Expression of Proteins Related Cell Cycle and Apoptosis during Diethylnitrosamine (DEN)-induced Hepatocarcinogenesis in Rats

PURPOSE: To explore the role of cell cycle and apoptosis regulators during hepatocarcinogenesis, the expression of cell cycle-related proteins (cyclin D1 and p27kip1) and apoptosis-related proteins (p53, survivin, caspase 3). METHODS: Sprague-Dawley rats were given 120 ppm diethylnitrosamine (DEN) as a carcinogen and sequentially sacrificed. The expression of cell cycle and apoptotic related proteins were examined by light microscopy and immunohistochemistry. RESULTS: During the DEN-induced hepatocarcinogenesis, sequential histologic changes from preneoplastic lesions (altered hepatic cellular foci, hyperplastic nodules, and hepatocellular adenomas) and ultimately overt hepatocellular carcinomas and metastatic lesions were noted. The cyclin D1 were progressively increased from preneoplastic lesions to hepatocellular carcinomas. However, the p27kip1 and the survivine proteins did not show any other difference with the increasing degree of carcinogenesis. The p53 and caspase 3 proteins were more significantly increased in hepatocellular carcinomas than preneoplastic lesions. The cyclin D1 protein expression did not show any correlation with the expression of p27Kip1 protein, but the p53 expression was related to the expression of survivin and caspase 3. CONCLUSION: From the above results, over-expression of cyclin D1 plays a role in the early and late stages of hepatocarcinogenesis. In addition p53 and caspase 3 might be useful markers for evaluating the risk of malignant transformation.

Comparison of Clinical Differences between Colonic Obstruction and Non-obstruction Groups in Colon Surgery

PURPOSE: The purpose for this study is to compare the clinical differences of the two groups (ie. colonic obstruction and non-obstruction) in colonic surgery. METHODS: A retrospective clinical analysis was done in 149 patients with colorectal disease who had been surgically treated from January 1995 to December 1997 at our institution. RESULTS: 1) The peak age of incidence was in the 7th. and 8th. decades (53.3%)in the obstruction group and 6th. and 7th. decades (54.3%) in the non-obstruction group, the sex ratio of male to female was higher in the obstruction group (2.00:1) than in the non-obstruction group (1.04:1). 2) The most common cause of colonic obstruction was malignant disease in both groups (75.4% in the obstruction group and 78.3% in the non-obstruction group). 3) The most frequent symptom and sign of the two groups were abdominal pain (36.8% and 2.6% respectively). 4) The most common location was cecum (24.6%) followed by sigmoid colon (22.8%) and rectum (15.8%) in the obstruction group, and rectum (40.2%) followed by ascending colon (15.2%), cecum (13.0%), and transverse colon (13.1 %) in the non obstruction group. 5) The right hemicolectomy was the most common procedure in the obstruction group (29.8%) while abdominoperineal resection was most frequently performed in the non-obstruction group (23.9 %). The surgical resection rate was 77.4% and 100% in obstruction group and non-obstruction group, respectively. 6) In the case of colon cancer, the stage of cancer (according to Modified Astler-Coller classification) was much higher in the obstruction group. An average 6.5 metastatic lymph nodes were found from 18.5 dissected lymph nodes in the obstruction group whereas 2.7 out of 13.9 lymph nodes in the non-obstruction group. 7) The postoperative complication rate of obstruction group were 21.4% whereas that of non-obstruction group were 15.0% respectively. The postoperative mortality rate was 14% in the obstruction group and 3.3% in the non-obstruction group. The complication rate and postoperative mortality of the obstruction group was higher than those of the non-obstruction group, especially in the malignant disesae group. CONCLUSIONS: The results of our study indicate that the obstruction group has a different clinical course from the non- obstruction group and associated higher postoperative complication and mortality rate.

The Effect of COX-2 Inhibitor on the Growth and Metastasis of Gastric Cancer Xenograft

PURPOSE: Tumor invasion and metastasis are known to be extremely important factors in the prognosis of cancer patients. Although recent studies have demonstrated that cyclooxygenase-2 (COX-2) is overexpressed in various cancers including gastric cancer, the mechanisms underlying the contribution of COX-2 to tumorigenesis and tumor promotion remain unclear. METHODS: In order to determine the role of COX-2 in tumor growth and metastasis, we investigated COX-2 expression, apoptosis and the expression of E-cadherin, CD44v6, MMP-2 and TIMP-2 in gastric cancer xenografts treated with meloxicam (a selective COX-2 inhibitor). RESULTS: Cells from the MKN45 gastric cancer cell line that overexpress COX-2 were inoculated subcutaneously into athymic mice. Oral administration with meloxicam reduced the tumor volume (P<0.01), induced apoptosis of cancer cells (P<0.01), suppressed the proliferation rates (P<0.01), increased the expression of E-cadhrin (P<0.05) and reduced the expression of MMP-2 and TIMP-2. CONCLUSION: The above data showed that COX-2 inhibitors can inhibit tumor growth and suppress metastatic potential by expression of adhesion molecules and suppression of metalloproteinases, suggesting that this inhibitor can be used as an additive anti-cancer drug in cases of stomach cancer with radical resection, although further evaluation is required.

