Treating Gynecomastia with Ultrasound-guided Vacuum-assisted Biopsy Device as a Cosmetic Method / 한국유방암학회지

PURPOSE: Gynecomastia can cause severe emotional phobia for breast cancer in elderly male and physical distress in young men. To select the appropriate cosmetic surgical approach for gynecomastia, I evaluated the usefulness of performing ultrasound-guided vacuum-assisted device excision of it. METHODS: Twenty-two cases of gynecomastia in 18 male were treated by vacuum-assisted biopsy device excision from November 2005 to June 2007. Their age range was 14-72 years old (mean, 34). The vacuum-assisted biopsy device excision was performed by 11G needle in 7 cases and 8G needle in 15 cases. I checked the number of extracted tissue pieces, the duration time of the procedure, immediate complications, and breast ultrasound after 3 months. RESULTS: The mean number of extracted tissue pieces was 69, and the average procedure duration was 25 minutes. There were no significant immediate complications such as bleedings and skin necrosis, and there were no clinically serious complications on 3 months follow-up examinations. During operation under local anesthesia, all patients tolerated the procedure. After vacuum-assisted biopsy device procedure, the cosmetic results were good to excellent for all the patients. CONCLUSION: Vacuum-assisted biopsy device excision was an effective surgical option, especially for small and glandular gynecomastia. I suggest this is a useful alternative procedure to surgery and liposuction, or it could be used effectively as a co-operative procedure with liposuction.

The Proteomics Approaches to Find Bio-Markers in Serum of Locally Advanced Breast Cancer Patients / 한국유방암학회지

PURPOSE: Breast cancer continues to be a major cause of death, despite the advances in the study of many prognostic factors. Although many prognostic factors have been studied, none reliably predict the response to treatment. This uncertainty in the prognostic factors could be overcome by defining the changes, occurring in patients at either the gene or protein level. Herein, attempts were made to examine the protein repertoire of patients using Proteomics. MATERIALS AND METHODS: Using conventional Proteomics, the high resolution 2-D electrophoresis followed by computational image analysis(Melanie program) and protein identification with mass spectrometry (MALDI-TOF), the serum of locally advanced breast cancer patients (stage III) was analyzed, and attempts were made to define the differences between recurred (or metastasis) patients ,and disease free patients of more than 4-years duration after surgery. RESULTS: In the 2-D electrophoresis of serum, about 1,000 spots were gained in each gel, with the up and down expressed protein spots compared to the normal control protein map. Six of seven patients had Cytokeratin 9 in their peripheral blood. In the serum of recurred patients (one of two), no Haptoglobin-related proteins were detected. All five un-recurred patients had normal or elevated levl of serum Haptoglobin-related proteins. CONCLUSIONS: The reduction of Haptoglobin-related proteins indicated the humoral immuno-depression in recurred patients. These findings may suggest the continuation of proper humoral immunity was important in the prevention of cancer recurrences or metastasis after surgery, especially in locally advanced breast cancer patients, which may suggests the value of immunotherapy in breast cancer patients to obtain good results.

The Proteomics Approaches to Find Bio-Markers in Serum of Locally Advanced Breast Cancer Patients / 한국유방암학회지

PURPOSE: Breast cancer continues to be a major cause of death, despite the advances in the study of many prognostic factors. Although many prognostic factors have been studied, none reliably predict the response to treatment. This uncertainty in the prognostic factors could be overcome by defining the changes, occurring in patients at either the gene or protein level. Herein, attempts were made to examine the protein repertoire of patients using Proteomics. MATERIALS AND METHODS: Using conventional Proteomics, the high resolution 2-D electrophoresis followed by computational image analysis(Melanie program) and protein identification with mass spectrometry (MALDI-TOF), the serum of locally advanced breast cancer patients (stage III) was analyzed, and attempts were made to define the differences between recurred (or metastasis) patients ,and disease free patients of more than 4-years duration after surgery. RESULTS: In the 2-D electrophoresis of serum, about 1,000 spots were gained in each gel, with the up and down expressed protein spots compared to the normal control protein map. Six of seven patients had Cytokeratin 9 in their peripheral blood. In the serum of recurred patients (one of two), no Haptoglobin-related proteins were detected. All five un-recurred patients had normal or elevated levl of serum Haptoglobin-related proteins. CONCLUSIONS: The reduction of Haptoglobin-related proteins indicated the humoral immuno-depression in recurred patients. These findings may suggest the continuation of proper humoral immunity was important in the prevention of cancer recurrences or metastasis after surgery, especially in locally advanced breast cancer patients, which may suggests the value of immunotherapy in breast cancer patients to obtain good results.

