumors. To investigate whether LOH on chromosome 14q is confined to the distal part or whether it is related with prognosis, we performed an LOH study with 6 microsatellite markers covering the entire arm of 14q in 77 sporadic colorectal cancers and compared it with clinical parameters. RESULTS: Thirty-six (36) tumors (46.7%) showed LOH at one or more markers, and the highest rate was observed in D14S48 (43.5%) and the lowest in D14S297 (30.6%). No statistical differences were seen at different loci of 14q. We observed LOH in 17 less- advanced tumors (Dukes' A & B) and in 19 advanced tumors (Dukes' C & D). There is little evidence that LOH of 14q is related to tumor recurrence, the disease-free survival rate, or the overall survival. CONCLUSION: These results indicate that the entire long arm of chromosome 14 may delete in sporadic colorectal cancers but this loss may not be related to tumor stage and prognosis. We provide evidence that one or more tumor suppressive loci on chromosome 14q may contribute to colorectal carcinogenesis.

Breast Carcinoma Following Silicone Injection

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.

Breast Carcinoma Following Silicone Injection

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.

The Effect of the Cyclosporine in the Renal Ischemic and Reperfusion Injury / 대한이식학회지

During renal ischemia, ATP is degraded to hypoxanthine and xanthine oxidase is accumulated. When reperfusion develops, large amount of oxygen is supplied and superoxide radicals are generated. Free radical species were generated by a series of oxygen mediated reaction resulted in lipid peroxidation in the cellular membrane, which causes renal injury. Cyclosporin (CsA) is a potent immunosuppresant. however, one of the main adverse effects of CsA is nephrotoxicity. The mechanism of nephrotoxicity is still not fully understood. Only we proposed it as being responsible for the derangement of renal function, enhanced free radical species, vasoconstriction, ATP depletion, several vasoactive mediators. Based on the previously studied data with experimental animals, we studied a relationship between ischemia and reperfusion renal injury and cyclosporine with experimental rats. Four groups of Sprague-Dawley rats were studied: 1) a control group, only 60 minnites clamping and on day 3 is sacrified, 2) second control group, 60 minnites clamping and on day 5 is sacrified, 3) in the third and fourth group, after 60 minnites clamping, cyclosporine, 20 mg/kg/day was administrated intraperitoneally and were sacrified on day 3 and day 5, respectively. Antioxidant enzymes (SOD, Catalase), TBA-RS, GGT were measured by a specific biochemical method, and results were analyzed according to Wilcoxon rank sum test. p-value <0.05 was considered statistically significant. In cyclosporin administrated rats, GGT was elevated significantly on day 3 and day 5 (p=0.0367, p=0.0216), but SOD, Catalase, TBA-RS were not identified a significant change. In conclusion, on renal ischemia and reperfusion,cyclosporin induced renal injury is not related to free radical species, which suggests that other unknown mechanisms influence renal injury.

Anal Endosonographic Findings of Internal Anal Sphincter in Normal Adult Korean

PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.

The Value of the Expression of bel-2 and p53 in Colorectal Carcinomas

There are a lots of evidences that colorectal cancer arise as a result of multiple alterations of genes. Many attempts were made to understand the role of oncogenes and suppressor genes as a prognostic indicator, recently. Although histopathologic staging of tumor is the most important prognostic factor up to now, it is not enough to be used with full confidence. Apoptosis or programmed cell death represents a deletion of damaged or natural cell mechanism. The bel-2 proto-oncogene is known as a inhibitor of apoptosis that may allow accumulation and propagation of cells containing genetic alterations. Overexpression of bcl-2 probably plays a role in colorectal carcinogenesis. The aim of this study was to determine bcl-2 and p53 expression in colorectal carcinoma in correlation with apoptosis, clinical parameters, and histopathology, and to test their prognostic significance in patient with colorectal carcinoma. The bel-2 and p53 protein were identified by immunohistochemical staining using monoclonal and polyclonal antibody. The apoptotic index was detetermined by microscopic examination of hematoxyln and rosin-stained sections at x400. The materials subiected to this study were 54 paraffin-embedded colorectal carcinomas, which were collected randomly from January of 1992 to December of 1994 at Department of Surgery, Chosun University Hospital. Of 54 cases, 21 (38.9%) and 22(40.7%) showed positive expression of bel-2 and p53 protein respectively. Mean apoptotic index(AI) was 2.99% in colorectal carcinoma. Bcl-2 expression did not correlated with p53 expression or apoptotic index. Positive expression of p53 or AI was not correlate with any other clinical and pathologic parameters. An inverse correlation was found between bel-2 expression and increased tumor stage or Iymph node metastasis (P<0.05). In conclusion, these results suggest that bcl-2 expression is significant associated with early stage in colorectal carcinoma. But bcl-2 p53 and AI can`t be a independent prognostic factor in colorectal carcinoma. Further investigations to clarity its possible role in controlling the tumor decelopment and growth of colorectal carcinoma are needed.

Arterial thrombosis associated with nephrotic syndrome; a case report and review (adult cases in the English literature)

The thromboembolic complications of nephrotic syndrome are reasonably common, including spontaneous peripheral venous and/or arterial, pulmonary arterial, and renal venous occlusions. However, in comparison to the relatively high incidence of the venous thromboembolic complications with hypercoagulable status, arterial thromboses have been reported much less and it was only 20 cases in the English literature so far. Furthermore, the most cases were pediatric patients rather than adults. Therefore, this report describes an adult nephrotic cases complicated by superior mesenteric artery thrombosis leading to death via catastrophic hospital course. Also, we reviewed the literature in English regarding cases of arterial thromboses in adult nephrotic patients with special interest to locations of thrombosis, underlying histopathologic types of glomerulopathy, and use of steroids or diuretics before its development.

Results of surgical treatment for perforated peptic ulcer

No abstract available.