A Case of Femoral Neuropathy after Renal Transplantation / 대한이식학회지

A few cases of femoral neuropathy that were developed after renal transplantation have been reported in western literature. The possible causes of this neuropahty that discussed in recent studies are compression of nerve by self-retaining retractor during operation, ischemia of femoral nerve by iliac muscle hematoma etc. We experienced one case of femoral nerve neuropathy after right iliac fossa renal transplantation that developed at first postoperative day without definitive etiology in all study. It was improved symptomatically after 2 weeks of postoperative day, so we reported this case with brief review of the literatures.

The Effect of Meloxicam on Tumor Growth and Angiogenesis of Human Gatric Cancer Cell Line Xenograft in Nude Mice

PURPOSE: In general, tumor growth is dependent on angiogenesis. COX, known as modulator of angiogenesis, consists of two at least isozymes constitutive COX-1 and stress- induced COX-2. The latter is known in case of gastric cancer to be overexpressed in neoplastic tissue but not in adjacent normal tissue. To clarify the effect of COX-2 inhibitors on tumor growth and angiogenesis, we investigated the effects of Meloxicam (a selective COX-2 inhibitor) on gastric cancer xenograft in nude mise that overexpress COX-2. METHODS: MKN45 gastric cancer cell lines that overexpress COX-2 were inoculated subcutaneously into athymic mice. The mean tumor volume, apoptotic index, proliferative index, microvessel count and angiogenic factors (VEGF and bFGF) were measured in the control group (12 cases) and the meloxicam treated group (23 cases). RESULTS: There was no significant difference of COX-2 expression between the control and meloxicam treated groups in mRNA level as measured by RT-PCR, nor in protein level by Western blotting. However, in the meloxicam treated group, apoptosis was increased to a statistically significant degree (P<0.01) while the proliferation index as measured by Ki-67, the mean tumor volume and angiogenesis were all significantly decreased, as compared with the control group (P<0.01). CONCLUSION: The possible suppression of angiogenesis and tumor growth in gastric cancer xenograft by meloxicam suggests potentially. Novel and promising applications of COX-2 inhibitors in the adjuvant treatment of gastric cancer. However, further clinical study will be needed to determine its efficacy in such treatment modalities.

Efficacy of Hooked-Wire Needle Localization for Nonpalpable Breast Lesions

PURPOSE: The more frequent use of screening mammography, along with improved imaging equipment and techniques, is today resulting in an increasing detection rate for suspicious nonpalpable lesion and thus an increasing need for needle localizations and biopsies. We evaluate the efficacy of hooked-wire fine needle localization. METHODS: From August 1992 to August 1999, 146 hooked-wire needle biopsies were performed at our institution for nonpalpable mammographically detected abnormalities. Specimen roentgenographies were done in all cases. The clinical datas, including mammographic findings and pathologic results, were reviewed retrospectively. RESULTS: Patients ranged in age from 13 to 74 years (a mean of 45.7 years). Of the total 146 cases, 23 (15.7%) were found to be malignants (52.2 percent of these malignancies were carcinomas in situ and 47.8 percent were invasive carcinoma). The chance of a biopsy containing a malignant lesion was 17.2 percent if the biopsy was done for a microcalcification found on a mammograms, 7.7 percent for mass densities, and 28.6 percent if both were present. Benign pathological lesions were proven in 123 cases (84.3%) of the total 146 cases. The most common benign lesion was fibrocystic disease. A minor complication of the hooked-wire needle insertion occurred in one patient who had a hematoma requiring evacuation. Three patients experienced faintness, dizziness, and syncope during needle localization. The morbidity and the mortality rates for biopsies of the breast were nil. CONCLUSION: These results suggest that hooked-wire needle localization for nonpalpable lesion in the breast is a most useful diagnostic modality.

A Case of Massive Hemobilia after Laparoscopic Cholecystectomy

"Hemobilia" upper gastrointestinal bleeding that originates from within the biliary tract, is a rare complication of the laparoscopic cholecystectomy. Only a few cases have been reported in the literature. It is more common in accidential or iatrogenic injury of the liver and bile ducts, even occurring spontaneously in cholelithiasis, several inflamatory processes, and vascular and neoplastic changes. The laparoscopic cholecystectomy is a recently developed and advanced surgical procedure that has rapidly gained acceptance. Its complications remain to be clinically analyzed. The authors experienced a case of massive hemobilia after a laparoscopic cholecystectomy. A 54-years-old man with hemobila resulting from right hepatic artery pseudoaneurysm communicating with the intra-hepatic bile duct was treated with angiographic tanscatheter embolization on the of 24th postoperative day. We report this case with a brief review of the literature.