Usefulness of Ultrasound-guided Mammotome Biopsy for Microcalcification

PURPOSE: To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. MATERIALS AND METHODS: Twenty-one calcific lesions in 21 women (aged 33-56 years) underwent ultrasound-guided, vacuum-assisted, mammotome biopsy and a mean of 14 specimens per lesion were obtained. Calcification retrieval was defined as identification of calcifications on specimen radiographs. In the 13 cases of calcifications which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammography-guidance. Radiographs of the specimens and histologic findings were reviewed and scheduled follow-up imaging was performed for evaluation of the complications of biopsy. RESULTS: Ultrasound-guided, vacuum-assisted, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcification on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance. Surgery revealed DCIS in 1 (4.8%) of 21 lesions, infiltrating ductal carcinoma in two (9.5%), fibroadenomas with calcifications in 6 (28.6%), fibroadenomas with adenosis in 2 (9.5%), and fibrocystic change with calcifications in 10 (47.6%). Clinical significant complications did not occur on follow-up examination in any of the cases. CONCLUSION: Ultrasound-guided, vacuum-assisted, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images.

Investigation of Early Protein Changes in the Urinary Bladder Following Partial Bladder Outlet Obstruction by Proteomic Approach

We investigated the pathophysiological mechanism by proteomic approach as a possible tool to detect the marker proteins to develop lower urinary tract symptoms following bladder outlet obstruction (BOO). Rats were randomized into 3 groups; control, sham operation and BOO groups. BOO group was divided into 1, 3, and 5 day-group. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry using rat urinary bladders. A comparison of bladder of BOO group with control bladder showed that three proteins of optineurin, thioredoxin and preprohaptoglobin were over-expressed in the bladder of BOO group. In addition, four proteins, such as peroxiredoxin 2, transgelin, hippocampal cholinergic neurostimulating peptide (HCNP) and beta-galactoside-binding lectin, were under-expressed in the bladder of BOO group. These data supported that downregulation of HCNP might make detrusor muscle be supersensitive to acetylcholine, up-regulation of optineurin means the protection of nerve injury, and down-regulation of transgelin means the decreased contractility of detrusor muscle. Beside these proteins, other proteins are related to oxidative stress or have a nonspecific function in this study. However more information is needed in human bladder tissue for clinical usage.

Proteomic Approach for Identifying Marker Proteins in the Urinary Bladder Precancerous Conditions Induced by BBN(N-butyl-N-(4-hydroxybutyl) nitrosamine) / 대한비뇨기과학회지

PURPOSE: Simple and noninvasive methods for the diagnosis of transitional cell carcinoma of the bladder are needed for the prevention of invasive tumor. A proteomic technology has recently been developed to facilitate protein profiling of biological mixtures. We investigated the role of this proteomic approach as a possible tool to detect the marker protein during the initiation stages on BBN-induced bladder carcinogenesis in rats. MATERIALS AND METHODS: Ten rats group A were given 0.05% BBN in drinking water for 12 weeks. Ten rats in group B were designated as a control group and were not given BBN. Whole urinary bladders of all rats were excised at 12 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. RESULTS: A comparison of urinary bladder hyperplasia tissue with control tissue showed that five proteins; actin gamma2 propeptide, cytokeratin-20, proapolipoprotein, alpha2 actin(alpha-cardiac actin) and heat shock 27kDa protein 1 were over-expressed in hyperplastic tissues. Three protein; transcription factors, seminal vesicle secretory protein VI precursor and hypothetical protein RMT-7 were under-expressed in hyperplastic tissues. CONCLUSIONS: In an animal model system, BBN-induced, urinary bladder mucosal hyperplasia resulted in an increase in five proteins and a decrease in three proteins. Of these altered proteins, CK-20 and SVS-VI seem to be important. The proteomic approach may be a simple and noninvasive method for monitoring and follow-up of bladder cancer patients. However more information is needed regarding CK-20 expression in nonmalignant urological disease and in human tumor tissue, and regarding SVS-VI expression in other organs, for clinical usage.

The Change of Endometrial Thickness in Tamoxifen-treated Postmenopausal Breast Cancer Patients / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to investigate the effect of tamoxifen on endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer after chemotherapy. METHODS: Fifty-eight tamoxifen-treated postmenopausal breast cancer patients underwent periodically transvaginal ultrasonography twice a year for 2 years and then once a year. We analyzed the correlation between the sonographic endometrial thickness and the duration of tamoxifen therapy. RESULTS: The mean endometrial thickness of breast cancer patients before tamoxifen therapy was 4.68 mm. But the mean endometrial thickness increased to 5.03 mm at 6 months, 5.21 mm at 12 months, after which it slightly declined to 5.13 mm at 18 months. And then it increased to 5.15 mm at 24 months, and 5.24 mm at 36 months. There was a significant increase in endometrial thickness after tamoxifen therapy compared with before tamoxifen therapy (por=5 mm. No cases of endometrial cancer were detected. CONCLUSION: Significant increase in endometrial thickness with the duration of tamoxifen therapy in postmenopausal tamoxifen-treated patients may be associated with a high risk of endometrial pathologies in these patients.

Report of Benign and Malignant Adenomyoepithelioma of the Breast / 한국유방암학회지

Adenomyoepithelioma is a rare benign tumor which occurs mainly in the skin, salivary gland and very rarely in the breast, in case of malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic histology and immunohistochemical features. We report two cases of adenomyoepithelioma, one was benign occuring in the outer upper quadrant of the right breast (48-year-old female), and the other was malignant adenomyoepithelioma occuring in the peri-areolar of the left breast (46-years-old female). We confirmed with both H&E stain and immunohistochemistry. We report benign and malignant adenomyoepithelioma of the breast occurred in middle aged women.

The Proteomics Approach to Find Biomarkers in Gastric Cancer

Gastric cancer is a very serious disease and is naturally resistant to many anticancer drugs. To reduce the mortality and improve the effectiveness of therapy, many studies have tried to find key biomarkers. Proteomic technologies are providing the tools needed to discover and identify disease-associating biomarkers. The proteomic study of gastric cancer establishes any specific events that lead to cancer, and it provides a direct way to define the true function of genes. Using two dimensional (2-D) electrophoresis of the stomach cancer tissue, we have gained about 1,500 spots in each gel, and 140 protein spots also were identified. Among the identified proteins, there were seven over-expressed proteins in stomach cancer tissue: NSP3, transgelin, prohibitin, heat shock protein (hsp) 27 and variant, protein disulfide isomerase A3, unnamed protein product and glucose regulated protein. There were also seven under-expressed proteins in stomach cancer: Apolipoprotein A-1, p20, nucleoside diphosphate isomerase A, alpha 1 antitrypsin, desmin, serum albumin and sero-transferrin.

Clinical Analysis and Comparison of Mammotome Biopsy between 8G and 11G Probes / 한국유방암학회지

PURPOSE: We analysed the clinical data to compare the usefulness of ultrasound guided vacuum-assisted Mammotome biopsy between 8G and 11G probes. METHODS: 108 cases in this study underwent an ultrasound- guided minimally invasive excisional breast biopsy through small incision. Removal of the breast lesions was accomplished Mammotome biopsy with 8G or 11G probes. RESULTS: The 108 lesions was excised. Mean size of the lesions were 10.7 mm in 8G and 9 mm in 11G. 105 lesions (95%) had benign pathology, three lesions (2.8%) were malignant, and two lesions (1.9%) had atypical ductal hyperplasia. As procedural complications, hematoma was 23/58 (39.7%) in 8G and 10/50 (20%) in 11G, and ecchymosis was 33/58 (55%) in 8G and 11/50 (22%) in 11G. But there was no major complications which need hospitalization and surgical intervention. CONCLUSION: Breast biopsy using Mammotome with 8G probe is as safe as 11G and effective technique.

Chemosensitivity Test in Human Breast Cancer / 한국유방암학회지

PURPOSE: Breast cancer ranks as the second most frequent cancer in women in Korea, and the rate is gradually increasing. Compared to European countries and USA., the Korean breast cancer occurs at a younger age (mean age: 47) than in western countries (mean age: 60). We suppose that there is some biological differences between Korean and western breast cancer. This study was designed to determine the target chemotherapy agents for use on individual patients and define target patients for chemotherapy during the post-op period. Additionally, we desired to acquire primary data for further proteomic analysis of patients. METHODS: Twenty-one patients with breast cancer were entered in this study. Tumor specimens were taken and informed consent was obtained for use of the samples in drug sensitivity testing. MTS[3-(4,5-dimethylthiazol-2-yl)-5- (3-carboxy methoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt] assay was able to be preformed in 16 patients (success rate, 76.2 percent). We used four drugs including Adriamycin, Epirubicin, 5-FU, and Taxol. RESULTS: In the axillary lymph node negative group, 5-FU (56.62%) and Taxol (53.85%) were sensitive drugs. There were no sensitive drugs in the p53 over-expression group. In the wild p53 group, 5-FU was the only sensitive drug. 5-FU was sensitive in both the ER and PR positive groups. Taxol was sensitive in the c-erbB2 low expression group. CONCLUSION: We obtained the results for chemosensitivity of breast cancer of Korean women. 5-FU and Taxol were relatively sensitive drugs, however we believe further data should be collected and added to obtain complete chemosensitivity results.

Chemosensitivity Test in Human Breast Cancer

PURPOSE: Breast cancer ranks as the second most frequent cancer in women in Korea, and the rate is gradually increasing. Compared to European countries and USA., the Korean breast cancer occurs at a younger age (mean age: 47) than in western countries (mean age: 60). We suppose that there is some biological differences between Korean and western breast cancer. This study was designed to determine the target chemotherapy agents for use on individual patients and define target patients for chemotherapy during the post-op period. Additionally, we desired to acquire primary data for further proteomic analysis of patients. METHODS: Twenty-one patients with breast cancer were entered in this study. Tumor specimens were taken and in formed consent was obtained for use of the samples in drug sensitivity testing. MTS[3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxy methoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt] assay was able to be preformed in 16 patients (success rate, 76.2 percent). We used four drugs including Adriamycin, Epirubicin, 5-FU, and Taxol. RESULTS: In the axillary lymph node negative group, 5-FU (56.62%) and Taxol (53.85%) were sensitive drugs. There were no sensitive drugs in the p53 over-expression group. In the wild p53 group, 5-FU was the only sensitive drug. 5-FU was sensitive in both the ER and PR positive groups. Taxol was sensitive in the c-erbB2 low expression group. CONCLUSION: We obtained the results for chemosensitivity of breast cancer of Korean women. 5-FU and Taxol were relatively sensitive drugs, however we believe further data should be collected and added to obtain complete chemosensitivity results.

The Expression of High Mobility Group I (Y) Proteins in Human Breast Cancer

PURPOSE: The precise mechanisms of tumorigenesis of breast cancer remains unknown in spite of major efforts. Recent studies have shown that High Mobility Group I (Y) Proteins [HMGI(Y)] have an important role in the regulation of chromatin structure and function, and that HMGI(Y) protein expression is generally correlated with a malignant phenotype. This study was undertaken to define the relationship of the HMGI(Y) protein expression between malignant breast tissue and non-malignant breast tissue in human, and clinico- pathologic findings were reviewed for this purpose. METHODS: Using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for HMGI(Y) with beta-actin, this study demonstrated the expression of HMGI(Y). The p53, ER, and PR. were defined by immunohistochemical staining. RESULTS: The HMGI(Y) expression was increased in the malignant tissue (90%), than in benign (76.9%) or normal (65%) tissue (p=0.031). As for the invasive ductal cancers, there was no difference between the HMGI(Y) expression and histopathologic parameters. CONCLUSION: These results suggest that the HMGI(Y) expression may be of little pathogenetic prognostic importance in human breast cancer.

Expression of High Mobility Group Protein Family HMGI(Y) and HMGI-C in Human Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Breast cancer results from the progressive accumulation of a series of genetic alterations leading to neoplastic transformation. Recent studies have shown that a) HMGI proteins play an important role in the regulation of chromatin structure and function and b) the expression of aberrant HMGI [HMGI(Y) and HMGI-C] proteins is generally correlated with malignant tumors. We tried to define the function of HMGI in carcinogenesis and we compare the expression of HMGI with known clinicopathologic parameters. MATERIALS AND METHODS: Using Reverse transcriptase-polymerase chain reaction (RT-PCR), we determined the expression of HMGI mRNA in 60 primary malignant tumors, 20 normal tissue, 13 benign tumors, and four ductal carcinoma in situ. Immunohistochemical staining of p53, ER, PR, and clinicopathological parameters were evaluated. RESULTS: The expression of the HMGI(Y) mRNA increased more in malignant tissue (90%, 54 of 60) than in benign (76.9%) and normal (65%) tissues (p=0.031). The expression of HMGI-C mRNA was visible only in malignant (48.4%, 29 of 60) and benign (23.1%, 3 of 13) tumors. The expression of HMGI-C mRNA increased more in malignant tumors than in benign tumors (p<0.001). In invasive ductal tumors (n=50), the expression of HMGI-C mRNA was observed more in high grade tumors (grade 3~81.3%, grade 1, 2~32.4%) (p=0.005). Among the prognostic parameters, only the number of mitotic figures was related to the expression of HMGI-C mRNA (p=0.046). CONCLUSION: These results suggest that a) HMGI-C gene may be correlated with the formation of breast tumors and b) the expression of HMGI-C gene may be of pathogenetic and prognostic importance in human breast cancer.

The Expression of High Mobility Group I (Y) Proteins in Human Breast Cancer / 한국유방암학회지

PURPOSE: The precise mechanisms of tumorigenesis of breast cancer remains unknown in spite of major efforts. Recent studies have shown that High Mobility Group I (Y) Proteins [HMGI(Y)] have an important role in the regulation of chromatin structure and function, and that HMGI(Y) protein expression is generally correlated with a malignant phenotype. This study was undertaken to define the relationship of the HMGI(Y) protein expression between malignant breast tissue and non-malignant breast tissue in human, and clinico- pathologic findings were reviewed for this purpose. METHODS: Using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for HMGI(Y) with beta-actin, this study demonstrated the expression of HMGI(Y). The p53, ER, and PR. were defined by immunohistochemical staining. RESULTS: The HMGI(Y) expression was increased in the malignant tissue (90%), than in benign (76.9%) or normal (65%) tissue (p=0.031). As for the invasive ductal cancers, there was no difference between the HMGI(Y) expression and histopathologic parameters. CONCLUSION: These results suggest that the HMGI(Y) expression may be of little pathogenetic prognostic importance in human breast cancer.

A Study of the Expression of p53 and the Product of bcl-2 in Early and Advanced Gastric Cancers

PURPOSE: To evaluate of the role in carcinogenesis of p53 over-expression and bcl-2 inhibition in early gastric and advanced gastric cancers, we investigated the immunohistochemical tissue status of 31 primary early gastric-cancer patients and 31 primary advanced gastric-cancer patients. METHODS: DO7, the monoclonal antiserum to the P53 protein, and clone 124, the monoclonal antibody to the bcl-2 protein, were used for the immunohistochemical analysis of the 31 surgically resected primary early gastric cancer specimens and the 31 surgically resected advanced gastric-cancer specimens. The expressions were scored and divided into negative, positive, low expression, and overexpression. RESULTS: The clinicopathologic parameter; tumor depth of invasion, histologic type, and differentiation, were not related with the expression status of p53 or bcl-2. Of the 31 primary early gastric-cancer patients, 14 exhibited p53 overexpression and 16 showed negative the bcl-2 expression; 5 cases had both p53 overexpression and negative bcl-2 expression. Of the 31 advanced gastric cancer patients, 19 showed the p53 overexpression, and negative bcl-2 expression, 15 exhibited both p53 overexpression and negative bcl-2 expression. CONCLUSION: These results suggest that cell cycle alteration and apoptosis control by p53 and bcl-2 may play roles in the carcinogenesis of gastric cancer. However, there are many other mediators that may facilitate carcinogenesis. This study proved that bcl-2 is a valuable prognostic factor.

Counseling for Breast Disease Using the Internet / 한국유방암학회지

Rapid progress in the development of communication devices has enabled us to use various and tremendous medical information regardless of time or place. Today, in Korea there are many homepages on the web which provide medical information, hospital information, and counseling on medical fields, but more detailed recent medical information, better quality control, and a greater variety of communication skills are needed. We analysed the data about breast cancer clinic on web from November 1998 to October 1999. The frequent questions were breast mass44%, breast pan 29%, and counseling on breast cancer 25%. The most frequent users were in their 3rd decades 55%, 4th decades 8%, and unknown cases 23%. The average number of visitors on wed was 454 per month. In near future, we believe that the use of the web as a information source will grow rapidly and we everyone will use internet in Korea. So, we should realize the virtual space is a reality, and we should use it as a proper education system for the people.

Detecting p53 gene mutation of breast cancer and defining differences between silver staining PCR-SSCP and immunohistochemical staining

This study detects and defines the patterns of p53 gene mutations in breast cancers. We analyse p53 gene mutations through comparing the results of single-strand-conformation-polymorphism (SSCP) and immunohistochemistry (IHC), and we try to define the differences between the results of SSCP and IHC. Twenty-seven fresh primary breast cancer tissues and eight normal breast tissues were studied. The IHC was done with the usual streptavidin-biotin peroxidase complement method by using monoclonal antibody DO-7. The results of staining was scored. The SSCP method was done by using Cold SSCP Electrophoresis System. Overexpressions of p53 protein were seven (25.9%) among 27 cancer cases on IHC. Four (57.1%) of seven cases were positive in SSCP. In SSCP, the mutations were detected in 10 (37%) among 27 cancer cases. The mutations were two in exon 5, one in exon 8, and seven cases in exon 7. All of 10 mutations were proved by sequencing analysis. Of them, only four (40%) were positive in IHC. We consider the IHC as a screening method for p53 gene mutations.

Counseling for Breast Disease Using the Internet

PURPOSE: Rapid progress in the development of communication devices has enabled us to use large amounts of various kinds of medical information, regardless of time or place. Today, in Korea there are many homepages on the web which provide medical information, hospital information, and counseling on medical fields in Korea, but more detailed recent medical informations, better quality control, and a greater variety of communication skills are needed. Methods and RESULTS: We analysed the data on the web from November 1998 to October 1999 about breast cancer clinic. The frequent questions were about breast mass (44%), breast pain (29%), and counseling on breast cancer (25%). The most frequent users were in their 3rd decade (55%), 4th decade (8%), and unknown age cases (23%). The average number of visitors on web was 454 per month. CONCLUSION: In near future, we believe that use of the web as an information source will grow rapidly and the most of the people in Korea will use internet. For that purpose, we should realize that virtual space is a reality, and we should use it as an effective technique for educating the public.

A case of sclerosing encapsulating peritonitis presenting a huge pseudocyst formation in end stage renal failure on the maintenance hemodialysis / 대한내과학회지

Sclerosing encapsulating peritonitis(SEP) is now a well-recognised, but uncommon complication of chronic ambulatory peritoneal dialysis(CAPD). The etiology is unclear, but SEP is believed to be multifactorial. The most important factors seem to be the length of time on peritoneal dialysis and previous episodes of peritonitis. Anorexia, nausea, vomiting, weight loss, abdominal pain, and a reduction of the ability of the peritoneum to act as a dialyzing membrane are the usual presenting problems. We experienced one case of SEP presenting a huge pseudocyst in the patient of end stage renal failure on the maintenance hemodialysis for 5 years, even though he had a history of CAPD for 5 years. So we report this case with review of the literature.